Thursday, April 9, 2009
Comparative effectiveness needs publicity, along with research
Since you're reading this blog, you probably already know that the evidence against vitamins has been piling up. Several recent studies have indicated that the disease-preventing properties of fruits and veggies don't carry through when extracted into vitamin pills.
But apparently the word has not gotten out to the general public. Or so it seems from a recent New York Times article which is likely to send shivers down the spine of any believer in evidence-based medicine. The article describes a recession-linked upturn in vitamin sales (new customers up 20% at the Vitamin Shoppe in the last six months) and quotes several economizing shoppers who are replacing their prescription meds and doctor visits with vitamin and supplement purchases. There's even a physician-assistant student who has cut back on fruits and vegetables to buy fish oil and antioxidant supplements.
Ack! It's one thing to spend a little disposable income on probably useless vitamins, but to buy them instead of healthy food? Of that $400 mill the government's planning to spend on comparative effectiveness research, maybe a little should go toward telling people about the things we already know are ineffective.
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5 Comments:
If you are concerned about vitamins that the report from ConsumerLab.com makes it much worse.
http://www.reuters.com/article/healthNews/idUSTRE53842O20090409
It seems that what is in the bottle may not be what is on the label.
Double ack! Aren't fish oil and antioxidants way more expensive than fruits and veggies?
It never ceases to amaze me how some people still believe in magic bullets.
I used to be a dietitian and decided to go back to broad spectrum public health because people assume that just because they eat they are nutrition experts...it's like beating your head against a brick wall trying to tell them otherwise...
I'd like to think otherwise because I am an idealist- but years of public ignorance wore me out. People don't want to hear balance, moderation, and exercise- they all want to think we are keeping some health secret from them and the establishment is all a conspiracy!
And then there are the people that can't afford $130 for 10 minutes with a doctor or $1 for an orange. I gave up taking my meds when my co-pays got to $290 of my $1518 income on long term disability. I find I sleep better when I am not trying to decide between lights and food. My other health problems don't seem to be any worse without the pills.
This really speaks to my main concern about the ultimate value of comparative effectiveness studies. No matter how informative they may be in shaping the practice of medicine, they have a tough time being correctly communicated and implemented. In my latest posting at nuts for healthcare (http://nutsforhealthcare.com/2009/04/17/evidence-based-medicine-the-dare-to-compare/), I referred to the Allhat study for hypertension drugs as an historical example of comparative effectiveness insights not really making much of a difference. It's quite disconcerting.
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