Talk:Dietary supplement/Archive 2

The Vitamin Myth
Here's an excellent RS article about dietary supplements and Linus Pauling:


 * The Vitamin Myth: Why We Think We Need Supplements, The Atlantic, by Paul Offit, Jul 19 2013

Brangifer (talk) 19:19, 20 July 2013 (UTC)
 * It's hopeless to tell people they gain nothing from taking little pill-things.


 * Perhaps best to let them. It's much cheaper than seeing a doctor for some trivial complaint, and often he or she will just dispense some almost equally useless pill. It turns out real medicine can often only do so much.

108.204.142.171 (talk) 23:41, 20 July 2013 (UTC)


 * That is, BTW, a really excellent article that should be incorporated as a source here. It ought to be included on Wikipedia entry on linus pauling

108.204.142.171 (talk) 01:16, 21 July 2013 (UTC)


 * That's why I posted it here and there. Right now I'm too busy with other things to do it justice. -- Brangifer (talk) 01:23, 21 July 2013 (UTC)
 * Looking at this source more closely, it may justify a statement in lede of this article to the effect that "dietary supplements have been broadly shown to increase the risk of heart disease and cancer, and as a health matter, their ingestion should be wholly avoided."
 * Dunno but there's a lotta research cited.

108.204.142.171 (talk) 02:53, 24 July 2013 (UTC)


 * The article's second graf is just added, based on Offit's article. The research he presents is extremely solid, as are his own credentials. Based on this, any responsible account of dietary supplements ought to include this general information VERY prominently. Hence this new second graf.

108.204.142.171 (talk) 22:05, 4 August 2013 (UTC)

lede

 * I added material from Offit, but somebody insists on watering it down. Why something so clear cannot be clearly stated is... unclear. Perhaps it's a matter of conventional "Wikipedia style?"


 * Speaking of which, I find it annoying to wade through the first two, turgid grafs in order to be told, essentially, that dietary supplements are intended to supplement diet. But this approach is engrained in so many Wikipedia articles that to question it is heretical.

Other thoughts later. 108.204.142.171 (talk) 13:45, 5 August 2013 (UTC)


 * That somebody was me. The Offit article, unfortunately, does not satisfy WP:MEDRS, I think.  If you think  it does, there are boards to get community feedback on that.   It is a great article but we need to add MEDRS-compliant sources to back up the stronger content that you want.  There must be a review that summarizes the several large clinical trials that have been done.  Also the text that you added "Many of the most widely used supplements have been proven in numerous, large-scale studies to significantly increase the risk of cancer and heart disease," particularly the "many" went too far beyond Offit, which discusses clinical trials of Vitamin C (which had no negative effects (contradicting what you wrote), but no positive ones either);  a trial of a "multivitamins, magnesium, zinc, copper, and iron ", and a few trials of Vitamin E with or without selenium, and a trial of Vitamin A/beta-carotene.   That is actually just a few, and as the article says, over 50,000 dietary supplements are on the market. Jytdog (talk) 14:32, 5 August 2013 (UTC)

response

 * Materials covered in the Offit article, taken together, actually do constitute many (all? nearly all?) of the most widely used supplements, which is presumably why he mentions them. Also, one ought to give due weight simply to Offit as an authority in his own right.
 * Moreover, the studies he cites would surely satisfy Wikipedia's "med" standards. (If MEDRS-compliant sources are necessary, then are supplements "medicine?")
 * Though it's futile to dispute those standards, they seem to be written by and for wannabe doctors, whereas the Wikipedia audience is....exactly who for this article?
 * Here and too often elsewhere, it seems theintended audience is merely other Wikipedia editors, whose main role is to check various boxes, rather than write for an defined audience or particular purpose.
 * It's a very practical problem that is probably insurmountable. In reality, no one will ever come to this article needing to know that "dietary supplements include vitamins... (!!!). Yet Wikipedia editing protocol almost demands this sort of approach.
 * School "textbooks" perhaps face a similar problem, written with such a generalized audience in mind, and with so many editors and bureaucrats involved, that the things become nearly useless.


 * Practically speaking, perhaps the most significant aspects of "dietary supplements" would be in the realms of business and culture, rather than science and medicine (where they have little or no significance).


 * Best source I can think of on business side would be SEC documents on the larger companies, especially an offering prospectus of a company going public. But any 10-K often includes a generalized market description, including major competitors. Given pervasive threat of securities class action lawsuits, everything written is audited by third party.
 * As for culture (history & etc) sources, I just don't know.15:54, 5 August 2013 (UTC) — Preceding unsigned comment added by 108.204.142.171 (talk)


 * Thanks for talking.  Your response above doesn't seem to be based on what WP:MEDRS actually says.

Responding to a couple of things you write above, here are the first 2 paragraphs of MEDRS, for your convenience: Wikipedia's articles, while not intended to provide medical advice, are nonetheless an important and widely used source of health information. Therefore, it is vital that the biomedical information in all types of articles be based on reliable, third-party, published sources and accurately reflect current medical knowledge.

Ideal sources for such content includes literature reviews or systematic reviews published in reputable medical journals, academic and professional books written by experts in the relevant field and from a respected publisher, and medical guidelines or position statements from nationally or internationally recognised expert bodies.

The purpose of MEDRS is not so editors can check boxes; it is to ensure that Wikipedia provides accurate, reliable information on health-related matters to the public. This is important and I believe strongly in it.

And no - applying MEDRS does not mean the dietary supplements are "medicine". And as I mentioned, I do not believe that The Atlantic is a MEDRS-compliant source.

Finally, while I am glad you have backed off from "most" to the somewhat more specific "many (all? nearly all?) of the most widely used supplements") this is still hand-wavy and unbacked by sources. The top-selling dietary supplements in 2009 (according to Consumer Reports) were B Vitamins, Vitamin C, Vitamin D, Vitamin A, and multivitamins. The Offit article doesn't mention B or D and while it mentions C, it mentions no harm from C. So the article says that two out of the top five were harmful in the trials that it mentions.  To go a little further, the Offit article doesn't mention doses at which any of the supplements in the trials were given, so we don't know (from Offit) if they were mega-doses or standard supplementation doses.... Offit also doesn't mention supplements like calcium or folate, which are also widely used and as far as I know, no RCT has shown negative effects from them. Outside of Offit probably failing MEDRS, I don't see how the broad statements you want to make are supported even by Offit. Jytdog (talk) 16:48, 5 August 2013 (UTC)

OFFIT

 * Offit is, by any standard, a prominent and well-trained medical authority. He is crystal clear about the very solid research upon what he is saying is based.
 * Yet here, all of this is automatically open to question from anonymous editors and by "medical standards" produced by anonymous editors (who claim deep authority).
 * Perhaps Wikipedia "doctors committee" will one day sponsor hospitals at which we can all go to die?
 * As a minor journalist published world-wide for past 20 years, and as another person permanently banned from Wikipedia-- let's point out that this is obviously very weird, deeply sad, very silly and utterly unproductive and non-useful
 * So let's keep an open mind...about dietary supplements.... until the cows come home....and we're dead from lack of anti-oxidants...etc.
 * Good luck.

108.204.142.171 (talk) 21:49, 5 August 2013 (UTC)
 * ? You have been permanently banned from Wikipedia? Jytdog (talk) 21:55, 5 August 2013 (UTC)
 * Permanently and totally, as you can see.

108.204.142.171 (talk) 22:19, 5 August 2013 (UTC)
 * well that is awkward.Jytdog (talk) 22:32, 5 August 2013 (UTC)
 * So true! Perhaps before proceeding, you should  consult and administrator?

108.204.142.171 (talk) 00:45, 6 August 2013 (UTC)
 * What username were using when you were banned, and who is the admin who banned you?  And what for?  Funny game you are playing!  Jytdog (talk) 00:51, 6 August 2013 (UTC)
 * I don't care to play what I consider the Wikipedia "game," whereby one must stroke administrators' egos. They are quite free to play their game as they please.
 * Actually, I recently did a fair bit of work on editing & improving this article (which remains rather weak), before somebody brought up the Atlantic Magazine article.
 * That one of the most venerable magazines in America isn't an acceptable source is, quite simply, a very dumb idea.

108.204.142.171 (talk) 17:26, 7 August 2013 (UTC)

Note on Quakwatch

 * I put a note on wikipedia page referenced in above hedline, saying, accurately I think, that this article is "complete mess" and inviting attention from quack patrol.... Probably nothing will happen.

I gather that seeking informed editing is wrong etiquette via wikipedia. Obviously. Sorry. Ban Me again. — Preceding unsigned comment added by 108.204.142.171 (talk) 01:44, 15 August 2013 (UTC)
 * Your post doesn't invite any action or further discussion. On this talkpage you have had multiple editors sympathetic to your position, that this article is poorly written and does not express the general consensus that many dietary supplements are not beneficial. You have lost this support largely due to your unwillingness to abide by Wikipedia's general standards, not overstating or sensationalizing the content of a source, and not using reliable sources (i.e. those from a medical publication and not a magazine). Each place has its own standard that you must abide to when you join, you wouldn't send in an article to a journal using a different format, and you can't edit Wikipedia in a fashion that explicitly disregards its own standards. Wikipedia is a community project, and that requires editors to be able to interact positively with each other. If you want to provide a medical source that meets our reliable source policies then we will be happy to accept it and its content in this article. If you feel there needs to be changes to Wikipedia's policies then you are free to voice your opinion on those pages. No one here is trying to stand in the way of good faith editing, and most likely if you appealed your previous ban in a good faith attempt it would be lifted. Please consider just relaxing, Wikipedia doesn't need to be a high stress environment and plenty of editors are willing to cooperate if you approach discussion in a calm manner.AioftheStorm (talk) 04:57, 15 August 2013 (UTC)
 * Edit: I have just read QuackWatches introduction to dietary supplements and think it is very well written, and would like it if this article was written more like that. As Barrett notes there are many legitimate uses for dietary supplements, as well as a many uses that are over-hyped and unnecessary.AioftheStorm (talk) 05:19, 15 August 2013 (UTC)

WORST ARTICLE ON WIKIPEDIA?
This is one of the worst Wikipedia articles I have ever, ever seen ... much worse than the articles on various aspects of the Kennedy assasination! I have my scientific training from Yale University and Northwestern University in the U.S., and I will tell you - in science, you can almost never, ever make an absolute statement, without qualification. This article is full of that kind of error.

Having read a great deal on the Internet about some topic does NOT make you an expert; if you were a true expert, you would know better than to over-generalize on the basis of any amount of data available. Some one with wiki-skills really should clean up this mess! Stop using Wikipedia as the battleground for your ego-driven virtual combat, and think about how to make the article most useful to the reader! — Preceding unsigned comment added by 75.132.12.83 (talk) 02:25, 20 January 2014 (UTC)


 * The above comment is perhaps useful for expressing your unhappiness but it is not helpful for improving the article. Would you please point out specific content that you think needs improving?  Thanks. (btw, new comments generally go at the bottom of the page, not the top - this keeps things in chronological order. Please feel free to cut this thread including my comments and paste it below, if you like) Jytdog (talk) 12:09, 20 January 2014 (UTC)

I definitely agree with the sentiment here. I came to this page hoping for some basic information on supplemenation, early history, etc, and all I've really read is what could almost be described as "a bad review". Whilst supplementation may be used as a marketing plot from some overzealous businesses, supplementation as a whole isn't entirely a moot point. I've read numerous studies indicating that certain types of supplementation have been great in remedying lost nutrients - be it from a poor diet/metabolism or due to illness itself. If this page is trying to argue that a specific type of nutrient supplementation is useless, then it should be more specific. This "consensus" that supplementation is pointless that keeps getting alluded to on this talk page should probably be better referenced, because to someone who just read it for the first time, seems more like someone is just arguing a point here. Hopefully someone with a much better writing ability agrees with me, and we can see some objectivity on this page in the future. — Preceding unsigned comment added by 155.143.3.15 (talk) 18:10, 23 March 2014 (UTC)
 * as per the response above.. please bring some specific ideas, and also information about these studies you have read so we can consider using them as sources in the article. Jytdog (talk) 18:19, 23 March 2014 (UTC)

New section on FDA approved claims
Am considering adding a section on FDA approved claims, like folic acid and pregnancy. Started doing some reading and found this - very interesting telling of the story of folic acid, showing regulators grappling with ambiguous science in good faith, with public health concerns first in mind, amid political, lobbying, and activist pressures that all intersect in crazy ways. Jytdog (talk) 18:29, 23 March 2014 (UTC)

Definition
I just added a definition section because I did not think the article clearly defined what a dietary supplement is. I found text from Dietary Supplement Health and Education Act of 1994 and did not think that was very clear either, but I went with it. Other United States sources include layman explanations created by the FDA - Q&A on Dietary Supplements and Dietary Supplements: What You Need to Know - which in my opinion also do not give a clear definition. I made the best United States definition that I could at first pass.

I would like to find any international definition that exists, or a definition from another country which conflicts with the US definition. On searching PubMed, Cochrane, and Google Scholar, I was also unable to find any paper which I thought gave an authoritative definition, but I am sure one must exist somewhere. The Codex Alimentarius, a United Nations project, says a little.

I am not happy with the sourcing that I used both because I expected a clearer definition and because I was hoping for a definition not rooted in United States law. Perhaps nothing clearer exists. Anyone who has other ideas for improving this please share.  Blue Rasberry  (talk)  19:33, 26 June 2014 (UTC)

Specific examples
I just cut some content from this article.

According to scientific evidence, supplements of beta-Carotene and Vitamin E, possibly also Vitamin A, increase mortality. Also supplements of other antioxidants, B vitamins, folic acid or minerals and multivitamin supplements fail to decrease mortality, as well as morbidity to major chronic diseases. However, vitamin D supplements may be useful, but the evidence this far is not conclusive.
 * Specific examples of dietary supplement uses

Moreover, many supplements have no practical effect. For example, glucosamine and chondroitin, often thought to relieve joint pain, have been shown to be without benefit. Relief reported for these supplements may be explained by the fact that many people taking them on a doctor's recommendation are also taking other pain relievers. Another common supplement, omega-3 fatty acids, has been similarly shown to be without benefit for heart and cholesterol level of healthy individuals.

Some supplements are harmful. For example, one study funded by the National Institute of Health found that men who consumed vitamin E supplements had a higher rate of prostate cancer than men who did not. Also, it has been found that among patients with coronary heart disease, elevated calcium levels are associated with increased mortality.

A metastudy showed that daily multivitamin supplements do not prevent the weakening of cognitive performance. Another study showed that multivitamins and omega-3 fatty acids do not alleviate existing mild or medium dementia.

In Dec 17th 2013, the editorial of the scientific Annals of the Internal Medicine journal criticized heavily dietary supplements referring to research surveys. Systematic reviews did not find evidence that vitamin or multivitamin supplements would reduce mortality in general or cardiovascular or cancer mortality. On the contrary, many random clinical trials have shown that beta-carotene, vitamin E and possibly also high doses of vitamin A increase mortality.
 * Increased mortality due to supplements

JAMA journal published a review on 68 random trials (232,606 participants, 385 publications) showing that supplements of beta-carotene and vitamins A and E seem to add mortality. The effect of vitamin C and selenium was unclear.

Cochrane Database Syst Review published a review of 78 random trials (296,707 participants). In its fixed-effect models antioxidants were shown to increase mortality, particularly beta-carotene and vitamin E.

According to a study on almost 39,000 American women since the 1980s showed that multivitamin, folic acid, Vitamin B5, iron, magnesium, zinc and copper supplements may increase mortality and also other supplements do not seem to decrease common chronic diseases.

Bodybuilding supplements often involve health problems.
 * Bodybuilding supplements

For example, the "natural" best-seller Craze, 2012's "New Supplement of the Year" by bodybuilding.com, sold in Walmart, Amazon etc., was found to contain undisclosed amphetamine-like compounds. Also other products by Matt Cahill have contained dangerous substances causing blindness and liver damage, and experts say that Cahill is emblematic for the whole industry.

Natural supplements such as green tea pills may damage liver and cause liver transplants, hepatitis and deaths. Yet people believe that "natural" is healthy or that supplements have been researched.
 * Natural supplements

The catechin contained in green tea is claimed to accelerate metabolism, so they are sold as fat-burners. Green tea pills often contain many times more catechin than a cup of tea and can be toxic to liver, particularly for some people.

I intended to remove all the content about specific dietary supplements, and to make this article a general review of the concept of dietary supplements. A lot of specific content is cut and pasted here.

I do not mean to delete this information entirely, but perhaps I should make a section listing specific types of dietary supplements, then link out to those main articles, and move this content to those other articles. I am thinking about this - I am not sure what is best. I am putting it here for now.  Blue Rasberry  (talk)  20:00, 26 June 2014 (UTC)

Moved content about regulation over food and dietary supplements
There was a section of this article about the Regulation of food and dietary supplements by the U.S. Food and Drug Administration, but that concept has its own article, and the content here was being developed independently of that article. I moved content here to the talkpage there, and I hope that from there it can be integrated into that article. If anyone has comments about this, please bring them to Talk:Regulation of food and dietary supplements by the U.S. Food and Drug Administration.  Blue Rasberry  (talk)  19:11, 27 June 2014 (UTC)

WP:SYNC
I just read the lead of Bodybuilding supplements and compared it to the current+previous revisions of Dietary supplements. It looks like the lead was copy/pasted into this article at some point in the past. Given that this section is simply WP:SUMMARYSTYLE-based coverage of the bodybuilding supplements article, I think it would be a good idea to revise the lead of the bodybuilding supplements article using the current content in this article and then selectively transclude the lead of the bodybuilding supplements article into Dietary supplements. That transclusion can be implemented by replacing all of the content within that section of this article with the following wikitext markup:

 Seppi  333  (Insert 2¢) 17:41, 30 January 2018 (UTC)


 * ✅  Seppi  333  (Insert 2¢) 18:05, 30 January 2018 (UTC)