Big Pharma Has Some Serious Competition

On a sunny summer morning, Janelle stops by a cobbler’s shop on her way to work.

Cobbler: (smiling while looking up from his breakfast, a vegetable omelet with avocado slices on top and some fruit salad on the side) Morning. How can I help you?

Janelle: (handing the cobbler a pair of shoes) The heels on these are loose. Do you think you can fix them?

Cobbler: (inspecting the shoes) Yes, it’ll be $25. I’ll have them ready for you by Thursday. You can pay me when you come back to get them.

Janelle: Great. Thank you. By the way, your breakfast looks very good. You eat well, huh?

Cobbler: Yep! It feels good to feel good, right?

Janelle: Amen. Do you take supplements too?

Cobbler: No, nutrition supplements aren’t my thing. I’m a food guy.

Janelle: But you know about the benefits of supplements, right? It’s important to make sure you get a lot of nutrients.

Cobbler: It’s funny you say that. I was just reading a few scientific papers about this. One that jumped out at me dealt with lycopene and cardiovascular disease. I have the paper right here:

“Cardiovascular disease (CVD) is a major contributor to morbidity and mortality in the United States and worldwide. A link between diet and CVD is well established, with dietary modification a foundational component of CVD prevention and management. With the discovery of bioactive components beyond the essential nutrients of foods, a new era of nutritional, medical, botanical, physiologic, and analytical sciences has unfolded. The ability to identify, isolate, purify, and deliver single components has expanded the dietary supplement business and health opportunity for consumers. Lycopene is an example of a food component that has attracted attention from scientists as well as food, agriculture, and dietary supplement industries. A major question, however, is whether delivering lycopene through a supplement source is as effective as or more effective than consuming lycopene through whole food sources, specifically the tomato, which is the richest source of lycopene in the Western diet.”

Janelle: Neat. They’re directly comparing getting lycopene from tomatoes and supplements. What did they find?

Cobbler: It was a systematic review. They reviewed several randomized, controlled studies:

“In this review, we examined clinical trials comparing the efficacy of lycopene supplements with tomato products on intermediate CVD risk factors including oxidative stress, inflammation, endothelial function, blood pressure, and lipid metabolism. Overall, the present review highlights the need for more targeted research; however, at present, the available clinical research supports consuming tomato-based foods as a first-line approach to cardiovascular health.” (1)

Janelle: So I’m better off putting tomatoes in my salad than I am taking lycopene supplements?

Cobbler: Yes, that’s what scientific evidence demonstrates. Or making chili. Or tomato sauce. Or Tomato soup. Or simply having some sliced tomatoes. You name it.

Janelle: You’ve really got me thinking.

Cobbler: Another very interesting thing happens when people take nutrition supplements: a licensing effect. Basically, when people take nutrition supplements, they use nutrition-supplement-taking as a license to engage in harmful behavior. I was just reading about this too:

“The use of dietary supplements and the health status of individuals have an asymmetrical relationship: the growing market for dietary supplements appears not to be associated with an improvement in public health. Building on the notion of licensing, or the tendency for positive choices to license subsequent self-indulgent choices, we argue that because dietary supplements are perceived as conferring health advantages, use of such supplements may create an illusory sense of invulnerability that disinhibits unhealthy behaviors. In two experiments, participants who took placebo pills that they believed were dietary supplements exhibited the licensing effect across multiple forms of health-related behavior: They expressed less desire to engage in exercise and more desire to engage in hedonic activities (Experiment 1), expressed greater preference for a buffet over an organic meal (Experiment 1), and walked less to benefit their health (Experiment 2) compared with participants who were told the pills were a placebo. A mediational analysis indicated that perceived invulnerability was an underlying mechanism for these effects. Thus, a license associated with the use of dietary supplements may operate within cycles of behaviors that alternately protect and endanger health.” (2)

Janelle: I know so many people like that! A woman I work with is always talking about the supplements she takes, and she also drinks more wine than almost anyone I know and brings donuts into the office at least three times a week.

Cobbler: Yeah, that’s licensing. She’s convinced herself she’s all set since she takes nutrition supplements, and then she does other things detrimental to her well-being.

Janelle: I guess that’s the promise of well-being in a pill.

Cobbler: People love popping pills, Janelle. They love the promise of a quick-fix. Big supp is well aware of this, and they prey on people. Big supp is a $37 billion industry, and it’s growing rapidly. They’re on their way to catching up with big pharma.

Janelle: (smiling) Bigg supp. That’s good. It sounds like they’re out to get us too.

Cobbler: They certainly don’t have our backs. Most people selling nutrition supplements have no training at all in any field even remotely related to wellness. Maybe worse, some are wellness professionals who absolutely know better and are taking advantage of their position of authority to make a buck. A lot of bucks. I’ll text you a video of a news report showing “Dr. Oz” testifying to the Senate so you can see what a smarmy liar hawking nutrition supplements looks like.

Janelle: Gross! I guess the one thing I feel okay about is the fact that supplements can’t do any harm. They’re probably a massive waste of money, but they’re basically harmless, right?

Cobbler: (giving Janelle a look that indicates he knows something to the contrary) There’s actually a large, longitudinal scientific study called the Iowa Women’s Health Study with results published in the prestigious Archives of Internal Medicine you need to know about. The researchers followed over 38,000 women for 18 years. That found that only calcium supplements were associated with lower mortality. Every other nutrition supplement studied either had no effect on mortality or increased mortality. That included multivitamins which were associated with a six percent increase in mortality risk. This is publicly available information. Anyone can read about the Iowa Women’s Health Study on the internet. But you’re not going to hear about it from anyone selling nutrition supplements:

“In agreement with our hypothesis, most of the supplements studied were not associated with a reduced total mortality rate in older women. In contrast, we found that several commonly used dietary vitamin and mineral supplements, including multivitamins, vitamins B6, and folic acid, as well as minerals iron, magnesium, zinc, and copper, were associated with a higher risk of total mortality. Of particular concern, supplemental iron was strongly and dose dependently associated with increased total mortality risk. Also, the association was consistent across shorter intervals, strengthened with multiple use reports and with increasing age at reported use. Supplemental calcium was consistently inversely related to total mortality rate; however, no clear dose-response relationship was observed.” (3)

Janelle: Yikes! People should be aware of this!

Cobbler: Yes! Another great scientific study to tell people about is one in which researchers examined the contents of dozens of nutrition supplements from a dozen nutrition-supplement businesses. This’ll make anyone think twice about nutrition supplements:

“Product substitution occurred in 30/44 of the products tested and only 2/12 companies had products without any substitution, contamination or fillers. Some of the contaminants we found pose serious health risks to consumers.” (4)

Janelle: I’m not sure what’s most egregious: substitution, contamination, or fillers. It’s an unholy trinity of unethical practices!

Cobbler: Yeah, it’s the Wild West out there. There could be anything in nutrition supplements.

Janelle: But all you hear is they’re so “natural”.

Cobbler: Nutrition supplements aren’t natural. Nowhere in nature are there isolated antioxidants or isolated probiotics or isolated nutrients of any kind. It makes no sense to take nutrition supplements when the nutrients in supplements exist in food in their actually natural form. The minions of big supp are always blasting big pharma and claiming their nutrition supplements are natural, but no pills are natural. Nutrition supplements don’t grow on trees.

Janelle: Ugh. The marketing is so over the top. They make supplements seem like the be-all-end-all to wellness. What do you do when one of those supplement salespeople gives you the hard sell? One of my other coworkers has been on my case for months.

The cobbler turns around and walks to one of his work benches and returns with a shoebox in his hands to show Janelle.

Cobbler: (handing Janelle the shoebox) I give them this and tell them it’ll be $600.

Janelle: (curiously going through the shoebox) There’s one rubber soul, a bunch of thumbtacks, six pairs of shoelaces (two of them are almost torn to shreds), some sandpaper labeled “insole”, two uppers that may or may not fit with this one soul, a screwdriver labeled “toe cap”, some glue, and a shoe horn with a very jagged edge. How’s this worth $600? I could get a very functional, very beautiful pair of shoes that are already made for me for $75. These are shoe parts, some that don’t work, some that are downright dangerous, and some that aren’t even what they say they are. And I’ve got to try to put the shoes together by myself. And you’re going to charge me $600?

Cobbler: Exactly. That’s why I prefer food over nutrition supplements.

Janelle: (stunned and shaking her head) Today is going to be an interesting day.

“There is no greater enemy to a thing than its predatory mimic.”
—Stefan Molyneux

Author’s note: Nutrition supplements have their place. It’s the indiscriminate use of them that’s a bad idea. Be careful out there.

(1) Whole Food Versus Supplement: Comparing the Clinical Evidence of Tomato Intake and Lycopene Supplementation on Cardiovascular Risk Factors. Advances in Nutrition, 2014, 10.3945/an.114.005231.
(2) Ironic Effects of Dietary Supplementation: Illusory Invulnerability Created by Taking Dietary Supplements Licenses Health-Risk Behaviors. Psychological Science, 2011, 10.1177/0956797611416253.
(3) Dietary Supplements and Mortality Rate in Older Women: The Iowa Women’s Health Study. Archives of Internal Medicine, 2011, 10.1001/archinternmed.2011.445.
(4) DNA Barcoding Detects Contamination and Substitution in North American Herbal Products. BMC Medicine, 2013, 10.1186/1741-7015-11-222.

About Jason Gootman
Jason Gootman is a Mayo Clinic Certified Wellness Coach and National Board Certified Health and Wellness Coach as well as a certified nutritionist and certified exercise physiologist. Jason helps people reverse and prevent type-2 diabetes, cardiovascular disease, and other ailments with evidence-based approaches to nutrition, exercise, stress reduction, holistic wellness, and, most importantly, lasting behavior improvement and positive habit formation. As part of this work, Jason often helps people lose weight and keep it off, in part by helping them overcome the common challenges of yo-yo dieting and emotional eating. Jason helps people go from knowing what to do and having good intentions to consistently taking great care of themselves in ways that help them add years to their lives and life to their years.