Bad science and worse journalism in recent vitamin D stories....
Today's Post: Friday, 3-5-2010
A. There were two stories in the past week that were related.
I’ll list them first and excerpts from the stories and then comment.
1. Last Monday, 3-1-2010, Reuters had a story with this headline:
“Calcium, vitamin D pills don't help heart: study”
It contained this paragraph.:
“Before people who already get enough start taking vitamin D and calcium supplements, senior author Dr. Howard D. Sesso, from Brigham and Women's Hospital in Boston, and his colleagues wanted to study the evidence to support their use - and make sure there are no hidden risks involved.”
And this one:
“None of the 17 studies they uncovered was designed specifically to look at effects of the supplements on heart disease, heart attack, stroke, or death due to related causes.”
And this one:
“So at this time, Sesso says "no" to suggestions that healthy people supplement their diet with calcium or vitamin D.”
The SOURCE was listed as: Annals of Internal Medicine, March 2, 2010.
2. “Calcium and vitamin D may not cut cholesterol” also from Reuters, appeared this past Wednesday, 3-3-2010
Their Lynne Peeples, who wrote the article, led with this paragraph:
“People looking to improve their heart health by lowering their cholesterol levels won't find help from calcium and vitamin D supplements, according to a new study”
The study's lead author was Dr. Swapnil Rajpathak of the Albert Einstein College of Medicine in New York.
But his research did NOT find evidence that calcium and vitamin D supplements did nothing that improved heart health!
Unfortunately, most, less sophisticated, readers will read Lynne Peeples’ comment as “People looking to improve their heart health won't find help from calcium and vitamin D supplements, according to a new study.” So her choice of words borders on being irresponsible.
Dr. Rajpathak was a more responsible and informed expert than either Dr Sesso from the other study or the journalist who wrote up his study.
In his study of 1,191 post-menopausal women, they randomly assigned about half of them to take a daily supplement of calcium (1000 milligrams) plus vitamin D (400 IU) while other half of the women took identical-looking placebos.
After five years, no differences were seen between the two groups in any of the lipids measured, including total cholesterol levels, "bad" LDL cholesterol and triglyceride levels, and "good" HDL cholesterol levels.
So, what he found was that women who took daily supplement of calcium (1000 milligrams) plus vitamin D (400 IU) did not show any heart disease protection FROM improving their lipid profile.
But improving their lipid profile and cholesterol measures is NOT the same as showing to zero protection from heart attacks. There are many other causes of heart attacks from gum disease bacteria to inflammation to high blood pressure and more.
Did vitamin D or Calcium wind up with the supplemented women improving on other heart disease measures or on how many actual heart attacks they had compared with the other women?
They didn’t look at those things in this study. And for the journalist’s paragraph to have been accurate as many people will read it --about this study, they would have had to have done both.
For, example, the article had this paragraph also.:
“In a smaller study of postmenopausal women published in 2004, Reid and his colleagues found significant benefits for calcium supplementation alone: a potential reduction of up to 30 percent in the risk of experiencing a cardiovascular event.”
THIS study looked at the bottom line. And it DID find that calcium prevented heart attacks.
And here’s why I know that Dr Rajpathak thinks more clearly and is more responsible in his published remarks than Dr Sesso.:
This comment he made was in the story also.:
“"High intake of calcium and vitamin D may be useful for other health-related outcomes," said Rajpathak.”
B. My comments.
Neither Dr Sesso or the much better doctor and researcher, Dr Rajpathak, did their homework.
There IS a large body of research into vitamin D and its use to protect health and heart health.
Neither doctor shows signs of having read much of it. So it’s hardly surprising they’d make mistakes doing research on it.
1. The level of vitamin D3 that is protective starts at 1700 iu a day and is probably much higher for really good results. (One study that DID find beneficial results from taking vitamin D found that 1700 and up got results and 1,000 and less did not.)
In fact, there is good reason to believe that 3,000 iu of vitamin D3 is the real minimum requirement needed to support most people in good health according to the current research.
So doing research with 400 iu a day of vitamin D or analyzing studies using that little proves nothing.
In fact, the people who show the best health results have blood levels of 80 or more. In some people, to get them there, researchers and doctors have found that until they achieve that level initially they need to take over 10,000 iu a day of vitamin D3.
This suggests that any good test on which you can make general recommendations needs to test at least an intake of 3,000 iu a day.
And, the gold standard would be research that compared people with blood levels of 80 to 100 with people of 35 or less which is more typical of people taking 400 iu a day or less of vitamin D.
Neither of these studies did that. Neither of the doctors nor the Johns Hopkins doctor who wrote a supporting editorial about the first study in the journal where it appeared show evidence of knowing anything at all about this research.
To me this is bad science and irresponsible journalism.
2. Dr Rajpathak at least knew enough to do one piece of research that looked directly at the bottom line results. Did the intervention prevent heart attacks?
Things like increasing HDL and lowering high levels of overall LDL and lowering triglycerides DO prevent heart attacks.
But the research on vitamin D showing that taking enough of it IS heart protective focused on 3 different areas from those lipids.
a) It has been shown that high levels of CRP inflammation are predictive of heart attacks and other cardiovascular problems.
Vitamin D is anti-inflammatory. So the research to do would take people who have high readings on the HSCRP test and have 3 groups. One does whatever they were doing only or takes just 400 iu a day of vitamin D; one takes an extra 3,000 iu a day of vitamin D3; and one takes whatever amount of vitamin D3 it takes to get their blood level of vitamin D to the 80 to 100 range and keep it there.
If the second two groups show significant drops in their CRP levels, adequate supplementation of vitamin D3 IS protective.
b) It has been shown to be extremely predictive to have calcification of the plaque inside your blood vessels. And such calcification of blood vessel plaque can be measured.
Does adequate supplementation with vitamin D3 as already described prevent this from forming or reduce it once formed?
I believe such studies indicating exactly that have already been done.
But, if not, they could be done using levels of vitamin D likely to have an effect instead of the tiny 400 iu level. And such tests would be far more indicative than testing changes in cholesterol or other lipids.
c) Vitamin D has been found to strengthen heart muscle.
That suggests taking enough vitamin D would make surviving a heart attack more likely, make getting heart failure less likely or happen at a later age, and might be helpful to give people who already have heart failure.
Those three uses count as heart protective.
Even better, doctors now measure the ejection fraction from the left ventricle that measures the effective strength of the heart. Researchers could test to see if adequate supplementation of vitamin D3 improves that reading in patients where it is low.
d) The bottom line is, because so many things influence whether someone gets a heart attack or not, it’s important to never put down a potentially helpful agent until a test of whether or not people who are given enough of that agent to be effective get fewer heart attacks or less severe heart attacks that they are more likely to survive and recover from or both.
One of these studies, the one by Dr Sesso, states that vitamin D is not heart protective. But he did not do such a study or read the research to qualify him to do such a study either!
Dr Rajpathak, by contrast, was much more precise and responsible. He found that 400 iu of vitamin D when taken with 1,000 mg daily of calcium failed to improve blood lipids.
He also had the good sense to point out that vitamin D has other health benefits that he did not directly research.
At least with Dr Rajpathak, he seems objective enough that if he reads the more current research some of which had not yet been done or not yet reported when he began his current study a bit over 5 years ago, he might yet do valuable research on vitamin D and the heart once he learns of and reads the more current information.
Today's Post: Friday, 3-5-2010
A. There were two stories in the past week that were related.
I’ll list them first and excerpts from the stories and then comment.
1. Last Monday, 3-1-2010, Reuters had a story with this headline:
“Calcium, vitamin D pills don't help heart: study”
It contained this paragraph.:
“Before people who already get enough start taking vitamin D and calcium supplements, senior author Dr. Howard D. Sesso, from Brigham and Women's Hospital in Boston, and his colleagues wanted to study the evidence to support their use - and make sure there are no hidden risks involved.”
And this one:
“None of the 17 studies they uncovered was designed specifically to look at effects of the supplements on heart disease, heart attack, stroke, or death due to related causes.”
And this one:
“So at this time, Sesso says "no" to suggestions that healthy people supplement their diet with calcium or vitamin D.”
The SOURCE was listed as: Annals of Internal Medicine, March 2, 2010.
2. “Calcium and vitamin D may not cut cholesterol” also from Reuters, appeared this past Wednesday, 3-3-2010
Their Lynne Peeples, who wrote the article, led with this paragraph:
“People looking to improve their heart health by lowering their cholesterol levels won't find help from calcium and vitamin D supplements, according to a new study”
The study's lead author was Dr. Swapnil Rajpathak of the Albert Einstein College of Medicine in New York.
But his research did NOT find evidence that calcium and vitamin D supplements did nothing that improved heart health!
Unfortunately, most, less sophisticated, readers will read Lynne Peeples’ comment as “People looking to improve their heart health won't find help from calcium and vitamin D supplements, according to a new study.” So her choice of words borders on being irresponsible.
Dr. Rajpathak was a more responsible and informed expert than either Dr Sesso from the other study or the journalist who wrote up his study.
In his study of 1,191 post-menopausal women, they randomly assigned about half of them to take a daily supplement of calcium (1000 milligrams) plus vitamin D (400 IU) while other half of the women took identical-looking placebos.
After five years, no differences were seen between the two groups in any of the lipids measured, including total cholesterol levels, "bad" LDL cholesterol and triglyceride levels, and "good" HDL cholesterol levels.
So, what he found was that women who took daily supplement of calcium (1000 milligrams) plus vitamin D (400 IU) did not show any heart disease protection FROM improving their lipid profile.
But improving their lipid profile and cholesterol measures is NOT the same as showing to zero protection from heart attacks. There are many other causes of heart attacks from gum disease bacteria to inflammation to high blood pressure and more.
Did vitamin D or Calcium wind up with the supplemented women improving on other heart disease measures or on how many actual heart attacks they had compared with the other women?
They didn’t look at those things in this study. And for the journalist’s paragraph to have been accurate as many people will read it --about this study, they would have had to have done both.
For, example, the article had this paragraph also.:
“In a smaller study of postmenopausal women published in 2004, Reid and his colleagues found significant benefits for calcium supplementation alone: a potential reduction of up to 30 percent in the risk of experiencing a cardiovascular event.”
THIS study looked at the bottom line. And it DID find that calcium prevented heart attacks.
And here’s why I know that Dr Rajpathak thinks more clearly and is more responsible in his published remarks than Dr Sesso.:
This comment he made was in the story also.:
“"High intake of calcium and vitamin D may be useful for other health-related outcomes," said Rajpathak.”
B. My comments.
Neither Dr Sesso or the much better doctor and researcher, Dr Rajpathak, did their homework.
There IS a large body of research into vitamin D and its use to protect health and heart health.
Neither doctor shows signs of having read much of it. So it’s hardly surprising they’d make mistakes doing research on it.
1. The level of vitamin D3 that is protective starts at 1700 iu a day and is probably much higher for really good results. (One study that DID find beneficial results from taking vitamin D found that 1700 and up got results and 1,000 and less did not.)
In fact, there is good reason to believe that 3,000 iu of vitamin D3 is the real minimum requirement needed to support most people in good health according to the current research.
So doing research with 400 iu a day of vitamin D or analyzing studies using that little proves nothing.
In fact, the people who show the best health results have blood levels of 80 or more. In some people, to get them there, researchers and doctors have found that until they achieve that level initially they need to take over 10,000 iu a day of vitamin D3.
This suggests that any good test on which you can make general recommendations needs to test at least an intake of 3,000 iu a day.
And, the gold standard would be research that compared people with blood levels of 80 to 100 with people of 35 or less which is more typical of people taking 400 iu a day or less of vitamin D.
Neither of these studies did that. Neither of the doctors nor the Johns Hopkins doctor who wrote a supporting editorial about the first study in the journal where it appeared show evidence of knowing anything at all about this research.
To me this is bad science and irresponsible journalism.
2. Dr Rajpathak at least knew enough to do one piece of research that looked directly at the bottom line results. Did the intervention prevent heart attacks?
Things like increasing HDL and lowering high levels of overall LDL and lowering triglycerides DO prevent heart attacks.
But the research on vitamin D showing that taking enough of it IS heart protective focused on 3 different areas from those lipids.
a) It has been shown that high levels of CRP inflammation are predictive of heart attacks and other cardiovascular problems.
Vitamin D is anti-inflammatory. So the research to do would take people who have high readings on the HSCRP test and have 3 groups. One does whatever they were doing only or takes just 400 iu a day of vitamin D; one takes an extra 3,000 iu a day of vitamin D3; and one takes whatever amount of vitamin D3 it takes to get their blood level of vitamin D to the 80 to 100 range and keep it there.
If the second two groups show significant drops in their CRP levels, adequate supplementation of vitamin D3 IS protective.
b) It has been shown to be extremely predictive to have calcification of the plaque inside your blood vessels. And such calcification of blood vessel plaque can be measured.
Does adequate supplementation with vitamin D3 as already described prevent this from forming or reduce it once formed?
I believe such studies indicating exactly that have already been done.
But, if not, they could be done using levels of vitamin D likely to have an effect instead of the tiny 400 iu level. And such tests would be far more indicative than testing changes in cholesterol or other lipids.
c) Vitamin D has been found to strengthen heart muscle.
That suggests taking enough vitamin D would make surviving a heart attack more likely, make getting heart failure less likely or happen at a later age, and might be helpful to give people who already have heart failure.
Those three uses count as heart protective.
Even better, doctors now measure the ejection fraction from the left ventricle that measures the effective strength of the heart. Researchers could test to see if adequate supplementation of vitamin D3 improves that reading in patients where it is low.
d) The bottom line is, because so many things influence whether someone gets a heart attack or not, it’s important to never put down a potentially helpful agent until a test of whether or not people who are given enough of that agent to be effective get fewer heart attacks or less severe heart attacks that they are more likely to survive and recover from or both.
One of these studies, the one by Dr Sesso, states that vitamin D is not heart protective. But he did not do such a study or read the research to qualify him to do such a study either!
Dr Rajpathak, by contrast, was much more precise and responsible. He found that 400 iu of vitamin D when taken with 1,000 mg daily of calcium failed to improve blood lipids.
He also had the good sense to point out that vitamin D has other health benefits that he did not directly research.
At least with Dr Rajpathak, he seems objective enough that if he reads the more current research some of which had not yet been done or not yet reported when he began his current study a bit over 5 years ago, he might yet do valuable research on vitamin D and the heart once he learns of and reads the more current information.
Labels: badly reported studies on vitamin D and the heart, prevent heart attacks, protect your heart, vitamin D and protecting your heart
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