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called mitochondria, where the body converts food to energy, a process that requires oxygen and so is called oxidation. One consequence of oxidation is the generation of electron scavengers called free radicals (evil). Free radicals can damage DNA, cell membranes, and the lining of arteries; not surprisingly, they’ve been linked to aging, cancer, and heart disease. To neutralize free radicals, the body makes its own antioxidants (good). Antioxidants can also be found in fruits and vegetables—specifically, selenium, beta-carotene, and vitamins A, C, and E. Studies have shown that people who eat more fruits and vegetables have a lower incidence of cancer and heart disease and live longer. The logic is obvious: if fruits and vegetables contain antioxidants—and people who eat lots of fruits and vegetables are healthier—then people who take supplemental antioxidants should also be healthier.

      In fact, they’re less healthy.

      In 1994, the National Cancer Institute, in collaboration with Finland’s National Public Health Institute, studied 29,000 Finnish men, all long-term smokers more than fifty years old. This group was chosen because they were at high risk for cancer and heart disease. Subjects were given vitamin E, beta-carotene, both, or neither. The results were clear: those taking vitamins and supplements were more likely to die from lung cancer or heart disease than those who didn’t take them—the opposite of what researchers had anticipated.

      In 1996, investigators from the Fred Hutchinson Cancer Research Center, in Seattle, studied 18,000 people who, because they had been exposed to asbestos, were at increased risk of lung cancer. Again, subjects received vitamin A, beta-carotene, both, or neither. Investigators ended the study abruptly when they realized that those who took vitamins and supplements were dying from cancer and heart disease at rates 28 and 17 percent higher, respectively, than those who didn’t.

      In 2004, researchers from the University of Copenhagen reviewed fourteen randomized trials involving more than 170,000 people who took vitamins A, C, E, and beta-carotene to see whether antioxidants could prevent intestinal cancers. Again, antioxidants didn’t live up to the hype. The authors concluded, “We could not find evidence that antioxidant supplements can prevent gastrointestinal cancers; on the contrary, they seem to increase overall mortality.” When these same researchers evaluated the seven best studies, they found that death rates were 6 percent higher in those taking vitamins.

      In 2005, researchers from Johns Hopkins School of Medicine evaluated nineteen studies involving more than 136,000 people and found an increased risk of death associated with supplemental vitamin E. Dr. Benjamin Caballero, director of the Center for Human Nutrition at the Johns Hopkins Bloomberg School of Public Health, said, “This reaffirms what others have said. The evidence for supplementing with any vitamin, particularly vitamin E, is just not there. This idea that people have that [vitamins] will not hurt them may not be that simple.” That same year, a study published in the Journal of the American Medical Association evaluated more than 9,000 people who took high-dose vitamin E to prevent cancer; those who took vitamin E were more likely to develop heart failure than those who didn’t.

      In 2007, researchers from the National Cancer Institute examined 11,000 men who did or didn’t take multivitamins. Those who took multivitamins were twice as likely to die from advanced prostate cancer.

      In 2008, a review of all existing studies involving more than 230,000 people who did or did not receive supplemental antioxidants found that vitamins increased the risk of cancer and heart disease.

      On October 10, 2011, researchers from the University of Minnesota evaluated 39,000 older women and found that those who took supplemental multivitamins, magnesium, zinc, copper, and iron died at rates higher than those who didn’t. They concluded, “Based on existing evidence, we see little justification for the general and widespread use of dietary supplements.”

      Two days later, on October 12, researchers from the Cleveland Clinic published the results of a study of 36,000 men who took vitamin E, selenium, both, or neither. They found that those receiving vitamin E had a 17 percent greater risk of prostate cancer. In response to the study, Steven Nissen, chairman of cardiology at the Cleveland Clinic, said, “The concept of multivitamins was sold to Americans by an eager nutraceutical industry to generate profits. There was never any scientific data supporting their usage.” On October 25, a headline in the Wall Street Journal asked, “Is This the End of Popping Vitamins?”

      Studies haven’t hurt sales. In 2010, the vitamin industry grossed $28 billion, up 4.4 percent from the year before. “The thing to do with [these reports] is just ride them out,” said Joseph Fortunato, chief executive of GNC, the largest chain of vitamin, mineral, and supplement stores in the United States. “We see no impact on our business.”

      How could this be? Given that free radicals clearly damage cells—and given that people who eat diets rich in substances that neutralize free radicals are healthier—why did studies of supplemental antioxidants show they were harmful? The most likely explanation is that free radicals aren’t as evil as advertised. Although it’s clear that free radicals can damage DNA and disrupt cell membranes, that’s not always a bad thing. People need free radicals to kill bacteria and eliminate new cancer cells. But when people take large doses of antioxidants, the balance between free radical production and destruction might tip too much in one direction, causing an unnatural state in which the immune system is less able to kill harmful invaders. Researchers have called this “the antioxidant paradox.” Whatever the reason, the data are clear: high doses of vitamins and supplements increase the risk of heart disease and cancer; for this reason, not a single national or international organization responsible for the public’s health recommends them.

      In May 1980, during an interview at Oregon State University, Linus Pauling was asked, “Does vitamin C have any side effects on long-term use of, let’s say, gram quantities?” Pauling’s answer was quick and decisive. “No,” he replied. Seven months later, his wife was dead of stomach cancer. In 1994, Linus Pauling died of prostate cancer.

      Despite a wealth of scientific evidence, most people don’t know that megavitamins are unsafe. So why don’t more people know about this? And why haven’t regulatory agencies sounded an alarm? The answer is predictable: money and politics.

Part III

       3

       The Supplement Industry Gets a Free Pass: Neutering the FDA

      Liberty for the wolves is death for the lambs.

      —Isaiah Berlin

      Government oversight of the pharmaceutical industry has been a long, tortuous journey filled with unimaginable tragedies. “The story of drug regulation,” wrote historian Michael Harris, “is built on tombstones.”

      It started with purveyors of patent medicines.

      “How much is your health worth, ladies and gentlemen? It’s priceless, isn’t it? Well, my friends, one half-dollar is all it takes to put you in the pink. That’s right, ladies and gents. For fifty pennies, Nature’s True Remedy will succeed where doctors have failed. Only Nature can heal and I have Nature right here in this little bottle. My secret formula, from God’s own laboratory, the Earth itself, will cure rheumatism, cancer, diabetes, baldness, bad breath, and curvature of the spine.”

      In the 1800s, medical hucksters could claim anything. Boston Drug cured drunkenness. Pond’s Extract treated meningitis. Hydrozone prevented yellow fever. Peruna calmed inflammation of the ovaries. Liquozone cured asthma, bronchitis, cancer, dysentery, eczema, gallstones, hay fever, malaria, and tuberculosis. And Dr. Williams’ Pink Pills for Pale People treated all that and more. Sales were limited only by what customers were willing to believe. By the turn of the century, patent medicines were a $75-million-a-year business. It didn’t last. On June 30, 1906, the federal government stepped in, passing the Pure Food and Drug Act. Three men led the charge; one was concerned about foods, another about drugs, the third about neither.

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