is the BBC's treatment of the vitamin supplementation really "balanced"? See the communications below and make up your own mind if you are able to see the programme at 21.00 h on 16 September.
When we saw the following promotion about BBC2's forthcoming Horizon programme, we telephoned Horizon and expressed our concerns. In our view, it appeared from the promotion that the angle might be negative at least with regard to high dose Vitamin C and "one type of vitamin" (no doubt beta-carotene) that "may actually increase the chances of catching the disease (cancer)."
The BBC then asked us to put our concerns in writing. This we did. They then responded in writing.
See all these communications below:
1) The BBC2 promotion
2) Our email to the BBC
3) The BBC's reply.
We ask those who have access to BBC, to watch BBC2 Horizon at 21.00 h GMT and make up your own minds.Did the programme offer a "fair and balanced view" as claimed by the BBC? If you have concerns, we urge you to communicate these concerns to the BBC. Please offer your feedback or comments via the BBC Message Board after you've seen the programme.
Britain is becoming a nation of pill poppers. We consume £300 million worth of vitamin supplements every year. But are they actually doing us any good? Could they even be dangerous?
Horizon begins its 40th anniversary season by examining the latest research, and conducts its own specially commissioned experiments to investigate the truth.
The film focuses mainly on high dose vitamin supplements. They are sold everywhere as nature's remedy in pill form - promoted in newspapers and lifestyle magazines as key to a happy, healthy lifestyle.
But, as this film shows, it's not quite so simple.
The programme includes research that says that despite what everyone believes, high doses of Vitamin C do nothing to prevent the common cold, and how one type of vitamin that was thought to prevent lung cancer may actually increase the chances of catching the disease.
Plus, many of us might be inadvertently taking too much Vitamin A, and putting ourselves at increased risk of bone disease.
In a film that mixes hard science, original research and top quality film-making, Horizon gets to grips with what vitamins really do - for good or ill.
-----Original Message----- From: Dr Robert Verkerk [mailto:[email protected]] Sent: 10 September 2004 10:50 To: Kim Creed
Subject: Horizon: Truth About Vitamins / ANH concerns
A media consultant, Adrian Shaw of Ikon Associates, who has worked closely with us at the Alliance for Natural Health, found details about your forthcoming Horizon programme on the BBC2 website, due to be televised on 16 September.
We note from the limited information available in the public domain that the programme is quite likely to provide a somewhat negative view on the importance of vitamins, showing for example research that demonstrates the lack of efficacy of high dose Vitamin C on the common cold and the fact that "one type of vitamin" (presumably beta-carotene) might actually increase the risk of cancer.
I am writing to you simply to warn you, in the event that you might not have been made fully aware, that such arguments are extremely well known and have been used many times by the 'anti-vitamin protagonists'. There is, however, another and very important side to the story and given the typically very high standard of Horizon, I am hoping that if these types of negative studies are reported, studies which show considerably more positive results are also reported for balance.
There is considerable research for example to show that high dose vitamin C reduces recovery time in sufferers of the common cold. In the case of beta-carotene, the ATBC Study and CARET Trial, which are likely to have been referred to in your programme, do indeed show an increasing tendency for lung cancers, but this effect is limited to high risk groups, namely smokers and asbestos workers. Furthermore, these studies have been conducted with synthetic beta-carotene which has been shown to be less beneficial than the natural form, particularly when present without other carotenoids.
Below is an extract from a report (attached) by the Alliance for Natural Health Expert Committee to the Food Standards Agency which critiqued the UK Expert Group on Vitamins and Minerals interpretation of these studies: -----------------------------------------------------------------------------------
In respect of the ATBC Study and the CARET Trial, the EVM report states:
"Epidemiological studies have suggested an association between supplementation with â-carotene and an increase in lung cancers in smokers and in individuals who have been heavily exposed to asbestos."
There are important misrepresentations in this statement, as shown below:
a) the studies are described as being epidemiological, implying that they were looking at a baseline or background levels of supplementation in the population; in fact, both studies were active interventions with relatively high dose supplements.
b) the supplementation continued for six years and four years respectively in the two studies. Given that, in the ATBC study the subjects had been smokers for an average of 36 years, at a rate of over 20 cigarettes daily, it is evident that the changes leading to the initiation of cancer will have happened before supplementation started. It is possible to infer from the studies that â-carotene, as used, does not cure or retard cancer once begun; but certainly not that it encourages cancer.
c) the EVM report ignores the reported finding that, in the ATBC study, those subjects with the highest blood levels of â-carotene (and of vitamin E) at the start of the study had the lowest risk of developing cancer. This is the true epidemiological finding.
d) the following statement in the ATBC study is also ignored:
"In light of the totality of the data available on the relationship between the intake of antioxidant vitamins and a corresponding reduction in cancer, an adverse effect of â-carotene seems unlikely and may well be, in spite of formal statistical significance, due to chance."
Once again, as with vitamin B6, EVM group have selected a study of highly questionable significance to be their key document. There are a number of other points on which these studies and their interpretation can be criticized, but these are of limited relevance here. Some of these points are considered in a review by Hughes (1999), ignored by the EVM.
Using two studies which show the possibility of increased susceptibility to lung cancer among high risk individuals in order to develop USLs for the entire population is flawed. The EVM conceded that:
“Observational studies in humans have shown that high intake of â-carotene-containing foods in the diet, as well as higher serum â-carotene levels, are associated with reduced risk of chronic diseases, such as coronary heart disease and cancer.”
Surely the EVM, even with its misinterpretation of the ATBC Study and CARET Trial, would have been more prudent to recommend inclusion of a contraindication on the label that warned smokers and asbestos workers of possible risks associated with â-carotene supplementation. This would allow the majority of the population to derive the clear benefits of â-carotene supplementation, particularly when in conjunction with other antioxidants such as Vitamins C and E.
Finally, it is surprising that the EVM omit a number of key studies and reviews, yet cite 7 studies which are Roche Internal Research Reports.
3.2.3 Absent data
As with other micronutrients considered by the EVM, important human studies have been omitted by the EVM. One recent example is the Age-Related Eye Disease Study (AREDS 2001) involving 3640 participants, ages 55-80, with an average follow-up of 6.3 years. The authors found no statistically significant serious adverse effects associated with any of the formulations used, as well as beneficial effects on visual acuity of the antioxidant supplements (including 15 mg /day â-carotene) combined with zinc.
Another study by Jialal & Grundy (1993) (â-carotene 30 mg/day) also showed no adverse effects.
I would of course be very happy to discuss any aspect of these issues with you, either on or off the record. We would also be in a position to point you in the direction of leading international scientific experts who are able to corroborate the key importance of vitamins and discuss some of the reasons why certain studies have shown negative or neutral effects. An extremely important issue is synergy i.e. the effects of vitamins and nutrients in combination with one another, given this is the natural state of nutrients in foods. Scientific methodology, in contrast, is often reductionistic, and attempts to explore the effects of single or limited variables. This is a common reason for failure of some of the studies using single or limited combinations of vitamins.
I look forward to hearing from you in due course. If you would like to contact me directly by telephone, it might be easiest to call me via my mobile (0771 484 7225).
Dr Rob Verkerk -------------------------------------------------------------------------- Robert Verkerk BSc, MSc, DIC, PhD Executive Director Alliance for Natural Health t +44 (0)1252 371 275 m +44 (0)771 484 7225 e [email protected] w www.alliance-natural-health.org
3) The BBC response
-----Original Message----- From: Kim Creed [mailto:[email protected]] Sent: 13 September 2004 11:07 To: Dr Robert Verkerk Cc: ANH Info; David C. Hinde ANH; [email protected] Subject: RE: Horizon: Truth About Vitamins / ANH concerns
Hi Rob, thanks for your note below.The Horizon programme on vitamins which goes out next Thursday 16th September on BBC TWO at 9.00pm is a fair and balanced view of the subject and encompasses scientific opinionsacross the range. Specifically the film makes it very clear that there is a distinction between synthetic beta-carotene and beta-carotene found in food. Likewise, we also make it clear that Vitamin C does have a benefit once you have caught a cold. We are certainly not in the business of providing a "negative view about vitamins" and the film is fully up to Horizon's standards.
I do hope you will watch and enjoy the film next Thursday.