Skip to main content

The year medical 'fixes' got busted

By Aaron Carroll
updated 6:46 AM EST, Tue December 31, 2013
A study published in the Annals of Modern Medicine found that vitamins do not prevent heart disease or cancer after all.
A study published in the Annals of Modern Medicine found that vitamins do not prevent heart disease or cancer after all.
STORY HIGHLIGHTS
  • In 2013, some common therapies were shown to be less effective than we thought
  • Aaron Carroll: Some examples -- exercise is better than pills, vitamins don't work
  • Carroll: Therapies that work for severe cases (statins, antibiotics) are over used
  • Carroll: We spend billions on these when we could spend it on better measures

Editor's note: Aaron E. Carroll is a professor of pediatrics at the Indiana University School of Medicine and the director of its Center for Health Policy and Professionalism Research. He has supported a single-payer health system during the reform debate. He blogs about health policy at The Incidental Economist and tweets at @aaronecarroll.

(CNN) -- It's hard to be too curmudgeonly about the state of medicine right now. After all, you're much less likely to die of almost any disease today than at any other time in human history. Infant and maternal mortality are at an all-time low. Life expectancy is on the rise. And yet, 2013 feels like it was a bit of a disappointment in terms of medical advances.

Part of that is because some commonly used therapies were shown to be less effective than we thought. A few weeks ago, I wrote here that lifestyle changes are just as effective for reducing your chances of dying from heart disease, stroke and diabetes as drugs were. Yet we spend billions of dollars on such drugs.

Multivitamins have been the subject of many studies. Some have shown them to be of limited benefit; a few showed vitamins caused some minor improvements in the risk of certain diseases like cancer.

Aaron Carroll
Aaron Carroll

More adults in the United States take vitamins than don't, and on these, too, we spend billions of dollars per year. But three studies published in the Annals of Internal Medicine this year laid waste to these claims. One of them was a huge meta-analysis that found vitamins didn't prevent heart disease or cancer after all. Another showed that vitamins did nothing to improve cognitive functioning in men over the age of 65.

The studies were accompanied by an editorial titled: "Enough is Enough: Stop Wasting Money on Vitamin and Mineral Supplements."

The FDA has also made news this year by banning things we once thought were good for us. First it went after trans fats. It's hard to believe, but these additives became popular, in part, because the medical community believed they were safer than animal fats. Turned out we were wrong.

Because of a growing body of evidence, it's hard to ignore that trans fats are, in reality, more dangerous, and worsen cholesterol levels in people who eat them. Unless the FDA alters course, which seems unlikely, they will be all but eradicated from our foods in the near future.

Making sense of multivitamins
Replacing trans fats
FDA on antibacterial soap: Prove it

The FDA also went after antibacterial soaps. For decades these have been touted as a way to prevent disease by making hand washing more effective. Of course, for decades the FDA knew there was no proof that they worked any better than plain old soap, but until now it didn't do anything about it. That changed just a few weeks ago. Companies will have to start producing evidence of their effectiveness, or remove the antibacterial components from their products.

One of the reasons for our concern, by the way, is the growing evidence that our overuse of products to fight bacteria could lead to a future where they don't work at all. In addition to the antibacterial chemicals in soaps, antibiotic drugs are used quite a bit in raising livestock. Earlier this year, a person died in New Zealand from an infection that was resistant to every single antibiotic they could find. This led many to worry about a not-too-distant future where many of our medical gains would be reversed.

At some point, we must accept that if something works for the very ill, it does not mean that it works for everyone. Vitamins have a place in the treatment of people who are truly clinically malnourished. Providing them to people who already get more than enough does no good.

Statins were studied, and worked, in people at high risk for heart disease; but we're seeing guidelines that push them on huge numbers of Americans. Antibiotics have their place in fighting real bacterial infections, but we often use them when they're not needed.

At the same time, we don't spend nearly enough on public health measures that could make much more of a difference. We have no problem subsidizing the cost of drugs, but we'd hardly consider subsidizing exercise or dieting at the same levels. When we look back on 2013, it feels like we're relying too much on medical fixes for problems that have other solutions, and, perhaps, beginning to see their limitations.

Follow us on Twitter @CNNOpinion

Join us on Facebook/CNNOpinion

The opinions expressed in this commentary are solely those of Aaron Carroll.

ADVERTISEMENT
Part of complete coverage on
updated 4:47 PM EDT, Fri April 18, 2014
Jim Bell says NASA's latest discovery support the notion that habitable worlds are probably common in the galaxy.
updated 2:17 PM EDT, Fri April 18, 2014
Jay Parini says even the Gospels skip the actual Resurrection and are sketchy on the appearances that followed.
updated 1:52 PM EDT, Fri April 18, 2014
Graham Allison says if an unchecked and emboldened Russia foments conflict in a nation like Latvia, a NATO member, the West would have to defend it.
updated 9:11 AM EDT, Fri April 18, 2014
John Sutter: Bad news, guys -- the pangolin we adopted is missing.
updated 1:10 PM EDT, Sat April 19, 2014
Ben Wildavsky says we need a better way to determine whether colleges are turning out graduates with superior education and abilities.
updated 6:26 AM EDT, Fri April 18, 2014
Charles Maclin, program manager working on the search and recovery of Malaysia Flight 370, explains how it works.
updated 8:50 AM EDT, Fri April 18, 2014
Jill Koyama says Michael Bloomberg is right to tackle gun violence, but we need to go beyond piecemeal state legislation.
updated 2:45 PM EDT, Thu April 17, 2014
Michael Bloomberg and Shannon Watts say Americans are ready for sensible gun laws, but politicians are cowed by the NRA. Everytown for Gun Safety will prove the NRA is not that powerful.
updated 9:28 AM EDT, Thu April 17, 2014
Ruben Navarrette says Steve Israel is right: Some Republicans encourage anti-Latino prejudice. But that kind of bias is not limited to the GOP.
updated 7:23 PM EDT, Wed April 16, 2014
Peggy Drexler counts the ways Phyllis Schlafly's argument that lower pay for women helps them nab a husband is ridiculous.
updated 12:42 PM EDT, Wed April 16, 2014
Rick McGahey says Rep. Paul Ryan is signaling his presidential ambitions by appealing to hard core Republican values
updated 11:39 AM EDT, Wed April 16, 2014
Paul Saffo says current Google Glasses are doomed to become eBay collectibles, but they are only the leading edge of a surge in wearable tech that will change our lives
updated 2:49 PM EDT, Tue April 15, 2014
Kathleen Blee says the KKK and white power or neo-Nazi groups give haters the purpose and urgency to use violence.
updated 7:56 AM EDT, Wed April 16, 2014
Sen. Sheldon Whitehouse and Rep. Henry Waxman say read deep, and you'll see the federal Keystone pipeline report spells out the pipeline is bad news
updated 7:53 AM EDT, Wed April 16, 2014
Frida Ghitis says President Obama needs to stop making empty threats against Russia and consider other options
ADVERTISEMENT
ADVERTISEMENT
ADVERTISEMENT
ADVERTISEMENT