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 11:16 AM EDT, Thu August 28, 2014
Whitney Barkley says many for-profit colleges deceive students, charge exorbitant tuitions and make false promises
updated 4:48 PM EDT, Thu August 28, 2014
Mark O'Mara says the time has come to decide whether we really want police empowered to shoot those they believe are 'fleeing felons'
updated 10:32 AM EDT, Thu August 28, 2014
Bill Frelick says a tool of rights workers is 'naming and shaming,' ensuring accountability for human rights crimes in conflicts. But what if wrongdoers know no shame?
updated 10:43 PM EDT, Thu August 28, 2014
Jay Parini says, no, a little girl shouldn't fire an Uzi, but none of should have easy access to guns: The Second Amendment was not written to give us such a 'right,' no matter what the NRA says
updated 9:40 AM EDT, Thu August 28, 2014
Terra Ziporyn Snider says many adolescents suffer chronic sleep deprivation, which can indeed lead to safety problems. Would starting school an hour later be so wrong?
updated 5:53 PM EDT, Thu August 28, 2014
Peggy Drexler says after all the celebrity divorces, it's tempting to ask the question. But there are still considerable benefits to getting hitched
updated 7:05 PM EDT, Thu August 28, 2014
The death of Douglas McAuthur McCain, the first American killed fighting for ISIS, highlights the pull of Syria's war for Western jihadists, writes Peter Bergen.
updated 6:42 PM EDT, Tue August 26, 2014
Former ambassador to Syria Robert Ford says the West should be helping moderates in the Syrian armed opposition end the al-Assad regime and form a government to focus on driving ISIS out
updated 9:21 AM EDT, Wed August 27, 2014
Ruben Navarrette says a great country does not deport thousands of vulnerable, unaccompanied minors who fled in fear for their lives
updated 9:19 AM EDT, Wed August 27, 2014
Robert McIntyre says Congress is the culprit for letting Burger King pay lower taxes after merging with Tim Hortons.
updated 7:35 PM EDT, Tue August 26, 2014
Wesley Clark says the U.S. can offer support to its Islamic friends in the region most threatened by ISIS, but it can't fight their war
updated 7:26 AM EDT, Wed August 27, 2014
Jeff Yang says the tech sector's diversity numbers are embarrassing and the big players need to do more.
updated 4:53 PM EDT, Tue August 26, 2014
America's painful struggle with racism has often brought great satisfaction to the country's rivals, critics, and foes. The killing of Michael Brown and its tumultuous aftermath has been a bonanza.
updated 4:19 PM EDT, Tue August 26, 2014
Ed Bark says in this Emmy year, broadcasters CBS, ABC and PBS can all say they matched or exceeded HBO. These days that's no small feat
updated 3:19 PM EDT, Tue August 26, 2014
Rick Martin says the death of Robin Williams brought back memories of his own battle facing down depression as a young man
updated 11:58 AM EDT, Tue August 26, 2014
David Perry asks: What's the best way for police officers to handle people with psychiatric disabilities?
updated 3:50 PM EDT, Mon August 25, 2014
Julian Zelizer says it's not crazy to think Mitt Romney would be able to end up at the top of the GOP ticket in 2016
updated 4:52 PM EDT, Mon August 25, 2014
Roxanne Jones and her girlfriends would cheer from the sidelines for the boys playing Little League. But they really wanted to play. Now Mo'ne Davis shows the world that girls really can throw.
updated 12:29 PM EDT, Mon August 25, 2014
Peter Bergen and Emily Schneider say a YouTube video apparently posted by ISIS seems to show that the group has a surveillance drone, highlighting a new reality: Terrorist groups have technology once only used by states
updated 5:04 PM EDT, Mon August 25, 2014
Kimberly Norwood is a black mom who lives in an affluent neighborhood not far from Ferguson, but she has the same fears for her children as people in that troubled town do
updated 5:45 PM EDT, Fri August 22, 2014
It apparently has worked for France, say Peter Bergen and Emily Schneider, but carries uncomfortable risks. When it comes to kidnappings, nations face grim options.
updated 1:27 PM EDT, Tue August 26, 2014
John Bare says the Ice Bucket Challenge signals a new kind of activism and peer-to-peer fund-raising.
updated 8:31 AM EDT, Fri August 22, 2014
James Dawes says calling ISIS evil over and over again could very well make it harder to stop them.
updated 9:05 PM EDT, Sat August 23, 2014
As the inquiry into the shooting of Michael Brown continues, critics question the prosecutor's impartiality.
updated 6:47 PM EDT, Fri August 22, 2014
Newt Gingrich says it's troubling that a vicious group like ISIS can recruit so many young men from Britain.
updated 10:50 AM EDT, Thu August 21, 2014
David Weinberger says Twitter and other social networks have been vested with a responsibility, and a trust, they did not ask for.
updated 7:03 AM EDT, Fri August 22, 2014
John Inazu says the slogan "We are Ferguson" is meant to express empathy and solidarity. It's not true: Not all of us live in those circumstances. But we all made them.
updated 8:23 AM EDT, Fri August 22, 2014
Retired Lt. Gen. Mark Hertling says he learned that the territory ISIS wants to control is amazingly complex.
updated 3:51 PM EDT, Wed August 20, 2014
Cerue Garlo says Liberia is desperate for help amid a Ebola outbreak that has touched every aspect of life.
updated 1:42 PM EDT, Thu August 21, 2014
Eric Liu says Republicans who want to restrict voting may win now, but the party will suffer in the long term.
updated 11:38 AM EDT, Thu August 21, 2014
Jay Parini: Jesus, Pope and now researchers agree: Wealth decreases our ability to sympathize with the poor.
updated 8:00 AM EDT, Thu August 21, 2014
Judy Melinek offers a medical examiner's perspective on what happens when police kill people like Michael Brown.
updated 6:03 PM EDT, Tue August 19, 2014
It used to be billy clubs, fire hoses and snarling German shepherds. Now it's armored personnel carriers and flash-bang grenades, writes Kara Dansky.
updated 1:27 PM EDT, Wed August 20, 2014
Maria Haberfeld: People who are unfamiliar with police work can reasonably ask, why was an unarmed man shot so many times, and why was deadly force used at all?
ADVERTISEMENT
ADVERTISEMENT
ADVERTISEMENT
ADVERTISEMENT