Skip to main content

The year medical 'fixes' got busted

By Aaron Carroll
December 31, 2013 -- Updated 1146 GMT (1946 HKT)
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
December 20, 2014 -- Updated 0242 GMT (1042 HKT)
Conservatives know easing the trade embargo with Cuba is good for America. They should just admit it, says Fareed Zakaria.
December 20, 2014 -- Updated 0112 GMT (0912 HKT)
We're a world away from Pakistan in geography, but not in sentiment, writes Donna Brazile.
December 19, 2014 -- Updated 1709 GMT (0109 HKT)
How about a world where we have murderers but no murders? The police still chase down criminals who commit murder, we have trials and justice is handed out...but no one dies.
December 18, 2014 -- Updated 2345 GMT (0745 HKT)
The U.S. must respond to North Korea's alleged hacking of Sony, says Christian Whiton. Failing to do so will only embolden it.
December 19, 2014 -- Updated 2134 GMT (0534 HKT)
President Obama has been flexing his executive muscles lately despite Democrat's losses, writes Gloria Borger
December 18, 2014 -- Updated 1951 GMT (0351 HKT)
Jeff Yang says the film industry's surrender will have lasting implications.
December 18, 2014 -- Updated 2113 GMT (0513 HKT)
Newt Gingrich: No one should underestimate the historic importance of the collapse of American defenses in the Sony Pictures attack.
December 10, 2014 -- Updated 1255 GMT (2055 HKT)
Dean Obeidallah asks how the genuine Stephen Colbert will do, compared to "Stephen Colbert"
December 18, 2014 -- Updated 1734 GMT (0134 HKT)
Some GOP politicians want drug tests for welfare recipients; Eric Liu says bailed-out execs should get equal treatment
December 18, 2014 -- Updated 1342 GMT (2142 HKT)
Louis Perez: Obama introduced a long-absent element of lucidity into U.S. policy on Cuba.
December 16, 2014 -- Updated 1740 GMT (0140 HKT)
The slaughter of more than 130 children by the Pakistani Taliban may prove as pivotal to Pakistan's security policy as the 9/11 attacks were for the U.S., says Peter Bergen.
December 17, 2014 -- Updated 1600 GMT (0000 HKT)
The Internet is an online extension of our own neighborhoods. It's time for us to take their protection just as seriously, says Arun Vishwanath.
December 16, 2014 -- Updated 2154 GMT (0554 HKT)
Gayle Lemmon says we must speak out for the right of children to education -- and peace
December 17, 2014 -- Updated 1023 GMT (1823 HKT)
Russia's economic woes just seem to be getting worse. How will President Vladimir Putin respond? Frida Ghitis gives her take.
December 17, 2014 -- Updated 0639 GMT (1439 HKT)
Australia has generally seen itself as detached from the threat of terrorism. The hostage incident this week may change that, writes Max Barry.
December 12, 2014 -- Updated 2020 GMT (0420 HKT)
Thomas Maier says the trove of letters the Kennedy family has tried to guard from public view gives insight into the Kennedy legacy and the history of era.
December 15, 2014 -- Updated 1456 GMT (2256 HKT)
Will Congress reform the CIA? It's probably best not to expect much from Washington. This is not the 1970s, and the chances for substantive reform are not good.
December 15, 2014 -- Updated 2101 GMT (0501 HKT)
From superstorms to droughts, not a week goes by without a major disruption somewhere in the U.S. But with the right planning, natural disasters don't have to be devastating.
December 15, 2014 -- Updated 1453 GMT (2253 HKT)
Would you rather be sexy or smart? Carol Costello says she hates this dumb question.
December 14, 2014 -- Updated 2253 GMT (0653 HKT)
A story about Pope Francis allegedly saying animals can go to heaven went viral late last week. The problem is that it wasn't true. Heidi Schlumpf looks at the discussion.
December 14, 2014 -- Updated 1550 GMT (2350 HKT)
Democratic leaders should wake up to the reality that the party's path to electoral power runs through the streets, where part of the party's base has been marching for months, says Errol Louis
December 13, 2014 -- Updated 2123 GMT (0523 HKT)
David Gergen: John Brennan deserves a national salute for his efforts to put the report about the CIA in perspective
December 12, 2014 -- Updated 1426 GMT (2226 HKT)
Anwar Sanders says that in some ways, cops and protesters are on the same side
December 11, 2014 -- Updated 1439 GMT (2239 HKT)
A view by Samir Naji, a Yemeni who was accused of serving in Osama bin Laden's security detail and imprisoned for nearly 13 years without charge in Guantanamo Bay
December 14, 2014 -- Updated 1738 GMT (0138 HKT)
S.E. Cupp asks: How much reality do you really want in your escapist TV fare?
ADVERTISEMENT