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
September 19, 2014 -- Updated 0157 GMT (0957 HKT)
Ruben Navarrette says spanking is an acceptable form of disciplining a child, as long as you follow the rules.
September 19, 2014 -- Updated 0158 GMT (0958 HKT)
Steven Holmes says spanking, a practice that is ingrained in our culture, accomplishes nothing positive and causes harm.
September 18, 2014 -- Updated 1831 GMT (0231 HKT)
Sally Kohn says America tried "Cowboy Adventurism" as a foreign policy strategy; it failed. So why try it again?
September 18, 2014 -- Updated 1427 GMT (2227 HKT)
Van Jones says the video of John Crawford III, who was shot by a police officer in Walmart, should be released.
September 18, 2014 -- Updated 1448 GMT (2248 HKT)
NASA will need to embrace new entrants and promote a lot more competition in future, argues Newt Gingrich.
September 16, 2014 -- Updated 2315 GMT (0715 HKT)
If U.S. wants to see real change in Iraq and Syria, it will have to empower moderate forces, says Fouad Siniora.
September 18, 2014 -- Updated 0034 GMT (0834 HKT)
Mark O'Mara says there are basic rules to follow when interacting with law enforcement: respect their authority.
September 16, 2014 -- Updated 1305 GMT (2105 HKT)
LZ Granderson says Congress has rebuked the NFL on domestic violence issue, but why not a federal judge?
September 16, 2014 -- Updated 1149 GMT (1949 HKT)
Mel Robbins says the only person you can legally hit in the United States is a child. That's wrong.
September 15, 2014 -- Updated 1723 GMT (0123 HKT)
Eric Liu says seeing many friends fight so hard for same-sex marriage rights made him appreciate marriage.
September 12, 2014 -- Updated 2055 GMT (0455 HKT)
David Wheeler wonders: If Scotland votes to secede, can America take its place and rejoin England?
September 12, 2014 -- Updated 2036 GMT (0436 HKT)
World-famous physicist Stephen Hawking recently said the world as we know it could be obliterated instantaneously. Meg Urry says fear not.
September 11, 2014 -- Updated 1721 GMT (0121 HKT)
Sally Kohn says bombing ISIS will worsen instability in Iraq and strengthen radical ideology in terrorist groups.
September 11, 2014 -- Updated 1327 GMT (2127 HKT)
Artist Prune Nourry's project reinterprets the terracotta warriors in an exhibition about gender preference in China.
September 10, 2014 -- Updated 1336 GMT (2136 HKT)
The Apple Watch is on its way. Jeff Yang asks: Are we ready to embrace wearables technology at last?
ADVERTISEMENT