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  • Original article (free access with registration): Pieter A. Cohen, The Supplement Paradox: Negligible Benefits, Robust Consumption. JAMA. October 11, 2016 (14):1453-1454  doi:10.1001/jama.2016.14252 

  • Summary of original article: Nutritional supplements are dangerous and expensive and are not supported by research; people who use nutritional supplements are ignorant or are intellectually Medieval because they are against scientific principles. 

  • Logical fallacies and factual errors:

  1. Sweeping generalizations: Cohen writes During the past 2 decades, a steady stream of high-quality studies evaluating dietary supplements has yielded predominantly disappointing results about potential health benefits, whereas evidence of harm has continued to accumulate. Sweeping generalizations without citations are the epitome (nadir) of weak journalism and lazy thinking. Specifically, the fact that Cohen would cite the 2006 Clegg study shows that Cohen is not a discerning reader, and that he cannot identify the supposed "high-quality studies" to which he feigns to refer. 

  2. Failure to cite supporting research: Cohen writes During the past 2 decades, a steady stream of high-quality studies evaluating dietary supplements has yielded predominantly disappointing results about potential health benefits, whereas evidence of harm has continued to accumulate. Sweeping generalizations without citations are the epitome (nadir) of weak journalism and lazy thinking. Cohen fails to substantiate these statements throughout his article. If Cohen had submitted this paper to any of the graduate or doctorate nutrition courses I have taught, he would have failed the assignment; not because I disagree with his position but because he failed to articulate and substantiate a rational argument. 

  3. Unprofessional, unscientific level of authorship: The fact that JAMA published a paper that would not pass an undergraduate writing assignment tells a lot about the lack of editorial acumen and (lack of) commitment to intellectual integrity at JAMA.

  4. Highly selective use of outdated and low-quality research: The irony or lack of integrity demonstrated in this publication is that the author pretends to be the representative of 1) good science, and 2) current research and then he cites 1) bad publications, and 2) old studies. He apparently just wanted to say whatever he wanted to say, regardless of the data, but to support his predetermined conclusion, he had to rely on outdated and poorly conducted studies. And then he has the arrogance to state that people with a different opinion are the ones who are ignorant and against science. 

  5. Intellectual inbreeding against nutrition: the recycling of low-quality work with low-quality analysis by people untrained and inexperienced in the clinical practice of nutrition: When doctors with no training in nutrition (lack of acumen) cite poorly conducted studies performed by people with no training in nutrition (which generally produce negative results) and then conclude that nutrition is inefficacious, which is nearly the same as saying that the fundamental biochemistry-physiology that underlies human existence is itself clinically irrelevant.

  6. Lack of rational consistency: Cohen writes But even supplements that are useful in treating certain conditions are frequently overused among the general population to “improve” or“maintain” health... So he acknowledges that some supplements are useful in treating certain conditions (no details and no citations) and then he states that they are overused (no details, no definitions of what is "overuse" and what the consequences might be, and no citations).

  7. Petty insinuations, while contradicting himself: Cohen writes But even supplements that are useful in treating certain conditions are frequently overused among the general population to “improve” or“maintain” health... So he acknowledges that some supplements are useful in treating certain conditions (no details and no citations) and then he uses petty insinuations by putting quotation marks around improvement and maintenance of health. Well, Mr Cohen, if supplements are useful in treating certain conditions  then by definition those supplements are useful for improving and maintaining health; the unnecessary quotation marks are small and petty. 

  8. Pandering to fear and uncertainty: He concludes without details and without citation, "... identifying products that are causing more harm than good." 

  9. Argumentum ad hominem: Cohen states that the two reasons people use nutritional supplements are: 

1.  They are ignorant of the facts, and that medical doctors (who are themselves notoriously ignorant of nutrition because medical schools and residency programs do not teach about nutrition) need to educate these patients. How would medical doctors, who are untrained in nutrition, be expected to provide any meaningful information? Wouldn't they default to being naysayers, as Cohen himself models? 

2.  They are resistant to science and the scientific method, which is to say that they are intellectually Medieval, existing in an intellectual state that is prior to the discovery and dissemination of scientific knowledge. 

 

Cohen's JAMA Editorial: Incompetent and Unaware: The pathetic irony of this headline-making "Editorial" is that it is worse than the research and the positions that it claims to refute. The fact that JAMA published a paper that would not pass an undergraduate writing assignment tells a lot about the lack of editorial acumen and (lack of) commitment to intellectual integrity at JAMA. Nevertheless, this article will get picked up by local and national news outlets and will be used to discourage use of health-promoting nutrition, despite the evidence, and by the self-same outlets that advocate drug-dependency for any and all ailments and which advocate high-carbohydrates for the burgeoning diabetic population that was previously described as "glucose intolerant" but are now labeled "insulin resistant." See video commentary above and other videos on this page for more details.

Overview (Part 1) of the Functional Inflammology Protocol

Dr Vasquez's "functional inflammology protocol", famously recalled by the FINDSEX ® acronym, is reviewed in this presentation for its application to the three general types of inflammatory diseases/responses: 1) metabolic inflammation, including glial activation and emphasizing the component of mitochondrial dysfunction, 2) allergic inflammation, including asthma and eczema, and 3) autoimmune inflammation, including rheumatoid arthritis, psoriasis, and the many other conditions that Dr Vasquez has detailed in his books starting in 2004 (Integrative Orthopedics) and 2006 (Integrative Rheumatology, now published as Inflammation Mastery, 4th Edition). 

Dr Vasquez introduces the "Functional Inflammology Protocol" at the 2013 International Conference on Human Nutrition and Functional Medicine (PDF brochure)

Inflammation Mastery 4th Edition

 

Supplement Paradox of Underconsumption despite Robust Benefits: Commentary on JAMA's Oct 2016 Antinutrition Polemic

The image immediately above is a critique of the Clegg study; this critique was written by DrV in approximately 2009 and is published in Inflammation Mastery. This image excerpt is also provided below on this page in an easier-to-read size. 

The image immediately above is a critique of the Clegg study; this critique was written by DrV in approximately 2009 and is published in Inflammation Mastery. 

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