Dr Nick Chartres

01/05/2023

Brad Phillips In All Articles, Dr Nick Chartres, Nutrition

“… diet, exercise and medications all have a role to play in weight loss”… or is there something more effective we could be doing??

Dr. Nicholas Chartres

5 min read

I recently spotted this article in The Sydney Morning Herald with the following headline “Why diet, exercise and medications all have a role to play in weight loss”

The industrialized food industry (Coca-Cola, Nestle, McDonald’s et al.) along with the pharmaceutical drug companies that make these drugs love to read a headline such as this in our national newspapers.

In fact, they play a large role in this type of discursive framing. The industrialized food industry avoids being held accountable for causing the global obesity epidemic and the pharmaceutical industry profits from the medicalization of a condition that is preventable through strong government regulation.

As the headline suggests, this article discusses the need for new weight loss drugs to tackle obesity that have been shown to be effective in weight loss.

This article says that “the chorus of disapproval” for bringing new weight loss drugs onto the market is because people lack willpower and choose to be obese.

I strongly disagree.

As someone who has spent time working in the Metabolic and Obesity and Diabetes Unit in one of Sydney’s largest hospitals, I know (and evidence shows) that obesity is not caused by a lack of willpower. It was the main reason why I went from wanting to be a health practitioner trying to help an individual, to a researcher focused on identifying how various corporate actors like the industrialized food and pharmaceutical industries distort the science on the health harms of their products and undermine any regulatory efforts to limit their sale.

Obesity is caused by the industrialized food industry that has hijacked our food systems with Ultra Processed Foods (UPFs). Highly strategic food marketing practices coupled with biologically addictive properties of these highly affordable and available, high-calorie, nutrient-deficient UPFs mean that our willpower and innate physical and psychological mechanisms that control weight will always be overridden.

We didn’t/don’t blame an individual for being addicted to nicotine and smoking so we should not blame an individual for being addicted to these UPFs. They stimulate the same pathways in the brain. To limit the harm caused by smoking we regulated the tobacco industry.

“The chorus of disapproval” should be because pharmaceutical drugs are one of the leading causes of death with a large percentage of those who die having taken their drugs correctly. The article points to the success of the drugs in achieving weight loss in studies conducted up to 1 ½ years and their possible benefits in reducing heart disease and stroke.

But what about the long-term harms that these short-term studies can’t identify? As one of the experts points out – “we won’t know until they’ve been in use for a while”…. but the headline has already told us we need them to lose weight.

Additionally, health isn’t just about keeping weight off. If you continue to consume UPFs filled with chemicals and synthetic products, we know our risk of dying from cancer, heart disease, and any causes will be higher than those who don’t. These drugs don’t change the quality of our food systems.

“The chorus of disapproval” should also be because as one of the experts highlights “people who need the help of these drugs most are often those who can least afford them”.

I recognize the urgent need for intervention for people that are obese and unable to lose weight (truly I do, with friends and family living with it), but this article exemplifies how our system of health care focuses on treatments (treatments that those that need them most can’t afford) rather than causes. Is this really what health care is?

And although both experts acknowledge the overconsumption of energy due to highly processed food and the role our genes play in us gaining weight and not being able to lose weight, nowhere in the article, however, do they say that we must regulate the food industry. Only at the bottom of the article was this one line “We also need other strategies, including a crackdown on marketing the junk food fueling obesity.”

My other main concern about an article like this is that the two experts that were quoted for this story have both received payments from the pharmaceutical company that makes the weight loss drug and this information wasn’t disclosed in the article (for one of the experts you can look this information up under the Medicines Australia “Payments to Healthcare Professionals”, for the other I searched their publications and funding).

This information is very important for the reader and should always be disclosed, especially when someone is recommending a new drug treatment.

Obesity and the health harms caused by obesity can only truly be addressed with systems-level change (so government regulation). This escalating burden of chronic disease, caused by entirely preventable lifestyle illnesses through the consumption of UPFs, along with the treatment of millions of Australians with drugs that may provide benefit without understanding the long-term harms, to me, is a health system completely broken and captured by the industrialized food and pharmaceutical industries.

While “Prevention and treatment are not the same”, how about we start with this framing first when discussing weight loss and obesity in the public domain:

All clinicians, scientists, public health researchers, and consumers must advocate for regulation of the industrialized food industry, as we have with tobacco. For example – we must add graphic warning labels of breast cancer on UPFs that have been linked to such cancers; tax all sugar-sweetened beverages and UPFs that contain emulsifiers, colorings, or flavorings; ban all junk food advertising of sporting events and on television as we did with tobacco; pass legislation for subsidies that encourage farmers growing fruits, vegetables, and healthy whole foods and not farming to overproduce corn and soy used in the manufacture of UPFs.
Drugs should only ever be recommended with extreme caution.
If drugs are discussed publicly, explain to individuals that if you lose weight with drugs, you likely will need to keep taking the medications forever to keep the weight off and the long-term effects are unknown. All drugs have side effects and these weight loss drugs won’t improve your diet quality.
Any experts that recommend the use of any pharmaceutical interventions disclose the financial conflicts of interest they have with the company that makes the drug they are recommending.

Perhaps then we will see headlines such as “Why regulating the food industry is the key to weight loss”.

Dr. Nicholas Chartres is the Associate Director of Science and Policy at the Program on Reproductive Health and the Environment, University of California, San Francisco. Dr. Chartres conducted the first in-depth study of the association of industry sponsorship and its influence on primary nutrition research. He also analyzed how the food industry attempts to drive the research agenda by funding studies that measure the effects of nutrients, and not dietary patterns, that can be used to market food products. This research has contributed to an improved understanding of how these types of biases may influence the primary research that is used in informing the recommendations made in national dietary guidelines.

21/03/2023

Brad Phillips In All Articles, Dr Nick Chartres

Corporate Wellbeing Provider, Good Mood Dudes, Rebrands to Good Mood Group

[Sydney, NSW] – A leading provider of evidence-based workplace wellbeing solutions, has today announced it is rebranding as Good Mood Group, effective immediately.

The rebrand reflects the evolution of Good Mood Dudes, from a small team of passionate wellbeing consultants to a well-rounded solution provider with a broad-reaching panel of highly regarded health experts.

The new name, Good Mood Group, has been chosen to reflect both growth of the business and its services.

Initially a provider of nutrition-focused wellbeing solutions, the business has shifted towards a model that covers what founder Dr Nick Chartres calls, a holistic model of evidence-based workplace wellbeing.

“While some wellbeing providers focus on supporting organisations in one or two particular areas of wellbeing, Good Mood Group is committed to providing expert-led, evidence-based solutions across a range of areas we know are critical to individual mental health and physical wellbeing including sleep, stress management, along with nutrition and exercise or movement.”

Good Mood Group’s solutions are designed to complement initiatives that may already be in place within an organisation, such as Employee Assistance Programs (EAPs) and/or company-led wellbeing awareness initiatives and employee benefits.

“While discounted gym memberships, step challenges and complimentary fruit definitely have their place, Good Mood Group is focused on providing a done-for-you solution – we’re a way for companies to ensure they are providing high quality, evidence-based education on areas that will influence an individual’s wellbeing. We help companies go beyond the usual employee benefits and implement a program that creates good moods – wherever you may be working from. Our new name reflects this.” said Chartres.

Good Mood Group counts several highly qualified researchers among their programme advisors, including public health experts, sleep epidemiologists, psychologists, physiotherapists, and exercise physiologists.

“We’re excited to expand on the work we’ve done with clients such as KPMG, Centuria Capital, the Zenith and others. We’ve been able to create solutions that break through misinformation and foster community, despite the new normal – a world where flexibility and working from anywhere is here to stay.”

“As an employer competing for talent, an accessible, well-rounded wellbeing solution to support evidence-based positive lifestyle choices should be a no-brainer. Not only (and it’s now well established) because it is an investment that makes a difference to the bottom line and retention, but because more good moods are important to public health – mentally-well workers are better able to support families, their community and those around them.” concludes Chartres.

The Good Mood Group website, social media pages, and other communication channels have been updated to reflect the name change. Current and future clients can continue to expect the same level of high-quality service and support from Good Mood Group.

For more information about Good Mood Group, its experts and services, visit https://goodmoodgroup.com.au/

Media Contact:

Dr Nick Chartres

Good Mood Group

Email: nick@goodmoodgroup.com.au

Phone: 0403 959 502

31/10/2022

Tayla Schuit In All Articles, Dr Nick Chartres, Exercise, Mental health, Nutrition, Sleep

What Employees Want

Good Mood Dudes founder Dr. Nicholas Chartres, sits down with The Guardian to discuss the new landscape of work/life balance and what employees expect from their workplace.

As featured in:

With the dust starting to settle after almost 3 years of disruption to our way of life due to Covid-19, evidence of what employees expect in the workplace is now becoming clear.

While the transition to working from home came with its challenges as employees and employers had to conform to Covid-19 restrictions, what’s emerged is a new way to think about work-life balance. People are now seeking flexible work hours, healthier work environments, and autonomy in their roles over less valuable employee ‘perks’. Good Mood Dudes’ Dr Nick Chartres says “In most businesses right now, it’s all about autonomy and flexibility: the autonomy to select how many days in which people are going into the office, as well as the flexibility to adjust that on a week by week basis”.

But autonomy and flexibility are not the only important things people are seeking. “Natural light, fresh air, and end-of-trip facilities – so people can ride into work or go to the gym at lunchtime – are now pretty much mandatory for a lot of companies,” says Chartres. “Being close to public transport, supermarkets, gyms, parks, and green space is also great.” A workplace that makes the commute to work shorter and easier with the physical destination also being a place of comfort is a top request by employees today.

Experts suggest that many people are now wanting to walk or cycle to work and when they arrive they want the office environment to offer an enjoyable experience that allows them to work effectively in comfort. Whilst psychosocial factors of company culture can impact the comfort of an employee in an office environment, things like having privacy to focus as well as spaces that support collaboration and interaction with teams are crucial.

Whilst the voices of those who prefer a more laissez-faire approach to leadership are being heard, it is important to remember that every employee is different and will have different needs when it comes to being able to work most effectively.

If you’re looking to support your employees and are not sure where to start, book a strategy call with us today.

31/10/2022

Tayla Schuit In All Articles, Dr Nick Chartres, Nutrition

The Debate on Corporate Sponsorship of Our National Sporting Teams

In this opinion piece, Good Mood Dudes founder Dr. Nicholas Chartres provides his view on this article: Australian cricket captain Pat Cummins slammed for hypocritical ‘ethical objections’ of major sponsor Alinta Energy

Over the last two weeks, corporate sponsorship of our national sporting teams has been strongly debated across Australia, from the front pages of our leading newspapers and even the WhatsApp chat I have with former cricket teammates.

Australian men’s cricket captain, Pat Cummins has stated he has ethical issues about team sponsor Alinta Energy. Its parent company has been listed as one of Australia’s highest carbon emitters, and despite its well-publicized claims it is investing in renewable energy sources, is rated very low on The Green Electricity Guide which considers the timeframe companies propose to stop using coal, whether a company frequently causes local environmental harm, and is transparent in their marketing.

Those opposed to the views expressed by Pat Cummins have pointed to the fact that he has already received money from Alinta Energy to appear in ads, that he flies first class, and drives an SUV with high carbon emissions. All valid points that are hard to disagree with.

And while climate change is the single greatest threat to human and planetary health, the current rates of childhood obesity have immediate consequences for our childrens’ future. The promotion of KFC by the Australian cricket team and its captain is of equal concern.

However, I applaud him for raising the issue.

I personally believe that we could use a threshold that if a company produces, manufactures, distributes, or sells a product that leads to health disparities and social and environmental injustices, then the government should prevent sporting teams from having them as a sponsor. Sport/professional sports should solely be about health promotion, especially for our children, and these industries sell products that erode such benefits.

It is still not widely understood, but non-communicable diseases (NCDs), or chronic diseases are the main causes of deaths globally. Environmental exposures, including tobacco, petrochemicals, pesticides, ultra-processed food, alcohol, and pharmaceutical drugs like opioids, along with climate change-related events, including extreme weather and wildfires, are the main drivers of these chronic diseases harming human health.

The responses I have received to this idea when raised on my WhatsApp chat ranged from “well then, there will be no one to fund the teams, and the players won’t get paid, so good luck” to “you drink beers, fly on planes, eat Maccas and use Panadol, so..”.

My response to these comments is grounded in the same logic as why we as a society eventually condemned tobacco advertising in sport – because we know the tobacco industry used sports and sportsmen as a vehicle to hide and distract from the harm of their products.

It remains to be seen, but I think there are still a lot of companies that will be able to fill the void left by these industries sponsoring our sporting teams. It happened when tobacco sponsorship was banned so there is good reason to think the same will happen again.

29/09/2022

Tayla Schuit In All Articles, Dr Nick Chartres, Nutrition

Ultra-processed foods: it’s not just their low nutritional value that’s a concern

In this opinion piece, Good Mood Dudes founder Dr. Nicholas Chartres provides his view on this article: Ultra-processed foods: it’s not just their low nutritional value that’s a concern

What if we said that by eating nutrient deficient food, filled with chemicals, you have a significantly higher risk of dying younger from heart disease or cancer?

Pretty scary, huh?

Well in the UK, US and Canada, and Australia ultra-processed foods (nutrient deficient food, filled with chemicals) now account for ~50% or more of calories consumed.

The food industry has told us that by fortifying these ultra-processed foods with other nutrients, it makes them healthier for us. The Health Star Rating system in Australia is a prime example of this tactic.

However, it has now been identified that chronic inflammation may be a key contributor to why ultra-processed foods increase our disease risk. The industrial-sounding products and chemicals both within these foods (flavourings, colourings, emulsifiers, and thickeners) and the packets they are served in (very high levels of PFAS or ‘forever’ chemicals are found in various fast food packets) may be recognized by the body as foreign – like an invading bacteria or virus. It is proposed our body goes into fight mode against these harmful agents, causing an inflammatory response.

So why is this so bad?

Scientists have established ten Key Characteristics (KCs) that reflect the properties of cancer-causing hazardous agents. These include things like does the agent alter DNA repair, induce oxidative stress, or does it induce chronic inflammation. These KCSs of carcinogens have been applied in the evaluation of more than 70 carcinogens at the International Agency for Research on Cancer (IARC), the world’s leading agency for classifying carcinogens.

When we are continually eating ultra-processed foods (which we must be if ~50% of our diet comes from them), then we are likely to be in a state of chronic inflammation and therefore at a greater risk of disease.

The article then points to the best ways we can prevent this disease state from happening. 1) Do not eat ultra-processed foods at all, and 2) Eat a plant-based diet.

Simple enough, right?

Well, doing these two things can be extremely difficult. This is because our food environment is flooded with these hyperpalatable food products, their marketing and advertising is ubiquitous and persuasive, and they are very cheap, making them affordable for very low-income communities, who are often the highest consumers of these products.

So, what is the solution?

Well, part of it has to be government action and regulation, just like how we regulated tobacco, by banning advertising, increasing sales taxes and introducing plain packaging, just to name a few.

Dr Nicholas Chartres is the Director of Science & Policy at the University of California, San Francisco working with the Program of Reproductive Health and the Environment. His work focuses on US federal chemical policy and regulation.

Nick received his PhD from The University of Sydney, where his thesis examined ways to reduce bias in public health guidelines, including the primary studies that are used in our national Dietary Guidelines. Nick also has a Masters in Nutrition.

15/09/2022

Brad Phillips In All Articles, Dr Nick Chartres, Exercise, Mental health, Nutrition

These harrowing cancer statistics can actually be good news. Wait, what?

In this opinion piece, Good Mood Dudes founder Dr. Nicholas Chartres provides his view on this article: These harrowing cancer statistics can actually be good news

When I first read this headline, I assumed that this article was going to discuss new government regulations on industry (alcohol in this instance), spurred by more unequivocal evidence on the already established health effects caused by harmful products like alcohol.

Instead, the story focused on what the individual can do to change their behaviour, with education being a key component of that behaviour change.

Seems reasonable, I hear you say.

Let me explain the shortcomings of this approach and why it is the narrative that the industries that produce these harmful products love to see published.

While the story points to the fact that smoking rates in Australia have dropped from 24% in 1995 to 11% in 2021, this was not done through education campaigns alone. It took an aggressive suite of regulatory measures for this to occur. These included an increase in sales taxes, a complete ban on advertising and marketing (sports advertising was one of the first to go), and the introduction of plain packaging, coupled with aggressive graphic health warnings by the Australian government.

Government action must be part of the solution.

I study the commercial determinants of health. This includes the strategies that industries like tobacco, alcohol, packaged food, and fossil fuels use to sell their products, as well as the political and economic systems that they operate within.

As economic globalization has intensified over the last two decades, these determinants of health have not only become the leading cause of disease but have also created health inequities within and across countries. For example, communities of color and low-income communities have experienced disproportionate consequences and impacts on their health due to either higher consumption rates of alcohol, tobacco, and ultra-processed foods or higher rates of exposure to toxic air pollution (due to the combustion of fossil fuels) and chemicals.

These industries use a suite of tactics aimed at preventing government regulation, which includes distorting the science on the human and planetary health effects of their products, undermining the policy process via lobbying, and shaping the narrative on their brands and products through evocative marketing and corporate social responsibility campaigns.

Now I love a beer and a pie at the footy. However, it’s vital that stories covering chronic health statistics should not be presented as a “really good news story” without being accompanied by perspectives addressing the need for government regulation to implement strategies like those mentioned above which have proven successful in tobacco control.

Without strong government action, these statistics will continue to increase, and I cannot see the silver lining in that.

31/08/2022

Tayla Schuit In All Articles, Dr Nick Chartres, Exercise, Nutrition

Fast Food & Sports Stars Don’t Mix

In this opinion piece, Good Mood Dudes founder Dr. Nicholas Chartres provides his view on this article: GP-turned-MP to demand action on junk food advertising

Kids love sports stars.

They buy the shoes and clothes they wear, the cricket bats they use and the sports drinks they drink.

Therefore, a new bill to stop junk food sponsorship of children’s sport and ads shown during prime-time television like 20/20 cricket, when kids are watching with their families, is a welcome move to help reduce the number of overweight and obese Australian children.

We know from the success of smoking cessation rates globally that advertising, especially via mass media, is one of the most pervasive ways that companies can increase sales and consumption of their harmful products. If we cut advertising, we cut consumption and we can cut the resulting rates of disease that are caused by these harmful products.

Although advertisements for unhealthy foods and drinks are banned during broadcasts of television programs made for pre-schoolers, the average 5-8 old is still being exposed to more than 800 junk food television ads a year. Currently, the federal government has allowed the food industry to govern itself through a self-regulatory code, with junk food companies arguing that they are not advertising to children by sponsoring their sports because they only use their brand names and not pictures of their products.

However, the food industry knows that kids look up to sports stars and they still have a significant opportunity to get our kids hooked on their ultra-processed foods. If Australian men’s cricket captain Pat Cummins can eat KFC and still be one of the best athletes in the world, why wouldn’t an 8-year-old think that he can do the same?

It’s time to get serious and properly protect our children by banning all junk food advertising from sport.

21/07/2022

Brad Phillips In All Articles, Dr Nick Chartres, Nutrition

About those five serves of veg a day you’re not eating

In this opinion piece, Good Mood Dudes founder Dr. Nicholas Chartres provides his view on this article: About those five serves of veg a day you’re not eating

If you’re eating your 5 & 2 each day you’re in the minority in Australia.

But before you beat yourself up, Dr Nicholas Chartres, who conducted the first in-depth study on how industry sponsorship influences nutrition research, and is an expert in identifying and analyzing industry influence in the research process, encourages us to consider the role of government and ‘Big Food’ in all of this.

Here are his 3 takeaways from this story:

– ~6% of Australian adults and ~9% of children eat the recommended two serves of fruit and five serves of vegetables per day. This is actually up from 5.1% in 2014/15 and 4.2% in 2011-12.
– Affordability of buying vegetables is the single greatest barrier to consuming them (despite the unequivocal evidence that the more of them we eat, the lower our risk of dying a premature death from things like heart disease).
– “We need to move away from blaming the individual”.

So, the simple solution??

The government could subsidize farmers/primary producers to reduce the price of fruits and vegetable to consumers, increase their availability and in theory increase consumption (although removing the highly processed foods from our shopping aisles would also need to be addressed, I think to see meaningful change in consumption patterns of fruits and vegetables).

This would then lead to reductions in non-communicable disease risk and early dying, therefore significantly reducing our health care spending without any additional government spending. How?

The government could offset these subsidies by taxing ‘Big Food’ – the companies that reap millions of dollars from making our children sick with highly processed food commodities, that offer no nutritional value and are ubiquitous in our food systems and environment (think sugar-sweetened beverages – which have been taxed successfully in several countries of the world, leading to reduced consumption patterns).

Sounds simple, right?? Why isn’t it happening here?

It is due to the structural influence (economic and political) ‘Big Food’ has on our decision-makers.

However, there is hope. The Australian government led international efforts for cigarette plain packaging and a tobacco tax, which were successful in reducing smoking prevalence. And since obesity has overtaken smoking as the leading cause of premature death and illness in Australia, I think it’s time for government action.

11/07/2022

Brad Phillips In All Articles, Dr Nick Chartres

The US supreme court has declared war on the Earth’s future

In this opinion piece, Good Mood Dudes founder Dr. Nicholas Chartres provides his view on this article: The US supreme court has declared war on the Earth’s future

As an academic working in US environmental science policy, and a father of three children, I was deeply concerned by the Supreme Court of the United States (SCOTUS) opinion in West Virginia vs. EPA that will significantly weaken the US Environmental Protection Agency’s (US EPA) authority to regulate carbon dioxide emissions from power plants (the second-largest source of planet-warming pollution). Let me explain why.

The Case

The original case is about the Clean Power Plan that sought to combat climate change by capping carbon pollution from power plants, a rule developed during the Obama administration. That would have allowed US EPA to use the most effective regulatory tools to address greenhouse gas emissions from power plants – a shift from coal to energy sources that produce fewer emissions. However, in an unprecedented action, the plan was put on hold in 2016 due to pressure from the coal industry.

Congress granted US EPA authority to regulate toxic pollutants through laws like the Clean Air Act (CAA) and Clean Water Act (CWA), which have led to vast improvements in the air and water quality in the US. Such authorities granted by Congress are critical as it gives an expert agency like US EPA the power to address significant and quickly evolving environmental health issues, as and when they arise.

SCOTUS was called to rule on whether the CAA allows US EPA to issue nationwide regulations over the power sector or if the Agency should be limited to regulating changes at individual power plants.

The Court Ruling

In a 6-3 opinion, consisting of the recent conservative Justice appointments made under the Trump Administration, SCOTUS sided with West Virginia and the coal industry in adopting a narrow interpretation of the CAA and rejected the idea that US EPA has the authority to regulate greenhouse gas (GHG) emissions.

SCOTUS ruled that if Congress wanted to give an administrative agency (like EPA) the power to make “decisions of vast economic and political significance,” it must explicitly state this. It did so by applying a doctrine it enshrined into the case law, the “major questions doctrine”. So if the court thinks an agency is overreaching in future cases it can strike down any manner of policies. This reasoning is a concerning departure from traditionally held deference to federal agencies to regulate and develop rules based on their expertise.

In the dissent, Justice Elena Kagan writes “Whatever else this Court may know about, it does not have a clue about how to address climate change…The Court appoints itself—instead of Congress or the expert agency—the decision-maker on climate policy. I cannot think of many things more frightening.”

Why I am so concerned

The precedence this ruling sets is deeply concerning as certain rulemakings across federal agencies like US EPA (along with the financial sector, health care and others) will now need to rely on clear legislative authority to withstand legal challenges, but with a narrowly divided House and Senate, which is in gridlock, these actions seem unlikely.

The most troubling thing for my children and others is that to cut GHG emissions by 50% by 2030 to prevent the catastrophic effects of climate change, we need the US government to have every policy tool at its disposal. Historically they have been the largest contributor to GHG in our atmosphere, and they are now number two only to China. So what they do really matters. This SCOTUS decision now takes one of the most important tools away and has the potential to undermine all federal authority and agency power.

Finally, this damaging court decision once again makes clear the importance of efforts to expose industry tactics and influence on the judicial, executive, and legislative branches of government.

12/08/2021

Lara Gray In All Articles, Dr Nick Chartres, Nutrition

The Truth About Supplements

Supplements are often the first question I get asked about.

The magic bullet that will improve your overall health and wellbeing in one or two (or sometimes 6) tablets a day! There are few, but critically important populations that do need supplements. For example, any woman of reproductive age is recommended to take a multivitamin every day to get sufficient folic acid. Folic acid supplementation reduces the chance of having a baby with neural tube defects. These defects occur very early during gestation, often before a woman knows she is pregnant.

The main challenge in determining if they work or not is the one size fits all approach. There is A LOT of research done on supplementation. It is a multibillion-dollar industry that benefits from making health claims demonstrating the efficacy and or effectiveness of their products.

If you think about all of the different supplements out there and all of the different health outcomes they purport to benefit, you are going to find some that have evidence to support their use. For example, if you look at the Cochrane Library Database* that houses the GOLD standard in reviews of the evidence for clinical studies and type in “probiotic” you will see that there are 56 reviews on them spanning topics such as “probiotics for treating eczema” to “probiotics for non‐alcoholic fatty liver disease and/or steatohepatitis”… And you will see there are over 7381 individual trials on them!

So do they work? Maybe. It depends on what you are trying to measure.

One of the biggest issues (and sometimes dangers) with recommending supplements is that there is an assumption that a particular naturally occurring vitamin or mineral in food, if taken in isolation and in high doses will lead to better health as we believe we understand the mechanisms by which it works.

Let’s take vitamin A or E as an example. These are antioxidants that combat free radicals. We assume vitamin A or E will reduce the damage to cells caused by free radicals, including damage to our DNA, which may play a role in the development of cancer. Seems logical these vitamins could help reduce cancer. Better load up on antioxidants supplements.

Well they did just that back in the 1990s and early 2000s with a series of studies that were designed to improve cancer outcomes in high risk groups.

One study conducted in the 1990’s wanted to test if the health effects of vitamins found in fruits and vegetables, retinol and beta carotene, (think vitamin A), which had been seen to be in higher concentrations in people with lower rates of lung cancer, would be the same when taken as a supplement.

Over 18,000 men and women at a high risk of developing lung cancer were either assigned a beta-carotene and retinyl palmitate (vitamin A) supplement taken daily or a placebo. The study was stopped ahead of schedule because participants who were randomly assigned to receive the beta-carotene and Vitamin A were found to have a 28% increase in incidence of lung cancer and a 17% increase in incidence of death compared to the placebo group.

A second study in 2001 was conducted to determine the long-term effect of vitamin E and selenium on reducing the risk of prostate cancer in approximately 34,000 relatively healthy men >55 years. It was assumed these antioxidants would reduce the risk of cancers in high enough doses.

Oral selenium and vitamin E was planned to be taken for a follow-up of a minimum of 7 and maximum of 12 years at very high doses. It was found that the risk of prostate cancers in men that were supplemented with vitamin E was 17% greater compared to a placebo (no supplement). In the selenium group there was also an increased risk but it wasn’t statistically significant.

So what does all of this mean?

Both of these studies highlight that caution should be used when recommending or using high doses of vitamins or micronutrients. Naturally occurring dietary constituents (i.e. vitamins and minerals) are part of normal physiology, and either deficiency or excessive doses are harmful.

It doesn’t mean you shouldn’t adhere to advice given to you by your doctor or dietician if treating a medical condition, but it does show that the assumed benefit of a vitamin or mineral is not always correct when taken in isolation.

This lack of benefit/potential harm from single antioxidants was later confirmed in 2012 with one of those GOLD standard Cochrane reviews I was talking about before that looked at Antioxidant supplements for prevention of mortality in healthy participants and patients with various diseases.

This review included 78 clinical trials with 296,707 participants randomised to antioxidant supplements (beta-carotene, vitamin A, vitamin C, vitamin E, and selenium) versus placebo or no intervention. They found, wait for it, an increased risk of mortality was associated with beta-carotene and possibly vitamin E and vitamin A, but was not associated with the use of vitamin C or selenium, with absolutely no benefit of antioxidant supplements in the general population or in patients with various diseases.

Ok, but you are really here for me to tell you whether fish oil is good for you or not. Right? Well.

A recent large Cochrane Review assessed the effects of increased intake of fish and plant-based omega-3 fats on all-cause mortality, cardiovascular events and blood lipids levels, mainly via capsules, as many people believe that taking omega-3 supplements reduces risk of heart disease, stroke and death.

The review included 86 clinical trials and over 120,000 participants that compared greater omega-3 intake versus lower omega-3 intake for at least a year. The review found that increasing EPA and DHA (omega-3 fats found in fish) had little or no effect on all cause mortality, cardiovascular death, stroke, or heart irregularities.

So, what’s the take away from all this?

Some supplementation is necessary for some people.

There will be new studies that may change what we know on some of the topics I have shared with you here, and if they do, and the reviews are high quality, without industry funding then the thinking around supplementation may change. But if you’re healthy, and not a female trying to fall pregnant or sexually active and of reproductive age, eat a minimally processed, plant-based diet and you are going to be in good health!

* Cochrane Library Database – If you ever want a summary of the evidence on a topic that uses randomized controlled trials to test an intervention, then this is the place to look – and they now give great plain language summaries.

Dr Nick Chartres is the Director of Science & Policy at the University of California, San Francisco working with the Program of Reproductive Health and the Environment. His work focuses on US federal chemical policy and regulation.