Do you do one thing every morning for your health,
like millions of other people?
No, I don't mean brushing your teeth.
I mean take vitamin pills.
I'll tell you now - I don't take any vitamins.
But I want to find out if I should.
And if I did, what would they do for me?
I'm Dr Giles Yeo.
As a scientist, I investigate our genes,
our diet and our health.
I want to find out if the vitamins, minerals, botanical supplements
are all that they appear to be.
I'll try to find out what supplements are actually doing
for our health,
by digging deeper than the eye-catching words
on the packaging.
For a lot of people, it'll not do what it says on the tin.
I'll put our diets to the test...
Oh, my God!
..to discover who really needs a supplement.
Those curly fries gave her almost 50% of her daily folate.
And I'll investigate if antioxidant vitamins -
A, C and E - are really the miracle for our health
that we've been promised.
If we can take antioxidants, we can prolong the life.
We can stop the diseases from appearing.
At least, that was the theory.
And how science may now be revealing what antioxidant supplements
could actually be doing to us.
In the Olympic centres worldwide, this topic was heavily debated.
And then some of the centres even totally removed antioxidants
from their training schedule.
Is it time we took a really rigorous, scientific approach
to these everyday miracle pills?
Supplements are sold on high streets everywhere.
The industry is worth more than £400 million
in this country alone.
You can buy them over there.
You can even buy them back there.
Nearly half of us take a vitamin or mineral supplement every day.
How did this come to be?
The story begins more than 130 years ago
at a Dutch Army research institute in Indonesia.
In the 19th century, there were these mysterious diseases
that weren't caused by drugs.
One was rickets.
Another was scurvy.
And then there was beriberi, which can damage the nervous system
or lead to heart failure.
So by the 1880s, beriberi had become endemic
in the Dutch colonies in Indonesia.
And people just did not know what was causing it.
One man was doing his best to solve the mystery.
There was a doctor, Christiaan Eijkman, who thought that it was
a bacteria causing the disease
and he was trying to find out what this bacteria was.
The only cause of disease Eijkman knew of at the time was infection.
And then something happened to change his mind.
There were chickens who were getting sick,
and it seemed to have something to do with their diet.
Now, the men who fed the chickens told Doctor Eijkman
that when the chickens were ill, he was feeding them white rice.
But when he went back to feeding them unpolished brown rice,
the chickens recovered.
It turned out the skin of the brown rice contained
what Dr Eijkman called the anti-beriberi factor,
which ended up becoming known as vital amine,
or vitamin.
The big discovery was diseases could be caused by being deficient
in vitamins and minerals, found mostly in food.
Blindness can be caused by a lack of vitamin A.
Our bodies turn the beta-carotene in carrots into vitamin A.
Now, birth defects can be caused by a lack of B9,
otherwise known as folate, which can be found in avocados.
Scurvy is caused by a lack of vitamin C,
which can be found in oranges.
Now, lack of vitamin D can then cause rickets.
Now, you can get vitamin D from cheese, from eggs -
but mostly, we get it from the sun.
Now, a lack of iron can cause anaemia.
And iron can be found in meat.
And you can find loads of zinc in beans.
Once vitamins were discovered in food, enterprising chemists
soon made them into pills.
And a new industry was born.
Vitamin and mineral supplements to be taken in addition to food.
What might buying these products do for us?
I want to know what vitamins and minerals
we're getting from our food,
and who might need a supplement.
I'm meeting a nutrition scientist here at Greenwich University
to help me find out.
The key evidence showing whether we're getting enough
vitamins and minerals, known as micronutrients, from food
is the Government's National diet and nutrition survey.
Horizon has recruited a group of volunteers
to help illustrate its findings.
One of the "volunteers" is me.
We know only just over a quarter of adults are eating five fruit
and veg a day, which the Government recommends we get as part
of a healthy, balanced diet.
And I suspect I'm not one of them.
Hello. Hi. Hello.
I'm Giles. Hannah? Hello. Hi.
Are you Tatiana?
I want to know how diets that include different amounts
of fruit and veg might affect the amount of micronutrients we get.
Julia is a student who doesn't have much time or money
to spend on cooking.
Now, are you a food as fuel human being,
or do you say you love your food?
I love my food. I'm a massive foodie. OK.
But a lot of my food consists of chocolate!
So, Hannah - how about you?
Tell me about yourself and don't make me feel bad about me.
So, I am yoga teacher. Oh, my God!
I'm now getting the idea of what's going on.
On the one hand, yes, food is fuel for me.
But if I eat badly, by which I mean, if I don't eat a lot
of fruit and vegetables,
if I eat a lot of processed foods,
for me, I feel a massive dip in my energy levels,
in my mood.
I guess, I would like to think that I am somewhere in the middle.
I mean, I think I eat healthily when I cook because I know what goes
in and I do know how to cook.
But in situations when I get back late, or a Friday night,
sometimes on the weekends - then I end up buying
and having takeaways.
Dinner presentation - not my strength.
Here's what the three of us typically eat.
Hannah normally gets five fruit and veg a day.
I've just got home, making myself a massive salad.
Julie manages perhaps a couple?
Having curly fries, my favourite.
And I reckon I'm about three or four.
Sunday night, and what do we have? Roast beef.
I believe that's the king of all dinners,
probably packed full of vitamins.
Spinach, tomatoes, cucumber, some gherkins,
because I just love them.
This is my go-to snack.
I've got poppadoms, prawn curry.
I've got a peshwari naan, I love peshwari naan.
That is as many vegetables as I can fit in.
Some kind of vegan creation.
I am having Arctic Roll.
Our diets are fairly typical for people our age.
Dr Tatiana Christides has measured levels of six vitamins and minerals
in our blood.
Give us the pain.
I'll start with the happy.
In terms of your vitamin A, you're within the normal range. OK.
Which, actually in the United Kingdom,
most people's blood levels of vitamin A
are in the normal range.
Our blood levels of the other vitamins we tested
were mostly normal, too.
The national diet survey shows that most age groups are getting
close to, or above, the amount of vitamins the Government says
we need to be healthy and to avoid diseases or deficiency from food.
But there is one big exception.
So, Giles, your vitamin D level is actually low.
I am surprised.
The Government survey shows around a fifth of adults in the UK
have low blood levels of vitamin D.
In the autumn and winter when there's less sun,
the Government advises all of us to consider a daily supplement.
So, what about our mineral levels?
If we look at Hannah's bloodwork - when we look at her iron levels,
her iron levels actually are low.
Despite having the healthiest diet of all of us, Hannah is like
nearly half of teenage girls and just over a quarter of women
who get less iron from their diet than the Government recommends.
If you actually turn out to be iron deficient or iron deficient anaemia,
then that is one of the places where you want to take supplements.
And that's a really important point.
The Government recommends children under five are given supplements.
Plus another group...
Pregnant women or women that are thinking of becoming pregnant,
are recommended to increase their folate intake.
And that is 100% supported by the evidence.
We all know we should get five a day as part of a balanced diet
to help us stay healthy,
lowering the risk of heart disease, stroke and some cancers.
But Tatiana wants to show us how the food many of us actually eat,
although often high in salt, sugar, saturated fat and calories,
is not short on micronutrients.
Ah, here's my favourite takeaway.
You get quite a few micronutrients from this.
So you need 40mg of vitamin C, and this gives you 13.
So you see, it's almost a third of your vitamin C
in one of your three meals. Perfect. OK.
You get a lot of fibre in this meal.
You do get some iron, actually.
You get some calcium from that meal.
So really, this is giving you a broad range of micronutrients.
But I think what you'd want to think about is the number of calories.
And what about Julia's curly fries?
Those curly fries gave her
almost 50% of her daily folate.
In the curly fries? In the curly fries.
Good - because I have curly fries a lot.
While fruit and veg are good sources of vitamins and minerals,
even diets we eat in the West, that often fall short
of five a day, can be rich in these micronutrients.
I don't think the argument for taking supplements
should be related to the five a day.
I think that's the bottom line.
The evidence suggests, and this bloodwork illustrates,
that on average as a nation,
we are meeting our vitamin requirements through our diet.
One of the real dangers with saying, "If you're not
"meeting your five a day, take a supplement,"
is not only that you don't need those supplements to achieve
adequate nutrient status,
it's more importantly that you're also not getting
the benefit of fruit and vegetables, such as fibre.
And you don't get any of the thousands of other compounds
that are present in fruit and vegetables.
Our love affair with vitamin and mineral supplements is growing.
The global market in supplements of all kinds is valued
at more than £100 billion and rising.
So how did this industry become such a giant when relatively few people
in the affluent world fall into groups that governments say
actually need to take a supplement?
I'm going to examine one crucial aspect of how supplement companies
market their products to us.
And it's not what they've led us to believe -
but what's being downplayed.
The story begins with Professor Arnold Beckett,
former chairman of Vitabiotics.
Founded in 1971, Vitabiotics is now the largest vitamin company
in the UK, with a reported turnover of over £300 million a year.
It has over 20 ranges of vitamin products,
including Wellman, Wellwoman and Pregnacare.
On their website, Vitabiotics says that Vitabiotics is proud
to have had world renowned scientist Professor Arnold Beckett
at its head for 18 years.
Before he became chairman of Vitabiotics, Professor Beckett
made an influential argument about what consumers need to be told
about vitamin products and what we don't.
It's revealed in the story of Tandem IQ, a long forgotten multivitamin
for children sold by a company called Larkhall
in the early 1990s.
A BBC programme featured a trial investigating
if the multivitamin could help children perform at school.
In some cases, it appeared to.
Our findings appear startling and could well have lessons
for every parent, every teacher - indeed, for our whole society.
The multivitamin featured the trial on its packaging,
and unsurprisingly, it sold like hot cakes.
Later, another BBC programme cast doubt on the trial.
Several expert nutritionists condemned the study as being flawed
by poor methodology.
We referred these packets to Shropshire Trading Standards Office.
I'm meeting the people behind Tandem IQ.
Two former vitamin industry insiders -
Rita Greer and Dr Robert Woodward.
Hi, I'm Giles. Hello, I'm Rita.
Rita, hello. Dr Woodward?
Yes, hello there.
Thank you very much for...
Dr Woodward did his PhD under Professor Beckett,
a renowned pharmaceutical chemist
and a pioneer of drug testing in sport.
In 1992, when Shropshire trading standards brought charges
against Robert's company over the marketing of Tandem IQ,
he tapped up his old professor for help.
I said, "Will you represent me in the Shropshire case?"
And he did. He was very happy to back me.
We have come to this archive to look at legal documents that show
how the defence that Tandem IQ put forward defined an approach
to selling vitamins that lasts to this day.
Professor Beckett was an expert witness.
Here we are. The box is enormous.
So this was the original?
That's the original Tandem IQ pack that was marketed,
originally, that was in 1990-something.
This was the one that caused all the controversy.
The controversy centred on Tandem IQ's name and packaging.
Trading Standards alleged consumers were being given the false
impression it could increase the IQ of the vast majority of children
when there was no proof.
Larkhall pleaded not guilty to three charges
under the trade descriptions act.
These things are open to interpretation.
In these boxes are documents written by Professor Beckett, defending
how Tandem IQ had been marketed.
First, he likened vitamin supplements to medicines.
So, this is the trading standards department versus Larkhall.
A report of Professor Arnold H Beckett.
Ah, yeah.
Beckett here says the product Voltaren, although rightly claimed
as a drug for treating arthritis, has been shown not to be effective
or suitable for more than 50% of patients with arthritis.
Likewise, supplementation with vitamins and minerals in a diet
will not be effective for all children.
Now - this is, OK,
actually tremendously candid about the fact
that vitamins will not work for everyone. That's right.
I think that's what his general view was, and so's mine.
In a report for Robert's company, Professor Beckett noted
the magistrate had said there was no evidence of any complaint
from a member of the public,
before he himself wrote, "perhaps the public show
"more common-sense in realising that a product does not work
"for everyone than the trading standards in Shropshire."
That's scathing.
So Beckett's argument here is that people should use
their common-sense when they're looking at the pack.
Yes, this is just very typical of him.
The magistrate decided that Tandem IQ's marketing meant a significant
number of potential customers would be likely to form
the impression that the tablets were capable of a general
and widespread effect in increasing the overall IQ of children.
Larkhall was found guilty on three charges of making
a false trade description.
The evidence in these boxes that Professor Beckett believed
the public do not need to be told that vitamin supplements don't work
for everyone is striking.
Cheers, mate. Thank you.
At the time of the case, Professor Beckett had been
a technical advisor for more than a decade to Vitabiotics.
I never saw much of Beckett once he threw his lot in
with Vitabiotics. I didn't really, no.
Three years after the case, Professor Beckett became
Chairman of Vitabiotics...
See you guys later, have a safe drive home.
..and helped turned it into the juggernaut it is today.
I don't buy the argument that, "Everyone knows, it's common sense.
"Of course, people know that they don't work." No, they don't!
The public do not know that vitamins do not work for everyone.
The public need to know this.
Vitabiotics told us:
I want to know how supplement companies today
strike the balance over what they tell the public
about the effectiveness of their products,
and what is left out.
Let's start with how supplements are regulated.
Because vitamins are found in food - vitamin supplements are regulated
as foods, not medicines.
It means that vitamin companies don't have to prove
that their products are effective like a drug company would.
But it does also mean that the claims they can make are limited.
For example, they can't claim that their products can prevent
or cure disease.
It leads to some pretty interesting word games.
One is a phrase printed on many brands of vitamins products.
I'm going to find out exactly what "contributes to normal" means.
Hi, I'm Giles. Hello, Giles. Pleased to meet you.
I'm meeting Professor Sean Strain in this pathology museum
overflowing with abnormal body parts.
In 2006, Sean lead a European panel of scientists weighing the claims
vitamin companies wanted to put on their products
against the evidence.
The EU then stipulated the claims that vitamin companies can make.
Each claim has an authorised form of words that companies can use.
Like this one.
OK, so, here, for example, we have Vitabiotics Wellkid.
Their claim here is that with iron to contribute to normal
cognitive development of children.
That's a very simple one, Giles, because there's no dispute here
about iron and cognitive development,
because if children are iron deficient,
they actually are anaemic and they're lethargic,
they have difficulty concentrating, etc.
"Contribute to normal" is written so small,
you might miss it.
And that's important because the wording is telling you
who will benefit from taking the product.
"Contribute to normal" means that you're having an effect there,
or you could have an effect there if your particular measure
or your particular health relationship is abnormal.
You can normalise it.
Wellkid is aimed at children between ages of four and 12.
The national diet survey shows that 3% of girls and 1% of boys
aged ten and under have iron intakes below the recommended amount.
The different sized words that make up the claim emphasises
cognitive development over the caveat, "contribute to normal."
The consumer may not get an effect of these
if they are already replete, and have enough of the vitamin
or mineral already.
So, for a lot of people, it'll not do what it says on the tin.
Another popular authorised claim is iron contributes
to the reduction of tiredness.
But again, the claim doesn't tell the whole story.
It doesn't mean anything unless it actually has
a caveat attached to it. I'll give you an example.
"Iron contributes to the reduction of tiredness and fatigue,
"if you are low on iron."
Because, just to be clear, if you're not low on iron,
it's not going to make you feel less tired.
You just have to get more sleep. Yeah.
It's true. It's true? Yep. It's true.
Like other brands, Vitabiotics are doing nothing wrong by using
the wording of the authorised health claims on packaging.
But companies could be much clearer who will actually benefit
from taking their products.
EU regulations allow the wording of the claims to be varied to help
consumer understanding, as long as it does not change the meaning.
That means companies could clarify what "contributes to normal" means
by adding a caveat if they chose to.
What strikes me after speaking to Sean
is while "contributes to normal" is technically correct -
leaving out the explicit caveat makes it utterly baffling
to most of us.
It only makes sense, it's only true if you're actually
deficient or abnormal in that particular vitamin or mineral.
It is just not true for the vast majority of people
that are purchasing these products.
I guess I hadn't really thought about it like that before and I just
feel like the majority of us are actually being misled.
Vitabiotics told us that:
They say the phrase is "legally required wording."
And because the...
The appeal of supplements doesn't rest on the torturous small print.
Ever since supplementing took off in the 1970s,
there's been a popular conception - if taking a little is good,
more must be better.
As we know, the Government recommends we get a certain amount
of each vitamin and mineral every day to avoid diseases of deficiency.
But many supplements contain higher doses.
Does that mean they're better for us?
Now, some products make a point of the dose.
So, for example, this Superdrug vitamin C product
is labelled "high strength"
with each tablet providing 25 times the recommended daily amount.
Others - you've got to make your way through the small print on the back.
For example, eight of the active ingredients on the back of
Centrum Advanced Multivitamins is above what you'd actually need.
Now, remember that any nutrients provided by supplements is on top
of what you get from food.
The EU takes a different approach, using more recent data,
recommending higher amounts of vitamins and minerals
to maintain health, not just to avoid deficiency.
Even on this basis, Superdrug's high-strength vitamin C
provides 12.5 times the recommended amount in one pill.
Superdrug told us:
And their product range is "safe for all."
Pfizer told us:
Taking high doses began with a group of vitamins that,
for many, have taken on miraculous properties.
Vitamins A, C, and E are antioxidants.
They've helped persuade us, when it comes to supplementing,
more is better.
Hi, guys, I'm about to head Stateside
in order to find the origins
of the antioxidant miracle.
Welcome to the home of the vitamin supplementing craze.
A Wild West of claims, pitches and promises.
None bigger than how vitamins A, C and E could transform our lives.
I want to know how far the rush towards antioxidant supplementing
has been driven by science,
and to what extent hope, belief, even money has played a role.
It all began with the work of one scientist.
I'm meeting his daughter.
Robin? Yes, Giles. Nice to meet you. Hello.
I have coffee for all of you, if you'd like it.
Do you know what? I would love coffee. OK, here.
Robin's father was a biochemist in the 1950s.
Wonderful.
Our obsession with antioxidants grew out of Professor Denham Harman's
pursuit of the secret of living a longer, healthier life.
He was known as the grandfather of the ageing movement,
because there hadn't been that field before.
Professor Harman had a theory, ageing is driven by a process
happening in cells throughout the body.
Tell me about your dad's big idea about ageing.
His whole idea about ageing were free radicals.
Basically there are atoms that break free,
and as they break free, they cause damage to the body.
Whether it be wrinkles or sagging skin - that's what people think of
as visible signs of ageing. Right.
But the reality is - your body is ageing
on the inside as well.
Free radicals are produced as our body turns oxygen
and food into energy.
And just like oxygen and water corrode iron,
too many free radicals lead to oxidative stress,
which can cause damage to our cells.
Professor Harman believed this could lead to disease.
And whether it be heart disease, Alzheimer's, even cancers
- part of it's the free radicals.
You know, the body breaking down.
Antioxidant molecules can ward off free radicals.
Our body produces some antioxidants, but we get more from foods -
particularly fruit and vegetables.
And of course, supplements.
What my dad took was vitamin E, he took vitamin C,
Alpha-Lipoic Acid, and also selenium.
A new view of the role played by vitamins in our health was emerging.
Very different to established medical science.
Taking more vitamins than our bodies need to prevent conditions
like beriberi could make us healthier.
It was trying to combat the effects of the ageing
from the free radicals.
It wasn't to compensate for a deficiency,
because in our family, we had a healthy diet.
But even with a healthy diet, sometimes you needed
more than just a regular diet could provide.
So that's why he recommended some of the pills that he took.
But it had nothing to do with a deficiency.
How did Professor Harman's belief, more is better when it comes
to antioxidants, become big business?
Hiya. Table for two, please.
Any number of books that actually emanated from your dad's studies -
some making bigger claims among others, shall we say?
Richard Passwater, for example.
Did you know Richard Passwater? I know who he is.
He was a friend of my dad's.
Richard Passwater's 1975 bestselling antioxidant bible,
Supernutrition, claimed that if people followed
the Supernutrition programme,
then heart disease would be reduced by 60-80%,
and cancer would be reduced by 30-40%.
When you get something like this written in these books -
really quite sensational, I'm going to go with it for now,
what was your father's feeling about that?
I know my dad thought you could lessen the odds
by taking the antioxidants.
But I don't know about those numbers.
I don't think he felt that.
And as far as claims being made, people did run with them.
My father was not a sensationalist,
nor was he ever claiming anything like that.
So that goes to other people - not my dad.
The claims made by vitamin evangelists on the back
of Professor Harman's work fuelled the growth
of the supplements industry.
My father never endorsed any product.
He just was focused on the research.
Professor Harman's key claim, oxidative damage can cause disease,
has not been proven.
Nonetheless, the supplementing craze took off.
So what I learned from Robin today is this began
with the study of ageing.
Then it became "antioxidants can make you healthier,
"possibly even live longer."
The message is amplified by books, industry gets involved,
and suddenly, you need vitamins for optimal health.
It has framed our entire view of vitamin supplements.
I'm going to put myself through something of a physical ordeal.
It's all in the aid of understanding how the supplements industry
tries to convince us their products are a key ingredient
in a healthy lifestyle.
I don't know what the weather is like when you're watching this,
but it's now December and it's...
..not warm.
This is a lot better.
We all know exercising is good for us - whether we are young,
or not quite so young.
Something vitamin companies understand very well indeed.
Vitabiotics' Wellman and Wellwoman products are endorsed
by top athletes - cricketers, boxers,
even a six-time World Champion swimmer.
In statements quoted on Vitabiotics' website,
swimmer Mark Foster says - "Wellman helps me to maintain
"optimum energy release as it provides the whole family
"of B vitamins, including B3."
High jumper Jayne Nisbet says, "I use Vitabiotics
"to enable me to train to my fullest."
But when it comes to using sport to sell products,
that's far from the end of the game.
In the promotional material for their popular multivitamin product,
Wellman, Vitabiotics highlights one effect of getting physical.
On their website for Wellman, they say that free radicals
are generated in greater number during exercise.
As we know, free radicals can cause oxidative stress
that can damage our cells.
Wellman contains antioxidant vitamins
which can fend off free radicals.
So, antioxidants protect against the oxidative stress
generated during exercise.
I mean, it sounds great.
But there's no definitive proof of what antioxidant supplements
are doing for our health.
I'm meeting one scientist whose work on Professor Harman's
free radical theory of ageing led him to investigate what happens
when we exercise and take antioxidant supplements.
Michael.
Hi.
Professor Michael Ristow's research began with microscopic C.elegans...
..worms whose two to three-week life span makes them
ideal to study ageing.
He wanted to understand how free radicals might affect
how long these simple organisms live.
We stress them so they produce more free radicals. Right.
Expecting that they would live shorter.
But the opposite was happening.
The worms that would produce more free radicals
would live longer,
which already was not really consistent with what we expected.
Then he gave the worms producing more free radicals antioxidants.
They should, according to textbooks and public knowledge, live longer.
But the opposite happens.
They did not live longer any more, but they lived shorter.
You're actually shortening the life of worms
when you actually add antioxidants? Yes.
This was a sign Professor Harman's free radical theory could be wrong.
Evidence from other studies, involving C.elegans,
fruit flies and mice, have also undermined the theory.
But what about humans?
Michael decided to measure the impact of antioxidants on one aspect
of our biochemistry that can be used to predict life span.
Time to work out.
I notice you didn't bring your gym clothes,
Professor Ristow. I forgot, I'm sorry.
Regular exercise cuts the risk of heart disease,
stroke and cancer.
Can I conduct an interview on a rowing machine?
Exercise lowers cholesterol and blood pressure
and increases insulin sensitivity,
which is beneficial because it lowers glucose in our blood.
It's well established that a high degree of insulin sensitivity
predicts health, life span and so forth.
When we exercise, our bodies produce more free radicals.
Michael wanted to find out how antioxidants affect
insulin sensitivity, so he monitored 40 young men
exercising over four weeks.
Half were given supplements of vitamins C and E,
though at doses up to 16 times greater than contained in Wellman,
and half, a placebo.
We found if you exercise without an antioxidant... Yes?
..you do perfectly well. OK.
However, combining exercise with antioxidants,
you have no improvement in insulin sensitivity.
The effect of exercise is gone.
So everything stays as if you would not exercise.
Conclusion being - the free radicals that your muscle
is producing during exercise are required
for increasing insulin sensitivity
and required for increasing health.
And if you interfere that with antioxidant supplements,
this is not happening any more.
These findings raise the possibility that rather than always
harming our health, free radicals at certain levels
could be beneficial,
suggesting we need to see free radicals in a different way.
All doses of oxidative stress, of free radicals, are good.
Like with a vaccination inducing immune response,
we consider oxidative stress in a similar way.
It's a low-dose stress that induces defence mechanisms
in the cell and in the internal organism to deal
with other stressors, including, but not only,
oxidative stress much better than they would normally do.
I totally endorse oxidative stress being a problem
at extremely high doses.
However, 99.9% of us will never get even remotely in that range.
Several studies with differing designs from Michael's
found oxidative stress can promote insulin resistance.
The opposite of his results.
The role of oxidative stress in our health is complex
and not fully understood.
Nonetheless...
In the Olympic centres worldwide, this topic was heavily debated.
Some of the centres even totally removed antioxidants
from their training schedule.
Vitabiotics told us their products:
Their products are:
For nearly 50 years, millions of us have taken
antioxidant supplements,
believing they're helping our health.
But efforts to prove antioxidant supplements
could help prevent diseases have led to questions about
what these pills might actually be doing for our health
in ways few scientists expected.
One researcher has been trawling back
over decades of clinical trial data, looking for answers.
Dr Christian Gluud is building a picture of antioxidant supplements
very different from what we've believed.
Hello, sir! Hello, sir!
What a place! Yeah.
Tell me, how did we begin to buy into the antioxidant miracle?
Because it's so easy to understand
that your body gets oxygenised, like the iron here.
And if we can take antioxidants and stop that rust,
we can prolong the life,
we can stop the diseases from appearing.
At least that was the theory.
And not only the public, but certainly also
very large parts of the medical world
had strong beliefs that this is so.
Strong beliefs that seem to be backed up by science.
Epidemiological studies have shown an association
between eating lots of fruit and veg, foods rich in antioxidants,
and lower incidences of heart disease and cancer.
So in the 1980s and '90s,
large trials began looking at whether antioxidant supplements
could help prevent these diseases.
The results were disappointing,
sometimes troubling.
In one trial, smokers were given beta-carotene,
a precursor of vitamin A,
to see if it could prevent lung cancer.
The study had to be stopped early.
There was a 28% increase in the number of lung cancers
in those taking the intervention.
It came as a shock.
And I think it came as...
It hit a wall of disbelief
in all those believing in antioxidants.
The search for evidence antioxidant supplements
could benefit health went on.
In 2004, Christian looked at 14 clinical trials,
examining whether antioxidant supplements
might prevent gastrointestinal cancers.
He wanted to know if statistical patterns in the pool data
could reveal effects that were not obvious in individual trials.
Our major aim was to look at,
can these substances reduce the cancer occurrence
from the mouth until the anus,
involving the gullet, the stomach,
the intestine, the liver,
the pancreas, all these organs.
We wanted to see that.
He was taken aback by the results of his statistical analysis.
We didn't see any effect on cancer prevention.
However, we saw increased mortality.
And that increased mortality came as quite a big surprise to us
because we hadn't expected this.
The response to the finding in the statistics,
suggesting an increased mortality rate, was cautious.
An article in the same journal that published Christian's study
questioned the method used.
And said, the idea that vitamin pills kill was scary speculation.
But Christian couldn't let it go.
So there was nothing else to do but go home and roll up our sleeves,
and say, "OK, then we have to look at everything".
Then Christian gathered as much data as he could.
He focused on 78 randomised clinical trials
conducted around the world between 1977 and 2011,
examining whether antioxidant supplements
could prevent conditions like lung cancer and heart disease.
The participants varied in age, whether they smoked,
and whether they had pre-existing diseases.
Do we have something to write with? Yep.
OK. I can do it.
Here you go, my friend. Thank you.
56 of these trials were identified as low risk of bias.
56 trials were of the best quality you could have. OK.
Meaning that it had proper randomisation
and proper blinding
and proper reporting of outcomes.
These trials involved more than 244,000 people
who had been given antioxidants or a placebo.
The doses of antioxidants varied,
but were often well above recommended dietary intakes,
and sometimes even safe upper levels.
Christian counted the number of deaths among those
taking antioxidants and those given a placebo.
To avoid introducing bias, he did not remove deaths from car crashes
or other non-dietary causes.
In statistical terms, he found, just as he did in his earlier study,
no evidence of benefit among those taking antioxidants,
and a small increase in the rate of mortality.
We saw that the mortality was increased by...
..4%.
This means if 100 people died in the placebo group,
statistically, 104 would die in the antioxidant group.
So, an additional four people would've died
if treated by antioxidants versus placebo? Yeah, yeah.
Next, Christian analysed a subset of data from 27 of the trials,
involving more than 46,000 people.
In these studies, antioxidants were given
without other vitamins or medicines.
Then we found a 12% increase in mortality.
Gosh!
These statistical increases in mortality rates are small.
Dwarfed by more easily-measured risks, like smoking.
But they add to emerging evidence
that there may be problems with antioxidant supplements.
The reaction from the regulatory authorities was nil.
And the companies continued to market
as if nothing had happened.
And they said, "Oh..."
They even referred to our data as, "They shouldn't be believed".
In spite of the fact that the industry had, themselves,
funded a lot of these trials.
In the 1950s, Professor Harman's free-radical theory
opened up the new scientific field of ageing.
Ever since his work was seized upon by vitamin evangelists,
millions of us have bought into the antioxidant miracle.
But the theory was always just a theory.
Now scientists are uncovering evidence undermining it.
Clinical trials, as well as Christian's statistical analysis,
have found no proof taking antioxidant supplements reduces
the risk of heart disease, stroke or cancer.
No actual deaths have been attributed to antioxidant supplementing.
But Christian's statistical finding of a small increase
in mortality rates raise a question.
Should antioxidant supplements
be subjected to the rigorous scientific investigation
applied to medicines to establish for certain
the actual impact of antioxidant supplements on our health?
Thinking about the consequences with billions of people
having taken these supplements
made me actually fear that many people may have died
from overuse of antioxidant supplements.
Christian's work only focused on
antioxidants consumed as supplements,
so provides no evidence about their impact in food.
The Health Food Manufacturers' Association told us
the levels in the trials were:
The supplements industry is expanding,
creating new and exotic products,
raising more questions about how supplements are tested.
One product is derived from a plant people have been consuming
for centuries.
So I'm Chinese, and I've been drinking green tea for ages. Ages.
And my grandma used to tell me
that if you had green tea together with a heavy meal,
it would actually help melt the fat.
Tapping into our belief can be good for us,
companies have concentrated green tea into a pill.
Because green tea, like other products derived from herbs,
such as Echinacea, are classified as foods,
regulators don't require safety tests for its concentrated form.
There is a concept in pharmacology called dose-response.
That is where a little bit of something is perfectly fine,
but when you have too much of it, it suddenly becomes a problem.
The dose, as they say...
..makes the poison.
Continue on I-635.
In Dallas, I'm going to see one consequence
of how green tea supplements are regulated.
I'm about to meet someone for whom the promise
of what supplements can do for your health
has turned into a nightmare.
Someone whose life has changed
after he had taken some green tea supplements.
Jim? Yes. Hi, I'm Giles.
Hi, it's nice to meet you. Come on in.
Nice to meet you. Thank you very much for having me here.
Ignore these guys. OK.
Jim McCants is 54.
Four years ago, he decided to try to improve his health.
My dad had a heart attack at age 59, and did not make it.
And I was determined to do what I can
to take care of myself as best I can
so that I don't miss out.
Then I saw an article on green tea extract, and started taking that.
Jim started taking a green tea supplement.
Less than three months later, Jim and his wife went
to their youngest son's high school graduation.
She looked at me and said, "Do you feel OK?"
I was, like, "Yeah, I feel fine. Why?"
"Well, your face is yellow, your eyes are yellow.
"You look terrible."
"No, I feel fine."
And then when I looked in the mirror, it was shocking.
The next day, Jim was admitted to hospital
with suspected liver damage that seemed to have come out of the blue.
For the last 30 years, I drank maybe a six-pack of beer a year.
No wine.
So alcohol was not a big part of my life.
And then the hepatologist drilled into,
"OK, what about any over-the-counter supplements?"
Jim's medical record shows the presumed cause of his liver injury
was the green tea supplement he had been taking.
A week later, Jim got the news he was fearing.
One of the liver doctors was front and centre.
She said, "You need a liver transplant,
"and this has to happen fast.
"You have days, you don't have a week."
I was thinking, "This looks very bleak for me".
Thankfully, a new liver was found the next day for Jim.
But after a life-saving transplant,
he still has serious health problems.
My life before was pretty active.
And now, it's much more sedentary
and I struggle with fatigue.
He now has kidney disease
and may need a transplant in the future.
Vitacost told us:
I didn't expect harm.
I expected that I might waste my money, OK?
I may take these and they don't do a bit of good.
I can accept that risk.
But the risk that it could cause my liver to fail,
cause my kidneys to be damaged,
that's a risk that's too high for somebody to take.
I'm staggered by Jim's experience.
I'm going to speak to a liver specialist
who has been tracking injuries linked to green tea supplements -
Professor Herbert Bonkovsky
from Wake Forest University School of Medicine.
I drink green tea all the time. Should I be concerned?
If you are drinking modest amounts of green tea,
you're very safe.
The greater risk comes in people
who are taking these more concentrated extracts.
There are likely to be a number of factors that make individuals susceptible to harm
from the naturally-occurring catechin chemicals in green tea,
including genetics and the way supplements are used.
Usually people are taking these green tea extracts,
trying to lose weight, so they're often not eating.
And we know from animal studies
that fasted animals absorb
a much higher percentage of the catechins
than do fed animals.
Millions of people take green tea supplements every day.
For the vast majority, it is safe.
But at least 80 cases of liver injury
linked to green tea supplements have been reported around the world.
The European Food Safety Authority recently concluded
that doses of catechins in green tea supplements at,
or above 800 milligrams per day may pose health concerns.
With the data they had, a safe dose could not be identified.
So what is clear is that there is now an increasing body of evidence
that green tea extracts above a certain dose
can harm some people.
Now, how high a dose? How many people? We don't know.
Because the science has not been done.
Industry is not mandated to do the science.
We need to fix this problem
so that the possibility of harm we saw in Jim today
cannot happen in anyone else.
Vitamin and mineral supplements can play a vital role in our health.
The Government has identified those at risk of being low in iron,
folic acid and vitamins A, C and D who might need a supplement.
When I took a blood test for this programme,
I found out I was low in vitamin D.
So now I am seriously considering taking a supplement.
The Government's view is most of us can get most of the vitamins
and minerals we need from our diet.
I categorically do not think the UK population as a whole
should be taking multi-supplements.
As a nation, for most micronutrients,
when you look at our blood levels,
in particular, if you exclude certain
high-risk groups, like adolescents,
we are meeting the needs of our body.
And there is no evidence
that once you meet those needs, more is better.
I've discovered emerging evidence antioxidant supplements
could potentially be harmful to our health.
So public perception of antioxidants needs to be changed
because whatever is in the public domain does not match science.
I don't mind that antioxidants have no measurable effect.
Where it becomes a problem
is if antioxidants are established to be harmful,
and that requires they must be regulated.
We are being left in the dark
about risks associated with taking green tea supplements.
I'm hoping they make the decision
to put a very strong warning label on the product
and let people know before they buy it, before they take it.
Ever since supplements were first sold,
profits have come with little proof.
So what I've learned is that
the vitamin industry has been selling us a promise...
..of being able to concentrate the goodness of food into a pill.
And we've been perfectly happy to buy into this
without asking the industry to prove whether or not it works,
or how safe it's been.
Is it time to take a more rigorous, scientific approach
with these miracle pills
and find out what they're actually doing for our health?