The Persistent Potency of Magical Thinking
It’s startling to see a medical journal and a major university promote magical thinking. But there it is. A press release from Oregon State University offers this headline:
Dietary Supplements an Important Weapon for Fighting Off COVID-19
We’ve said it before. Beware of such poppycock.
Using a Marginal Journal to Promote Nonsense
This particular example does a fine job of illustrating the problem. First, a marginal journal publishes questionable scientific speculation. Then that becomes the basis for a press release promoting nonsense to the public. The journal in question, Nutrients, is an open-access journal. People pay this journal to publish their papers. The cost is currently a little over two thousand dollars.
And yes, it’s a peer-reviewed journal. However, it’s worth noting that in 2018, all ten senior editors of Nutrients resigned. They said they did so because the journal pressured them to accept papers of mediocre quality and importance.
A Narrative Review
The paper in question is simply a narrative review. It covers evidence that good nutrition supports good immune function. The authors summarize evidence that too little of some nutrients can compromise a person’s ability to fight infections. Simple enough.
They also review evidence that supplements can reduce the risk of some viral infections. Agreement on the strength of this evidence is far from universal.
But then the authors go on to speculate. They suggest dietary supplementation to provide “nutritional support for the immune system” is a “compelling strategy.” In conclusion, they write:
Optimal nutrient intake, including supplementing above the RDA for certain immune-supporting vitamins, promotes optimal immune function, helps to control the impact of infections, and could help limit the emergence of novel, more virulent strains of pathogenic viruses.
Speculation ≠ Evidence
This is pure speculation. That’s no basis for making it a recommendation. No evidence tells us that relying on vitamin C or D (or any other supplement) will ward off the coronavirus. Informed speculation is fine. However, it should prompt further research. Not public health guidance.
In times that threaten our health, magical thinking rises up to give us comfort. We see it in the response to COVID-19, just as we’ve seen it in the response to obesity for decades (examples here and here).
Of course, wishing on a star is harmless. Nonetheless, it’s unwise to rely on magic to save you from the pandemic. Instead, we have handwashing, social distance, and good medical care. Hucksters, be gone with you!
Click here for more on how magical thinking hampered the pandemic response in China. For more on how such magical thinking goes global in this pandemic, click here.
Humbugging, etching by Thomas Rowlandson / Wikimedia Commons
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April 25, 2020
April 25, 2020 at 10:23 am, Lizabeth Wesely-Casella said:
Thank you for continuing to beat the drum on this. It’s important and appreciated!
April 26, 2020 at 9:50 am, Geoff Smith said:
Nope, you’re (almost) completely wrong. First of all, the press release is strange. The paper was published in January, not April https://www.mdpi.com/2072-6643/12/1/236. The co-authors don’t match the description (they’re from Bayer who makes vitamins). There is no doubt that journals are under pressure to publish, but the current editor-in-chief of Nutrients is a highly respected nutritionist. Prof. Lluís Serra Majem is Professor of Preventive Medicine and Public Health at the University of Las Palmas de Gran Canaria, where he is also Head of the UNESCO Chair in Research, Planning and Development of Local Health Systems, Director of the Nutrition Research Group. He’s also Founder and President of the Spanish Academy of Nutrition and Food Sciences,and the Foundation for Nutritional Research. None of that proves a word of the Gombart paper is true, but it does mean unsupported ad hominem attacks don’t carry any weight as to truthfulness.
Vitamins are not drugs (although some diseases can be prevented/cured but adequate intakes), but they play a key role in immunity. It is crazy to say having “adequate” intakes or status of any of the micronutrients will mean you never get sick. But there is strong evidence that a number of them may reduce risk. For example zinc ( https://link.springer.com/chapter/10.1007/978-981-15-0557-7_4 and https://pubmed.ncbi.nlm.nih.gov/27915460/), vitamin D (https://pubmed.ncbi.nlm.nih.gov/30675873/ and https://www.mdpi.com/2072-6643/12/4/988) and vitamin C (https://pubmed.ncbi.nlm.nih.gov/31487891/ and https://www.cochrane.org/CD000980/ARI_vitamin-c-for-preventing-and-treating-the-common-cold) can all play a role in reducing risk of viral infections. Of course there are no clinical trials of covid-19 patients or RCTs with hundreds of thousands of subjects. But to say it’s all “speculative” is simply wrong. Of course, we generally don’t know micronutrient status of patients but it’s not bad advice to take steps to insure micronutrient adequacy, in spite of the less than perfect evidence.
April 26, 2020 at 4:26 pm, Ted said:
Thanks, Geoff, for your comments. I agree with you on several points. Nutrition and micronutrients can be important for immune system function. And I agree with you that the press release is strange. Please note, though, that the paper referenced in the press release was indeed published on April 23. You’ll find it here: https://doi.org/10.3390/nu12041181. The paper that you’re referencing is a different one, with some of the same authors. It seems unusual that two papers, so similar to each other, would be published in the same journal within a few months of each other.
The current paper clearly says that nutrient supplementation “could help limit the emergence of novel, more virulent strains of pathogenic viruses.” That is most definitely pure speculation. And in my opinion, it’s unlikely to be true.
I see nothing wrong with informed speculation. But it should prompt further research, not public health guidance.
Finally, I disagree with your assertion that the evidence for supplementation to prevent viral infections is “strong.”