About vitamins and intellectual arrogance, professional blind-spots and unprofessional reactions on the subject

Be careful what you say about the place of vitamins in our daily life, and dismissing the need for them, I had to tell a doctor friend in a 23-member social chat group very recently. Days after, I continue to feel strongly enough about the intellectual arrogance, professional blind-spots and unprofessional reactions that were rearing its head that for the first time in 4 years, I wanted to blog about it. So, here goes.

Someone was asking about making donations towards Chinese New Year charity bags for residents in an old folks home, and in response to some concerns about mishandling of donation, a counter-proposal was made: How about donating some vitamins to improve the old folks' immunity? 

The doctor said: "I don't believe in vitamins. Skimmed through large studies. Most seems to not show convincing benefits. quite a proportion, negative effects." There was a disclaimer: "I didn't look at the details."

I couldn't not let this pass unchallenged.

"Dr XXX, Careful! I think it'd be good that you don't just look at the details, but study the details first, before dismissing an entire industry. The source of study material matters too." I have myself come across many questionable so-called scientific studies that sough to prove that vitamins are not only not helpful, they can be dangerous. It is interesting most of these studies use Vitamins A and E to prove the point. Not known to many is that of all the vitamins, Vitamin A and E in particular are the kind of vitamins that mega dose can harm the body and even increase mortality in subjects dealing with cancer!

I added: "I tell my guys don't pick on the side effects of certain medicine and the narrow-mindedness of certain professionals (I mean members of the profession) and then tar an entire profession or industry. Who knows, one day, you may well be in dire need of their wisdom and inputs and what are you going to do then? Reject the help ideologically?"

My doctor friend responded: "Thanks for the advice. That's why I had my disclaimer. Maybe you can advise us on what are the good and effective vitamins which we need beyond the healthy food we eat." 

I was careful to not go into anything that looks like an opportunistic sales pitch. So, I said: "Available on private consultations, depends on the concerns or the issues, general or specific."

Appreciating at that point that he was not going into an argument, I added: "Thanks for being a sport. Knowing what I know and experienced, I cannot let anyone make a dismissive remark about the relevance and need for vitamins and nutritional supplements and get away unchallenged."

I recall a seminar I attended many years ago at the Raffles Town Club  where a dietitian from a major hospital was speaking. She was asked what she thought about the need for vitamins and nutritional supplements, the same way this doctor friend was asked, "What do you recommend, good doc?" to which he said "I don't believe in vitamins...." That dietitian at the RTC talk said the same thing: "I don't believe in vitamins. All you need is a balanced diet." I could not let her dismissive response pass unchallenged. I raised my hand, stood up, and asked: "Excuse me, Miss xxx, You are a dietitian in a hospital and you care for the sick and advise them on their diet. Could you please tell me how many percent of people, on advice, can reasonably be expected to adopt the so-called balanced diet?" I remember she said, "cannot talk about percentage", to which I asked, "OK, could you say, more than half can do or less than half?" She said, "Less than half." So?

Back to my recent chat, I decided to offer some thought-provoking public service message about "the healthy food we eat". I said, "Most people don't or don't know how, and even those who are careful, tend to live and eat with "blind spots" that make people sick over time. That's why prevalence of diabetes rise alarmingly from 1:100 for people in their 20s to 1:5 for those in their 50s, and 1:3 for people in their 60s. Diabetes is not a major cause of death but it is a major cause of many major causes of deaths, Covid19 included. Supplements can and do help but supplements alone is not enough: Resetting our eating habits matter too and so is exercising our body."

"Happy to share more with anyone who seeks such knowhow."

The response, after the chat took a detour: "Thanks Eng Hai for the discussions. You have rightly said, "most don't or don't know how. So, instead of spending money and efforts getting vitamins for the general population, wouldn't it be better to spend efforts educating these people? I personally feel that most of the expensive vitamins, with additives, and sometimes preservatives and colorings, wouldn't be useful to them most times."

I said: "In this information age, there is no lack of education and information. Only a lack of receptivity and too much mental blockages, for which thankfully there is a powerful solution ;)" 

"Buy me a nice lunch some time, Dr, and I'll be happy to share the things people need to know to stay healthy and alive that they don't even know......"

This is where the chat went downhill, very fast. To my comment about there being no lack of education and information, the doctor said, " I think there are a lot more advertisements than information/education." To my comment about mental blocks, he said: "I am amused with accusations of mental blockages." 

I think I hit a raw nerve and the doctor seemed to have taken it personally. 

He made a passing remark to "vitamin peddlers". I chose not to react with comments about drug peddlers or drug pushers", though those words crossed my mind. 

To my offer to him to buy me a nice lunch so I can share my expertise, he took me for a cheap-skate and said: "If you'd like a free lunch, anytime, but I think I can do with less promotions." At that point, I chose to leave the conversation, and said "Haha, forget it". 

I did not want to impose on the other 21 members of the chat group who had stayed clear of what had become a kind of debate. It is a lot more serious and in-depth that the chat group is used to. But the doctor did not stop. 

Intellectual arrogance: "I am open to advice/insights from anyone who had read and digested fully information from reputable scientific journals".

Condescension: "Nowadays, there are a lot of fake videos out there. Just like fake information about vitamins." 

After the chat took another  detour, he apologized for side-tracking the discussion, and had to say this:

"Frankly, when our time is up, our time is up. It doesn't really depend on how much vitamins or exercises one indulge in but to a large extent, it depends on genetics and the type and amount of food."

He must have felt the urge to have the last word on the topic. What do you think of that final comment? "When our time is up, our time is up." What does that mean about seeking medical treatment when one is confronted with a potentially terminal disease? 

Why is taking vitamins and exercising an "indulgence"? 

He said much depends on one's genetics. If he was more open-minded, I would have like to invite him to a discussion about epigenetics, the science of countering one's genetic code and altering a genetic or hereditary pre-disposition to certain diseases. 

We agree on the importance of type and amount of food. But who do we go to for such information? There are lots of free advice and personal opinions. Who and where would be a good reliable and accountable source of information on metabolic nutrition?

I didn't feel a need to have the last word in that chat, or counter every debatable assertion. But I do want to serve notice that I will not allow any dismissive remarks about vitamins, nutritional supplements, nutraceuticals and genomeceuticals go unchallenged, especially from doctors to whom many surrender their judgement.