Last October I wrote a post cautioning readers about the risks of vitamin supplementation. Mega-dosing vitamins pose health problems such as a higher risk of cancer. Based on oncologist Dr. Larry Norton’s advice I argued that daily multivitamins pose similar risks.
Looks like I need to take that last part back. A large well-done study has recently come out that found a statistically significant reduction in the number of participants developing cancer if they took a daily multivitamin.
Conclusion In this large prevention trial of male physicians, daily multivitamin supplementation modestly but significantly reduced the risk of total cancer.
That was also a cohort study. All kinds of biases, and there’s no way that it can test for causation.
Now I’m not dismissing cohort studies out of hand. But the results of the study you link to should make one pause and say, “There appears to be an association between MVI use and mortality. Maybe we should test that with an RCT.”
They did one. It’s the study I talked about. It showed that MVIs reduce mortality. This was huge RCT with years-long follow-up.
Just so everyone knows, an “RCT” is a “randomized controlled trial,” and, as Wikipedia notes, have “a superior methodology in the hierarchy of evidence in therapy.”
What publication are you writing for and what is your deadline?
I told her and she wrote back:
I’m sorry but Dr. Norton is unavailable to weigh in.
I wrote back asking if anyone at the MSKCC “has a position generally on whether it is a good idea to take a multivitamin daily?” I haven’t received a response.
Well, until we learn anything new it looks like taking a daily multivitamin is a good idea, but mega-dosing specific vitamins or supplements is still inadvisable.
In short, the College reflects the formal and constitutional fact that the president is elected chief executive of a union of states – federated but sovereign – and not a glomeration of people. The executive of the Constitution, of the Founders, is president of the United States, not president of America. Its detractors consider it an anachronism, but if federalism still means anything – and sadly, that’s something of an open question – then the College is as vital as ever. It affirms that we vote as citizens of the several states, not mere residents of arbitrarily drawn administrative districts.
Let’s examine this and other dubious arguments:
The executive of the Constitution, of the Founders, is president of the United States, not president of America.
Just because something sounds profound doesn’t mean it is. The United States is America, which is why we’re, ya know, “united.” Foster seems to be making an argument that the president should represent the interests of states not of individual people. But states don’t have interests; people do. The geography of Nebraska doesn’t care or not if the Lilly Ledbetter Fair Pay Act remains the law of the land. Whether particular states populations have coherent interests or not, the electoral college is just a top-down government intervention into the free voting market, inefficiently subsidizing swing state issues over others.
It affirms that we vote as citizens of the several states, not mere residents of arbitrarily drawn administrative districts.
Foster might worry that federalism might have its feelings hurt if we don’t “affirm” it, but the presidential election’s real purpose is to choose the head of the national executive branch. Furthermore, what happened to his earlier suggestion that the president serves the states not “a glomeration of people?” A state, by definition, is an “arbitrarily drawn administrative district.” Is it good to lump people by arbitrary lines on a map or not?
Even if the president was the representative of the United States, not of the American people (whatever that means), the electoral college doesn’t even seem up to that task. We don’t just add up who won more states and decide that way. In a concession to slaveholders, the Founders gave smaller states more power. Rather than dividing up the electors equitably, each state gets 2 extra electoral votes and the rest get assigned proportionally by population size. So now voters in New Hampshire and Iowa’s votes count more those of Californians.
He goes on to argue that the electoral college ensures presidential candidates will take more broadly popular opinions instead of pandering to narrow “factions.” Apparently, Foster or Tara Ross, who he’s channelling, never heard of Yucca Mountain, corn ethanol, or any other swing-state concern.
Foster never makes it clear how a small percentage of votes in Ohio transubstantiates into the embodiment of the United States, while a national vote or similar scheme results in an unsuitable president. He warns of “potentially disastrous” repercussions, but never specifies what those might be. That’s unsurprising since Foster’s true concern is structure and signaling not consequences. So even though small state votes count more, swing voter issues matter more, and a president can be elected without the popular will or even without an electoral college majority, Foster and other conservatives and contrarians support this outdated and poorly designed institution.