Mind Games

Americans are increasingly heading to the supplements aisle at the first sign of a sniffle. Some believe that supplements are an effective way to head off a cold or the flu. Others are wary of the side effects associated with over-the-counter drugs, or alarmed about the risks cold medicines appear to pose to children.

Sales of cold and flu supplements have grown so much (8% in 2006, compared to 2% for over-the-counter drugs), that more traditional cold and flu brands have taken note. Even the mainstream Theraflu now makes a formulation, Fortifense, containing zinc, echinacea and vitamin C.

But are supplements worth the money spent on them? If the goal is a quick recovery or rapid relief from symptoms, the answer is probably not.
In 2006, sales of homeopathic immune boosters grew 13%, according to data collected by the Nutrition Business Journal; Airborne’s sales jumped nearly 50%, according to company figures. Although sales of formerly popular alternatives such as zinc and echinacea are lagging somewhat (sales dropped more than 6% and 16%, respectively, in 2006, according to the Nutrition Business Journal), they’re still among the top sellers for cold and flu – and both, along with vitamin C, are common ingredients in many patented blends.

“People will go out and spend a whole lot of money on these different products, and unfortunately there’s not that much that’s been shown to be effective,” said Dr. Ian Paul, a pediatrician at Penn State College of Medicine who has studied alternative remedies for coughs in particular (his research has so far shown that honey works better than cough syrup for kids).

In the absence of a cure for the common cold or flu, what most people are seeking is a little relief.

With alternative remedies, as with over-the-counter remedies, said Paul, that relief often comes from the belief that the treatment is working. “There’s such a large placebo effect with a lot of these things,” he said.

Andrew Shao, vice president of scientific and regulatory affairs for the Council for Responsible Nutrition, a trade association, agreed. “To say that things like vitamin C and zinc don’t work wouldn’t be totally accurate, because clearly for some people they do.”

The research may be equivocal, Shao added, “but you hear people all the time saying, ‘Well, I swear by it, it works for me.’ ”

There are, of course, better ways to treat or prevent a cold or the flu. A healthy diet with plenty of fruits and vegetables helps keep the immune system strong. Getting enough rest is critical for prevention and recovery. Exercise has been shown to reduce cold and flu infections, and so, of course, has frequent hand-washing.

What About Vitamin C?

Americans spend more money on vitamin C, roughly $330 million a year, than on any other purportedly immune-boosting supplement, according to the Nutrition Business Journal. Perhaps because it’s been around so long.
Vitamin C was first isolated in the 1930s, and studies investigating its potential to prevent colds got underway in the 1940s. In 1970, two-time Nobel Prize-winning chemist Linus Pauling touted the powers of C in his best-selling book, “Vitamin C and the Common Cold.” He was particularly inspired by a 1961 study at a ski school in the Alps. Kids in the study who took one gram of vitamin C per day (the U.S. Food and Drug Administration’s daily reference value is 60 milligrams a day) had 45% fewer colds than their untreated classmates. They also recovered from colds in two-thirds the time it took their peers to get better.

Pauling’s book and subsequent papers on the topic encouraged numerous researchers to investigate the alleged wonder vitamin in large-scale clinical studies of their own. Soon, conflicting evidence began to emerge. Some studies found the vitamin reduced the frequency of colds, some found it reduced the duration of colds, but still others found that it had no effect at all.

Last summer, the Cochrane Collaboration, a nonprofit organization that reviews the science on health topics, reviewed more than 50 well-designed, published studies on vitamin C and the common cold. The researchers found that taking at least 200 milligrams of C on a daily basis doesn’t reduce the odds of getting a cold — but it does speed recovery time by about 8% in adults. In children, it hastens recovery by 13.6%.

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