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Aurornis 6 hours ago

> Researchers have noticed it for 13 years! From the linked Ghaemi et al 2024 meta-analysis

You’re cherry picking papers. Others have already shared other studies showing no significant effects of Vitamin D intervention.

For any popular supplement you can find someone publishing papers with miraculous results, showing huge effect sizes and significant outcomes. This has been going on for decades.

With Omega-3s the larger the trial size, the smaller the outcome. The largest trials have shown very little to no detectable effect.

I think a lot of people are skeptical about pharmaceuticals because they see the profit motive, but they let their guard down when researchers and supplement pushers who have their own motives start pushing flawed studies and cherry picked results.

> In other words, if the effect on antidepressants vs placebo is ~0.4, and the effect of a placebo vs no placebo (just time) is ~0.7, that means the majority of the effect of antidepressants & OTC pain meds is due to placebo.

You keep getting closer to understanding why these effect size studies are so popular with alternative medicine and supplement sellers: They’re so easy to misinterpret or to take out of context.

According your numbers, taking Tylenol would be worse than placebo alone! 0.4 vs 0.7

Does this make any sense to you? It should make you pause and think that maybe this is more complicated than picking singular numbers and comparing them.

In this domain of cherry picking studies and comparing effect sizes, you’ve reached a conclusion where Vitamin D is far and away more effective than anything, placebo is better than OTC pain medicines, and OTC pain meds are worse than placebo.

It’s time for a reality check that maybe this methodology isn’t actually representative of reality. You’re writing at length as if these studies you picked are definitive and your numeric comparisons tell the whole story, but I don’t think you’ve stopped to consider if this is even realistic.

ncasenmare 6 hours ago | parent | next [-]

> You’re cherry picking papers.

I just picked the most recent meta-analysis I could find, which also specifically estimates the dose-response curve. (Since averaging the effect at 400 IU and 4000 IU doesn't make sense.)

> Others have already shared other studies showing no significant effects of Vitamin D intervention.

Yes, and the Ghaemi et al 2024 meta-analysis addresses the methodological problems in those earlier meta-analyses. (For example, they average the effects at vastly varying doses from 400 IU and 4000 IU)

> According your numbers, taking Tylenol would be worse than placebo alone! 0.4 vs 0.7

No, I understand this fine. Taking Tylenol would give you active medication + placebo + time, which is 0.4 + 0.7 + X > *1.1.* Taking open-label placebo is just placebo + time = *0.7* + X.

(Edit: Also, these aren't "my" numbers. They're from a major peer-reviewed study published in Nature, the highest-impact journal. I don't like "hey look at the credentials here", but I bring it up to note I'm not anti-science, see below paragraph)

===

Stepping back, I suspect the broader concern you have is you (correctly!) see that supplement/nutrition research is sketchy & full of grifters. And at the current moment, it seems to play into the hands of anti-establishment anti-science types. I agree, and I'll try to edit the tone of the article to avoid that.

That said, there still is some good science (among the crap), and I think the better evidence is accumulating (at least for Vitamin D) that it's on par with traditional antidepressants, possibly more. I agree that much larger trials are required.

svara 2 hours ago | parent [-]

> They're from a major peer-reviewed study published in Nature, the highest-impact journal.

No, the domain name is nature.com because it's in a Nature Publishing Group journal, Scientific Reports, which is their least prestigious journal.

It's a common mistake, and they do that on purpose, of course, to leverage the Nature brand.

It's also a mistake that implies a complete lack of familiarity with scientific publishing, unfortunately, which makes it a bit difficult to take your judgements regarding plausibility very seriously.

kadushka 3 hours ago | parent | prev [-]

the larger the trial size, the smaller the outcome

I find this a bit surprising. Could there be something else affecting the accuracy of larger trials? Perhaps they are not as careful, or cutting corners somewhere?

lamename 2 hours ago | parent | next [-]

Maybe. Those could be the case. But ignoring all confounding factors, this phenomenon is possible with numerical experiments alone. One of the meanings of "the Law of Small Numbers".

Basically, the possibility that the small study was underpowered, and just lucky...then the large studies with more power are closer to the truth. https://en.wikipedia.org/wiki/Faulty_generalization

kadushka 2 hours ago | parent [-]

Sure, could be just lucky. But if there are several successful small studies, and several unsuccessful large ones (no idea if this is the case here), we should probably look for a better explanation.

svara 2 hours ago | parent [-]

It does not require more explanation: publication bias means null results aren't in the literature; do enough small low quality trials and you'll find a big effect sooner or later.

Then the supposed big effect attracts attention and ultimately properly designed studies which show no effect.

hirvi74 2 hours ago | parent | prev [-]

Just my hypothesis, but I wonder if larger sample sizes provide a more diverse population.

A study with 1000 individuals is likely a poor representation of a species of 8.2 billion. I understand that studies try to their best to use a diverse population, but I often question how successful many studies are at this endeavor.

kadushka 2 hours ago | parent [-]

use a diverse population

If that's the case, we should question whether different homogeneous population groups respond differently to the substance under test. After all, we don't want to know the "average temperature of patients in a hospital", do we?