A generative data-visualisation of all the scientific evidence for popular health supplements by David McCandless and Andy Perkins.

I’m a bit of a health nut. Keeping fit. Streamlining my diet. I plan to live to the age of 150 in fact. But I get frustrated by constant, conflicting reports and studies about health supplements.

Is Vitamin C worth taking or not? Does Echinacea kill colds? Am I missing out not drinking litres of Goji juice, wheatgrass extract and flaxseed oil every day?

In an effort to give myself a quick reference guide, I dove into the scientific evidence and created a visualization for my book. And then worked with the awesome Andy Perkins on a further interactive, generative “living image”.

Play with interactive version | See the still image

This visualisation generates itself from this Google Doc. So when new research comes out, we can quickly update the data and regenerate the image. (How cool is that??) Hopefully then this should be a useful web resources for years to come.

About the image

This image is a “balloon race”. The higher a bubble, the greater the evidence for its effectiveness. But the supplements are only effective for the conditions listed inside the bubble.

You might also see multiple bubbles for certain supps. These is because some supps affect a range of conditions, but the evidence quality varies from condition to condition. For example, there’s strong evidence that Green Tea is good for cholesterol levels. But evidence for its anti-cancer effects is conflicting. In these cases, we give a supp another bubble.

The evidence

We only considered large, human, randomized placebo-controlled trials in our data scrape – wherever possible. No animal trials. No cell studies. Many of the health claims made by the $23 billion supplements industry are based on non-human trials. We wanted to cut through that.

This piece was doggedly researched by myself, and researchers Pearl Doughty-White and Alexia Wdowski. We looked at the abstracts of over 1500 studies on PubMed (run by US National Library Of Medicine) and Cochrane.org (which hosts meta-studies of scientific research). It took us several months to seek out the evidence – or lack of.

You can see our key results in this spreadsheet. (It’s the same spreadsheet that generates the interactive image).

Generation Game

This is our first interactive piece here on Information Is Beautiful. We’ll be doing more generative pieces over the next few months so stay tuned!

Updates

UPDATE 1: 6th Mar 2010 - We’ve updated the spreadsheet (changes in bold) and the viz after great feedback and new evidence and corrections from our amazing visitors. Thank you all so much.

Quick summary: We’ve added CoQ10, cocoa, capsaicin, L-Lysine and hyaluronic acid to the chart. And adjusted entries for Magnesium, Tumeric and Omega 3 (part of a massive downgrade of Omega 3 in fact). Read the change-log for full details

UPDATE 1: 10th Mar 2010 - Omega 3 has been downgraded in almost every category. See the spreadsheet (changes in bold) for more details.

See the visualisation | Check out the spreadsheet

Feed Us Back

As ever, we welcome your thoughts, crits, comments, corrections, compliments, tweaks, new evidence, missing supps, and general feedback. Thank you!

It was hell on earth to research. There’s a jungle of science around H1N1. Very hard to hack through. You can check all my sources here.

You can check all my sources here.

UPDATE 1: Interesting story here on how the H1N1 vaccine is made

UPDATE 2: Jan 2010: There’s now a Greek version of the H1N1 Swine Flu image. (Thanks to George Papadakis) and a Hebrew version (thanks Matty)

A note about the UK. These are the figures for Gardasil, the vaccine used in the US. In the UK, the dominant vaccine is Cervarix. For which I have no figures. Ben Goldacre explores some important points around Cervarix. Worth reading.

(You can explore my data here. I’ve put the data on three separate sheets inside the spreadsheet. Here are the original source documents from the US Centre Of Disease Control).

If you have any figures on Cervarix or any other facts and sources that can add to this diagram, please get in touch. Thanks!

If you’re looking for information on HPV, Cervical Cancer and immunisation, try these links
: The NHS page on the cervical cancer jab
: General info on immunisation, including HPV

Updates

UPDATE 1: I’ve been asked to include the other side of the Gardasil story which is represented by The National Vaccine Information Centre (www.nvic.org) – which is a nonprofit, non-medical organization founded by parents of vaccine-injured children.

In contrast to the Centre For Disease Control, the NVIC are strongly anti Gardasil. As evidence, they cite the case reports from the Vaccine Adverse Event Reporting System (VAERS) database. It tracks adverse side-effects of vaccinations across the US. Reporting is voluntary. Studies say it only catches around 10% of side-effects (source: LA Times). Though it’s fair to expect a higher capture rate for deaths.

On that database, the NVIC count 29 Gardasil-associated deaths. I’ve been through the database and pulled out the case reports on those deaths so you can read them for yourself. Download them here.

For extra info, the NY Times has an excellent article about HPV Vaccines here, exploring several perspectives.

UPDATE 2: A few people questioned how I calculated the theoretical odds for dying from Gardasil, as the numbers don’t seem to match. Yup, fair enough. I wasn’t really clear about that. Essentially, the numbers at the top of the image (20,400,000 doses etc) are not used to calculate the odds. Instead, the odds are calculated using the National Safety Council’s method. That is:

population of United States / number of deaths per year

That gives the one year risk rate. Then if you divide that number again by the average US lifespan (77.8 years) you get the lifetime risk. See the risk chart here.

UPDATE 3 I didn’t factor for the fact that women receive up to 3 jabs of Gardasil. So the 20 million doses figures does not necessarily equate to number of people receiving the vaccine. Changing the maths a bit (to assume an average of 2 jabs per person) has altered the numbers slightly on the graph. (Percentage of side effects 0.05% rises to 0.1%. Percentage of serious side effects 0.003% to 0.007%. And so on). Thanks to A for that correction.

This was very hard to research. The AIDS/HIV figures are especially difficult to find. Many of the numbers are locked into the tables of 1,000,000 page PDF reports. Grrrr!

(I tell you – when I sleep these days, my dreams unfold in rows and columns…)

Anyway, if anyone can find tighter, better figures, or can think of any key diseases I’ve missed (preferably with data!), please get in touch.

UPDATE 1: I’ve added this. Thanks to Gorka Cortazar for the suggestion.

UPDATE 2: I’ve edited the Seasonal Flu fatality figure, previously 9% to 0.1%. The original figure was based on the number of patients *severely* ill with ‘flu who died, not the overall number of infected people. Sorry for the error. (Thanks to Lucie Melahn for the correction). I’ve also reclassified MRSA to “serious” or invasive MRSA.

Is the US about to face a pandemic?

The USA still has the most cases in the world. The America media are starting to pump out alarming headlines. “200,000 deaths!”. Here are the current figures.

But when you factor in population sizes, the USA disappears off the map. (It’s actually 15th in the world)

Fatality rates: Is Swine Flu getting deadlier?

When you look at fatality rates for Swine Flu, the percentage of infected people who die, the results are depressingly unsurprising.

Although these nations have much fewer cases than Western nations, far more people are dying. Brazil’s fatality rate is a shocking 10%, against a world-wide average of around 0.3-0.5%.

When you compare these worldwide fatality rates against those from mid-July, you see a slightly worrying trend.

Swine Flu appears to be becoming more deadly in Latin America. Is this down to Western nations use of Tamiflu?

Swine Flu Advisory

Here’s the overall data in a table. Media reporting generally only focuses on the first column. But we think the other columns are more relevant.

The stand-out statistic from all this is the US’s death rate at 1.2%. It’s the only Western nation in the above-average rankings.

This may be down to Swine Flu’s particularly lethal interaction with obesity. An estimated 34% of American’s are obese (CDC)

If you are interested in more, you can see a live interactive table of Swine Flu figures here.
Sources and data in this Google Doc.