You have seen harmful effects in some supplements in the past, though. Fred Hutch’s CARET trial found an increased risk of lung cancer in some who took beta carotene, the compound that gives us bright yellow, orange, and red vegetables and vitamin A, right?
The CARET study (led at Fred Hutch by Drs. Gil Omenn, Gary Goodman and Mark Thornquist) was where I cut my teeth on large-scale trials. That trial showed that beta carotene and vitamin A supplements increased lung cancer incidence and death among heavy smokers or workers exposed to asbestos.
That was a big wake-up call to me, that these things that we think are good for us can be harmful.
When we use these supplements, we often use big doses. It’s not just replacing carrots and other yellow vegetables with a pill. They typically multiply the dose, thinking if a little is good, then more is better. The CARET trial made us think differently about that.
What else is going on with WHI? You have a few trials still in the works, yes?
WHISPER [WHI Sleep Hypoxia Effects on Resilience] is our large-scale observational study looking at sleep and its relationship to cardiovascular disease, cancer and cognitive function. That study is done and we’ll be seeing results in a few months. We’re learning how important sleep is for a lot of different processes.
The WHISH trial [WHI Strong and Healthy] is looking at physical activity in older women and still has a couple of years to go. It’s a really big trial, led here at the Hutch by Dr. Charles Kooperberg, and we’re anxious to see what physical activity means for these women; our WHI participants are now between 72 and 105. It’s a little scary to push physical activity among older adults, yet we believe movement is helpful. It’s a very interesting health question: How much should we be pushing physical activity at a later age?
LILAC [Life and Longevity After Cancer] is looking at the challenges and issues that cancer survivors face in their older years. We’re trying to ascertain the relationship between cancer, cancer treatment and the aging. We’re looking at people’s ability to function physically, cognitively — the ability to take care of yourself and to move. We want to know how much cancer treatment affects frailty.
We have more and more cancer survivors now and experts are talking about the forthcoming silver tsunami. As our population ages and the number of cancer survivors continues to go up, they are worried it is going to overwhelm the health system. Cancer and cancer treatment really does have an effect on people, so this is a really important public health problem.
Any final thoughts on the WHI and its accomplishments?
The Women’s Health Initiative shows how much women really want to learn about their health; it was driven by women and their need for better answers and it has been going strong for three decades.
We’ve had more than 2,000 papers published so far from WHI data and this year we are celebrating the 30th anniversary of the WHI’s Clinical Coordinating Center being launched at Fred Hutch.
The WHI is really all about teamwork. We have wonderful collaborators across the country, including at Brigham and Women’s Hospital who led the recent COSMOS studies. And I have a fabulous team here who have made extraordinary efforts embedding trials into our existing organization and our existing databases. Several people at the WHI Clinical Coordinating Center contributed significantly to the COSMOS studies, as well, including Lisa Johnson, Lesley Tinker, Aaron Aragaki, Rebecca Hunt, Bill Carrick, Emily Wion, Mary Pettinger and Jenny Schoenberg.
For more information on vitamins and supplements, check out the NIH Office on Dietary Supplements’ fact sheets found here.