At 12, Cian Moore loved playing football until his eyes started to hurt He had trouble focusing, reading, even kicking a ball.
He withdrew from people Cian was going blind.
I was terrified because I don't want to go blind.
For three years, his mother took him to many doctors, trying to find out why.
Those three years were the worst of being told
"There's nothing we can do," so it's like okay, he's blind, he'll be blind.
What no doctor thought to prescribe through all of those consultations was these, just two capsules a year can save a child's sight.
It can even save their life.
In fact, this remedy has already saved over five million lives, but this isn't a medicine, it isn't a drug.
This is vitamin A.
But why was Cian so low in this vitamin?
Well, since he was six year olds, he lived on bland foods such as chicken and chips, he wouldn't touch any fresh fruit or vegetables.
He'd starve, he wouldn't care or if you would make him he would vomit it.
Hundreds of thousands of malnourished children are on the brink of going blind because they lack vitamin A.
Most are in developing countries, and caught early, their sight can be restored.
For Cian, high dose vitamin A supplements saved the sight in his right eye, but he's permanently blind in the other.
Vitamin A literally has the power to make the blind see, yet here's the rub.
Taking extra vitamin A will not offer any benefit if you already have enough, and too much is toxic.
It can kill you.
In 1913, Antarctic explorers Douglas Mawson and Xavier Mertz were fighting for their lives.
With most of their food gone, they faced a stark choice.
Eat their dogs or die.
After reluctantly eating their dogs, the men fell ill, burning with fever.
Within days, Mertz was dead.
Mawson, against the odds, made it back to camp.
So what was the mystery illness that killed Mertz and nearly cost Mawson his life?
Well, when they ate their dogs, they weren't just eating canine flesh and fat, they also ate the dog's livers which contain high levels of vitamin A.
So basically, they overdosed.
Mertz went mad, his condition known as hypervitaminosis A.
Hypervitaminosis A is rare, but deadly, and today, we know it can be caused by overuse of high dose vitamin A supplements, the same kind of supplements that can save a child's sight.
This power and complexity lies at the heart of the great vitamin story.
I'm embarking on an epic, world spanning investigation of vitamin science in history.
That is one big fish.
I want to know how we discovered them.
You sure this is safe?
What they actually are.
The 13 vitamins can be divided into two teams.
How we learnt to build them.
Tonight, Walgreens and Target have pulled the products nationwide.
And how safe they are.
All vitamins, all nutrients, they are toxic in high amounts.
We gotta start taking these seriously as we should with every chemical we put into our bodies.
You shouldn't assume it's safe and you shouldn't assume it's beneficial.
Currently we don't know about the long term ethics of diet supplements.
I'm a scientist.
I'm also a father and I want to know how do I do the best for my son, and one day, might he be taking vitamin pills to Mars?
(engine blasting off)
Across the word, some experts claim that taking vitamins can be life savers, whereas others argue that it's just a waste of time or even dangerous, so how are we supposed to know whether the take them or not?
(train bell ringing)
Over a billion of us take at least one vitamin or supplement hoping to keep as healthy as possible for as long as possible, but most of us know nothing about them.
This ordinary meal contains almost every single essential vitamin and nutrient we need.
There are vitamins A, B, and K in the lettuce, lots of vitamin Bs in the chicken, vitamin C in the tomato, K in the cucumber, vitamin D in the egg yolk?
There are even vitamins in your coffee and that's before you add the milk.
In fact, this meal contains every single one of these but what are these exactly and what are they doing to our bodies, and how much do we actually need?
Around 100 years ago, we didn't even know that vitamins existed.
We knew we needed protein, carbohydrate, fat, and minerals and some suspected there were other vital substances in food but they had no name.
And then in 1911, a Polish chemist began some important experiments with some unfortunate pigeons and he changed the course of history.
His name was Dr. Casimir Funk.
♪ It must have been some flash of inspiration ♪
♪ Rendered scientifically precise ♪
♪ Conclusions that he drew from observation ♪
♪ Feeding pigeons different types of rice ♪
♪ He said some get sick ♪
♪ Some get well ♪
♪ It ain't no germ or virus, not as far as I can tell ♪
♪ There's something else inside that feed ♪
♪ It isn't something bad they get ♪
♪ It's something good they need ♪
♪ Thank you Dr. Funk ♪
♪ For helping us understand ♪ At the turn of the 20th century, millions of people were suffering from diseases rarely seen today, things like beri beri, pellagra, rickets, and scurvy.
Now, the thinking at the time was that it was the presence of something bad that made us sick, germs and toxins were all the range.
♪ It all comes down to the (mumbles) aminos ♪
♪ Casimir Funk is ♪ When Funk fed his pigeons white rice, starch, or sugar, they became ill.
But fed brown rice, they recovered.
So Funk wanted to identify the substance in the brown rice that cured them.
Now, Funk didn't know where this mystery substance actually was but he invented a word to describe it, from the Latin vita, meaning life, and amine, containing nitrogen.
Later, the E was dropped in English, so the word became vitamin.
Dr. Funk invented a catchy word that captured a fresh idea.
There was a new family of nutrients, the absence of which caused disease.
Soon it became evident that they were not all amines, but the name stuck and the word vitamin became famous, taking on a life of its own.
♪ Thank you Dr. Funk ♪
Over the next few decades, all 13 vitamins were identified.
Soon, they were synthesized and turned into pills.
Little did Dr. Funk realize, his vitamins would spawn
100 billion dollar a year industry.
Vitamania had begun.
♪ Thank you Dr. Funk ♪
♪ Casimir Funk, Casimir Funk ♪
I've come here to one of the largest nutritional trade shows on Earth.
They're expecting tens of thousands of people, all buying and selling the latest and greatest in vitamins and dietary supplements.
I want to see what's on offer.
After about four days, you really feel all the brain health benefits, so cognitive support, memory support, amazing sleep.
Historically, silver's known to be antiviral, antifungal, antibacterial to build your immune system by potentiating your white blood cell count.
They're organic botanical source vitamins and instead of putting them in isolated sugar syrups, we put them in more food.
Vitamins have managed to develop this halo around them where everything the word vitamin touches seems like it should be both miraculous and safe.
Science journalist Catherine Price spent five years investigating vitamins.
We tend to think of vitamins and supplements as this kind of home grown industry of people gathering herbs in their backyards and boiling oranges for vitamin C and it's actually a 40 billion dollar a year industry in the US and 100 billion dollars around the world and it's growing rapidly.
Who is taking vitamins?
More than half of Americans are taking some kind of supplement and ironically, that half is often the healthier half of the American population.
You have to have a certain amount of awareness and interest in health to go out and buy these products.
It has omega-369 and it's the only sauce of omega-7 in the plant sauce world.
All of our multi-vitamins have a base of omega-3 fish oil, multi-vitamin as well as vitamins E12 and D3.
C, D, E, all your B vitamins.
Folic acid, you name it, it's in there.
Most vitamins are self prescribed.
They're not recommended by a doctor.
So we should know that the biggest category for vitamins is multi-vitamins.
Most of us, not all of us, have been taught from a young age they're something that you take just in case.
Just in case you don't get enough fruits and vegetables from your diet, just take the multi-vitamin.
And I think when you talk about vitamins, a big part of the psychology is hope.
What you're looking at right here is a powdered magnesium citrate formula.
We have an adrenal fatigue formula that has a very heavy B-complex.
These are biological response modifiers.
Are there like vitamins in here?
Then, Catherine told me something I found staggering.
How are vitamins regulated?
Vitamins are not regulated the way that you would think they would be.
Technically, the FDA is in control of them, but all of these products around us, all of the 85 thousand dietary supplement products on the shelves, none of them are required to be tested for safety or for efficacy before they're sold.
So not at all.
The FDA cannot require any of these companies to test them to make sure they do what they say or that they're not going to hurt you.
And it's not just the US.
In Australia and Europa as well, they're not required to be tested for safety before sale.
But what about kid's vitamins?
Children's vitamins are regulated the same way adult vitamins are, which is to say they're not required to be tested for safety or for efficacy before they're sold.
So what you're giving your child doesn't have to be tested?
Never in history have we had the ability to manipulate our nutrition in such extraordinary ways, but how do we know if what we're doing is a good idea or not?
I'm a scientist, my background is in physics, and so I have a bias towards evidence and I'm skeptical of some of the marketing claims made here, but I'm trying to keep an open mind, after all, there have been at least 10 Nobel prizes awarded for vitamin science, so I'm in search of a deeper understanding and I want to start with the basics, like what exactly is a vitamin?
Vitamins are chemicals that are essential for life.
Without them, we get sick and we can die.
Our bodies can't make vitamins by themselves, so we usually get them from our food.
So far, 13 vitamins have been identified and although they share a name, these are very different molecules and they do very different things.
♪ Hey, hey, I'm vitamin A ♪
♪ The first vitamin on display ♪
♪ When you open your eyes, I help you see the light ♪
♪ When the germs arise, I'm gonna teach you to fight ♪
♪ Here we come, we're the vitamin Bs ♪
♪ We're a great big family ♪
♪ So much energy you can gain ♪
♪ For your metabolism and your genes and your brain ♪
♪ One two three five six seven nine 12, the Bs ♪
♪ Howdy folks, they call me vitamin C ♪
♪ Vitamin C ♪
♪ I'm a healer and protector and I can almost guarantee ♪
♪ You're impervious to scurvy if you get your share of me ♪
♪ Vitamin C, vitamin C, vitamin C ♪
♪ I think it's unfair, it almost seems cruel ♪
♪ To come from the sun and still be so cool ♪
♪ Warmest regards, vitamin D ♪
♪ Yeah ♪
♪ Well, babe I know sometimes it's hard to recognize ♪
♪ When you need some help to antioxidize ♪
♪ So stop those radicals from running wild and free ♪
♪ Look to me, E ♪
♪ Hey I'm K, there's something I'd say, I keep your body ♪
♪ Rocking in a critical way ♪
♪ A well known cornerstone for your blood and bone ♪
♪ I can't do it alone, you need all the crew, the whole ♪
♪ Retinue, props to do because that's how you grew ♪
♪ And that's what you need to get through the day, ♪
♪ Talk about vitamins A through K ♪
The 13 vitamins can be divided into two teams, the water soluble team consisting of all the B vitamins and vitamin C and the fat soluble team, consisting of A, D, E, and K, ADEK.
So why does this matter?
Well, we can get rid of excess water soluble vitamins in our urine, but the fat soluble ones are stored in our livers and fatty tissue, so they're the ones that can build up easily to toxic levels.
What does a food data miner do?
So essentially, I'm looking at all these different kind of (mumbles) foods.
Someone who's an expert in the vitamins in our food is dietician Dr. Yasmine Probst.
If I could see the amount of vitamins that I need every day, it would look like this?
That's right, that's a very close representation to what we need, they're tiny.
There's hardly anything here.
They're a speck on this plate here.
Yeah, like vitamin D there, nearly invisible.
It just looks like a few pinches of salt or spice.
Yeah, so it might be about the size of say, a poppy seed or something really tiny that people see on a regular basis.
So in order to get all the vitamins I need in a day, this is the food I need to eat?
That's right, that's right, not very many foods at all.
But I would eat this in one meal, this looks like dinner and dessert to me.
Well, this is the amount that you would need as an average adult male.
Some people imagine you need to eat a giant mound of food, you know like a pile of spinach to get the vitamins that you need in a day, but it's really not that much.
Well, I guess there's a little bit of confusion out there.
People think that the amount of food that you need are these really big numbers but it's really not that much and it's more about eating the right foods in the right balance so that you get the right nutrients that you need.
One carrot gives me all I would need of vitamin A.
That's right, one medium carrot.
When we eat a carrot, vitamins are released into the bloodstream, beginning a complex molecular dance.
Take vitamin A.
Our body makes it from a plant chemical called beta carotene and transforms it into forms of vitamin A that are essential for sight, immune function, and even how an embryo develops.
Each of the vitamins trigger amazing chemical reactions, and together, they impact every part of our body.
We can't hear, smell, think, touch, taste, breathe without these 13 vitamins, they don't just keep us alive, they are life.
And when it's all working well, it's a wonder.
But when we don't have enough, when there are deficiencies, the body's systems fail.
I noticed that I was getting very tired.
Weakness, blood was coming out through the side of the teeth and stuff and it started getting worse.
And then I also noticed that I was sleeping a lot.
Now, I'm talking about from six in the afternoon all the way
'til 10 in the morning, I mean, a lot.
And so that kind of scared me, so I knew something was wrong, so that's why I'm glad I went and I seen Dr. Churchill.
Sonny Lopez had a disease that no one had thought to look for, let alone test for for decades, and he wasn't the first case.
So the first patient came in with painful, bruisy rash on both of his legs and general joint pains and fatigue and other systems and he had been treated for what they thought was an infection of the legs with no improvement, people were looking for blood clots and other things and all of the tests were coming up negative.
Someone thought to ask about his diet.
They found that he had been eating nothing but white bread and American cheese for the last several years.
No fruits, no vegetables, nothing that would provide you with the basic level of nutrition that you would need.
Then, with that kind of nutritional problem, maybe we should check some vitamin levels and his vitamin C level came back at absolutely undetectable, level of zero.
Dr. Eric Churchill was stunned.
He realized the patients had a disease common more than
100 years ago, they had scurvy.
This is something you hear about with pirates in the
18th century, it's just not a disease that we thought people had anymore.
Scurvy was absolutely devastating it's been estimated that between the late 1400s and early
1800s, two million sailors perished as a result of this disease.
It's harder than I expected.
Medical historian Dr. John Waller has studied the links between scurvy and diet.
So this is a typical daily ration for a sailor in the royal navy in the 18th century, about a pound of very hard ship's biscuit.
Then they would get something like half a pint of dried peas.
Then salted meat, and it would be washed down with something like a gallon of beer every day.
But there was something missing from their diet.
Yeah, there's something very, very significant missing.
And that of course is vitamin C.
The thought that certain foods might cure scurvy wasn't a new one.
It was an old idea that had been discovered and forgotten many times.
Every so often, somebody would try citrus fruits.
The sailors would make what appeared to be a miraculous recovery, but it never became standard practice.
So how did they eventually figure out how to cure scurvy?
It happened very gradually, but there were a few really critical moments.
One of them took place in 1747, when a Scottish born ship's surgeon ran what is the first controlled clinical trial in human history.
Dr. James Lind had seen the horrors of scurvy firsthand.
Usually the ship's surgeon would try a range of supposed remedies and hope for the best, but Lind came up with a novel idea.
He took 12 men with scurvy and split them into pairs.
Each pair was given ship's rations plus one of the supposed cures of the time.
Cider, vinegar, seawater, something called
"elixir of vitriol" made from sulfuric acid, a concoction of garlic and mustard, or oranges and lemons.
The two sailors who had been receiving the citrus fruits had made a really remarkable recovery.
Now, the two who had received cider were somewhat improved.
The rest, they had continued to deteriorate and they were fast on the way to dying.
So this experiment had allowed him to arrive at a really clear conclusion, that fresh fruits and vegetables really can be used to cure scurvy.
How significant would you consider Lind's experiment?
There's no question that this single discovery saved millions of lives, but there's a broader and every bit as enduring effect of Lind's work and that is the way in which controlled clinical trial eventually becomes orthodoxy in medicine.
It's a species altering development.
Humans had unlocked the way to identify what cures will work.
When Lind goes to publish his findings a few years later, he buries the information in a few paragraphs 200 pages into his 400 page book.
It's as though not even Lind realizes the significance of his own discovery, and it may have been forgotten yet again if not for the work of a young doctor Gilbert Blain who manages to convince the British navy to supply lemon juice to its sailors.
The year is 1795.
That's one year after Lind's death and 48 years after his historic experiment.
With lemons and later limes as their secret weapon, the British navy emerged as the strongest on the globe.
The supply of fruit shaped the destiny of nations, allowing us to venture out across the seas, to live and to thrive fueled by the right nutrition.
But today, it seems that knowledge is being forgotten once again.
How many people live here?
I'd say about 15.
And how long you been living here?
Five years, Derek.
That's a pretty long time.
Yes, it is.
This is my castle right here.
This is my family, this is everybody I love.
That's me back when I was 21.
You had a lot of hair back then.
Yes, that was back in the hippie days, you know?
It's a beautiful family.
This is all the stuff, this is where I keep my cereal, my bread, peanut butter.
Refrigerate down the hall here, come on, I'll show you.
I like to eat burgers, hot dogs, sodas, cakes,
bad cereals, I'm not gonna lie to you.
I do eat a lot of sugar.
When I have my coffee, 15 sugars, two creams.
Many people who have difficulty affording food tend to go for food that is high fat, high calorie, and very filling.
If you have a limited food budget, those are the meals that will fill you up and will satisfy you more than eating fruits and vegetables.
Alright doc, how you been? Good, good.
In Sonny's case, he has got a lot of other things to worry about and for him, making sure to eat enough fruits and vegetables is very far down on his list.
I thought I had some kind of vicious disease and I was really, really scared, because that's an ugly word, scurvy.
So once we had diagnosed Sonny with scurvy, the first thing we did was to give him vitamin C tablets to correct the deficiency, and then, at a later visit when he said he was having trouble getting those supplements, I took out my prescription pad and I wrote
"One orange every day" and handed it to him.
It turned out that Sonny was part of an extraordinary scurvy cluster.
In the last five years, we've documented 30 cases of scurvy and as far as I'm aware, that's the largest collection of scurvy cases in the developed world outside of some exceptional circumstances like war or refugee situations.
So is it just an issue of all these people with scurvy not eating enough?
It's really not.
It's about the quality of the food that you eat.
Over half of the people that we diagnose with scurvy are actually obese and so they are getting enough calories in their diet but they are low quality, low nutrition calories, we use the phrase hypercaloric malnutrition one of the things about scurvy is that it's really not difficult to prevent.
This is not a high nutritional bar to reach.
And even something like a handful of ketchup packets a day contain enough vitamin C to keep you out of scurvy.
Not that I recommend people get all of their vitamin C from ketchup packets, but it's enough.
Surprisingly, the top vitamin C foods aren't all citrus.
Kiwi fruit, strawberries, and red peppers are all rich sources.
But vitamin C is fragile, it degrades with time.
One study showed that left at room temperature, 75 percent of the vitamin C in an apple can be lost in a week.
So just over time, the nutritional content is going down.
Yeah, it's affected by heat, by light, by storage conditions, lots of different things.
So what should you do if you want to maximize your nutrition?
I think keep it fresh, keep it local.
The sooner you pick it and consume it, that's probably the best.
Fascination with the power of vitamin C led scientists to isolate it and determine its chemical structure.
In 1937, this work one two Nobel prizes.
And led to the world's first synthetic or artificial vitamin.
So where do you think the vitamin C in your pills comes from?
This is the last remaining manufacturing plant for vitamin C in the western world.
The vast majority of vitamins produced today are synthetic.
That is, they're man made in chemical factories, and in general, the goal is to duplicate the exact structure of the naturally occurring vitamins.
Now, we'd hoped to show you how that's done here, but after 12 months of negations, we've not been able to film inside, so instead, to understand how to create a vitamin, we're gonna have to make our own.
To build a vitamin, you need raw materials.
And believe it or not, at least eight vitamins can be synthetically created from fossil fuel products like coal tar.
They contain components like acetone, found in nail polish remover, short chain alkanes, found in petrol, and various aromatic rings found in (mumbles).
The idea is to rearrange these building blocks into more complex chemical compounds.
Actually building vitamins, precision matters, as a single bond can alter function.
Not all synthetic vitamins come from fossil fuels.
For example, if you extract sugars from corn syrup.
Ferment them with bacteria and add a chemical reaction, you have synthetic vitamin C.
Most synthetic vitamins are chemically identical to the natural form, but without the fiber and micronutrients that come with food.
The end result is a vitamin made not by a plant, but in a plant.
It's far more efficient and cheaper to produce vitamins on an industrial scale.
Today, more than 80 percent of the world's vitamin C is made in China, and it's pretty hard to work out where all of the raw materials for vitamins come from but most are produced unquestionably like this, synthetically.
And then they're sent out across the globe to manufacturing plants, ready to be turned into vitamin pills.
Here in Australia, manufacturers are required to test raw materials on arrival, to ensure the product is what it says on the label.
Then, the manufacturing begins.
The raw vitamin material is blended with additives and binding agents, a different recipe for a different product.
Given the amount of vitamin needed is generally tiny, what makes up the rest of the pill?
Well, inactive materials like cellulose, sugars, or rice flour are often added to provide bulk and to help the tablets dissolve in the gut.
Colors and flavors can also be added to make the tablets more palatable.
The manufacturing process is similar for most synthetic vitamins, depending on the end product being made.
Thousands of generic looking pills then fill containers and the distinctive packaging takes place.
The vitamins are now branded and they're ready to hit the market.
It's interesting, if vitamin manufacturers here want to claim "made in Australia," by law, none of the raw ingredients actually have to come from this country.
And if you want to claim your product is natural, well, most of the regulators worldwide haven't defined what natural means, and so it can say natural on the label and yet contain synthetic ingredients.
But what if you've never taken a vitamin pill in your life?
You might think this entire vitamin manufacturing process is irrelevant to you, but then, you'd be wrong.
It turns out even if you're not popping vitamin pills, chances are you are ingesting synthetic vitamins because in at least 95 nations, they're being added to your food.
Eat Wonder Bread!
You want to grow bigger and stronger, don't you?
A sandwich daily and two slices of Wonder Bread every meal give you eight elements you need.
Around half the countries on Earth allow the addition of synthetic vitamins to common food products.
It's called fortification.
That's why you can help yourself grow bigger and stronger eight ways with Wonder Bread.
So be sure to eat Wonder Bread!
In places like the US and Australia, fortifying bread flour and margarine is required by law.
And companies often decide to add vitamins, mostly from the B family.
The B vitamins are sometimes called the pep vitamins, they help our bodies produce energy and assist in cell development.
Now, they're all water soluble, like vitamin C, which means our bodies don't store them, so we have to replenish them often.
Their discovery and synthesis took over 50 years and led to six Nobel prizes.
One of the vitamins added to bread is B9, better known as folate, so why is it being added to my bread?
At 29, Kim Robins is an international wheelchair basketball star.
He tours the world, playing professionally.
His body and entire life has been shaped by the power of folate.
Kim was born with a hemangioma on his back in the middle of his shoulder blades.
It was a legion which looked a bit like a red birthmark.
We were assured at birth that everything was okay.
And it wasn't until he was six months when flags started to be raised that perhaps he wasn't meeting all of his milestones.
After months of tests, Kim was diagnosed with a neural tube defect.
Effectively, a whole in his spinal column which caused permanent damage.
Part of my disability is that I have chronic back pain and that's in my lower back, so I get pain maybe 200, 250 times a day.
It's kind of like a back spasm.
My brain's fully functioning.
I guess it affects my leg function to some extent so I can walk, not super well, but I can walk a little bit.
Neural tube defects like Kim's can be caused by the lack of folate long before birth.
If you eat folate, it's the best kind of diet because it's actually found richly in leafy green vegetables, it's found in things like asparagus, it's found in strawberries, it's found in whole grains, so if you are eating fruits and vegetables, it's quite likely that you will have a diet rich in folate.
Folate is very important for both DNA and RNA repair, but also for the rapid development and multiplication of cells which is what's happening in the fetus, so it's essential for that.
Professor Fiona Stanley led the Australian arm of an international children's study that showed lack of folate in a mother's diet before she was pregnant could cause major defects in utero.
If before a woman knows that she's pregnant, the fetus is starting to form all of its major organs and one of the earliest, by perhaps the seventh week is the neural tube which starts as an open little trough and then starts to zipper up and it zips up and down.
I think of it like a zipper going down and as each link forms together, that's part of the neural tube forming and if it misses one link, that's where the neural tube defect would be.
Mine is up between T2 and T6, which is quite high up and so my spinal cord's a little bit withered, so some messages get through and some messages don't By the time a woman knows she's pregnant, it can be too late.
So scientists sought a way to get a form of folate into a food that everyone might eat.
There were lots of debates about what staple food should be fortified, and of course the one that was suggested was flour, bread making flour because bread seems to be such a ubiquitous food.
In 2009, Australian bread was fortified with folic acid, synthetic folate.
It might be added to all white flour for bread making.
It's the same in the US, Canada, and the UK.
Organic or traditional breads are exempt.
Folic acid supplements are also recommended for women planning to become pregnant.
I had no idea about folate before I fell pregnant.
I didn't even know about neural tube defects.
How it would have changed things if I'd have had folate in the early stages, we...
That would have been a huge difference, maybe Kim wouldn't be like this.
I can't change what's happened, it happened and I can't blame myself for that.
With folic acid fortification and supplementation, the rate of neural tube defects in Australia has halved.
I think it's pretty cool to be doing something that I love.
A lot of people ask me "If you could, would you prefer not
"to be in a wheelchair" and I say no because of maybe I never would have done all the things that I've done and I'm fairly satisfied with where I am and where I'm going.
Over 4000 neural tube defects occur every year in the European union, yet fortification is not mandatory here.
So why is Europe taking a different approach?
Dr. Mathilde Touvier leads a team of French researchers investigating the relationships between nutrition and health.
I'll take that, thank you.
It's all yours. Thank you.
How much of this bread is fortified?
No bread is fortified, in France, we don't fortify the flour with anything.
But you have the same problems here with neural tube defects.
Yes, sure, in fact, it is recommended for women who want to get pregnant or at the beginning of pregnancy to increase their intakes of vitamin B9 to prevent these birth defects.
But why not just put it in the bread?
No, the bread in France is quite a secret and traditional product, and no, it's not transformed.
But do you add vitamins to any foods?
Yes, there are fortifications of food with some vitamins or minerals but it's not mandatory, it's at the discretion of manufacturers.
A lot of people around the world are worried about getting too few vitamins.
Your concern is too many.
Yeah, it depends on country such as France or Europe.
You don't have problems of deficiency in general, you really have much more problem of excess, excess in the sugar, salt, and so on and maybe excess in vitamins if you take fortified foods, stable foods rich in vitamins, minerals and daily supplements.
Maybe you can reach excessive intakes.
The fortification of food by governments is the result of a careful assessment of potential risks versus benefits, but these days, industry can modify almost any food or drink with additional nutrients without the same scrutiny.
In the United States, you can find a claim about the things that these products bring to you, 200 percent of which you need per day, and if the recommendation is 100 person, why are you taking 200 per person, and American people are used to such claims and they are used with this idea of too much of a thing is really better.
In Europe, we really don't have this state of mind.
Today, there is one vitamin in particular that's increasingly being added to our food, vitamin D.
Low vitamin D has been linked to cancer, heart disease, dementia, it's been linked to over 100 different conditions.
There are some who claim we're in a midst of a global vitamin D deficiency.
So how do we decide whether we need extra vitamin D or not?
I've come to one of the coldest places on Earth to better understand the hottest vitamin on the planet.
For centuries, a mysterious and horrible condition affected thousands of children all around the world.
Their bones grew weak and broke easily and many were deformed, many died.
They call the condition rickets, but no one knew what caused it.
Oddly, here on the Norwegian coast, fewer cases were reported, so an important clue appeared to be fish.
The world's greatest cod harvest takes place here from January to April.
Millions of tons are caught, their flesh helping feed the world.
That is one big fish!
But there's another benefit.
A powerful traditional medicine called cod liver oil.
Here in Norway, the stories of the healing powers of the cod liver oil go back more than 1000 years.
It was a key part of the viking diet, prized for its strength giving utilities.
The Norse called it the gold of the sea.
This is a messy business.
I don't know that I like it very much.
So how do you know which one has a big liver?
That's the liver.
So the cod liver oil, do you think of it as a food or as a medicine?
Not really sick.
Does it taste like fish?
Do you like the flavor?
There are hundreds of thousands of heads and tails strung out on drying racks almost every village.
And it's incredible to see the scale of the cod fishing here and the smell.
The stench of cod blankets entire villages.
The locals say it's the smell of money, but the value of cod and their livers goes far beyond money.
It's also about health.
Professor Magritt Brustad is an expert in the links between food like cod and diseases, like rickets.
Rickets was a huge problem in Norway some years ago.
Rickets is a condition that is characterized by soft bone
so it causes your bone and your skeleton be disformed and it's rather painful.
And if this happens in childhood, it's permanent.
Yeah, if it's not treated.
I mean, this is just horrible.
Yeah, a lot of pain.
We knew many years ago that cod liver oil could cure rickets, but we didn't know why.
Magritt and I have come to see how codfish is turned into cod liver oil.
Welcome. Thank you!
You are not seeing this before.
It's a simple if revolting business.
Cut out the fish livers, throw them into barrels, and let them decompose.
The oil grows darker in the rotting process.
Then skim off the oil from the surface and drink.
You sure this is safe?
Yeah, it's not bad.
That was much better than I remember it as a child.
It's not nearly as bad as I was expecting.
Cod liver oil was so successful in treating rickets that people across Europe began feeding it to their children.
In the 1870s, it reached America, and mass marketing began.
But still, no one understood why it worked.
In the early days, cod liver oil was mostly marketed as again, a kind of product that would help build flesh.
In fact, this one product here of Scott's Emulsion, one of the biggest cod liver oil products.
Scott started making this product in the 1870s.
He really believed in advertising and he was able to make a fortune off of this particular product.
You know, the important thing is if you're marketing this, you want people to take it as much as possible.
By the late 1890s, the cod liver oil industry was booming, but the marketing ran decades ahead of the science.
It wasn't until 1913 that biochemist Elmer McCullum and Marguerite Davis proved the existence of an essential nutrient in cod liver oil.
They called it fat soluble A.
A simply for the first vitamin.
McCullum later identified another vitamin in cod liver oil, fat soluble D, the fourth vitamin.
And McCullum proved it was vitamin D that cured rickets.
So you have this new scientific knowledge coalescing with what is already kind of a market out there, so if you're marketing this stuff, I can't imagine anything better to come along.
[Derek] It's pretty incredible, right?
It is pretty incredible.
And there were hints of something else at play.
In 1920, microbiologist Harriette Chick carried out an experiment with children.
Half were given cod liver oil, the other half were not.
As expected, the children given the oil didn't develop rickets, but then Dr. Chick noticed that children with rickets who spent time outside in the sun healed rapidly.
She determined that cod liver oil and sunshine both cured rickets.
And vitamin D is the link.
How's that sunlight feeling?
Oh, it's wonderful.
So how does the sun deliver a vitamin?
When sunlight hits our skin, something remarkable happens.
Just under the surface lies a type of cholesterol.
When the sun's ultraviolet rays hit this molecule, it transforms, becoming a form of vitamin D.
This is the same molecule found in cod liver oil.
It then travels to the liver, where it's converted into the form that doctors measure in our blood.
This is then activated by the kidneys, and now, it's ready to help absorb calcium, building strong, healthy, rickets free bones.
Think that's about enough sun for one day.
But here in the far north, during the dark winter months, there's a distinct lack of sunshine, so to get enough vitamin D, over generations, people have devised rather remarkable meals to compensate.
This is cod.
And this is cod eggs, and this is the boiled liver.
It's fresh cod liver oil together with onion and pepper and salt.
And this is potatoes, Norwegians always have potato.
Ahh, very good.
This is the traditional (foreign language), packed with vitamin D.
So one meal of this will give you 16 out of 20 daily doses of the recommended amount of vitamin D.
This has kind of saved our vitamin D health in the north during the dark season.
But not everyone likes oily fish, let alone fish livers and cod liver oil.
So scientists invented something far more palatable.
So the first really important vitamin pill is this Osdogal, and this was developed actually by Casimir Funk.
We've solved a big problem that messy, nauseating oil is now a nice little pill in (mumbles) coated.
So cod liver oil really started this whole vitamin explosion?
Yes, cod liver oil really is the beginning of it.
With the new pills readily available, the era of cod as a key source of vitamin D was ended, and soon, the vast majority of vitamin D would be created in an utterly different manner from an utterly different beast.
Today, most of the world's vitamin D pills are created from the greasy wool of sheep.
Mostly Australian sheep.
So how do you turn sheep wool into a vitamin?
Let's give it a try.
Well, the wool is coated in a type of grease or lanolin, it's the stuff that makes your hands feel soft.
It's a mixture of fatty acids produced by the sheep's oil glands, and this lanolin is the key to making synthetic vitamin D.
Here's how it can be done.
The lanolin is separated from the wool by boiling in hot water and detergent.
Around 15 percent of the lanolin is a form of cholesterol, like the cholesterol under our skin.
This is a extracted and oxidized to produce a new compound which is then irradiated with ultraviolet light, transforming it into a precursor of vitamin D.
This chemical process mimics the biological process of the sunlight hitting our skin.
Several more steps create the end product, synthetic vitamin D.
And of course, it's not done like this, but on an industrial scale in factories.
Chemists from the University of Melbourne calculated that you can make a lot of money from a sheep's fleece.
Online, vitamin D3 can seel for about 50 Australian dollars per gram, but packaged in pill form, it can sell for around 3700 dollars per gram.
This makes vitamin D far more valuable than gold.
But the million dollar question is should we be taking vitamin D pills?
Today, most of us spend large parts of our days indoors, with limited exposure to direct sunlight.
So do we need more vitamin D?
Should we be taking supplements?
Dr. Rachel Neale is part of a global investigation trying to find out.
Vitamin D's not just a vitamin, vitamin D is a hormone that has a range of incredibly powerful effects on the cells in our body that could determine whether or not that cell starts to divide uncontrollably and become a cancer for example or whether or not that cell gets a mutation and kills itself.
So it's this incredibly powerful molecule that we need to understand a lot more about before we just recommend that everybody should take a supplement.
Rachel leads one of the world's largest clinical trials of high dose vitamin D.
21 thousand people are taking a vitamin D pill or a placebo, a sugar pill, for five years.
They're trying to see if taking vitamin D supplements reduces the risk of cancer and other diseases.
I think the general public have a perception that vitamin D is proven to be beneficial for a whole range of different health outcomes, like cancer and cardiovascular disease and the reality is that we know vitamin D's incredibly important for our bones, but beyond that, we don't yet have proof.
So why all the uncertainty?
Well first, there's debate around how much we actually need.
Vitamin D is measured in our blood in units generally called nanomoles per liter.
Experts agree that below 25 is considered deficient, but knowing what levels are sufficient is trickier.
A level over 50 is generally thought to be enough for good bone health for most people but others argue
for 75 or 100 or even higher.
It's worth noting that the US used a different measure, nanograms per milliliter and like metric versus imperial, this can cause international confusion.
So we don't yet have a single number that is accepted by all organizations and all scientists and all doctors around the world.
There's also controversy around blood testing, with studies showing different labs can get very different results, and although we know taking supplements increases the levels of vitamin D in our blood, we don't yet know if this improves our health.
So we don't know what vitamin D does yet.
We've got hints about what vitamin D might do but what we don't know is-
Different kinds of studies are revealing different kinds of clues.
These people are getting a fair amount of vitamin D.
Vitamin D studies are often observational, meaning they observe the world as it is.
For example, people with cancer often have low levels of vitamin D in their blood.
The link is clear and potentially important.
But it doesn't tell us if low vitamin D caused the cancer or if the cancer caused low vitamin D.
To work it out, we need to do the kind of study pioneered by James Lind back in 1747.
The randomized control trial.
Take a group of people, divide randomly in two, give vitamin D to one group and a placebo to the other, then, if you see a difference between these groups, you know it was caused by vitamin D, and better still, do this at scale.
The more people in your study, the more confident you can be of the results.
Rachel's results are due in 2021.
It's very exciting but currently the jury really is out on what we should be recommending to the population.
Despite the uncertainty, in 2016, UK scientists recommended an increase in the recommended daily amount of vitamin D.
Not everyone agrees.
One high profile champion of vitamin D has since changed his mind.
Geneticist professor Tim Spector.
I've studied vitamin D a lot in the last 15 years and we were the first group to show that the levels in individuals is actually partly controlled by your genes so we always assume it's purely how much sunshine you get or how much oily fish you're eating but in fact, about 50 percent of the levels vary just because the genes you've got and so everyone has a different normal level of their vitamins and that is generally holding true for all the vitamins we've been able to test so far so our idea of normal should actually be very person specific so you might have a normal level that's three times higher than mine and we don't really know what is the good level and what's low.
I think the public (mumbles) realize there is a controversy here and all these amounts of vitamins are important for us, but let's wait for the proper trials before we make a decision rather than the default being the artificial chemical first, worry about it later.
Let's get our facts right, make sure we're not doing something harmful first.
There's no doubt that we need to clinically manage people who have vitamin deficiency, it's important we recognize that vitamin D deficiency is a real thing, but we don't yet have the evidence to be able to say to the general population taking a vitamin D supplement is a good thing.
So should we just get more sun?
What about the risk of skin cancer?
Well, like everything around vitamin D, it's complicated.
In sunny climates, most people get enough from short bursts of sunshine a few times a week.
Although of course sunscreen should always be used.
And in less sunny places, more deliberate sun exposure may be needed, or your doctor may recommend supplementation.
Vitamin D is powerful, no question, but can we get too much of a good thing?
They were born at 9:45, so he came out first and she was a minute later, so they're just a minute apart.
When Becky Jackson gave birth to twins Joe and Elizabeth, she was thrilled.
So that's three months and you know, Joe was such a little chunkalunk at first.
But when she noticed her five month old daughter wasn't growing as quickly as her twin brother, Becky began to worry.
And so here's five months and you can see her eyes look a little baggy and sunken and her face just looks a little strange.
These pictures, nothing was alarming really until this one.
Suddenly, things took a turn for the worse.
Elizabeth wasn't gaining weight and she just wouldn't eat.
I noticed one day when I was changing her diaper that her stomach looked sunken, I could see the bottom of her ribcage and her skin looked and felt strange, almost like pizza dough.
Becky took her to the doctor for blood tests.
The next day, the doctor called.
She said "You have to go to children's hospital right now, "everything is all over the place, things that are low
"should be high, things that are high should be low, "nothing is where it should be."
I was freaking out, I was panicked, I didn't know what any of it meant for a couple of days which was the scary part.
The tests revealed that Elizabeth had toxic levels of vitamin D and this was causing dangerously high levels of calcium in her blood.
I have never seen a case of vitamin D toxicity until I saw Elizabeth.
She's only five or six months old and pretty much a baby's diet is mostly formula, so we had to do a little investigation why or where could she have gotten that.
When they first said the words "hypercalcemia" to me, then I did what every parent does and I googled and I got online and I found out everything I could about it and then I started to see a recurring theme of high doses of vitamin D, vitamin D overdose.
And I knew instantly.
So you start with powdered goat's milk and you put in eight scoops.
Becky didn't have enough breast milk for both twins, so she decided to keep Joe on breast milk while Elizabeth received a mix of breast milk and homemade formula.
Vitamin C, vitamin E, coral calcium.
This is cod liver oil.
It was an organic recipe of goat milk and coconut milk from a local health store.
And this was the soy lecithin which is a thickener.
And wanting to do the best for her baby, Becky decided to add a little something extra to the mix.
And then lastly is the vitamin D.
How much do you put in?
Well, the recipe calls for one drop.
That's all that-- that's it.
Put in. Which seems trivial at best, that's just silliness, that's not gonna do anything for anybody, so I would do the whole dropperful.
One ML or full dropper, like most infant droppers, would contain about 20 to 30 drops.
If there's too much vitamin D, then you will reabsorb a lot of the calcium, then it causes some of the symptoms would be increased urination, lack of appetite, both of which could lead to dehydration.
If this condition persisted without any treatment or intervention, this could ultimately lead to Elizabeth having kidney failure.
And then this was in the actual hospital with the feeding tube but she's rounded out, she's plumped up and had started to look normal again.
It took 10 days in hospital to stabilize her levels.
I felt very guilty.
I did this, this is something that I did and I knew that I was giving her too much when I was doing it but I thought
"What harm could there be?
"It's just a vitamin, it's like vitamin C, you get rid
"of what you don't need, how could it be a big deal?"
I was trying to be a good mom, I was trying to go above and beyond in a very easy, every day way that seemed so harmless.
I think people have underestimated the power of these vitamins with vitamin D.
You know, little mistakes can mean a lot if it's tenfold, hundredfold, that can really spell disaster.
Luckily, Elizabeth is now fine.
Her levels are normal.
It's difficult to overdose on vitamins in food, but easy to do with manmade vitamins as they can be consumed in such large quantities, and fat soluble vitamins like D can accumulate in body fat, reaching dangerous levels.
Becky Jackson and her family are not alone.
In 2015, the US Poison Center reported over 3000 calls concerning children under six who had taken too much vitamin D.
Throughout the world, the potential risks of dietary supplements are being studied carefully.
There's no question now that we have the data after decades of study, really, that the supplements are not risk free.
And in America, supplements send tens of thousands of consumers to emergency departments every year and thousands of hospitalizations every year are due to serious side effects of supplements.
Tonight, Walgreens and Target have pulled the products nationwide.
GNC did the same in--
In 2015, dietary supplements were pulled off the shelves of four major pharmacy chains in New York.
Most of the supplements tested didn't contain the materials listed on the label and many contained contaminants.
One of the serious safety concerns has been serious deficits in the manufacturing process.
For example, there have been multi-vitamins in which the amount of a mineral has been 100 times greater than what it should be, leading to serious health defects.
In other multi-vitamins, there has been drugs that weren't supposed to be in there at all, such as anabolic steroids, these are steroids that weightlifters might clandestinely use to get stronger have been found in multi-vitamins at such levels that people taking it became sick.
Specific risks are appearing around specific vitamins, like vitamin D.
We're seeing levels of five times, ten times normal in the blood of my patients when I see them with osteopetrosis and studies are now showing these people are now actually more prone to fractures and more prone to falling down and all the evidence is building up that we actually have a fairly narrow range of where these vitamins work.
Every vitamin has a toxic level and some of them are actually not that much higher than just the normal nutritional amount.
I see patients all the time who have vitamin B six levels in the toxic range and it can cause nerve damage for example.
In the 1990s, studies testing a form of vitamin A were halted when it became clear that participants were at an increased risk of dying.
That really shocked I think almost everyone.
We need to look at the type of supplement, we need to look at the amount of supplement, we need to look at what's being given to and it does seem that there are some places where vitamin supplements can definitely provide benefit, there are a number of places where they can provide some harm and there are a lot of places where they're still not sure what the outcomes will be.
So the big picture is that these products are not entirely safe.
It's not that they're gonna harm everyone who's gonna take them, certainly not.
The majority of people aren't gonna experience any adverse effects.
But my concern is this.
If these products are offering none to almost no benefit to a healthy consumer, but posing a small risk of harm, why should we be recommending them and why should consumers be using them?
Now there's no questions that medicines can have dangerous side effects and complications.
But they're clearly stated on the label and doctors know to look out for them.
It's a known risk.
The issue with vitamins and dietary supplements is that they're perceived to be risk free.
Yet there can be complications, there can be side effects, and there can be bad products.
It's not a no risk proposition.
Yet, in the US, there's no legal requirement for products to be tested for safety or effectiveness before they go on sale.
In the US and in many countries, the laws are lax to the point where you can basically put any combination of vitamins and minerals in a pill, call it anything you want and make pseudo-health claims for it.
So it's the wild west.
Clearly, there is a huge problem in supplement use that's not regulated, there are things there that shouldn't be there, there are things that should be there that aren't there.
It is sort of the wild west.
To understand how this could happen, we need to look back.
To see how the line between food and medicine became blurred.
♪ Well, let's talk about the US government of 1938 ♪
♪ The burgeoning new industry, they didn't regulate ♪
♪ Said it makes no sense ♪
♪ They're just dispensing nutrients my dear ♪
♪ And if we pop that bottle top, we know what we would hear ♪
♪ I am not a medicine, I am not a drug ♪
♪ Dude, I'm food, so don't intrude, it's rude ♪
♪ To pull my plug ♪
♪ I wanna be a mystery, don't peer inside the pill ♪
♪ And if I'm not a medicine ♪
♪ Perhaps you never will ♪
In 1938, a new US law requires all pharmaceutical drugs to be tested for safety, but vitamins escaped this regulation, opening the door for the industry to expand.
And by the 1970s, the industry is booming.
The FDA, concerned about high dose vitamins, tries to tighten the rules, but fails.
They try again in the 90s.
This time, they want better labeling and to remove unsafe products.
But the industry fights back, claiming the regulation will make it too expensive and limit consumer choice.
♪ You know I wear my therapeutic promises with pride ♪
♪ But every name I have to claim discreetly qualified ♪
♪ No reason to investigate, no reason to delay ♪
♪ You might just live forever if you take me twice a day ♪
♪ Oh but I am not a medicine, I am not a drug ♪
♪ To keep me cheap you need to sweep me right under the rug ♪
♪ Hey FDA, get out the way, why can't we stay like this ♪
♪ Where I am not a medicine ♪
♪ And ignorance is bliss ♪
In 1994, a new US law is passed, forbidding the testing of dietary supplements for safety or effectiveness before sale.
And the industry explodes from around 4000 products to over 85000.
Perhaps the most surprising part about the way that supplements are regulated is that it is because of us consumers, we supported this legislation.
We lobbied on behalf of the dietary supplement industry to get congress to pass a sweeping law in 1994 that forever forbade the FDA from requiring that dietary supplements be tested or for efficacy before they're sold.
What do you mean forever?
Like unless there's another law, that's just how it is.
Different countries have different regulations.
In Australia, most vitamin products are classified as complimentary medicines.
Manufacturers must certify that they use low risk ingredients, products contain what they say they contain and they have evidence to back up health claims.
But, it's a trust based system.
Products don't have to be proven safe or effective before they go on sale.
In Europe, vitamin products are regulated as food supplements and again, they don't have to be tested before they go on sale.
However, the laws are tougher.
To claim a health benefit, for example, manufacturers must show proven scientific evidence, and in France, high doses of vitamins generally need a medical prescription.
But increasingly, people are buying their vitamin products online.
So globally, it's a case of buyer beware.
And yet, we can't forget that in cases of real deficiency, vitamin supplements can transform lives.
They can save a child's sight.
They can be life savers.
But what if we're healthy, with no known deficiency?
How do we decide whether to take them or not?
My final stop is to meet experts planning the ultimate human journey.
I wanna know, are they taking supplements to Mars?
The (mumbles) of (mumbles) hit a new era of American space exploration.
NASA is preparing to send humans to Mars around 2030.
Imagine a three year round trip with only the food you have on board to survive.
They can't go down the street and go to a restaurant.
If they don't like what you've provided, they can't go to the grocery store and have hundreds of choices.
So this is where we freeze dry the products.
Dr. Grace Douglas leads NASA's research into the nutritional needs of astronauts.
The focus is on taking whole foods into space.
And all of our freeze dried foods get made in this lab here, so cook like you would at home and then they get put in here frozen and the moisture gets pulled out of them.
In flight, they'll add the water back and it rehydrates to be just like the meal it was before we pulled the water out.
Some of the vitamins actually do really well through this process.
Strawberry shortcake, ready for you, Chris.
I like the look of this, this is your shrimp dish, is it?
That's shrimp cocktail. Wow, these are really cool, and a burger, of course, very American.
So this one's sweet and sour chicken.
Honey coming out pretty well there, there we go.
Chocolate pudding cake.
So will NASA be sending vitamin supplements to Mars?
The only one we send is vitamin D and that's because you get a lot of your vitamin D exposure from sunlight exposure on your skin and we're not gonna have that option in space flight.
Only vitamin D?
Yeah, we expect that we have all the other nutrients in a wide variety of a balanced food system.
Why is food better than supplements?
Food is just core and fundamental to every aspect of human health and performance, so it's central to these missions and there's really no way because there's so many different vitamins in food, there's so many things that you're getting that you can't replicate at this point in a pill.
Okay, there we go, it says 75, so we're gonna put in 75.
I mean to me, it feels like the linchpin, right?
To determine whether a crew gets to Mars and is happy and healthy and ready to go.
It sounds to me comes down to the food.
It's one of the great needs, you have oxygen, water, and food, and no matter what, you can't go anywhere or do anything with the human system without those three critical things.
How do you like it?
It's fantastic, I would eat this, absolutely.
For three years.
For three years, this is all I get?
This is mission control Houston.
As we come up on the first two critical Orion program milestones, the service module faring panel jettison and the launch abort system jettison--
Our growing understanding of the power of food is revealing something extraordinary.
As well as the 13 vitamins, there are thousands of other chemicals in food, a multitude of molecules working in complex and often mysterious synergy.
Together, they protect against disease, but they don't always have that same power if they're isolated from our food.
At this point in time, we can't begin to think that a supplement could replicate what we would get from a food or replace whole foods in our diet.
Foods contain dozens of essential micronutrients, but they also contain literally thousands of compounds that we've only minimally studied up until this point in time.
Even if it's comfortable to think that this pill will solve many problem of the daily life and will prevent longterm or chronic diseases, and it's not true and it's not proven for the moment and what is proven are the relationship between diet and health.
I actually think it's unfortunate that there's been so much hype and pseudoscience around vitamins, so you have people who are evidence based, science based who think
"Oh, vitamins are all nonsense," no, they're not, actually, it's science, it's nutrition, it's medicine.
What's nonsense is over hyping vitamins or pretending that they're something that they're not.
You know, before, when I thought of vitamins, I thought of pills.
I had kind of forgotten that they all come from food, but now I've learned it's really not that hard to get everything you need from food and there's so much more to food than we currently understand.
After all, we've been getting our food from vitamins for millions of years.
You think we'd have it all worked out in barely a hundred?
So should we take our vitamins?
By eating good food, and if you feel like you need something extra, maybe the best thing to do is think of vitamins as if they're medicines.
That is, if you take them, take them seriously.
(people chattering under soft music)