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More than half of adults take dietary supplements, and use of supplements in the US is projected to increase. ... In 2021, people in the US spent an estimated almost $50 billion on dietary supplements and the dietary supplement industry spent about $900 million on marketing. (Jenny Jia, MD, MSc, Natalie A. Cameron, MD and Jeffrey A. Linder, MD, MPH, 6/21)

Currently, US adults spend more than $10 billion per year on vitamins and dietary supplements,1 believing against most evidence that fortified gummy bears and water infused with vitamins will improve their health and well-being. Vitamins are necessary for life, the difference between healthy gums and scurvy, between strong bones and rickets. But, as the recent US Preventive Services Task Force (USPSTF) recommendation statement2 and updated evidence report and systematic review3 show, there is little evidence that supplemental vitamins and minerals prevent cancer, cardiovascular disease, or mortality. (Peter A. Ubel, MD, 6/21)

America’s science policies are changing. America’s scientists need to change with them. The recent controversies over the Food and Drug Administration’s accelerated approval of an Alzheimer’s treatment are a lesson in the costs of failing to do so. A year ago, the FDA fast-tracked Biogen’s aducanumab — the first new Alzheimer’s drug in almost 20 years — even after an expert panel nearly unanimously recommended against giving it the green light. The decision has been so contested that lawmakers are now trying to change the FDA’s accelerated approval process. (Jason Karlawish, 6/20)

The continuing spread of SARS-CoV-2 remains a Public Health Emergency of International Concern. What physicians need to know about transmission, diagnosis, and treatment of Covid-19 is the subject of ongoing updates from infectious disease experts at the Journal. (Eric J. Rubin, M.D., Ph.D., et al, 6/16)

Prescription drug prices remain stubbornly high in the U.S. even though making drugs more affordable is a priority for both Democrats and Republicans. There are many reasons for the lack of progress. Some are deliberate, others are accidental. A dizzying and byzantine pharmaceutical system with minimal transparency is one part of the problem. Companies’ ability to stymie reform, like not allowing Medicare to negotiate drug prices, is another. So is anti-competitive behavior from drug manufacturers, which games the system at the expense of patient affordability and access to medications. (Ravi Gupta and Joseph S. Ross, 6/17)

During the British cholera epidemic of 1831, William O’Shaughnessy reported that the blood of victims “has lost a large portion of its water…a great proportion of its neutral saline ingredients” and that “of the free alkali contained in healthy serum, not a particle is present in some cholera cases.”1 He advocated for the restoration of the missing water and salts, an approach that was embraced by the Scottish general practitioner Thomas Latta, who reported the striking resuscitative effects described above.2 Two centuries later, key questions remain: which fluids, how much, and toward what targets? (Lauralyn A. McIntyre, M.D., M.H.Sc., and John C. Marshall, M.D., 6/17)