Keith Ellis
06-29-2006, 12:51 PM
Vitamin Pros and Cons
A recent Wall Street Journal article featured a particularly scathing critique of vitamins, suggesting that in reality they "may be doing more harm than good." My quick reaction was shock at such a strong statement in light of the increasing support from both conventional and naturopathic practitioners regarding vitamin usage. Could it be true? Do antioxidants actually promote rather than fight cancer? Does taking vitamin E really increase one's chance of dying? Yes to both, if you use them improperly. Done right, vitamins are as critical for our good health as ever.
THE DEVIL IS IN THE DETAILS
Not to worry, says Eric Yarnell, a naturopathic physician and registered herbalist of the American Herbalists Guild based in Seattle, Washington, and author of Clinical Botanical Medicine. He assured me that vitamins remain the crucial ingredients for health that they have always been, and suggested that the article was seriously flawed. Most egregiously, the author overgeneralized and failed to look at the details of the studies (what forms of vitamins were used, who the participants in the trials were, etc.)... and, as I have outlined with regard to several specific herb studies in the past, the devil is in the details.
Certified nutrition specialist Shari Lieberman, PhD, agrees, noting that the piece focused almost exclusively on negative results, when there are thousands of rigorous clinical studies that meticulously document the health benefits of vitamins. In her opinion, the article was "a hatchet job with very little scientific basis."
To delve more deeply into the matter, and to help ease any confusion and concern in the minds of Daily Health News readers, let us look at to the experts to take a closer look at the article's portrayals of individual vitamins. Their analysis follows...
B VITAMINS
What the Wall Street Journal said: B vitamins (folic acid, B-12, B-6, etc.) are "touted" for heart health, as they lower levels of the toxic amino acid homocysteine. However, recent studies demonstrated that although the vitamins did indeed lower homocysteine, they did not lower heart attack risk. The article goes on to grudgingly acknowledge folic acid's well-documented role in preventing neural tube defects in babies, with the observation that "not all the research into vitamin B is controversial."
Our experts respond: According to Dr. Yarnell, not only is the evidence that folic acid prevents birth defects not "controversial," it is rock solid and enjoys virtually universal support from health experts. Dismissing this uniformly positive research with such faint praise is typical of the article's sniping, negative tone.
As for B vitamins and homocysteine, upon closer analysis new information comes to light. For example, since the US now mandates folate supplementation in breads and other grain products, we're no longer as folate-deficient a population as we used to be, and folate supplements are not likely to make as significant an impact. Moreover, while the Vitamin Intervention for Stroke Trial demonstrated that B vitamins were not effective in preventing second cardiovascular events overall, a substantial subgroup (including heart attack patients who did not have abnormal B-12 levels or significant kidney impairment) experienced an impressive 21% drop in subsequent ischemic stroke, coronary disease or death.
Your best bet: For optimal effect, take B vitamins together in a B-complex vitamin. A standard daily dosage is 50 mg. A simple blood test can determine whether levels of specific B vitamins such as folic acid or B-12 are low and require additional supplementation.
VITAMIN C
What the Wall Street Journal said: The article describes research into vitamin C as "disappointing," acknowledging but pooh-poohing the fact that it shortens the duration (by one day) of colds. Even worse, the author suggests that antioxidant vitamins, including C, might be "cancer promoters" rather than "cancer fighters," and disrupt chemotherapy.
Our experts respond: Anyone who has suffered the pain and misery of a cold would no doubt be delighted to take vitamin C and get better a day earlier. In addition, the Journal article fails to mention that the same studies indicate that C also reduces the severity of colds. What Dr. Yarnell found particularly ridiculous was the suggestion that vitamin C might promote cancer or be harmful to take during chemotherapy.
Vitamin C is a powerful antioxidant that prevents cell damage from free radicals, and many other studies -- animal and human -- indicate that vitamin C possesses both tumor growth-inhibiting and chemo-potentiating effects, says Dr. Yarnell. In the end, one's conclusion depends on which analysis one reads, and he points out that the Wall Street Journal article consistently dealt with the negative, vitamin-bashing research. For more on the use of antioxidants during chemotherapy see Daily Health News, June 1, 2006.
Your best bet: An average dose of vitamin C consists of 500 mg to 1,000 mg daily. When you are ill or under stress, a naturopathic physician (ND) may recommend higher doses. Dr. Lieberman adds that antioxidants work synergistically, and vitamin C is much more powerful when taken with vitamin E. Vitamin C protects the watery parts and E the fatty parts of your body's cells.
BETA-CAROTENE AND VITAMIN A
What the Wall Street Journal said: Several studies indicate that beta-carotene (a carotenoid in brightly colored fruits and vegetables that acts as a precursor to vitamin A) can raise the incidence of lung cancer in smokers.
Our experts respond: Virtually all studies indicate that smokers who consume the most beta-carotene-rich fruits and vegetables have the lowest levels of lung cancer. In the study in question, to test this hypothesis, men who smoked cigarettes or were exposed to lung-damaging asbestos were given 20 mg to 30 mg daily of supplemental beta-carotene. Paradoxically, the men who consumed beta-carotene developed more lung cancer than those who received placebo.
According to Dr. Lieberman, the problem here is the form of vitamin used -- synthetic beta-carotene. You cannot equate nutrient-rich fruits and veggies with this single supplement. In her opinion, synthetic beta-carotene should not even be sold, since it may act as a disease-encouraging pro-oxidant (as opposed to a disease-fighting antioxidant) by interfering with the body's absorption of other carotenoids.
Your best bet: Dr. Yarnell agrees, and advises that instead of taking synthetic beta-carotene, you opt for mixed carotenoids -- a supplement that is far closer to the form these nutrients take in nature. If you take vitamin A without medical supervision, do not exceed the federal government's daily recommended dietary allowance (RDA), which for women age 19 and older is 2,310 international units (IU) and for men age 19 and older is 3,000 IU.
CALCIUM AND VITAMIN D
What the Wall Street Journal said: Calcium and vitamin D supplementation may not reduce the risk of fractures in women, or at least it may reduce them only in women over age 60. Moreover, calcium supplements may raise the risk for kidney stone formation. The article also cites a study recommending 800 IU daily of vitamin D for older people who are at risk for a vitamin D deficiency.
Our experts respond: It's amazing how deficient many people are in vitamin D, observes Dr. Yarnell. This vital nutrient helps the body absorb calcium, which is essential to forming and maintaining strong bones. In his opinion, the dosage in the Wall Street Journal piece is woefully inadequate, and at any rate, whenever possible, we are better off getting our daily quota of the "sunshine vitamin" by spending time outdoors every day.
As for calcium, we begin stockpiling this vital mineral in our younger years, when we should be sure to eat plenty of calcium-packed foods such as leafy green vegetables (collards, kale, etc.), broccoli and sardines. (As I've mentioned before, cow's milk is best reserved for calves.) Taking supplements when we are older may not be enough to fully compensate for earlier deficits and continued poor eating habits that include calcium-leeching soft drinks, but it is still beneficial. To prevent kidney stones, Dr. Yarnell recommends taking calcium and any vitamin D supplements with food.
Your best bet: Dr. Yarnell points out that our bodies can naturally synthesize all the vitamin D we need with just 15 to 20 minutes of sun exposure daily. In dark winter months, when people can't get outdoors or if there is a deficiency, he recommends up to 2,000 IU of vitamin D daily. The recommended daily intake of calcium (which for better absorption is often paired with vitamin D) is 1,000 mg to 1,200 mg daily for adults. To prevent kidney stones, Dr. Yarnell recommends taking calcium and any vitamin D supplements with food.
VITAMIN E
What the Wall Street Journal said: Like the B vitamins, vitamin E has been "touted" for heart health, but may result in a higher risk of dying.
Our experts respond: The study cited was deeply flawed. It was a meta-analysis of 19 clinical trials that lumped together different types of vitamin E and different types of patients (many of whom were already at higher risk due to heart disease or diabetes). And again, there was a problem with the form of vitamin used. It matters hugely what kind of vitamin E you take, explains Dr. Yarnell. Natural vitamin E (d-tocopherol) is highly preferable to the synthetic form (dl-tocopherol) because it is much better absorbed by the body. Unfortunately, Dr. Yarnell points out that large-scale studies almost invariably go with what is cheapest -- synthetic vitamin E.
Your best bet: Dr. Yarnell recommends a natural vitamin E blend that contains both tocopherols and tocotrienols, which work together synergistically for optimal effect. (Most multivitamins contain only alpha-tocopherol.) An average dose consists of 200 to 400 IU daily. (Caution: People taking blood-thinning medications such as warfarin (Coumadin) should check with their physicians before using vitamin E.)
A recent Wall Street Journal article featured a particularly scathing critique of vitamins, suggesting that in reality they "may be doing more harm than good." My quick reaction was shock at such a strong statement in light of the increasing support from both conventional and naturopathic practitioners regarding vitamin usage. Could it be true? Do antioxidants actually promote rather than fight cancer? Does taking vitamin E really increase one's chance of dying? Yes to both, if you use them improperly. Done right, vitamins are as critical for our good health as ever.
THE DEVIL IS IN THE DETAILS
Not to worry, says Eric Yarnell, a naturopathic physician and registered herbalist of the American Herbalists Guild based in Seattle, Washington, and author of Clinical Botanical Medicine. He assured me that vitamins remain the crucial ingredients for health that they have always been, and suggested that the article was seriously flawed. Most egregiously, the author overgeneralized and failed to look at the details of the studies (what forms of vitamins were used, who the participants in the trials were, etc.)... and, as I have outlined with regard to several specific herb studies in the past, the devil is in the details.
Certified nutrition specialist Shari Lieberman, PhD, agrees, noting that the piece focused almost exclusively on negative results, when there are thousands of rigorous clinical studies that meticulously document the health benefits of vitamins. In her opinion, the article was "a hatchet job with very little scientific basis."
To delve more deeply into the matter, and to help ease any confusion and concern in the minds of Daily Health News readers, let us look at to the experts to take a closer look at the article's portrayals of individual vitamins. Their analysis follows...
B VITAMINS
What the Wall Street Journal said: B vitamins (folic acid, B-12, B-6, etc.) are "touted" for heart health, as they lower levels of the toxic amino acid homocysteine. However, recent studies demonstrated that although the vitamins did indeed lower homocysteine, they did not lower heart attack risk. The article goes on to grudgingly acknowledge folic acid's well-documented role in preventing neural tube defects in babies, with the observation that "not all the research into vitamin B is controversial."
Our experts respond: According to Dr. Yarnell, not only is the evidence that folic acid prevents birth defects not "controversial," it is rock solid and enjoys virtually universal support from health experts. Dismissing this uniformly positive research with such faint praise is typical of the article's sniping, negative tone.
As for B vitamins and homocysteine, upon closer analysis new information comes to light. For example, since the US now mandates folate supplementation in breads and other grain products, we're no longer as folate-deficient a population as we used to be, and folate supplements are not likely to make as significant an impact. Moreover, while the Vitamin Intervention for Stroke Trial demonstrated that B vitamins were not effective in preventing second cardiovascular events overall, a substantial subgroup (including heart attack patients who did not have abnormal B-12 levels or significant kidney impairment) experienced an impressive 21% drop in subsequent ischemic stroke, coronary disease or death.
Your best bet: For optimal effect, take B vitamins together in a B-complex vitamin. A standard daily dosage is 50 mg. A simple blood test can determine whether levels of specific B vitamins such as folic acid or B-12 are low and require additional supplementation.
VITAMIN C
What the Wall Street Journal said: The article describes research into vitamin C as "disappointing," acknowledging but pooh-poohing the fact that it shortens the duration (by one day) of colds. Even worse, the author suggests that antioxidant vitamins, including C, might be "cancer promoters" rather than "cancer fighters," and disrupt chemotherapy.
Our experts respond: Anyone who has suffered the pain and misery of a cold would no doubt be delighted to take vitamin C and get better a day earlier. In addition, the Journal article fails to mention that the same studies indicate that C also reduces the severity of colds. What Dr. Yarnell found particularly ridiculous was the suggestion that vitamin C might promote cancer or be harmful to take during chemotherapy.
Vitamin C is a powerful antioxidant that prevents cell damage from free radicals, and many other studies -- animal and human -- indicate that vitamin C possesses both tumor growth-inhibiting and chemo-potentiating effects, says Dr. Yarnell. In the end, one's conclusion depends on which analysis one reads, and he points out that the Wall Street Journal article consistently dealt with the negative, vitamin-bashing research. For more on the use of antioxidants during chemotherapy see Daily Health News, June 1, 2006.
Your best bet: An average dose of vitamin C consists of 500 mg to 1,000 mg daily. When you are ill or under stress, a naturopathic physician (ND) may recommend higher doses. Dr. Lieberman adds that antioxidants work synergistically, and vitamin C is much more powerful when taken with vitamin E. Vitamin C protects the watery parts and E the fatty parts of your body's cells.
BETA-CAROTENE AND VITAMIN A
What the Wall Street Journal said: Several studies indicate that beta-carotene (a carotenoid in brightly colored fruits and vegetables that acts as a precursor to vitamin A) can raise the incidence of lung cancer in smokers.
Our experts respond: Virtually all studies indicate that smokers who consume the most beta-carotene-rich fruits and vegetables have the lowest levels of lung cancer. In the study in question, to test this hypothesis, men who smoked cigarettes or were exposed to lung-damaging asbestos were given 20 mg to 30 mg daily of supplemental beta-carotene. Paradoxically, the men who consumed beta-carotene developed more lung cancer than those who received placebo.
According to Dr. Lieberman, the problem here is the form of vitamin used -- synthetic beta-carotene. You cannot equate nutrient-rich fruits and veggies with this single supplement. In her opinion, synthetic beta-carotene should not even be sold, since it may act as a disease-encouraging pro-oxidant (as opposed to a disease-fighting antioxidant) by interfering with the body's absorption of other carotenoids.
Your best bet: Dr. Yarnell agrees, and advises that instead of taking synthetic beta-carotene, you opt for mixed carotenoids -- a supplement that is far closer to the form these nutrients take in nature. If you take vitamin A without medical supervision, do not exceed the federal government's daily recommended dietary allowance (RDA), which for women age 19 and older is 2,310 international units (IU) and for men age 19 and older is 3,000 IU.
CALCIUM AND VITAMIN D
What the Wall Street Journal said: Calcium and vitamin D supplementation may not reduce the risk of fractures in women, or at least it may reduce them only in women over age 60. Moreover, calcium supplements may raise the risk for kidney stone formation. The article also cites a study recommending 800 IU daily of vitamin D for older people who are at risk for a vitamin D deficiency.
Our experts respond: It's amazing how deficient many people are in vitamin D, observes Dr. Yarnell. This vital nutrient helps the body absorb calcium, which is essential to forming and maintaining strong bones. In his opinion, the dosage in the Wall Street Journal piece is woefully inadequate, and at any rate, whenever possible, we are better off getting our daily quota of the "sunshine vitamin" by spending time outdoors every day.
As for calcium, we begin stockpiling this vital mineral in our younger years, when we should be sure to eat plenty of calcium-packed foods such as leafy green vegetables (collards, kale, etc.), broccoli and sardines. (As I've mentioned before, cow's milk is best reserved for calves.) Taking supplements when we are older may not be enough to fully compensate for earlier deficits and continued poor eating habits that include calcium-leeching soft drinks, but it is still beneficial. To prevent kidney stones, Dr. Yarnell recommends taking calcium and any vitamin D supplements with food.
Your best bet: Dr. Yarnell points out that our bodies can naturally synthesize all the vitamin D we need with just 15 to 20 minutes of sun exposure daily. In dark winter months, when people can't get outdoors or if there is a deficiency, he recommends up to 2,000 IU of vitamin D daily. The recommended daily intake of calcium (which for better absorption is often paired with vitamin D) is 1,000 mg to 1,200 mg daily for adults. To prevent kidney stones, Dr. Yarnell recommends taking calcium and any vitamin D supplements with food.
VITAMIN E
What the Wall Street Journal said: Like the B vitamins, vitamin E has been "touted" for heart health, but may result in a higher risk of dying.
Our experts respond: The study cited was deeply flawed. It was a meta-analysis of 19 clinical trials that lumped together different types of vitamin E and different types of patients (many of whom were already at higher risk due to heart disease or diabetes). And again, there was a problem with the form of vitamin used. It matters hugely what kind of vitamin E you take, explains Dr. Yarnell. Natural vitamin E (d-tocopherol) is highly preferable to the synthetic form (dl-tocopherol) because it is much better absorbed by the body. Unfortunately, Dr. Yarnell points out that large-scale studies almost invariably go with what is cheapest -- synthetic vitamin E.
Your best bet: Dr. Yarnell recommends a natural vitamin E blend that contains both tocopherols and tocotrienols, which work together synergistically for optimal effect. (Most multivitamins contain only alpha-tocopherol.) An average dose consists of 200 to 400 IU daily. (Caution: People taking blood-thinning medications such as warfarin (Coumadin) should check with their physicians before using vitamin E.)