"The Case Against Vitamins" article in the WSJ
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free skin care · Wed Mar 29, 2006 12:10 pm

Read an interesting article a few weeks ago in the WSJ. Thought I would post it since we have been discussing eating habits and vitamins lately.

Not indorsing, agreeing, or disagreeing just posting because thought it was interesting. Also, sorry for posting entire thing but if I put a link you would have to pay for the service to be able to read it. Enjoy!

THE JOURNAL REPORT: PERSONAL HEALTH

Prevention
The Case Against Vitamins
Recent studies show that many vitamins not only don't help. They may actually cause harm.
By TARA PARKER-POPE
March 20, 2006; Page R1

Every day, millions of Americans gobble down fistfuls of vitamins in a bid to ward off ill health. They swallow megadoses of vitamin C in hopes of boosting their immune systems, B vitamins to protect their hearts, and vitamin E, beta carotene and other antioxidants to fight cancer.
It's estimated that 70% of American households buy vitamins. Annual spending on vitamins reached $7 billion last year, according to industry figures.
But a troubling body of research is beginning to suggest that vitamin supplements may be doing more harm than good. Over the past several years, studies that were expected to prove dramatic benefits from vitamin use have instead shown the opposite.

THE JOURNAL REPORT
See the complete Personal Health report.
Beta carotene was seen as a cancer fighter, but it appeared to promote lung cancer in a study of former smokers. Too much vitamin A, sometimes taken to boost the immune system, can increase a woman's risk for hip fracture. A study of whether vitamin E improved heart health showed higher rates of congestive heart failure among vitamin users.
And there are growing concerns that antioxidants, long viewed as cancer fighters, may actually promote some cancer and interfere with treatments.
Last summer, the prestigious Medical Letter, a nonprofit group that studies the evidence and develops consensus statements to advise doctors about important medical issues, issued a critical report on a number of different vitamins, stressing the apparent risks that have emerged from recent studies. The Food and Nutrition Board of the National Academy of Sciences -- the top U.S. authority for nutritional recommendations -- has concluded that taking antioxidant supplements serves no purpose.

BEYOND VITAMINS
People hear that if they take vitamins they'll feel better," says Edgar R. Miller, clinical investigator for the National Institute on Aging and author of an analysis that showed a higher risk of death among vitamin E users in several studies. "But when you put [vitamins] to the test in clinical trials, the results are hugely disappointing and in some cases show harm. People think they are going to live longer, but the evidence doesn't support that. Sometimes it's actually the opposite."
Not everybody is buying these results. Consumers remain devoted to their vitamin regimens. Industry groups such as the Council for Responsible Nutrition reject the recent evidence, saying the research is flawed or the people studied were too sick to start with, making it impossible to draw any broad conclusions for the rest of us. "I don't think it's black and white," says Andrew Shao, vice president of regulatory and scientific affairs for the council. "It's important to know that a lot of these studies have been done in diseased populations. I suppose the expectations are too high. These vitamins are not drugs. They can't be expected to cure or reverse 20, 30 or 40 years of disease."
Everyone needs vitamins, which are key nutrients the body can't make. But micronutrients from foods usually are adequate to prevent vitamin deficiency, which is rare in the U.S. Even so, vitamin B-12 supplements for the elderly and folic acid for women of child-bearing age are recommended.
But the proven benefits of a few supplements pale next to the growing concerns about widespread vitamin use. Nobody knows why high doses of vitamins taken as pills might cause harm. One theory has to do with free radicals, a common byproduct of the normal chemical reactions that occur in cells. Every day cells get damaged due to a variety of factors including sunlight, the foods we eat and natural aging. This creates free radicals, highly reactive molecules that can damage tissues and lead to cancer and heart disease. Although the body has several ways of coping with free radicals, many people believe high doses of vitamins help, mopping up free radicals before they can do much damage.
But the problem is that free radicals may serve an important purpose, sending a powerful signal to the body's immune system, which enlists its own army of soldiers to fight the free radicals and fix the damage. The theory is that by taking vitamins, we undermine that message system and upset the balance of antioxidants and free radicals in the body. It may be that vitamins clean up the free-radical mess, but the immune system isn't alerted to fix the damage, allowing disease to set in.
Another concern is that while vitamins from food sources are necessary and good for you, consumers today often scarf down vitamins at levels that are more like a pharmaceutical dose than something found in nature. In a test tube, high doses of a single antioxidant can turn bad, evolving into pro-oxidants -- meaning they start to oxidize and create free radicals, causing the very problem you were trying to prevent.
Here's a look at what science shows about the risks and benefits of some particular vitamins.

VITAMIN E
Vitamin E has long been touted as beneficial to heart health, based in part on observational studies that have shown diets rich in fruits and vegetables containing E and other vitamins are associated with a decreased risk of coronary disease. Vitamin E also has been studied as a way to help Alzheimer's disease and to prevent prostate cancer.
But research into vitamin E supplements has been disappointing. Most clinical trials in recent years have been inconclusive or shown no benefit -- and some have suggested harm. The University of California-Berkeley Wellness Letter, from the same institution that discovered the vitamin in 1922, last year said it no longer recommended vitamin E supplements because of the data showing no benefits.
Last year, Johns Hopkins University researchers in Baltimore published a shocking finding. After reviewing the data from 19 vitamin E clinical trials of more than 135,000 people, the analysis showed high doses of vitamin E (greater than 400 IUs) increased a person's risk for dying during the study period by 4%. Taking the vitamin E with other vitamins and minerals resulted in a 6% higher risk of dying.
Not everyone agrees with the methods used in the study. And most of the patients were already unhealthy, so the results may not apply to healthy people.
Since the analysis was published, another study of about 9,500 patients evaluated long-term use of 400 IUs of vitamin E daily. The study didn't show any statistically meaningful differences between vitamin users in terms of cancer, heart attacks or stroke, but the vitamin E takers had a 13% higher risk for heart failure.
The risk of taking vitamin E for cancer is also of concern. Last year, the Journal of Clinical Oncology published a study of 540 patients with head and neck cancer who were being treated with radiation therapy. The patients took 400 IUs of vitamin E or a placebo. The supplement reduced side effects by nearly 30%. But recurrence rates among the vitamin E users were 37% higher. The finding was not statistically meaningful, but has raised concerns that vitamin intake could hinder the effectiveness of treatments.
Not all the vitamin E news has been bad. Last year, the Women's Health Study evaluated use of 600 IUs of vitamin E every other day by nearly 40,000 healthy women. Overall, there was no benefit of using vitamin E for major cardiovascular events or cancer. But a subgroup analysis found there was a 24% lower risk for cardiovascular deaths and a 26% reduction in major cardiovascular events among women over 65. The researchers said those findings weren't conclusive, however, in part because they contradict other clinical-trial evidence.
Another study, called Select, is looking at whether vitamin E and selenium lower risk for prostate cancer. The study won't finish for several years, but this summer a safety monitoring committee will review the results to date to see whether any significant risks or benefits have emerged. In February, another study reported in the Journal of the National Cancer Institute showed no clear benefit of vitamin E on prostate-cancer risk, although there was benefit among a subgroup of smokers.
The Select trial already offers a cautionary tale on vitamin use, says Eric Klein, head of urologic oncology at the Cleveland Clinic and a Select investigator. Select was started after a study of smokers in Finland looked at beta carotene and vitamin E to prevent lung cancer. While vitamin E users had an unexpected lower risk for prostate cancer, the beta carotene users had a higher risk for lung cancer. "The psyche of the U.S. population is that a nutraceutical can't be harmful and might be helpful, so why not take it?" says Dr. Klein. "That thinking is just not correct. The message is: Be careful until the data is in."

BETA CAROTENE AND VITAMIN A
Vitamin A is a family of compounds that play a role in vision, bone health, cell division and the regulation of the immune system. Retinol is one of the most usable forms of vitamin A. Several carotenoids, the darkly colored pigments found in many plant foods, can be converted to vitamin A, but beta carotene is the carotenoid that is most efficiently converted to vitamin A.
Although studies have suggested an association between diets rich in beta carotene and vitamin A and a lower risk for many types of cancer, the supplements taken in pill form have proved risky.
The 1994 Finland study of smokers taking 20 milligrams a day of beta carotene showed an 18% higher incidence of lung cancer among beta carotene users. In 1996, a study called Caret looked at beta carotene and vitamin A use among smokers and workers exposed to asbestos. The trial was stopped when the participants taking the combined therapy showed a 28% higher risk for lung cancer and a 26% higher risk of dying from heart disease.
More recently, a 2002 Harvard study of more than 72,000 nurses showed that those who consumed high levels of vitamin A from foods, multivitamins and supplements had a 48% higher risk for hip fracture than nurses who had the lowest intake of vitamin A. Notably, nurses who ate a lot of foods high in vitamin A also had higher risk, possibly indicating that too many foods are now fortified with the vitamin. Milk, margarine and breakfast cereals are fortified with vitamin A. High intake of vitamin A has also been associated with a higher risk of birth defects.

VITAMIN C
Ever since Nobel laureate Linus Pauling extolled the virtues of vitamin C more than 30 years ago, Americans have been taking handfuls of the pills, convinced the vitamins do everything from preventing colds to fighting cancer. But like other vitamin studies, research into vitamin C has been disappointing.
Last summer, the Cochrane Database of Systematic Reviews looked at the clinical-trial evidence for vitamin C supplements in treating the common cold. Among 23 studies, there was no overall benefit to using vitamin C to prevent colds. However, six studies of marathon runners, skiers and soldiers exposed to significant cold or physical stress showed about a 50% reduction in colds with vitamin C use. But the investigators warned that these were extreme circumstances and probably don't apply to the general population. Vitamin C may slightly shorten the duration of colds, but the investigators said the small difference may not even be noticed by patients.
There are also concerns about risks associated with vitamin C. A 1999 analysis in the British Medical Journal showed that in three studies, vitamin C didn't lower death rates among elderly people, and may actually have increased the risk of dying slightly. Last year, the cancer journal CA reported that antioxidant supplements, including vitamin C, should be avoided by patients being treated for cancer. Scientists have found that cancer cells gobble up vitamin C faster than normal cells, suggesting that any protection vitamin C gives might be even greater for tumors than normal cells. In 2001 scientists showed that cancer cells may become resistant to chemotherapy drugs after treatment with vitamin C. "It's a mistake to think that cancer cells...don't like nutrients," says Gabriella D'Andrea, oncologist with Memorial Sloan-Kettering Cancer Center in New York and author of the review.
Whether any of the antioxidant vitamins are cancer fighters or cancer promoters remains an open question. Although some data suggest a benefit, others suggest harm. In October 2004 Copenhagen researchers reviewed seven randomized trials of beta carotene, selenium, and vitamins A, C and E (alone or in combination) in esophageal, gastric, colorectal, pancreatic and liver cancer. The antioxidant users had a 6% higher death rate than placebo users.

B VITAMINS
A regimen of B vitamins, including folic acid, vitamin B-12 and vitamin B-6, has been touted as a way to improve heart health by lowering homocysteine, an amino acid thought to be a risk factor for heart attack. But last week, two studies presented to the American College of Cardiology showed that while the vitamins do lower homocysteine levels, taking them doesn't lower risk for heart attack.
The patients in the studies weren't healthy. They had diabetes, heart disease or a history of heart attack. The New England Journal of Medicine said the consistency of the results "leads to the unequivocal conclusion" that the vitamins don't help patients with established vascular disease.
But the medical community remains divided on whether the vitamins might still be useful for healthy people. "This should not close the book on the investigation of whether B vitamins in a healthy population helps reduce risk of cardiovascular disease," says Dr. Shao of the Council for Responsible Nutrition.
Not all the research into vitamin B is controversial. Folic acid supplements for women of child-bearing age have dramatically reduced the incidence of neural-tube defects in babies. Elderly people can develop an inability to absorb vitamin B-12 from food, so supplements may be recommended as we get older.

CALCIUM AND VITAMIN D
A 2005 study in the British Medical Journal didn't show any reduction in fracture risk among women who took 1,000 milligrams of calcium with 800 IUs of vitamin D a day. But the Women's Health Initiative recently suggested that calcium and vitamin D may lower hip-fracture risk in women over 60. Calcium users, however, had a 17% higher risk for kidney stones.
Elderly people, particularly those who have dark skin, get little exposure to sunlight and don't drink milk, are at risk for vitamin D deficiency and are typically advised to take supplements. One study suggests the most benefit comes with about 800 IUs of vitamin D a day.
Most doctors and health experts now suggest that consumers interested in taking vitamins stick to a multivitamin rather than concoct their own cocktails of high-dose vitamins. But even this practice is being questioned because there's little evidence to support it. In August the British Medical Journal looked at multivitamin use among elderly people for a year, but found no difference in infection rates or visits to doctors.
Researchers urge caution when interpreting results from various vitamin studies. Many factors, ranging from the type of vitamin to the age and health of the participants, may influence the results, says Marion Dietrich, postdoctoral associate in the Nutritional Epidemiology Program at Tufts University. What is clear, however, is the important role a healthful diet plays in preventing illness. Large dietary-intervention studies have shown that a healthful diet reduces risk of cardiovascular disease.
But doctors say many patients view vitamins as a quick fix to compensate for poor eating habits, and resist any suggestion that taking them may not be beneficial. "A lot of people are passionate about their vitamins," says Dr. Miller of the National Institute on Aging. "I don't know where they get it from, but it's not based on scientific evidence."
--Ms. Parker-Pope, who writes The Wall Street Journal's weekly Health Journal column, served as contributing editor of this report.

free skin care · Wed Mar 29, 2006 6:27 pm

I think this is very misleading. Sure taking superdoses of some vitamins (esp the fat soluble ones can lead to trouble but there is a huge body of evidence including a large Scandanavian study showing people who take multivitamins stay young longer (in terms of mental capacity) than those that don't. It even showed those who started earlier benefited most. IN addition most of the MDs I know and work with take a slew of supplements (with Resveratrol, alpha lipoic acid and acetyl-L-Carnitine being the most used). I take these also because I see directly the results from people here studying Resveratrol.

Nowadays there are scare stories about everything! I think a dose of common sense goes a long way.

free skin care · Wed Mar 29, 2006 6:30 pm

PS There is one other thing I forgot to mention. When taking vitamins it is important to take a balanced vitamin supplement and a balanced mineral supplement.

This is because problems can arise by having non optimal ratios of certain things (e.g. Calcium and Mg should be balanced). But again I think this is just common sense anyone who looked even briefly on the WEB could find out these issues.

free skin care · Wed Mar 29, 2006 8:53 pm

Hi Shelley01 - I read this article when it was first published, and most of it contained data I'd already read in other reports. Unlike sharky, I think there's something to it, and I find it a bit alarming -- not for myself, since eating a bowl of Total cereal (with its added vitamins) in the morning with blueberries on top is the only supplementation to my diet -- but for the general population. Sales of supplements are increasing, and so is obesity. I think this may be correlational rather than coincidental, insofar as people don't eat healthfully and think a handful of supplements a day will make up for their poor diets. Also, demography plays a role -- our nation is getting older, and consciousness of one's mortality is a great inducement towards lifestyle changes. For example, I've recently read another article about the increasing numbers of "anti-aging" clinics that have opened which not only promote the use of supplements, but also injections of hormones, etc. These are generally run by physicians who claim to personally espouse this approach to advancing age. My natural skepticism makes me wonder, however, if even physicians can't resist cashing in by exploiting peoples' fear of getting/looking old. Time will tell.

Unfortunately, many people are either too lazy or unwilling to bother making the [sometimes] radical changes in diet that may lead to better health, i.e. taking the time to prepare and eat fresh fruits and vegetables -- simple as that. Grocery stores (which are literal marketplaces and reveal what people are truly consuming) stock an increasing amount of processed and prepared foods. Restaurants are proliferating and people dine out more and more. One reason why I rarely go out to eat is because most restaurant fare, while very tasty, is generally heavily laden with fats and salt and offers much less fresh (and unadulterated) veggies than I prefer. The portion sizes get larger all of the time, too. Bottom line -- eating habits are trending in an unhealthful direction. So what do people do? Take supplements, as if they can only do good and do no harm!

I don't believe they're always harmful, and indeed the WSJ article only referred to the most commonly used ones. But I think the general population is not as informed about them as they should be and, at a possible risk, sometimes think the more they take, the better. I DO agree with sharky about balance. Balance in general is a guiding principle in my life.

free skin care · Thu Mar 30, 2006 6:19 am

Mapril: I agree with you about diet I do not use processed foods except for flax bread for that reason (have you looked at the salt content on a normal can of soup. I looked at a Snow's corn chowder can and it contains 2100mg. of sodium in a 15oz can and disguises it by saying that it is 600 per 1/2c serving and who on earth eats a 1/2 c of soup!).

I disagree on supplements. In the case of a vegetarian diet they are a must. My sis is a vegan and takes many supplements because she was ill without them. Alos when you are aging no matter how healthy your diet is things are breaking down. I'm not gung ho on life extension but I don't want to live my last 20 years in a bad state. That's mostly controlled by genes but I've seen first not second hand what some of the supplements do on many levels and I'm all for them. That's not to say that people don't go wacko over supplements and do bad things to themselves (I think HgH shots are bad because they cause other changes like stopping your bodies natural production) but if someone eats a good diet and reads real literature and then proceeds with moderation it is not much of a risk.

I belive like Dylan Thomas
"Rage, rage against the dying of the light"!

free skin care · Thu Mar 30, 2006 8:27 am

Sharky – I have done a lot of research on the web and as I said in my first post I did not post the article to indorse it, agree with it, or disagree. However, I did post it so people could read, come up with their own questions, and even use the article as a starting point. I don’t think it is a “scare story” and I am sorry if you are offended by my posting of it but I like that it gets people to start thinking about vitamins and if they are using them as a crutch instead of having a balanced diet.

Additionally, how do people know who and what to trust on the web? You, in your profession, have a leg up because you work with doctors and scientists. I am guessing you have access to journals that some of us do not. In my profession, I can tell you who has a better balance sheet and which stocks to watch. I understand cash flow statements and read financial statement footnotes……..I don’t expect everyone to understand those things……and clearly they do not or people would not invest in such horrible businesses….but that is another topic. My point is that it is difficult to know where to get “good” information from so an article like this can be a starting point or in least get people to think about something they might not otherwise think about.

I put the poll in so that we could all see how many people are taking supplements and how many supplements a day.

Personally, I take two a day (but I usually forget on the weekends). I take prenatal and omega-3. I eat a healthy and nutritional foods and exercise for an hour six times a week and lift weights twice a week (used to do a lot of yoga but have stopped……not really sure why!! Hmm, need to think about that). I feel good and hardly get sick.

So, I am glad everyone has an opinion and I am interested in what everyone here thinks…..but please don’t think that I am indorsing anything……

free skin care · Thu Mar 30, 2006 8:55 am

I do not trust any WEB info. I do use it for recent info but just to get names to search for in the real literature. You may or not remember a case 2 years ago when one of the top "lawyers' on lawyers.com (a somewhat respectable site) was a teenage boy who got his advice from watching TV shows.

I actually teach a class that includes how to use the WEB and how much misinformation is there even on good sites.

Use MEDLINE or PUBMED search engines for real info. At most libraries the abstracts are free. Sometimes you have to pay for the actual text but often people publish reprints of their articles on the WEB so you can then get the article for free. The medical literature is also not the greatest it is more prone to bias that the physical sciences through who funded the work (eg. national sugar org., national beef org etc. not to slur these just to make a point).

Again sorry if I offended you.

Fri Mar 31, 2006 3:21 am

While I feel I should be taking something, at the moment I'm in lazy/forgetful mode and hence not taking any. Therefore I'd be choosing the "0" option if there was one.

free skin care · Fri Mar 31, 2006 8:05 pm

I know there has always been controversy over whether supplements help and I know certain ones must not be taken in large quantities but I really want to believe that the ones I'm taking are helping me.

Here's my list:
multi
calcium/magnesium
glucosamine
salmon oil
flax oil
evening primrose oil
new addition of Natural Calm magnesium drink

I'm not taking anything in massive quantities and I don't eat much processed food that is supplemented. I feel like I should be taking an iron supplement because we don't get spinach here, I don't eat meat and I don't eat lentils every day. Maybe I should start eating an iron fortified cereal.

I just googled this up http://ods.od.nih.gov/factsheets/iron.asp and now I'm sure I need more iron. There is no way I'm getting enough in my diet.

free skin care · Sat Apr 01, 2006 5:31 pm

Some interesting things to consider.. the biggest marketing ploy I see with fortified food goods is the claim of "such and such times more vitamins than such and such"... when the most important thing we should take into consideration is the quality of the vitamins/minerals and how well they can be broken down and absorbed.

What if the compounds that the vitamins and minerals occur in are actually just passed right through the body or broken down into harmful substances?

I remember taking a women's multi which was made by Swisse, which was supposed to be much better than supermarket brands.. My pee after taking one of these tablets would be almost a green colour... which means so much excess vitamin B was passing through. Now I take a natural B complex which doesn't have the same nasty effect at all.

I agree with everyone, that diet is one of the best ways to improve health... and pills shouldn't be a short cut to good health or justification for bad eating habits.

free skin care · Tue Apr 04, 2006 8:42 am

well vitamins are good it just depend from where you get them.. I mean synthetic vitamins are bad and can do more harm then good. Look at all the vitamins on the shelves today. Hundreds right? And they are cheap. Most likely they are synthetic vitamins which are made in the lab and not natural that comes from fruit and vegatables.

Of course too much is bad of anything. Too much excercising is bad right? You need to let your body rest...

My mom takes a lot of vitamins like maybe 4 or 5 pills from 3-4 different bottles.

I take about 7-9 capsules every other day but from one natural multi-vitamin bottle that gives me everything I need for the body in one. I check the dosage and its not high. LOL after reading this article and seeing the high dosage they used i went to check the dosage right away. LOl no way near it so im good..

i get it herewww.ouramazingvitamins.com

In some cases the article is true and in some I dont think it is. Cause i did hear that a synthetic form of Vitamin C can actually do more harm than good so maybe the study came from use of synthetic vitamins.

GOod to know though

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