Friday, June 30, 2006

Homocysteine, B-Vitamins and Heart Disease

Homocysteine, B-Vitamins and Heart Disease The headlines say that a recent study proves ‘B-Vitamins don’t prevent heart attacks’, but these reports are highly misleading. In fact, it’s the homocysteine theory of heart disease that has been somewhat discredited by recent studies, but B-Vitamins are continually successful at lowering this inflammatory chemical and at reducing the number of non-fatal strokes. So why do news reports call B-Vitamins, which behaved exactly as predicted by previous studies, “ineffective”? It would be more accurate to apply that term to the medical theorists whose proposed link between homocysteine and heart disease deaths has now been challenged by these studies. The real news is that homocysteine is probably not the strong predictor of heart disease that was previously suggested. In other words, while B-Vitamins and other nutrients do enhance the body’s energy production cycle and prevent the build up of homocysteine, homocysteine may not be a strong factor predicting deaths from heart disease in high-risk patients with preexisting conditions. These B-Vitamins have been confirmed as significantly reducing levels of homocysteine (an undesirable, inflammatory chemical temporarily produced in the Citric Acid energy cycle) that can accumulate in the absence of certain essential B-Vitamins (folic acid, B6 and B12) and other nutrients known as methyl donors (found in the nutrients choline, TMG, DMG and SAM-e). This has been confirmed in the American Heart Journal report: “BACKGROUND: Dietary supplementation with folic acid and vitamin B12 lowers blood homocysteine concentrations by about 25% to 30% in populations without routine folic acid fortification of food and by about 10% to 15% in populations with such fortification. In observational studies, 25% lower homocysteine has been associated with about 10% less coronary heart disease (CHD) and about 20% less stroke. CONCLUSION: The strength of association of homocysteine with risk of cardiovascular disease may be weaker than had previously been believed.” So it's really the medical hypothesis linking homocysteine to deaths from heart disease that is being questioned by these studies, not the efficacy of the vitamins to lower homocysteine. The news stories suggesting that the B-Vitamins somehow failed are extremely misleading and do not accurately represent the data. This is a hauntingly familiar scenario. Somehow, vitamins get a lot of undeserved bad press, completely out of context from the details of the studies. Something is seriously wrong with our system of reporting about science when factually deficient reports are so often generated without being seriously questioned by medical experts. The public is given a false sense of what a study means, with dietary supplements frequently singled out as being harmful or useless (or both!), even when these accusations are not supported by good data. There is an understandable tendency for the media to embrace controversial stories, contributing to an environment where one single study is touted as negating every other study that has ever been done. But sometimes that one study is poorly designed, or gets inaccurately represented in the press (low fat diets, anyone?). It is understandable why such provocative reports get wide coverage, but not why the subsequent criticism of the studies doesn’t. This only leads to public confusion about supplements, diets, etc., which leads to a growing mistrust by the public of how reliable are media reports on nutrition topics. No wonder people are so confused about nutrition and diet, when even scientists can’t figure out how to study and report on these topics accurately! The sensational headlines and stories promoting controversial – and often contradictory - science reports have far more impact than the rare correction or follow-up report. Neil E. LevinCertified Clinical NutritionistDiplomate in Advanced Nutritional Laboratory AssessmentBloomingdale, IL 3/16/2006 Neil E. Levin is a certified clinical nutritionist and is a professional member of the International & American Associations of Clinical Nutritionists. Neil is a member of the Scientific Council of the national Clinical Nutrition Certification Board and has a Diplomate in Advanced Nutritional Laboratory Assessment. He is on the Board of Directors of the Mid-American Health Organization (MAHO), the Midwest regional affiliate of the National Nutritional Foods Association (NNFA). Neil has published many articles in magazines and newspapers, and has appeared numerous times on radio and television news programs. Neil is also the president of Nutrition for Optimal Health Association, Inc. (http://www.nutrition4health.org/), a not-for-profit nutrition education corporation based in Winnetka, Illinois. REFERENCES: B-Vitamin Treatment Trialists' Collaboration. Homocysteine-lowering trials for prevention of cardiovascular events: a review of the design and power of the large randomized trials. Am Heart J. 2006 Feb;151(2):282-7. Review. PMID: 16442889 Lonn E, et al. Rationale, design and baseline characteristics of a large, simple, randomized trial of combined folic acid and vitamins B6 and B12 in high-risk patients: the Heart Outcomes Prevention Evaluation (HOPE)-2 trial. Can J Cardiol. 2006 Jan;22(1):47-53. PMID: 16450017 Bonaa KH, et al. Homocysteine Lowering and Cardiovascular Events after Acute Myocardial Infarction. N Engl J Med. 2006 Mar 12; [Epub ahead of print] PMID: 16531614

Monday, June 26, 2006

Thursday, June 22, 2006

Links to articles by or featuring Neil

These may not always be active or may change over time, but at some point they did include articles citing Neil Levin. Article lists: http://www.nowfoods.com/index.php?action=search&search_text=levin&search_cat_id=184 http://fruitfulyield.com/index.php?action=portalindex&cat_id=3308 Bio and organizations: http://www.nowfoods.com/?cat_id=1486 http://www.nutrition4health.org/NOHAnews/Biographies/LevinBio.htm http://www.nnfamw.org/pages/directors.cfm http://www.moonlakepharmacy.com/?cat_id=1486 http://www.nutrition4health.org/NOHAnews/NNW03_30thCelebration.htm COX-2: http://www.taxtyranny.ca/images/HTML/Pharmacartel/Articles/Pharmacartel/15pharmacartel.html http://www.consciouschoice.com/cc1801/wh_altcox1801.html http://www.dragonflymedia.com/em/em2101/wh_altcox2101.html http://newstrove.com/cgi-bin/search.pl?search=Neil+Levin http://www.commongroundmag.com/2005/cg3201/wh_altcox3201.html http://www.back2nature.net/products/DEPRESSBAN_al.html http://www.shared-vision.com/2005/sv1801/wh_supplements1801.html Ephedra: http://www.fda.gov/ohrms/dockets/dailys/03/Mar03/032403/95N-0304-EC-409.htm http://www.nutraingredients-usa.com/news/news-ng.asp?id=48784-industry-prepares-for http://nutraingredients-usa.com/news/ng.asp?id=58391&n=dt59&c=dosiwzsxsulkgpe Genetic engineering: http://www.taxtyranny.ca/images/HTML/GMO/gmo16.html http://friendsoffreedom.org/article.php?sid=927 https://web01.aphis.usda.gov/regpublic.nsf/0/cd58768d114fdc5f85256eeb004d27ec?OpenDocument http://www.findarticles.com/p/articles/mi_m0HKL/is_1_8/ai_76445382 http://www.findarticles.com/p/articles/mi_go2275/is_200305/ai_n7568867 http://www.fda.gov/ohrms/dockets/dailys/01/Jun01/062801/062801.htm http://www.saynotogmos.org/ud2005/ujun05b.html#afraid http://www.fritthelsevalg.org/htmlsite/aktuelt.asp?parent=3&flag=1&id=212 Herbs: http://www.freedomofchoiceinhealthcare.ca/Articles/Herbal-Products/Herbal-Products2.html Interviews: http://www.health-strategy.com/contentmgr/showdetails.php/id/3564 http://www.vitaminretailer.com/VR/2005/11/VR1105AccidentWaitingtoHappen.htm Misc. articles: http://www.betterhealthcampaign.org/stories.cfm?storyID=15 http://www.nutrition4health.org/NOHAnews/NNF02NatStrAgnstBrstCancer.htm http://www.vitaminretailer.com/VR/articles/MushroomCooking.htm http://www.vitaminretailer.com/VR/articles/Calcium.htm http://www.curesnaturally.com/Articles/Herbs/Herbs9.html http://www.curevents.com/vb/showthread.php?s=a307b4c7d5623917b0a0641fa638e9b9&p=14619#post14619 http://www.freedomofchoiceinhealthcare.ca/Articles/Herbal-Products/Herbal-Products2.html http://www.hsrmagazine.com/articles/521feat2.html http://www.streamhill.com/usermods/article1001.asp http://www.vitaminretailer.com/VR/articles/VR0405InTheBlood.htm http://www.vitaminretailer.com/VR/articles/VR01104Relax..orElse.htm http://www.bodybuilding.com/fun/now9.htm http://www.hsrmagazine.com/articles/571feat2.html?wts=20051031074219&hc=18&req=levin http://www.drdavidross.com/modules.php?op=modload&name=News&file=article&sid=136&mode=thread&order=0&thold=0&POSTNUKESID=c94eacb7d65f1029851b3550f1be5da4 http://caonline.amcancersoc.org/cgi/eletters/55/5/319 http://www.newmediaexplorer.org/sepp/2006/01/28/chemicals_better_than_nature_perhaps_not.htm http://www.nutrition4health.org/NOHAnews/NNF02NatStrAgnstBrstCancer.htm http://www.prweb.com/releases/2006/3/prweb353385.htm http://www.curesnaturally.com/Articles/Cancer/Cancer41.html http://www.vitaminretailer.com/VR/articles/VR0504KosherVeggieSupps.htm http://www.vitamincfoundation.org/ http://www.allnutrition.org/3302-science-fails-not-supplements.html http://groups.blogdigger.com/groups.jsp?id=161 http://healthy.net/scr/article.asp?PageType=Article&id=2287 http://www.zero-risk.org/sasreport.htm http://www.bodybuilding.com/fun/now9.htm http://www.hsrmagazine.com/articles/5b1feat2.html?wts=20060620093737&hc=25&req=levin Multivitamins: http://www.herbshop.com/multivitamins_victim_of_truth_deficiency.htm NIH Multivitamins http://www.forbes.com/prnewswire/feeds/prnewswire/2006/05/22/prnewswire200605221001PR_NEWS_B_MWT_CG_CGM028.html http://www.lef.org/news/LefDailyNews.htm?NewsID=3870&Section=VITAMINS http://www.enzymeexperts.com/world-enzymes/nutritionist-says-wall-street-journal-wrong-on-vitamins.html Product Info: http://herbalremedies.com/chromium-1.html http://www.nutritiongeeks.com/Indole_3_Carbinol_200mg_Now_60/Indole_3_Carbinol_200mg_Now.html http://www.nutritiongeeks.com/Tri_Chromium_500mcg_with_Cinnamon_90/Tri_Chromium_500mcg_with_Cinnamon.html http://vitanetonline.com/description/N1428/vitamins/TRI-CHROMIUM-500MCG-+-CINNAMON---90-VCAPS/ http://www.herbalremedies.com/green-tea-extract.html Quality: http://consciouschoice.com/2005/cc1803/wh_lead1803.html SB722 Durbin Bill: http://www.bolenreport.com/articles/sb722.html http://www.toad.net/~bsimon/2003/week37.html Self Magazine: http://www.healthactioncenter.com/action/index.asp?step=2&item=23428 Sense About Science Report: http://www.planttrees.org/events.php?event=1.30_Natural%20Vs%20Chemical%20Debate Truth Advocate: http://www.newhope.com/nfm-online/nfm_backs/May_01/media.cfm?path=ex http://www.nowfoods.com/?action=itemdetail&item_id=38659&F=1&CSPID=25633a414015836230a2d675f2fe2b3e http://www.npicenter.com/anm/templates/newsATemp.aspx?articleid=11007&zoneid=40 http://www.newmediaexplorer.org/chris/2005/04/07/raw_deal_on_vitamins.htm http://www.nutraingredients.com/news/ng.asp?n=65423&m=1NIE127&c=dosiwzsxsulkgpe http://www.vitaminretailer.com/NIE/2006/01-02/NIE0106SpecialReportEUSupplements.htm http://www.planttrees.org/events.php?event=1.30_Natural%20Vs%20Chemical%20Debate http://www.thenhf.com/articles_29.htm Vitamin E: http://www.npicenter.com/NPIForums/ShowPost.aspx?PostID=22 http://www.naturalfoodsmerchandiser.com/asp/articleDisplay.asp?strArticleId=1230&strSite=NFMSite http://healthybody.xtend-life.com/newsletter.asp?nltype=15sec&page=58http://dan.xtend-life.com/newsletter.asp?nltype=15sec&rv=t&page=58&id=944902 http://sos-nhp.com/interactions/111.shtml http://www.curesnaturally.com/Articles/Supplements/84Supplements.html http://www.koshervitamins.com/shop/stores_app/ask.asp?$session39=36&page_id=2&Item_ID=262 http://www.annals.org/cgi/eletters/0000605-200501040-00110v1 http://www.newhope.com/naturalcategorybuyer/ncb_backs/Winter_05/trendspotting.cfm http://www.healthquestradioshow.com/Interviews/Vitamin%20E/Neil_Levin.htm http://www.elitealternatives.net/healthnews_10.html http://bmj.bmjjournals.com/cgi/eletters/330/7490/0-f http://www.koshervitamins.com/shop/stores_app/ask.asp?$session39=36&page_id=2&Item_ID=262 http://www.todayshealthtip.com/healthtipsarchive.html http://www.nutraingredients.com/news/ng.asp?id=59447 http://todayshealthtip.blogspot.com/ http://www.zero-risk.org/sasreport.htm http://www.shrc.net/Merchant2/shrc.web/PastSig/SIGNAL041118.htm http://www.zero-risk.org/sasreport.htm http://lifeextensionvitamins.com/gatounat.html http://prweb.com/releases/2006/3/prweb355903.htm http://www.parade.com/articles/editions/2006/edition_05-07-2006/Medical_Facts http://www.ffnmag.com/NH/ASP/strArticleID/628/strSite/FFNSite/articleDisplay.asp http://fruitfulyield.com/index.php?action=itemdetail&item_id=44175&F=1 Vitamin E Symposium-AOCS: http://www.naturalnewswire.com/2006/04/natural_health_.html http://www.forbes.com/prnewswire/feeds/prnewswire/2006/05/22/prnewswire200605221001PR_NEWS_B_MWT_CG_CGM028.html http://www.thesoydailyclub.com/Health&Beauty/vitaminE04252006.asp http://www.naturalhealthresearch.org/menu/events-news http://www.prnewswire.com/cgi-bin/stories.pl?ACCT=SPISPM.story&STORY=/www/story/04-25-2006/0004347505&EDATE=TUE+Apr+25+2006,+04:47+PM http://www.naturalnewswire.com/2006/04/natural_health_.html http://www.aocs.org/meetings/annual_mtg/proposal6.asp http://www.lef.org/news/LefDailyNews.htm?NewsID=3776&Section=VITAMINS http://www.vitamincfoundation.org/forum/viewtopic.php?p=2909&sid=397af97be1570d49b4b81100e200acd3 Wall Street Journal (The Case Against Vitamins - response 4/06) http://www.lef.org/news/LefDailyNews.htm?NewsID=3703&Section=VITAMINS http://www.lef.org/news/LefDailyNews.htm?NewsID=3776&Section=VITAMINS http://www.prnewswire.com/cgi-bin/stories.pl?ACCT=104&STORY=/www/story/04-12-2006/0004339302&EDATE= http://community.centurytel.net/index.cfm?action=financial.stock.fin_article&id=9298933 http://medianet.indiatimes.com/MdnArticleShow.aspx?ReleaseId=560168http://biz.yahoo.com/prnews/060412/cgw052.html?.v=44&printer=1 http://www.tunies.com/common/news/store_news.asp?task=store_news&SID_store_news=11&storeID=AA4DC8A2A7E54C35B6E3FF9417B88E92 http://www.krnv.com/Global/story.asp?S=4762436&nav=menu113_11 Neil E. Levin on the Internet

Wednesday, June 21, 2006

LAND OF CONFUSION: How Poor Science and Misleading Media Coverage Create Public Confusion About How Dietary Supplements Affect Health

This article has been published by the peer-reviewed Journal of Applied Nutrition and cannot be reprinted without permission. I share the copyright and can publish it here. LAND OF CONFUSION: How Poor Science and Misleading Media Coverage Create Public Confusion About How Dietary Supplements Affect Health Levin N. Land of Confusion: How Poor Science and Misleading Media Coverage Create Public Confusion About How Dietary Supplements Affect Health. J App Nutr, Vol 55, No. 1, 2005 8-15 © 2006 Neil E. Levin and the Journal of Applied Nutrition By Neil E. Levin, CCN, DANLA Certified Clinical Nutritionist, Diplomate in Advanced Nutritional Laboratory Assessment Poor scientific work done by physicians and scientists - plus a lack of proper filters in journalism’s coverage of science - is contributing to misleading and contradictory dietary supplement health information seen by consumers, leading to them making poor health choices. This is a review of some of the problems that have occurred, which will continue until they are exposed and challenged. POOR SCIENCE A. WRONG DOSE: The clinical study dose needs to be somehow related to that used in previous studies and to common doses taken by consumers. An appropriate dose for a mild condition will probably not work for a more severe condition, which should not be presented as a failure of the supplement. 19-21 B. WRONG DURATION: A long term, chronic problem will probably not be corrected by a short term use of a dietary supplement. Longer term studies may be necessary to correctly determine efficacy. 15, 27, 37 C. WRONG MATERIAL: The species and preparation of botanicals need to be the same as those available on the market and used for nutritional support of specific health issues. 24 D. WRONG PATIENT POPULATION: Age and illness related effects need to be taken into account. For example, incidences of myocardial infarction and coronary heart disease associated with intake of arginine by seniors is not relevant for athletes that use arginine for strength enhancement. And there is evidence that people with certain conditions, like cardiovascular disease, tend to take more supplements than the general population, but it is unscientific to assume that the supplements are therefore responsible for these advanced disease conditions in the absence of any real evidence . 4, 6, 10, 28, 36-37 E. AMNESIA: The most recent study does not invalidate all previous studies. The FDA agrees, asserting that the totality of the evidence must be taken into account when interpreting studies. 19 F. GARBAGE IN: Meta-analyses mathematically integrate a number of clinical studies. However, when the analyses fail to account for differences between the studies, and are conducted by statisticians that don't understand these differences, garbage emerges. 4, 5, 10 G. BREEDING IGNORANCE: Poorly conducted studies on nutrition are often done by physicians or statisticians who have inadequate training in nutrition. 4, 10, 28 Dietary supplements may have either "actives" e.g. glucosamine, or provide nutrition, e.g. vitamins. Clinical studies for these two different classes of supplements need to be different by virtue of mode of action, end points, etc. But many researchers don't know the difference, much less how to distinguish and set up these distinct types of studies. H. DATA BIAS: Author or journal bias affects interpretation of data. For example, small benefits from vitamins have been dismissed as probably occurring by chance, while equally slim risks are noted, highlighted and magnified in importance. 4, 8, 10, 22, 24, 28 I. ADVERSE EVENT REPORTS AREN’T EVIDENCE: Adverse Event Reports (AERs) are preliminary, unscreened possible associations between a substance and a side effect. They are intended as an early warning system so toxicologists, pathologists and other experts can try to isolate a dose-related cause and effect. AERs are NOT appropriately screened to justify using them as actual evidence of a substance having caused someone harm, particularly when most AERs involving dietary supplements are actually associated with combinations of pre-existing combinations, drugs and dietary supplements. Yet a bias that we should use these unsubstantiated AERs as primary evidence to ban certain dietary supplements is quite common, as was argued in banning the herb Ephedra. There is a false assumption by many government and medical authorities that most dietary supplement AERs are true, whereas drugs are actually protected against being more tightly regulated solely on the basis of their own, far more numerous and far more deadly AERs that are known to kill over a hundred thousand people every year. 11-14, 18, 22, 32, 33 J. TALK TO THE HAND: Journal editors often fail to publish criticisms of peer reviewed work. (No references, but isn’t that the point?) K. DATA CREEP: Abstracts or conclusions that do not closely reflect the study’s data. 4, 8, 10, 21, 24, 25, 28 L. CONFLICTS OF INTEREST: Failure to properly screen studies or panels of peer-reviewers to eliminate conflicts of interest. 8 M. VITAMINS AREN’T DRUGS: Failure to anticipate synergies that nutrients require to be safe or effective. 1-3 N. VARIABLE CREEP: Failure to properly isolate and measure variables beyond the supplements that could affect study outcome 1-3, 21, 28 O. TIME TRAVEL: Reliance on preliminary study methods (test tube, epidemiological) when animal and human science has already ruled out certain mechanisms of action that may be expressed in vitro. 26 P. QUANTUM LEAP: Assuming that injections are equivalent to oral administration of supplements without evidence that this is likely or despite evidence that it is unlikely. 25 Q. POOR SPORTS: Authors do not correct their own published work even in the face of overwhelming criticism or subsequent science that reveals problems with their work. 1-3, 10, 28 R. TUNNEL VISION: Nutrient intake is often measured but not blood levels, which should also be noted for the presence of synergists or agonists that might affect the results. 1-3, 10 S. POISON PEN: Assumption that dietary supplements, including essential vitamins, are inherently toxic and that people need to be protected from them. This may betray an institutional bias by toxicologists, against the large body of safety evidence. 7, 18, 21 T. WRONG END OF THE MICROSCOPE: Failure to note that the majority of Americans are deficient in more than one essential nutrient. 9 POOR JOURNALISM A. HYPE: Misleading or sensationalistic headlines and reports that position a study’s outcomes as being more meaningful than they are or that otherwise inaccurately depict a study’s data and conclusions. (Vitamin E, Beta Carotene) B. AMNESIA: The most recent study does not invalidate all previous studies. In fact, it might be a poorly designed “rogue study”. The FDA says that the totality of the evidence must be taken into account when interpreting studies. (Vitamin E) C. ARE WE HOME YET?: Headlining a study and then failing to publish critiques of that study. Also, ignoring subsequent studies that would discredit a previously covered study. (Vitamin E, Beta Carotene) D. NOT MY DEPARTMENT: Failing to cover new developments that would significantly impact people’s view on a topic that was previously covered and continuing to refer to the original, incorrect story. (Vitamin E, Beta Carotene) E. MISTAKEN IDENTITY: Reporting on failure of ingredients to act as expected because the studies were done on severely ill patients, whereas most dietary supplements are taken by people with mild to moderate symptoms. 1, 27 (Vitamin E, Beta Carotene, Glucosamine) F. RED HERRING: Failure to note the relative safety of dietary supplements versus drugs – in fact, dietary supplements are even safer than many other categories of food products - while reporting on the supposed “dangers” of supplements. 11-14, 18, 21, 23 (Many supplements) G. WRONG DIRECTION: Failure to note that most Americans are deficient in one or more essential nutrients while continuously warning against rare, typically non-fatal toxic effects of vitamins. 9 (Vitamins A, D, E) H. PRETZEL LOGIC: Headlining a supplement “failure” while largely ignoring the similar failure of a drug that was also tested in the same clinical trial, when the drug is actually approved for treating that condition and the supplement is not even allowed to claim to treat any disease. Which one really failed: the supplement or the approved drug? 15-17 (St. John’s Wort vs. amitriptyline, Glucosamine vs. ELEVEN different drugs) I. FACT CHECKING IS PASSE: Repeating inaccurate statements about dietary supplement dangers and regulation. (“Dietary supplements are unregulated.”) 18, 21 J. WEIRD SCIENCE: An appropriate dose for a mild condition will probably not work for a more severe condition, and a short term experiment may not quickly relieve a chronic condition, which should not be reported as a failure of the supplement. 19, 27 (Glucosamine, St. John’s wort) K. IS ‘THE PRESS’ REALLY JUST A COPY MACHINE?: Assuming that all press releases by researchers or government offices are true or that it is responsible journalism to simply broadcast/publish them without added context or opposing views, even when reporting on controversial topics (includes all points listed above). L. MAGNIFYING GLASSES BURN: An insignificant result on a study means that the study failed to produce statistically meaningful results, thus invalidating the data. Yet reporters mistakenly report on these studies and even magnify the insignificant “results” as headline news, serving only to mislead the public. In realty, the study design or execution probably failed, not the foods or supplements. (B-Vitamins and cancer risk (NORVIT trial), Low-fat diets don’t work, Vitamin E is dangerous, etc.) 10, 38, 39, 40 Example 1 Beta-carotene: Myth and Fact Some years ago an antioxidant study in Finland was halted early because of a widely reported increase in cancer rates among male smokers taking beta-carotene. 1 Headlines associated this supplement with cancer risk. Despite objections that the study was flawed, beta-carotene use dropped. A later analysis published in July 2004 took another look at that same Finnish smokers' study data, but now taking into account total antioxidant intake, which cleared away the scientific controversy. The smokers’ risk of getting lung cancer was inversely associated with total antioxidants in the diet, meaning that more total antioxidants resulted in fewer cancers. 2 A composite antioxidant index was generated for each of the 27,000 men over 14 years. The calculated amounts of carotenoids, flavonoids, Vitamin E, selenium and Vitamin C were compared to actual lung cancer rates, with a clear result: the combination of antioxidants lowered lung cancer risk in male smokers. Beta carotene was not the ‘bad guy’ that preliminary results suggested. Another large study has noted that high carotenoid intake, confirmed by measures of blood levels, was associated with lower mortality rates among the elderly over a ten year period. 3 Still, news reports - and even a recent NIH scientific panel - continue to refer to beta-carotene as potentially harmful, having somehow missed the newer, better evidence. The “media myth” continues long after the science has moved on, with even scientists missing the line of evidence exonerating beta carotene. Example 2 Vitamin E: Bogus Warnings The warning about taking doses over 400 IU of Vitamin E is based on bad science from a flawed, heavily criticized meta-analysis that has been largely discredited. 4 A major review in the American Journal of Clinical Nutrition looked at the same data much more carefully, ultimately reporting that doses of up to 1,600 IU daily are safe. 5 The Food and Nutrition Board of the Institute of Medicine sets the upper tolerable intake of Vitamin E at 1,500 IU, showing a strong scientific consensus that lower doses, such as the popular 400 IU capsules, are not dangerous. 9 Vitamin E reduced cardiac events by 34% in the US Nurses' Health Study and 39% in the US Health Professionals' Follow-up Study, also reducing cardiac mortality by 47% in the Iowa Women's Health Study. 29 Among 90,000 nurses the incidence of heart disease was 30% to 40% lower among those with the highest intake of vitamin E from diet and supplements. Researchers found that the apparent benefit was mainly associated with intake of vitamin E from dietary supplements. 29, 31 The 10-year SENECA study reported blood levels of Vitamin E were not associated with all-cause or cause-specific mortality. 30 Reports of increased death rates occur mostly in meta-analyses that combine dissimilar studies imperfectly due to faulty statistical models or added variables. This type of review study needs to be critically reviewed before accepting the results, but is rarely definitive. 38 Example 3 Killer Ephedra? Rand Corporation researchers reported that up to 155 reported deaths possibly linked to Ephedra were contradicted by its own review of published Ephedra studies that found no deaths, strokes or any serious side effects reported from using the herb. The Rand report also stated that ephedra, with or without caffeine, provided a statistically significant increase in short-term weight loss compared to placebo: about 2 pounds per month for up to 6 months. 32 The final FDA report that banned Ephedra in 2004 lowered the number of deaths possibly linked to Ephedra, stating that a total ban on the herb would possibly prevent only an estimated 0.7 to 1.2 deaths per year out of an estimated 3 billion doses taken by 20 million consumers. In banning Ephedra, the FDA said: “There is no requirement that there be evidence proving that the product has caused actual harm to specific individuals, only that scientific evidence supports the existence of risk.” 33 The agency also admitted that the U.S. General Accounting Office (GAO) had previously “criticized FDA's reliance on adverse event reports (AERs) as the basis for the proposed restrictions on dosage, frequency and duration of use”. This shows that the FDA banned an herb with no proven deaths attributed to it. Only unproven Adverse Event Reports (AERs), which the FDA screeners virtually eliminated upon closer examination, were used to show a theoretical risk from ephedra. In fact, the FDA justified its ban only by making several assumptions in its cost-benefit analysis: claiming that there were no health benefits from using ephedra (ignoring decades of science, including the Rand report), that the vast majority of AERs were valid (without any specific evidence given, also contrary to the historic record) and that there were no increased risks to users who would be forced to switch from ephedra to pharmaceutical drugs for weight loss (no documentation was given to justify this assumption). 33 The FDA report contrasts greatly with the Rand report and with several other published studies. Researchers from the Stroke Program at the University of Texas’ Department of Neurology reported that, “Ephedra is not associated with increased risk for hemorrhagic stroke, except possibly at higher doses.” 34 A toxicology journal review concluded that, “…the majority of the published nonclinical and clinical studies, and history of use, support the safety of ephedra at the proposed use levels”. 35 Millions of users, billions of doses, no piles of bodies, no hard evidence regarding serious adverse events such as heart attacks and strokes. Ephedra is safer than some other foods. Even the consumption of peanuts is reported to kill about 100 people a year. 18 Yet ephedra is illegal, at least for now. REFERENCES: 1. N Engl J Med. 1994 Apr 14;330(15):1029-35. The effect of vitamin E and beta carotene on the incidence of lung cancer and other cancers in male smokers. The Alpha-Tocopherol, Beta Carotene Cancer Prevention Study Group. 2. July 2004 American Journal of Epidemiology Development of a Comprehensive Dietary Antioxidant Index and Application to Lung Cancer Risk in a Cohort of Male Smokers. Margaret E. Wright , Susan T. Mayne, Rachael Z. Stolzenberg-Solomon, Zhaohai Li, Pirjo Pietinen, Philip R. Taylor, Jarmo Virtamo and Demetrius Albanes 3. Am J Clin Nutr 2005;82:879–886. Plasma carotene and alpha-tocopherol in relation to 10-y all-cause and cause-specific mortality in European elderly: The Survey in Europe on Nutrition and the Elderly, a Concerted Action (SENECA). Buijsse B, Feskens EJ, Schlettwein-Gsell D, Ferry M, Kok FJ, Kromhout D, de Groot LC. 4. Edgar R. Miller, III, MD, PhD; et al. High-dose vitamin E supplementation may increase all-cause mortality, a dose response meta-analysis of randomized trials. Annals of Internal Medicine: Online: Nov. 10, 2004: Print: 4 January 2005 Volume 142 Issue 1 5. John N Hathcock, et al. REVIEW ARTICLE: Vitamins E and C are safe across a broad range of intakes. American Journal of Clinical Nutrition, Vol. 81, No. 4, 736-745, April 2005. 6. Satia-Abouta J, et al. Dietary supplement use and medical conditions. Am Journal Preventive Medicine 24:43-51, January 2003. 7. The Lewin Group, DaVanzo, J. et al. Improving Public Health, Reducing Health Care Costs: An Evidence-Based Study of Five Dietary Supplements. September 22, 2004. 8. A study conducted by USA Today found that more than half of the experts hired to advise the government on the safety and effectiveness of medicine had a direct financial interest in the drug or topic they were asked to evaluate. An analysis of financial conflicts of interest at 159 FDA advisory committee meetings from January 1, 1998, through June 30, 2000, found that at 92% of the meetings, at least one member had a financial conflict of interest, while at 55% of meetings, half or more of the FDA advisers had conflicts of interest. These conflicts included helping a pharmaceutical company develop a medicine, then serving on an FDA advisory committee that judges the drug. 9. Food and Nutrition Board, Institute of Medicine. Dietary reference intakes for vitamin C, vitamin E, selenium, and carotenoids. A report of the Panel on Dietary Antioxidants and Related Compounds, Subcommittees on Upper Reference Levels of Nutrients and Interpretation and Uses of Dietary Reference Intakes, and the Standing Committee on the Scientific Evaluation of Dietary Reference Intakes. Washington, DC: National Academy Press, 2000. 10. Lonn E, et al. Effects of long-term vitamin E supplementation on cardiovascular events and cancer: a randomized controlled trial. JAMA. 2005 Mar 16;293(11):1338-47. PMID: 15769967 11. (Average 1982-1998): According to researchers, approximately 32,000 hospitalized patients (and possibly as many as 106,000) in the USA die each year because of adverse reactions to their prescribed medications. Source: Lazarou, J, Pomeranz, BH, Corey, PN, "Incidence of adverse drug reactions in hospitalized patients: a meta-analysis of prospective studies," Journal of the American Medical Association (Chicago, IL: American Medical Association, 1998), 1998;279:1200-1205, also letters column, "Adverse Drug Reactions in Hospitalized Patients," JAMA (Chicago, IL: AMA, 1998), Nov. 25, 1998, Vol. 280, No. 20. 12. Lazarou J, Pomeranz BH, Corey PN. Incidence of adverse drug reactions in hospitalized patients: a meta-analysis of prospective studies (JAMA): Incidence of adverse drug reactions in hospitalized patients: a meta-analysis of prospective studies. JAMA. 1998 Apr 15;279(15):1200-5. PMID: 9555760 13. FDA recent Recalls, Market Withdrawals and Safety Alerts: http://www.fda.gov/opacom/7alerts.html 14. FDA regulation of supplements: http://www.cfsan.fda.gov/~dms/supplmnt.html 15. Wheatley D. LI 160, an extract of St. John’s wort, versus amitriptyline in mildly to moderately depressed outpatients-a controlled 6 week clinical trial. Pharmacopsychiatry 1997; 30(suppl.):77–80. 16. Woelk H. Comparison of St. John’s wort and imipramine for treating depression: randomized controlled trial. BMJ 2000 Sep;321:536–9. 17. A total of 11 studies have compared SJW preparations with conventional antidepressants (7 tricyclic; 4 SSRI) concluding that SJW is effective for mild to moderate depression with a low side effect profile (Kasper, 2001). (Herbalgram) Kasper S. Hypericum perforatum– Review of clinical studies. Pharmacopsychiatry 2001;34 Suppl. 1:S51–5. 18. WATSON ET AL ■ 2003 AAPCC ANNUAL REPORT The American Journal of Emergency Medicine (22(5):335-404, 2004) 19. Bent S, Kane C, Shinohara K, et al. Saw palmetto for benign prostatic hyperplasia. NEJM. Feb 9, 2006;354(6):1-10. 20. Turner RB, Bauer R, Woelkart K, Hulsey TC, Gangemi DJ. An evaluation of Echinacea angustifolia preparations in experimental rhinovirus infections. N Engl J Med 2005;353:341-348 21. Blumenthal M, Farnsworth NR. Echinacea angustifolia rhinovirus infections [letter]. N Engl J Med. Nov.3, 2005;353(18):1971-1972. 22. 21 C.F.R. Pt. 119, Final Rule Declaring Dietary Supplements Containing Ephedrine Alkaloids Adulterated Because They Present an Unreasonable Risk (Published February 11, 2004) (Effective April 12, 2004) available at http://www.fda.gov/ohrms/dockets/98fr/1995n-0304-nfr0001.pdf 23. Szegedi A, Kohnen R, Dienel A, Kieser M. Acute treatment of moderate to severe depression with Hypericum extract WS® 5570 (St. John’s wort): randomized, controlled, double-blind, non-inferiority trial versus Peroxetine. BMJ 2005, BMJ Online First. 24. Taylor JA, Weber W, Standish L, Quinn H, Goesling J, McGann M, Calabrese C. Efficacy and safety of Echinacea in treating upper respiratory tract infections in children: A randomized controlled trial. J Amer Med Assn Dec 3, 2003;290(21):2824-30. 25. Fugh-Berman A, Myers A. Citrus aurantium, an ingredient of dietary supplements marketed for weight loss: current status of clinical and basic research. Exp Biol Med (Maywood). 2004 Sep;229(8):698-704. Review. PMID: 15337824 26. Xinhe Wang et al. Mechanism of arylating quinone toxicity involving Michael adduct formation and induction of endoplasmic reticulum stress. Proc. Natl. Acad. Sci. USA, 10.1073/pnas.0510962103 (2/27/06) 27. Glucosamine, chondroitin sulfate, and the two in combination for painful knee osteoarthritis. N Engl J Med. 2006 Feb 23;354(8):795-808. PMID: 16495392 28. Effects of Long-term Vitamin E Supplementation on Cardiovascular Events and Cancer. JAMA. Vol. 293 No. 11, Vol. 293 No. 11, March 16, 2005 29. Emmert DH, Kirchner JT. The role of vitamin E in the prevention of heart disease. Arch Fam Med. 1999 Nov-Dec;8(6):537-42. 30. Buijsse B, Feskens EJ, Schlettwein-Gsell D, Ferry M, Kok FJ, Kromhout D, de Groot LC. Plasma carotene and alpha-tocopherol in relation to 10-y all-cause and cause-specific mortality in European elderly: the Survey in Europe on Nutrition and the Elderly, a Concerted Action (SENECA). Am J Clin Nutr. 2005 Oct;82(4):879-86. PMID: 16210720 31. Stampfer MJ, et al. Vitamin E consumption and the risk of coronary disease in women. N Engl J Med 1993;328:1444-9 32. Shekelle PG, et al. Efficacy and safety of ephedra and ephedrine for weight loss and athletic performance: a meta-analysis. JAMA. 2003 Mar 26;289(12):1537-45. Epub 2003 Mar 10. PMID: 12672771 33. Federal Register: February 11, 2004 (Volume 69, Number 28). 34. Morgenstern LB. Use of Ephedra-containing products and risk for hemorrhagic stroke. Neurology. 2003 Jan 4;60(1):132-5. Erratum in: Neurology. 2003 Mar 25;60(6):1055. PMID: 12525737 35. Soni MG, Carabin IG, Griffiths JC, Burdock GA. Safety of ephedra: lessons learned. Toxicol Lett. 2004 Apr 15;150(1):97-110. Review. PMID: 15068827 36. Schulman SP. L-arginine therapy in acute myocardial infarction: the Vascular Interaction With Age in Myocardial Infarction (VINTAGE MI) randomized clinical trial. JAMA. 2006 Jan 4;295(1):58-64. PMID: 16391217 37. Clegg DO, et al. Glucosamine, chondroitin sulfate, and the two in combination for painful knee osteoarthritis. N Engl J Med. 2006 Feb 23;354(8):795-808. PMID: 16495392 38. Ioannidis JPA (2005) Why Most Published Research Findings Are False. PLoS Med 2(8): e124 39. Low-fat diets do not protect women against heart attacks, strokes, breast cancer or colon cancer, a major study has found, contradicting what had once been promoted as one of the cornerstones of a healthy lifestyle. Low-Fat Diet's Benefits Rejected. Study Finds No Drop In Risk for Disease. Washington Post. Wednesday, February 8, 2006 http://www.washingtonpost.com/wp-dyn/content/article/2006/02/07/AR2006020701681.html 40. European Society of Cardiology http://www.escardio.org/initiatives/News/events/esc_congress/DietSupplements.htm

Tuesday, June 20, 2006

Gamma Tocopherol Under Attack!

http://www.prweb.com/releases/2006/3/prweb355903.htm Gamma Tocopherol Under Attack Researchers at Ohio State University report that their test tube experiments using metabolites of two common forms of Vitamin E – alpha tocopherol and gamma tocopherol – injected directly into brain cells have shown that the alpha tocopherol metabolite protects brain cells in vitro (in test tubes, not live animal models) while the gamma tocopherol metabolite seems to damage brain cells in vitro. 1 The inevitable headlines will be that gamma tocopherol, the most abundant form of the eight isomers (forms) of the Vitamin E family found in food, may be harmful to cells. But there is much more to this story than that still-unproven theory. (PRWEB) March 9, 2006 -- Researchers at Ohio State University report that their test tube experiments using metabolites of two common forms of Vitamin E – alpha tocopherol and gamma tocopherol – injected directly into brain cells have shown that the alpha tocopherol metabolite protects brain cells in vitro (in test tubes, not live animal models) while the gamma tocopherol metabolite seems to damage brain cells in vitro. 1 The inevitable headlines will be that gamma tocopherol, the most abundant form of the eight isomers (forms) of the Vitamin E family found in food, may be harmful to cells. But there is much more to this story than that still-unproven theory. Foods or supplements containing Vitamin E family members will inevitably contain both forms, as well as measures of the 6 other isomers. These nutrients work as a team and occur together in Vitamin E-rich foods. 2-7 A person can’t eat a food or take a supplement containing isolated gamma tocopherol. That would only happen if a laboratory isolated that nutrient from a food that had also contained other forms of Vitamin E. In this study the lab went far beyond this, producing metabolites of gamma tocopherol and alpha tocopherol and injecting them (separately) directly into cells. This study really has no direct bearing on diets containing Vitamin E in forms that include both alpha and gamma tocopherol, nor on common supplement forms. We do not eat these isomers or their metabolites in isolation, and they do not directly flood brain cells as they follow their normal metabolic pathways. This is an artificial scenario that must be confirmed by in vivo (live animal or human) studies to validate that this theoretical effect actually happens within the body when the live beings consume multiple forms of Vitamin E in their diet or through supplementation. Since this brain cell damaging effect has not previously been noted in the clinical literature, it is not likely to be a real life concern. As the study’s authors point out, there is a preferential transport mechanism for alpha tocopherol. 8-10 That is a key reason that the authors chose to perform this experiment to explore the different effects of alpha and gamma tocopherol. But they then chose not to test the same forms found in the diet. The authors also tested whether adding NAC, another antioxidant, would reduce the damage associated with the gamma tocopherol metabolite and found that it did. This confirms the often-forgotten concept that antioxidants operate as a family and emphasizes that most current studies done on antioxidants, such as Vitamin E, suffer in accuracy by not looking holistically at real-life situations where antioxidants operate as a team and recharge each other, offering functional cellular protection that is often lacking with the application of a single antioxidant nutrient; or in this case, a metabolite. There is previous evidence that gamma tocopherol is a better antioxidant and has different health benefits than alpha tocopherol, so the combination of both forms may provide superior protection to cells. The desmethyl (gamma and delta) forms of both tocopherols and tocotrienols show greater antioxidant potential and cellular health benefits than alpha tocopherol alone.11-19 I would argue that any antioxidant study that fails to utilize in vivo evidence or that fails to take into account the total antioxidant status of the individual may not provide reliably repeatable results due to a failure to measure interactive nutrients. This illuminates the reason for the often contradictory results reported in antioxidant research: the researchers often fail to measure or control additional antioxidant variables in the subjects’ diet. 20-21 This study starts out on the wrong path by assuming that the preferential transport mechanism for alpha tocopherol means that gamma tocopherol may be harmful to the body. It then compounds the error by injecting a metabolite form of gamma tocopherol - that admittedly may not even exist in the body in significant quantities – into cells in a test tube setting. It is only a theory that taking gamma tocopherol supplements, which are not sold in isolation from other tocopherol isomers, may increase the levels of its metabolites in the body and that other antioxidants present in the body may not provide sufficient counterbalance to prevent side effects. Ironically, the theory that gamma tocopherol supplements may increase the level of these metabolites in the body has not even been tested, much less proven, by this study. The successful use of NAC in this study to counter the metabolite artificially introduced to brain cells in vitro argues that the theory that this metabolite may damage brain cells in vivo is seriously flawed. It would be unfortunate if this study generates headlines that falsely imply that harm from consuming gamma tocopherol – from foods or dietary supplements - has been demonstrated in this totally artificial scenario. That would be inaccurate reporting. This study only shows that isolated metabolites introduced into brain cells in a test tube may cause cell damage, not that any of this actually occurs in living beings. If it generates headlines scaring people away from this beneficial nutrient, they would be guilty of causing “much ado about nothing”. Neil E. Levin Certified Clinical Nutritionist Diplomate in Advanced Nutritional Laboratory Assessment 3/6/2006 1. Xinhe Wang et al. Mechanism of arylating quinone toxicity involving Michael adduct formation and induction of endoplasmic reticulum stress. Proc. Natl. Acad. Sci. USA, 10.1073/pnas.0510962103 (2/27/06) 2. Liu M, Wallin R, Saldeen (2002) Effect of mixed tocopherols on ecNOS, SOD, and PKC in leukocytes in human subjects. Nutr Res 22:1253-1263. 3. McIntyre BS, Briski KP, Gapor A, Sylvester PW. Antiproliferative and apoptotic effects of tocopherols and tocotrienols on preneoplastic and neoplastic mouse mammary epithelial cells. Proc Soc Exp Biol Med. 2000 Sep;224(4):292-301. PMID: 10964265 4. Pfluger P, Kluth D, Landes N, Bumke-Vogt C, Brigelius-Flohe R. Vitamin E: underestimated as an antioxidant. Redox Rep. 2004;9(5):249-54. Review. PMID: 15606977 5. Qing Jiang, Jeffrey Wong, Henrik Fyrst, Julie D. Saba, and Bruce N. Ames. -Tocopherol or combinations of vitamin E forms induce cell death in human prostate cancer cells by interrupting sphingolipid synthesis. PNAS 2004 101: 17825-17830; published online before print as 10.1073/pnas.0408340102 6. Schneider C. Chemistry and biology of vitamin E. Mol Nutr Food Res. 2005 Jan;49(1):7-30. Review. PMID: 15580660 7. Stephanie J. Weinstein, M.S., Ph.D., and Demetrius Albanes, M.D., et al. Higher serum a-tocopherol and gamma-tocopherol concentrations are associated with lower prostate cancer risk: Abstract No. 1096. 95th Annual Meeting of the American Association for Cancer Research, March 2004. (National Cancer Institute, the Fred Hutchinson Cancer Research Center in Seattle and the National Public Health Institute of Finland.) 8. Hosomi, A., Arita, M., Sato, Y., Kiyose, C., Ueda, T., Igarashi, O., Arai, H., and Inoue, K. Affinity for Alpha-Tocopherol Transfer Protein as a Determinant of the Biological Activities of Vitamin E Analogs. FEBS Letters 409:105-108, 1997. 9. Ikeda I, Imasato Y, Sasaki E, Sugano M. Lymphatic transport of alpha-, gamma- and delta-tocotrienols and alpha-tocopherol in rats. Int J Vitam Nutr Res. 1996;66(3):217-21. PMID: 8899454 10. Qureshi AA, Pearce BC, Nor RM, Gapor A, Peterson DM, Elson CE. Dietary alpha-tocopherol attenuates the impact of gamma-tocotrienol on hepatic 3-hydroxy-3-methylglutaryl coenzyme A reductase activity in chickens. J Nutr. 1996 Feb;126(2):389-94. PMID: 8632210 11. Handelman GJ et al, Oral alpha-tocopherol supplements decrease plasma gamma-tocopherol levels in humans. J Nutr. 1985 Jun;115(6):807-13. PMID: 3998871 12. Burton GH et al, Human plasma and tissue alpha-tocopherol concentrations in response to supplementation with deuterated natural and synthetic vitamin E. Am J Clin Nutr. 1998 Apr;67(4):669-84. PMID: 9537614 13. Huang HY, Appel LJ. Supplementation of diets with alpha-tocopherol reduces serum concentrations of gamma- and delta-tocopherol in humans. J Nutr. 2003 Oct;133(10):3137-40. PMID: 14519797 14. Khanna S; et al; Molecular basis of vitamin E action: tocotrienol modulates 12-lipoxygenase, a key mediator of glutamate-induced neurodegeneration. J Biol Chem. 2003 Oct 31;278(44):43508-15. Epub 2003 Aug 13. PMID: 12917400 15. Miyazawa T; et al; Anti-angiogenic potential of tocotrienol in vitro. Biochemistry (Mosc). 2004 Jan;69(1):67-9. PMID: 14972020 16. Stone WL; et al; Tocopherols and the treatment of colon cancer. Ann NY Acad Sci. 2004 Dec;1031:223-33. Review. PMID: 15753148 17. Nesaretnam K; et al; Tocotrienol-rich fraction from palm oil and gene _expression in human breast cancer cells. Ann N Y Acad Sci. 2004 Dec;1031:143-57. PMID: 15753141 18. Schaffer S; et al; Tocotrienols: constitutional effects in aging and disease. J Nutr. 2005 Feb;135(2):151-4. Review. PMID: 15671205 19. Tan B. Appropriate Spectrum Vitamin E and New Perspectives on Desmethyl Tocopherols and Tocotrienols. JANA Vol. 8, No.1, 2005 20. Wright ME, et al. Development of a comprehensive dietary antioxidant index and application to lung cancer risk in a cohort of male smokers. Am J Epidemiol. 2004 Jul 1;160(1):68-76. PMID: 15229119 21. Tamimi RM, et al. Plasma carotenoids, retinol, and tocopherols and risk of breast cancer. Am J Epidemiol. 2005 Jan 15;161(2):153-60. PMID: 15632265 © Copyright 1997-2005, PRWeb™. All Rights Reserved Terms of Service Privacy Policy http://www.nutraingredients.com/news/ng.asp?n=66328-vitamin-e Breaking News on Supplements & Nutrition - Europe Vitamin E – the need for perspective 09/03/2006- Conflicting study results concerning the benefits and safety of vitamin E are causing confusion amongst consumers, even though they are open to debate from fellow scientists and members of the supplements industry. A recent study reported an in vitro study on the toxicity of a vitamin E metabolite, gamma-tocopherol quinone, for mice brain cells. This study was reported on by NutraIngredients.com in an article which stressed that mouse and human cells naturally contain different quantities of the vitamin precursors. It is pointed out that it is highly debatable whether the toxic metabolite is even found in measurable amounts in humans. However in a follow-up interview, lead researchers Dr David Cornwell and Dr Jiyan Ma from Ohio State University said that in a communication on the results issued by the university they “were not as clear as they might have been”. Cornwell stressed: “Gamma-tocopherol itself does not have a damaging effect on cells. “The arylating quinone metabolite of gamma tocopherol does and it is possible, in our minds, that the metabolism of gamma-tocopherol to its quinone is the proximate cause of many of the extraordinary effects of gamma tocopherol,” said Cornwell. There are eight forms of vitamin E: four tocopherols (alpha, beta, gamma, delta) and four tocotrienols (alpha, beta, gamma, delta). Alpha-tocopherol (alpha-Toc) is the main source found in supplements and in the European diet, while gamma-tocopherol (gamma-Toc) is the most common form in the American diet. Gamma-Toc is consumed from vegetable oils such as corn and soybean, and also from nuts. Sources of alpha-Toc include olive oil and sunflower seeds. While the majority of research on vitamin E has focused on alpha-Toc, numerous reports have reported that gamma-Toc offers different benefits. For example, gamma-Toc was superior to alpha-Toc for removing species like reactive nitrogen oxides that cause cell damage. “It is important, therefore, that gamma-Toc is better than other lipid-soluble antioxidants in preventing nitrogen dioxide-mediated DNA strand breaks,” wrote William Stone and Andreas Papas in the Journal of the National Cancer Institute (1997, Vol. 89, pp. 1006-1014). Increased levels of gamma-Toc in faeces have also been linked to the elimination of faecel mutagens and a reduced risk of colon cancer (Journal of National Cancer Institute 1997 Vol. 89, pp. 1006-1014). While the data from the in vitro study clearly show that the gamma-tocopherol quinone is toxic to the mice brain cells, the implications for humans were not explored, and the study failed to consider several key points. Firstly, the human body naturally converts over half of ingested gamma-tocopherol to a different metabolite called 2,7,8-(beta-carboxylethyl)-6-hydroxychroman (gamma-CEHC) and then excretes the product in the urine and feces. It is therefore questionable if toxic quantities of the quinone metabolite would actually be found in the human body. Secondly, vitamin E intake will inevitably contain several, if not all, of the tocopherol and tocotrienols forms. It has been reported that mixed tocopherol preparations have greater antioxidant and anti-inflammatory effects than the alpha-form on its own (Nutrition Research, 2005, Vol. 25, pp. 877-889). It has also been shown that CEHC, arguably the main metabolite of gamma-Toc, has natriuretic factors which promote sodium excretion, which is linked to lowering blood pressure and improving heart health. Now Food’s Neil Levin, CCN, DANLA, agreed that the conclusions from this study, while valid in the specific case studied, could not be extended to the real world. In his response to the study, Levin wrote: “Since this brain cell damaging effect has not previously been noted in the clinical literature, it is not likely to be a real life concern. This study starts out on the wrong path by assuming that the preferential transport mechanism for alpha tocopherol means that gamma tocopherol may be harmful to the body. It then compounds the error by injecting a metabolite form of gamma tocopherol - that admittedly may not even exist in the body in significant quantities - into cells in a test tube setting. It would be unfortunate if this study generates headlines that falsely imply that harm from consuming gamma tocopherol - from foods or dietary supplements - has been demonstrated in this totally artificial scenario. This study only shows that isolated metabolites introduced into brain cells in a test tube may cause cell damage, not that any of this actually occurs in living beings. ” Copyright - Unless otherwise stated all contents of this web site are © 2000/2006 – Decision News Media SAS – All Rights Reserved. For permission to reproduce any contents of this web site, please email our Syndication department: contact our Syndication department. Full details for the use of materials on this site can be found in the Terms & Conditions. 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