Some artificial sweeteners cannot be used in cooking; for example, aspartame. By contrast, natural sweeteners typically do not lose their sweetness when cooked. And studies have indicated that artificial sweeteners may backfire by shutting down the satiety signals that tell us when we’re full…in those studies the groups fed artificial sweeteners ate up to 3 times the calories as control groups. Sugar alcohols don’t raise blood sugar as rapidly as sugar does, yet they’re as bulky as sugar so they can be used “spoon - for - spoon” to replace sugar. But their level of sweetness may vary, with xylitol being the closest to sugar. Sugar alcohols have a range of sweetness and absorption; the amount that is absorbed from the GI tract affects the possibility of it being somewhat laxative at high levels, which can vary from person to person. Sorbitol may be laxative at moderate levels of 10 grams or more, mannitol at over 20 grams; xylitol at over 30 grams. Erythritol is virtually free of a laxative side affect even at higher levels, but is expensive. Also, sugar alcohols tend to have a cooling effect in the mouth and actually taste better when combined with a different type of sweetener. Sugar alcohols also boast an FDA-approved health claim: “Frequent between-meal consumption of foods high in sugars and starches promotes tooth decay. The sugar alcohols in [name of food] do not promote tooth decay.” A whole leaf, full spectrum extraction of Stevia should preserve the many phytonutrients naturally present in the plant. One study reported over 100 natural Stevia phytonutrients; the majority being polyphenols and other plant antioxidants. By contrast, there are about 9 steviosides. And the new Reb A fraction products being sold as food sweeteners are only a single chemical isolated from the stevia plant. There is a bitter aftertaste associated with traditional Stevia products. Some mix Stevia with sugar alcohols like erythritol in order for the sweetener to mask the bitter aftertaste. The recent crossover of a certain isolated fraction of Stevia (Reb A) as a mass market sweetener has some drawbacks: it doesn’t taste like either whole leaf or other traditional Stevia extracts, and is combined with both erythritol and natural flavors. Many stevia products are still only legal to sell as herbal dietary supplements, not as sweeteners. Some companies may think that all stevia products are now approved for use in foods, but that is not true. Retailers should take their cues from the packaging, and only carry reputable brands that strictly follow labeling laws. It is primarily the isolated “Reb A” fraction of stevia that can be used in foods. Most other stevias have not been approved for food use. There is a wide selection of natural/alternative sweeteners: Organic Agave Nectar, Barley Malt powder, Organic Brown Rice Syrup (some have no gluten [usually barley malt] added; some do), Beet Sugar (for those with cane allergies), Date Sugar (look for pure dried date pieces with no oat flour added), Dextrose, Fructose, Lactose, Organic Maple Syrup, Organic Sucanat®, and Organic Turbinado Sugar.
Monday, November 30, 2009
Monday, November 09, 2009
Dietary Supplements Are Regulated In its Nov. 2 editorial, the Globe complained that the FDA is “powerless” to police dietary supplements and called for a repeal of the Dietary Supplement Health and Education Act of 1994. Health and Education Act of 1994. I suggest that the editors read the law and see what it is that they would lose by doing so. Mandatory Good Manufacturing Practices (GMP) were authorized by this law. GMPs control the manufacturing of all supplements, requiring quality controls, identity and safety testing. Federal GMPs are currently being implemented. No one in their right mind wants this to go away right when it is just getting started. Federal pre-approval of all new dietary ingredients (NDIs) is also required by DSHEA. Isn’t that close to what the editors suggest when they want pre-market approval of all new supplements? Adulterated products are already banned by this law. And steroids and steroid precursors are specifically banned under another more recent law that was supported by the dietary supplement industry. DSHEA bans misbranded products, such as those containing hidden drugs, and offers them absolutely no protection. In fact, the misbranded products that the editors complained about are actually defined as unlabeled drugs by the FDA, not as dietary supplements, so technically DSHEA does not even apply to them. Let’s leave out the evildoers who deliberately hide illegal drugs in bottles misbranded as dietary supplements. What does that leave us with? The vast majority of dietary supplement companies responsibly follow the law and do not have poor quality products. There are rarely cases of serious injuries or deaths from dietary supplements when you take away the products that are really illegal drugs made by outlaws who don’t care about the law or their own customers’ health. Responsible brands follow the new FDA dietary supplement GMPs, checking all ingredients for identity and purity and looking for contaminants and known adulterants. They truthfully declare all ingredients and correct dosages on the labels. They monitor product usage for adverse events and report serious ones to the FDA when they occur. They are not the criminals counterfeiting illegal drugs disguised as dietary supplements. What part of this cries out for such severe regulation that pre-market approval of new formulas is needed? How will new laws stop lawbreakers when their actions are already clearly illegal? Pre-market approval in Canada is a joke; many ingredients and formulas are not available there even though American citizens freely enjoy their use without serious issues. Some American manufacturers have already pulled out of the Canadian market, while others offer only small selections of their lines because of the bureaucratic hoop jumping required for government approval. If DSHEA is repealed, many safe legal products providing much-needed nutrients will disappear while the lawbreakers continue to do business, with a net harm to public health. http://www.boston.com/bostonglobe/editorial_opinion/editorials/articles/2009/11/02/police_these_pills_and_powders/
Tuesday, October 27, 2009
Why are the Public Health authorities silent on the role of nutrition to protect us during an official national health emergency? Do they not know, or simply not care? Is either answer acceptable to citizens concerned about their health and wanting to get practical/real/fair/impartial information that we can utilize to help protect our families? Here's what the experts are not telling us:
- Did you know that if you had the seasonal flu vaccine last year it may make you more vulnerable to the swine flu this year? Vaccines create antibodies that actually make you more susceptible to other organisms, like viruses and bacteria. (Four Canadian studies reported by CBC News, 9/23/09)
- Did you know that side effects of vaccines can be minimized if there are adequate levels of vitamin D in the person? (Epidemic influenza and vitamin D. Epidemiol Infect. 2006 Dec;134(6):1129-40. Review.)
- Did you know that a lack of vitamin D makes people far more likely to have respiratory infections? (On the epidemiology of influenza. Virol J. 2008 Feb 25;5:29. Review.) Did you know that the virus itself can become less aggressive and less prone to mutating into more dangerous forms if a person has adequate levels of nutrients, especially antioxidants? (Host nutritional status: the neglected virulence factor. Trends Microbiol. 2004 Sep;12(9):417-23. Review.)
- Did you know that antioxidants, like selenium, not only reduce our vulnerability to getting influenza but also reduce the chances that it will progress into pneumonia! (Host nutritional status: the neglected virulence factor. Trends Microbiol. 2004 Sep;12(9):417-23. Review.)
Monday, October 12, 2009
Glaucoma is pressure in the eyes and can be from different causes such as narrow/inflamed tear duct drainage or a type of high blood pressure type problem. Since synthetic prostaglandin eye drops (travatan, etc) are sometimes used to maintain normal pressure, it implies that natural prostaglandins (GLA, fish oil) might prevent certain forms of glaucoma. Cataracts and macular degeneration are caused by oxidative damage. http://www.ncbi.nlm.nih.gov/pubmed/17478338?ordinalpos=3&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum Lutein is the key but not sole antioxidant. It does take about 5 grams of fat to absorb 10 milligrams of lutein (usually found in a complex also containing zeaxanthin), so lutein only absorbs well if taken with a meal. Eye formulas are also very good to supply multiple antioxidants and eye nutrients. These should also be taken with meals. Lutein is also the yellow pigment in egg whites, dark green leafy vegetables, yellow corn, orange peppers and squash. http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pubmed&pubmedid=9828775
Wednesday, September 09, 2009
Clinicians giving several grams a day of pure L-Glutamine do not report excitotoxic reactions. The main one is for the synthetic chemical MSG. Sometimes people react to fermented foods, which indicates a problem in containment and nutritional status. Vitamin C removes glutamate from the neurons, which are additionally protected by antioxidants (tocotrienols, tocopherols, et al) and by magnesium. Branched-chain amino acids help to compartmentalize glutamates. Glutamine is fine with other aminos; the main competition is between the arginine pathway aminos (arginine, ornithine, and lysine); with another noted competition to get through the Blood Brain Barrier between the Large Neutral Amino Acids: aromatic aminos (tyrosine, phenylalanine, and tryptophan) and the BCAAs (leucine, isoleucine, and valine).
Almost all D’s on the market are nature-identical synthesized forms. D3 and D2 are both naturally occurring in foods, but in supplements the same forms are usually from synthesized sources. So D3 synthesized from sheep lanolin is no more natural than D2 from plants or fungi. In fact, the D3 made in the skin-liver-kidneys from cholesterol and sunlight is also literally synthesized. Either plant sterols or animal sterols (cholesterol in humans, lanolin from sheep) are irradiated with UV-B light to make D2 or D3, respectively. It is a synthetic process, either internally or to produce the supplemental form; in much the same way that vitamin C can be synthesized by most mammals (not humans) from blood glucose in a process that mirrors the commercially synthesized nature-identical form. By the way, Vitamin K is also synthesized as the exact same form found in green foods (K1). Fermented foods like cheese can also contain K2 (MK-4), which is synthesized by microbes like bacteria.
Monday, August 10, 2009
It appears that some vitamin brands are listing their products as Vegan, yet formulating them with vitamin D3 synthesized from Sheep's Lanolin. There is no Vegan source of vitamin D3, which is produced by chemical synthesis when animal fats called sterols are exposed to Ultraviolet light (UVB rays). D3, or cholecalciferol, is always made from animal fat. The other form, vitamin D2, or ergocalciferol, is from a Vegan source; though one has to watch out for animal gelatin stabilizers and microbeads in microencapsulated dry forms, especially. Vegan microencapsulation for dry forms of fat-soluble nutrients including beta-carotene and lutein was only perfected in mid-2005, so it is possible that some products made before then were mislabeled as Vegetarian if the company did not investigate its raw material sources carefully. (Many brands do not manufacture their own vitamin supplements, relying on contract manufacturers to make their outsourced formulas for them. In many cases, the brands do not normally have access to the full ingredient and finished product specifications of the actual manufacturer. This can lead to ignorance and errors when making label claims related to the presence or absence of allergens and animal products.) The D2 form is synthesized from plant sterols exposed to the same kind of light. Plant sterols, by the way, have an FDA-approved health claim that they "may reduce the risk of heart disease" and are considered healthy. http://www.fda.gov/Food/GuidanceComplianceRegulatoryInformation/GuidanceDocuments/FoodLabelingNutrition/FoodLabelingGuide/ucm064919.htm There is also a controversy over whether D3 is much better than D2. D3 is the form found in fish liver oils and is often added to fortify foods such as milk and orange juice. D3 is also the form that we synthesize in our own bodies when cholesterol (that animal sterol aforementioned) is exposed to UVB rays. D2 is likewise made by plants when their oils (plant sterols, or phytosterols) are exposed to UVB light. In modern studies, both forms are equally well absorbed and both are good at preventing rickets and maintaining bone mass. Both forms equally maintain the level of the active compound serum 25(OH)D3 levels. "Therefore, vitamin D2 is equally as effective as vitamin D3 in maintaining 25-hydroxyvitamin D status." http://www.sciencedaily.com/releases/2008/01/080102122306.htm It appears that D3 tests better than D2 in an occasional dosing schedule, like if you got it once a month from a doctor's office. But the assay is apparently flawed and is now known to not measure D2 very well, underestimating its circulating level. For everyday supplementation and fortification, both forms work equally well by all current measures. Some brands with "cultured" or "fermented" ingredients apparently believe that adding lanolin-sourced vitamin D3 to a yeast culture, then drying the whole thing and using it to make vitamins, somehow transmutes the animal fat form of the vitamin into a Vegan-friendly ingredient. They say that the yeast consumes the lanolin-derived vitamin and that the yeast is Vegan no matter what it is fed. But they present no evidence that yeast consumes vitamin D or changes it in any way. Quite the contrary; they brag about providing vitamin D3 – a known animal product - in a supposedly Vegan supplement. This indicates that they know that the form is not changed in any significant way by the yeast culture. One major brand, when asked by me only today, said that they do not disclose their D3 source for their vitamin labeled as Vegan because the source is both "irrelevant" and "proprietary". In other words, they won't tell us and we don't need to know. That pisses me off, pardon me for taking this apparent contempt for Vegans personally. I am not a Vegan but have been a vegetarian since 1972. I do not eat any type of flesh; avoiding not only all forms of meat but also animal broths, gelatin and leather. I scrutinize labels to assure that I am getting no animal products except for dairy, eggs, and honey. Now the Honest Nutritionist in me wants to sound the alarm that some companies are using animal products like gelatin and lanolin in their Vegan-claimed dietary supplements. Whether it's an honest (though sloppy) mistake or a deliberate attempt to have their cake and eat it too is hard to say for sure, but either way this is not fair to Vegans. I tend to fear the worst since they claim the supposedly superior and more popular D3 form in a product whose label also appeals to Vegans and Vegetarians who are being led to erroneously believe that there is now a Vegan-friendly source of D3. There isn't. It is just not true. We are being misled. D3 is not Vegan. D2 is, and is not a bad form as some try to claim. Some medical experts even want to routinely fortify the food supply with D3 because of the largely mythical superiority of that form; that would deprive all Vegetarians and Vegans of their right to avoid hidden animal products in our food. I believe that we have a fundamental right to select our diets based on individual religious, ethical, and cultural beliefs. It is wrong for a corporation to take that right away from us by incorrectly labeling their products that are marketed to Vegetarians and marked as Vegan. Mislabeled products are considered to be adulterated. Obviously, there is no safety issue here and it does not seem as if this matter has attracted much attention, as of yet. But these jokers have attracted my attention and I think that they deserve to get grassroots attention to their attempt to sell non-Vegetarian products to Vegetarians and Vegans. I am not naming names here but will not buy products made by any companies which suggest that animal-source D3 can ethically be sold to Vegans. If you are of the Vegetarian or Vegan persuasion, please check your product labels. If I see vitamin D3 in a product labeled as Vegetarian, I’d feel free to return it to the store as a mislabeled product and get my money back. Vote with your dollars and read product labels carefully before buying anything. If enough people do this, the companies with questionable products will have to deal with a lot of returns from unhappy customers and stores, combined with a drop in sales. Eventually, they will be forced to either correct their labels or change their formulas.
Thursday, August 06, 2009
ARTHRITIS DRUG WITHDRAWN, PEOPLE ARE LOOKING FOR ALTERNATIVES By Neil E. Levin, CCN, DANLA A major pharmaceutical company has announced a worldwide recall of its top arthritis drug due to cardiovascular problems seen in long-term users. Merck has withdrawn Vioxx from the market after a study was halted because users of the drug had 200% as much risk of getting heart attacks than participants taking a placebo. Medical experts are advising patients taking Vioxx to consult with their physicians about a substitute. If you are one of these people, there is no better time than now to discussthe use of natural alternatives to drugs with your doctor. If you can get temporary relief of aches and pains by using natural herbs and foods with minimal side effects rather than with more dangerous prescription drugs, why not? After all, dangerous side effects are one reason why drugs have restrictions on their sale in the first place. You have three basic choices to inhibit inflammation. Here they are, one at a time: PRESCRIPTION COX-2 INHIBITORS COX-2 Inhibitors help to prevent inflammation from developing by blocking the action of a certain chemical called COX-2. These drugs are noted for reducing "risk of clinically important GI (gastrointestinal) events" by some 50-60% versus non-steroidal anti-inflammatory drugs like aspirin and ibuprofen. However, most of the COX-2 Inhibitor drugs are also associated with an increased risk of cardiovascular problems. And there are still a goodly number of GI complaints in the COX-2 groups. Now one of the most prominent COX-2 inhibitor drugs has been pulled off the market for doubling the rate of heart attacks. Over-The-Counter NSAIDs (non-steroidal anti-inflammatory drugs) Doctors reportedly recommend NSAIDs, which are COX inhibitor drugs like aspirin and ibuprofen, more than they prescribe COX-2 inhibitor drugs like Celebrex and Vioxx. But there are also problems with NSAIDs. Gideon Bosker, MD, Assistant Clinical Professor at Yale University School of Medicine, reports on the use of NSAIDs for Osteoarthritis (OA) and Rheumatoid Arthritis (RA): "As every primary care practitioner knows, NSAID-associated GI toxicity has become a public health problem, especially among older patients with OA and RA. Gastrointestinal intolerance has been reported in up to 50% of patients on long-term NSAIDs. "NSAIDs cause irritations in the gastrointestinal tract, leading to bleeding and iron loss. (Bjarnason I, Macpherson AJ. Intestinal toxicity of non-steroidalanti-inflammatory drugs. Pharmacol Ther 1994;62:145-57) Going off drugs like aspirin and ibuprofen often causes a rebound effect that creates a cascade of inflammation in the Cox and Lox enzyme pathways. In one report the levels of these inflammatory markers was over 500% higher even two weeks after going off aspirin and ibuprofen! (Endres S. Oral aspirin and ibuprofen increase cytokin-induced synthesis of IL-1 beta and of tumour necrosis factor-alpha ex vivo. Immunology 1996;87(2): 264-270) Ibuprofen has caused kidney dysfunction and water retention. (Threlkeld DS, ed. Central Nervous System Drugs, Nonsteroidal Anti-Inflammatory Agents, Facts and Comparisons Drug Information. St. Louis,MO: Mar 1993, 251j-1l) There are about 16,000 deaths a year from NSAIDs, and 100,000 people hospitalized with serious complications. NSAIDs are blamed for over half of all liver failures in this country. These serious side effects have caused a demand for the COX-2 inhibitor drugs, which do not inhibit the COX-1 enzyme like some NSAIDs do. Two recent large studies (called CLASS and VIGOR) looked at the relative safety of NSAIDs versus COX-2 drugs. NSAIDs were shown to be associated with significantly more upper G.I. tract complications, including ulcers and bleeding. Partly because of such studies, COX-2 drugs have become a major success story for pharmaceutical companies over the past few years, becoming a multi-billion dollar a year business. Research published in the British Medical Journal found that 21% of adults with asthma are sensitive to aspirin. Aspirin may trigger a deadly reaction; as may ibuprofen, diclofenac and naproxen. The doctors recommend new warning labels on all products containing these drugs. DIETARY SUPPLEMENTS There are dietary supplements that may help control the inflammation associated with osteoarthritis. In some cases these will block the inflammatory COX-2 enzyme while not blocking the beneficial COX-1 enzyme. Some of these supplements will also block the 5-LOX inflammatory enzyme that is not blocked by many of the arthritis symptom relief drugs. SAMe (S-Adenosylmethionine) has been studied for depression, arthritis, and a host of other ills. Pronounced "Sam-ee", this substance was deemed effective enough to be studied in comparison to the COX-2 Inhibitor drug celecoxib (Celebrex), reportedly the least dangerous COX-2 drug in terms of cardiovascular risks. In this study 61 patients were enrolled in a randomized, double-blind, cross-over trial over a 4-month period. The researchers found that "SAMe is equivalent in almost all measures to COX-2 inhibitors (celecoxib) in relieving pain and improving function in subjects with osteoarthritis of the knee." Their functional parameters included depression, pain, impairment of physical activity and knee mobility and strength. The anti-inflammatory effects of aspirin and other drugs can also be achieved more safely with concentrated blends of spices and herbs that have a wide range of benefits. These formulas will block the COX-2 enzyme, which triggers inflammation in tissues as a response to chemical signals. NSAIDs block not only the inflammatory enzyme COX-2, but also the beneficial enzyme COX-1. The natural ingredients do not have this problem, because they block only the inflammatory enzymes. These natural ingredients will prevent the actions of not only the COX-2 inflammatory enzyme, but also of the 5-LOX inflammatory enzyme that the drugs do not usually affect. Look for an herbal formula that uses ingredients that have been shown to be helpful for inflammation and joint health, and also promoting normal cell growth (preventing abnormal growth). It should contain highly concentrated common spices like ginger and turmeric, which have been naturally extracted to contain the therapeutic chemicals in the plants. Other ingredients that will enhance an herbal formula are holy basil, EGCg-rich green tea extract, Boswellia, the antioxidant resveratrol and the enzyme bromelain (which helps digest damaged tissues so the inflammation can subside and you can rebuild). The herbs also serve as antioxidants and mild anticoagulants (bloodthinners). RELATIVE SAFETY The tremendous safety difference between dietary supplements and drugs is staggering. There are over 100,000 deaths a year from drugs versus a handful from all dietary supplements, which are far safer than any other category offered. Our risk of dying from eating dinner is far greater than from taking any dietary supplement. originally published September 30, 2004
Thursday, July 09, 2009
- avoid all animal proteins, they trigger cancer cell activity (esp. the milk protein: casein)
- organic diet
- plant based diet
- no microwaving, esp. in plastics!!!
- fish oil (molecularly distilled)
- mixed carotenoids (vs. beta-carotene) from food or supplements
- medicinal mushrooms (the common white button and portabella mushrooms will not hurt but won't help)
- low temp saunas for detoxification
Monday, July 06, 2009
Yes, Nature does produce vitamins by chemical synthesis; and thus these are literally "synthetic" vitamins: "Carotenoids are colorful fat-soluble pigments that are synthesized in nature by photosynthetic microorganisms." Components of variation in serum carotenoid concentrations: the Polyp Prevention Trial M R Forman, C B Borkowf, M M Cantwell, S Steck, A Schatzkin, P S Albert and E Lanza Eur J Clin Nutr 63: 763-770; advance online publication, April 16, 2008; doi:10.1038/ejcn.2008.26
Monday, June 29, 2009
Results 5 of about 25,600,000 for pitfalls of meta-analyses Google NZ Results 2 of about 180,000 for swine flu and nutritional supplements Google Results 8 of about 48,500 for plu code organic gm Google Results 4 of about 600,000 for l-taurine vs taurine Google Results 1 - of about 958,000 for 5 milligram is what microgram Google
Tuesday, June 09, 2009
Bias Against Natural Products By Neil E. Levin, CCN, DANLA www.honestnutrition.com June 8, 2009 Once again, a widely distributed article has savagely attacked the safety and efficacy of natural products; including vitamins, minerals, and herbs. That this article may be more commentary than journalism is immediately revealed by the author inexplicably linking energy medicine (with admitted health benefits for patients) with a concocted image of “shooing evil spirits”, even when performed by technicians in a top trauma hospital. The ignorance of journalists and medical experts is exposed when they claim that natural products are intended as cures and treatments. These products are actually prohibited by law from claiming this; allowed only documented claims to support healthy body structures and functions. Ironically, this is the same law – the Dietary Supplement Health and Education Act, DSHEA - that is falsely mischaracterized as “deregulation” of the industry. In fact, this law prohibits new ingredients without FDA pre-approval; empowers the agency to regulate manufacturing, advertising, and label claims; prohibits unsafe, adulterated, and mislabeled products; and even allows banning a product based on only theoretical risks. A recent companion law requires all serious adverse events be reported to the FDA; generating far fewer reports than expected. The erroneous assumption that dietary supplements should be considered as potential treatments or cures has resulted in many negative reports. One problem is that some medical researchers, perhaps too used to drug studies using novel substances, sometimes base reports mainly on supplementation levels but fail to properly understand or explain other relevant variables such as dietary intake and relationships to other nutrients that affect body levels and functions of the targeted nutrient. The synergies of natural substances in the diet are complex and interactive, but many researchers design simplistic studies that generate incomplete or misleading data; often leading to dramatic conclusions that the pharmaceutical advertising-dependent press eats up. A press that fails to investigate and present all of the relevant facts and perspectives in a sensational negative report may be accused of laziness, if not bias. Rigorous studies refuting negative reports about the safety of vitamin E, beta-carotene, herbs, the use of supplements with cancer treatments, and drug-nutrient interactions have been noticeably absent from the same media that eagerly broadcasts reports attacking nature’s own nourishing substances. Sadly, there is no matching eagerness to set the record straight. Let’s keep this in perspective. We have all seen drugs pulled from the market because of unforeseen safety issues, medical schools and authors of articles published in peer-reviewed journals accused of being on the take from pharmaceutical companies, contaminated drugs as well as hundreds of thousands of deaths and millions of hospitalizations caused by pharmaceutical side effects each year. Foods cause hundreds of deaths and millions of illnesses annually. Compare this to dietary supplement safety, where proven deaths are extremely rare. Supplement users believe in the healing power of nature, at odds with the often unproven treatments of conventional medicine. The goal of Integrative Medicine is putting aside traditional institutional medical bias to allow science to dictate the comprehensive treatment of an individual patient, including quality of life issues. Many millions of Americans choose to use natural products in order to protect and improve their own health and vitality. Reasonable people will reject these sensational assaults on natural health (including dietary supplements), recognizing that conventional medicine sometimes fails without a little help from Mother Nature. References: Cancer patients may very well tolerate the use of certain dietary supplements http://caonline.amcancersoc.org/cgi/eletters/55/5/319#176 The truth about Vitamin E - Vitamin E is safer than implied http://www.bmj.com/cgi/eletters/330/7490/0-f#99008 Scientists to discuss benefits of vitamin E http://www.nutraingredients-usa.com/Research/Scientists-to-discuss-benefits-of-vitamin-E Vitamin review offers balanced perspective to recent negative findings http://www.worldhealth.net/news/vitamin_review_offers_balanced_perspecti Antioxidant supplements - myth or misunderstood? http://www.nutraingredients.com/Research/Antioxidant-supplements-myth-or-misunderstood Prominent Nutritionist Sets The Record Straight http://www.the-health-gazette.com/health-gazette-blog/nutrition/prominent-nutritionist-sets-the-record-straight FDA regulation of dietary supplements is sufficient http://www.journalgazette.net/apps/pbcs.dll/article?AID=/20090131/EDIT09/301319890/-1/AP05 Impact of antioxidant supplementation on chemotherapeutic efficacy: a systematic review of the evidence from randomized controlled trials. Block KI, Koch AC, Mead MN, Tothy PK, Newman RA, Gyllenhaal C. Cancer Treat Rev. 2007 Aug;33(5):407-18. Epub 2007 Mar 23. Review. PMID: 17367938 Antioxidants and other nutrients do not interfere with chemotherapy or radiation therapy and can increase kill and increase survival, part 1. Simone CB 2nd, Simone NL, Simone V, Simone CB. Altern Ther Health Med. 2007 Jan-Feb;13(1):22-8. Review. PMID: 17283738 Should patients undergoing chemotherapy and radiotherapy be prescribed antioxidants? Moss RW. Integr Cancer Ther. 2006 Mar;5(1):63-82. Review. PMID: 16484715 Multiple dietary antioxidants enhance the efficacy of standard and experimental cancer therapies and decrease their toxicity. Prasad KN. Integr Cancer Ther. 2004 Dec;3(4):310-22. Review. PMID: 15523102 The efficacy and safety of multivitamin and mineral supplement use to prevent cancer and chronic disease in adults: a systematic review for a National Institutes of Health state-of-the-science conference. Huang HY, Caballero B, Chang S, Alberg AJ, Semba RD, Schneyer CR, Wilson RF, Cheng TY, Vassy J, Prokopowicz G, Barnes GJ 2nd, Bass EB. Ann Intern Med. 2006 Sep 5;145(5):372-85. Epub 2006 Jul 31. Review. PMID: 16880453 Higher baseline serum concentrations of vitamin E are associated with lower total and cause-specific mortality in the Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study. Margaret E Wright, Karla A Lawson, Stephanie J Weinstein, Pirjo Pietinen, Philip R Taylor, Jarmo Virtamo and Demetrius Albanes. American Journal of Clinical Nutrition, Vol. 84, No. 5, 1200-1207, November 2006. (Researchers were from the Nutritional Epidemiology and the Genetic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, and the Cancer Prevention Fellowship Program, Division of Cancer Prevention, National Cancer Institute, National Institutes of Health, Bethesda, MD, and the Department of Health Promotion and Chronic Disease Prevention, National Public Health Institute, Helsinki, Finland) Vitamins E and C are safe across a broad range of intakes. John N Hathcock, et al. REVIEW ARTICLE: American Journal of Clinical Nutrition, Vol. 81, No. 4, 736-745, April 2005. Potential for interactions between dietary supplements and prescription medications. Sood A, Sood R, Brinker FJ, Mann R, Loehrer LL, Wahner-Roedler DL; (Mayo Clinic). Am J Med. 2008 Mar;121(3):207-11. PMID: 18328304 Acute adverse effects of radiation therapy and local recurrence in relation to dietary and plasma beta carotene and alpha tocopherol in head and neck cancer patients. Meyer F, Bairati I, Jobin E, Gélinas M, Fortin A, Nabid A, Têtu B. Nutr Cancer. 2007;59(1):29-35. PMID: 17927499 Interaction between antioxidant vitamin supplementation and cigarette smoking during radiation therapy in relation to long-term effects on recurrence and mortality: a randomized trial among head and neck cancer patients. Meyer F, Bairati I, Fortin A, Gélinas M, Nabid A, Brochet F, Têtu B. Int J Cancer. 2008 Apr 1;122(7):1679-83. PMID: 18059031 The total antioxidant capacity of the diet is an independent predictor of plasma beta-carotene. Valtueña S, et al. Eur J Clin Nutr. 2007 Jan;61(1):69-76. Epub 2006 Jul 12. PMID: 16835597 [Supported by the European Community IST-2001–33204 'Healthy Market', the Italian Ministry of University and Research COFIN 2001 and the National Research Council CU01.00923.CT26 research projects.] No influence of beta carotene on oxidative DNA damage in male smokers. van Poppel G, Poulsen H, Loft S, Verhagen H. J Natl Cancer Inst. 1995 Feb 15;87(4):310-1. PMID: 7707423 Lack of effect of long-term supplementation with beta carotene on the incidence of malignant neoplasms and cardiovascular disease. Hennekens CH, Buring JE, Manson JE, et al. N Engl J Med. 1996 May 2;334(18):1145-9. PMID: 8602179 Lee IM, Cook NR, Manson JE, Buring JE, Hennekens CH. Beta-carotene supplementation and incidence of cancer and cardiovascular disease: the Women's Health Study. J Natl Cancer Inst. 1999 Dec 15;91(24):2102-6. PMID: 10601381 The Alpha-Tocopherol, Beta Carotene Cancer Prevention Study Group. The effect of vitamin E and beta carotene on the incidence of lung cancer and other cancers in male smokers. N Engl J Med. 1994 Apr 14;330(15):1029-35. PMID: 8127329 Development of a comprehensive dietary antioxidant index and application to lung cancer risk in a cohort of male smokers. Wright ME, et al. Am J Epidemiol. 2004 Jul 1;160(1):68-76. PMID: 15229119 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, et al. Am J Clin Nutr. 2005 Oct;82(4):879-86. PMID: 16210720 Effect of multivitamin and mineral supplementation on episodes of infection in nursing home residents: a randomized, placebo-controlled study. Liu BA, et al. J Am Geriatr Soc. 2007 Jan;55(1):35-42. Erratum in: J Am Geriatr Soc. 2007 Mar;55(3):478. PMID: 17233683 Nutrition intervention trials in Linxian, China: supplementation with specific vitamin/mineral combinations, cancer incidence, and disease-specific mortality in the general population. Blot WI, Li IY, Taylor PR, et al. J Natl Cancer Inst 1993:8ı:1483-92 Nutrition intervention trials in Linxian, China: multiple vitamin/mineral supplementation, cancer incidence, and disease-specific mortality among adults with esophageal dysplasia. Li JY, Taylor PR, et al. J Natl Cancer Inst. 1993 Sep 15;85(18):1492-8. PMID: 8360932 The Linxian trials: mortality rates by vitamin-mineral intervention group. Blot WI, et al. Am J Clin Nutr. 1995 Dec;62(6 Suppl):1424S-1426S. PMID: 7495242 Vitamins for Chronic Disease Prevention in Adults: clinical applications. Fairfield KM, Fletcher RH. JAMA. 2002;287:3127-3129.) Food-related illness and death in the United States. Mead PS, et al. Emerg Infect Dis. 1999 Sep-Oct;5(5):607-25. Review. PMID: 10511517 American Association of Poison Control Centers annual reports FROM THE CENTERS FOR DISEASE CONTROL AND PREVENTION: Unintentional Poisoning Deaths—United States, 1999-2004. JAMA, March 28, 2007; 297: 1309 - 1311. Incidence of adverse drug reactions in hospitalized patients: a meta-analysis of prospective studies. Lazarou J, Pomeranz BH, Corey PN. JAMA. 1998 Apr 15;279(15):1200-5. PMID: 9555760 Washington Post reported in its 7/21/06 edition on an Institute of Medicine study released a day earlier on the toll of improperly prescribed drugs. http://www.youtube.com/watch?v=qxAR7waukVc
Sunday, May 17, 2009
Sorry there's not much detail but this is a list that I made of nutrients that may be useful for someone who has had a stroke. I would suggest that you look each one up at a reputable online database, if interested. Of course, there are often difficulties at getting stroke survivors to take nutritional pills/caps; everything from swallowing to drug interactions. In no particular order: Vinpocetine Pycnogenol Nattokinase Rosemary Thyme Proline CoQ10 Phosphatidyl Choline Acetyl-l-carnitine vitamin E (all 8 tocopherols and tocotrienols) alpha-lipoic acid silymarin magnesium acetylcholine precursors: choline, PC, B5, huperzine
Monday, May 04, 2009
Sunday, May 03, 2009
Swine Flu: Does Nutritional Status Aid Immunity? By Neil E. Levin, CCN, DANLA A new health threat has arrived in our shrinking world: the swine flu. It is an organism for which there is no preventive vaccine; the commonly available flu vaccine does not include this strain, so offers no protection. Likewise, antibiotics target only bacterial strains so are useless to stop the viruses responsible for colds and flus. There are a couple of drugs (Tamiflu® and Relenza®) which are prescribed for those who have actually come down with the flu, and sometimes recommended for those who may come into contact with flu sufferers. However, they are expensive and typically work if you have one at home and take it at the first sign of illness. For example, the Tamiflu® website reports that, if taken within 48 hours of the first appearance of symptoms, adults may feel better about 1.5 days faster than patients who did not take it. When the avian flu (another Type A Influenza, the most common type) scare was around two or three years ago (remember SARS? Avian Flu? Bird Flu?), our family physician offered both my wife and me precautionary prescriptions of Tamiflu®, for which we would have had to pay about $200 out of pocket for a two person one-time supply. It wouldn’t be covered by insurance since we didn’t have an actual diagnosis of influenza. Besides that, there is a shortage and these drugs typically have a relatively short shelf life of only about a year. We respectfully declined the offer. While that is certainly an option for those who want to or need to pay to see a physician and get a prescription, and it may be covered by your insurance, it is not a practical option for most of us just wanting to improve our natural resistance to a known threat; and certainly not a cure. Besides, drugs have their own side effects (including shrinkage of the wallet) that should be noted by potential users. That’s precisely why they are controlled substances that are only available from medical professionals. What is the swine flu and what can we do to protect ourselves from it? According to Dr. Joe Bresee, Chief of the Epidemiology and Prevention Branch of the CDC (Centers for Disease Control and Prevention) Influenza Division, “Swine flu is a respiratory disease of pigs caused by Type A Influenza viruses. The symptoms of [swine] flu in people are similar to the symptoms of regular human flu and include fever, cough, sore throat, body aches, headache, chills and fatigue. Some people have reported diarrhea and [vomiting] associated with swine flu as well. There is no vaccine available right now to protect against swine flu. However, there are everyday actions that people can take to help prevent the spread of germs that cause respiratory illnesses like influenza. Take these everyday steps to protect your health. Cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash can after you use it. Wash your hands often with soap and water, especially after you cough or sneeze. Alcohol-based hand cleaners are also effective. Try to avoid contact with sick people.” Well, that is helpful, but only to a point. Also seemingly important is the fact that Americans who have come down with swine flu to date have had only one death - compared to well over a hundred Mexican deaths - and seem to have had contracted a much milder form of the illness than our unfortunate neighbors to the south. I speculate that the American diet, despite its known shortcomings, may in some ways still be superior in its content of some important nutrients to the average diet of many Mexican citizens, and perhaps support a better immune response. At the time of this writing though, only 20 of the 140 Mexican deaths attributed to pneumonia-like symptoms have actually been confirmed as the swine flu. No doubt new information will be coming in daily. But there are reportedly an estimated 36,000 deaths from the common flu every year, mostly the very old and the very young. After reviewing a number of scientific papers to assess the potential of foods and food supplements to improve our bodies’ natural response to the flu, there are a number of things that you and your physician may want to consider. In the battle to maintain healthy respiratory function and properly modulate immune response, natural nutritional substances can be helpful. Various vitamins, minerals, herbs and amino acids support optimal immune function and respiratory health. In fact, there is evidence that nutrient status of the host even affects the genetic expression of viruses; that is, an unsuitable environment (the well-nourished body) inhibits the ability of the virus to freely replicate and thrive. This is not a list of cures; it is a list of natural substances that have shown promise in improving survival or resistance to influenza as recorded in published studies. Those who want to support their immune system should investigate these with the knowledge and consent of your physician; physicians may want to note these natural products that may support the nutritional status of your patients. · AHCC In a recent study, supplementation with AHCC resulted in a dose-dependent increase in survival in mice in response to acute influenza infection (influenza A virus: avian flu, H1N1, PR8). · Andrographis paniculata has been shown in studies to support a healthy and balanced immune response by modulating the immune system’s production of immune cells (Interferon gamma (IFNg), Interleukin-2 (IL-2), and T-cells). Numerous clinical studies have demonstrated its ability to significantly increase cell-mediated immunity in response to stresses, such as those encountered during seasonal changes. · Astragalus (Astragalus membranaceous) is an Oriental herb well known for aiding the immune system. Astragalus has been shown in non-clinical studies to support a number of aspects of healthy immune function, including the enhancement of T-Cell and Natural Killer (NK) cell activity. Natural killer cells destroy unhealthy cells in the body virtually on contact. · Black Elderberry (Sambucus nigra) standardized extract may provide protection against oxidative stress and modulate inflammatory cytokines to protect respiratory function. Elderberry provides Vitamins A and C, as well as anthocyanins, which are potent free radical scavengers. Clinical and non-clinical studies have demonstrated Elderberry's immune-supporting properties. One article reported that, “Constituents of European elderberry neutralize the hemagglutinin spikes found on the surface of viruses, including flu viruses, preventing the viruses from piercing cell walls and replicating. European elderberry extracts also enhance immune function by increasing cytokine production.” It also reported that two randomized, double-blind, placebo-controlled clinical trials have shown that a European elderberry preparation “can inhibit influenza A and B viruses when given to patients within 48 hours of symptom development”. · Echinacea (Echinacea purpurea and Echinacea angustifolia) is well known for its immune modulating effects. E. purpurea extracts demonstrate significant immunomodulatory activities. “Among the many pharmacological properties reported, macrophage activation has been demonstrated most convincingly.” E. purpurea has been shown to have antiviral effects, with most studies looking at either rhinoviruses (colds) or herpes simplex virus type-1 (HSV-1). Its polysaccharides were able to exert an antiviral action on the development of HSV-1 disease when supplied prior to infection. Reductions in numbers of upper respiratory infections have been noted in several trials, but generally the differences in the large variety of commercial and non-commercial products studied have resulted in conflicting reports. However, a meta-analysis of previously published studies was published in the British medical journal The Lancet Infectious Diseases and concluded, “Published evidence supports echinacea’s benefit in decreasing the incidence and duration of the common cold.” · Garlic (Allium sativum) compounds have been shown to have some antiviral effects. For example, a compound called allitridin (diallyl trisulfide) has anti-human herpes virus (HCMV) activity via a mechanism associated with suppression of the virus’ gene expression. Other important and better known compounds include allicin and ajoene. Allicin has been shown to reduce the incidence of colds and flus. “Among the viruses which are sensitive to garlic extracts are the human cytomegalovirus, influenza B, herpes simplex virus type 1, herpes simplex virus type 2, parainfluenza virus type 3, vaccinia virus, vesicular stomatitis virus, and human rhinovirus type 2. · Larch tree (Larix occidentalis) polysaccharides (arabinogalactans) help to support healthy intestinal flora and aid healthy immune function. “They stimulate the immune system through the activation of phagocytosis, competitive binding of bacterial fimbrae, and the potentiation of the reticuloendothelial system's effects.” · Resveratrol, naturally occurring in grape vines, grape skins and red wine, improves immune response and down-regulates the activation and production of proinflammatory cytokines. · Selenium has been shown to help the immune system modulate inflammatory response in mice challenged with reactive agents. Animals deficient in the mineral had much poorer outcomes than those whose diets were supplemented with this antioxidant mineral. · Vitamin C (ascorbic acid, ascorbate) in divided doses supports immunity. Taking about 500 mg at a time enhances absorption and avoids a laxative effect possible at higher doses. In a two-year long controlled study, “vitamin C administration resulted in an 85-percent decrease in cold and flu symptoms compared to the control group”. In a controlled trial of 226 patients with influenza A, where about half received 300 mg of vitamin C daily: “Pneumonia was reported in two cases in the treatment group and 10 in the control group, while hospital stays for influenza or related complications averaged nine days in the vitamin C group and 12 days in the control group.” · Vitamin D (cholecalciferol, ergocalciferol) deficiencies have been associated with immune challenges (such as the flu) during the winter months when sunlight is not as able to produce the vitamin in our bodies. A deficiency can inhibit the body’s ability to maintain health and immunity. · Vitamin E (alpha-tocopherol) deficiencies have been shown to decrease immune response and increase inflammatory responses leading to possible tissue damage in the respiratory system. · Zinc is recommended for immunity. Use up to 30 mg per day for this use; higher doses could increase the need for copper. These statements have not been evaluated by the FDA. The information provided by this article is intended for scientific and historical reference only and is not intended to diagnose, treat, prevent or cure any disease. If you have been exposed to or think you may have flu or any disease, see a physician as soon as possible. Do not try to self treat swine flu or any other disease; influenza can be life-threatening. Please inform your physician before taking any food supplements if you take any medications or have a known medical condition. Read all product labels carefully and follow all directions and label cautions, and do not exceed the highest recommended servings. Neil E. Levin, CCN, DANLA is a board certified clinical nutritionist with a Diplomate in Advanced Nutritional Laboratory Assessment. He is a professional member of the International & American Associations of Clinical Nutritionists and serves on the Scientific Council of the national Clinical Nutrition Certification Board. REFERENCES http://www.tamiflu.com/treat.aspx http://www.relenza.com/ http://foodasmedicine.blogspot.com/2009/04/dr-joe-bresee-swine-flu.html http://www.cdc.gov/h1n1flu/ http://www.cdc.gov/od/oc/media/pressrel/r030107.htm Cunningham-Rundles S, McNeeley DF, Moon A. Mechanisms of nutrient modulation of the immune response. J Allergy Clin Immunol. 2005 Jun;115(6):1119-28; quiz 1129. Review. Zaslaver M, Offer S, Kerem Z, Stark AH, Weller JI, Eliraz A, Madar Z. Natural compounds derived from foods modulate nitric oxide production and oxidative status in epithelial lung cells. J Agric Food Chem. 2005 Dec 28;53(26):9934-9. Calder PC, Kew S. The immune system: a target for functional foods? Br J Nutr. 2002 Nov;88 Suppl 2:S165-77. Janeway, Charles A.; Travers, Paul; Walport, Mark; Shlomchik, Mark (2001) Immunobiology, 5th Ed., Garland Publishing, New York and London. Beck MA, Handy J, Levander OA. Host nutritional status: the neglected virulence factor. Trends Microbiol. 2004 Sep;12(9):417-23. Review. PMID: 15337163 Nogusa S, Gerbino J, Ritz BW. Low-dose supplementation with active hexose correlated compound improves the immune response to acute influenza infection in C57BL/6 mice. Nutr Res. 2009 Feb;29(2):139-43. PMID: 19285605 Ritz BW, Nogusa S, Ackerman EA, Gardner EM. Supplementation with active hexose correlated compound increases the innate immune response of young mice to primary influenza infection. J Nutr. 2006 Nov;136(11):2868-73. PMID: 17056815 Ritz BW. Supplementation with active hexose correlated compound increases survival following infectious challenge in mice. Nutr Rev. 2008 Sep;66(9):526-31. Review. PMID: 18752476 Hancke JL. PARACTIN® useful for the treatment of autoimmune diseases, and Alzheimer disease by activation of PPAR-Receptor. Instituto de Farmacologia, Universidad Austral de Chile, Valdivia Chile. Poolsup N, Suthisisang C, Prathanturarug S, Asawamekin A, Chanchareon U. Andrographis paniculata in the symptomatic treatment of uncomplicated upper respiratory tract infection: systematic review of randomized controlled trials. J Clin Pharm Ther. 2004 Feb;29(1):37-45. Paractin® website: http://www.paractinpr.com/research.php McKenna DJ, Hughes K, Jones K (2002) Astragalus. Alt Ther 8(6):34-40. Lei H, Wang B, Li, W-P, Yang Y, Zhou A-W, Chen M-Z (2003) Anti-aging effect of astragalosides and its mechanism of action. Acta Pharmacol Sin 245(3):230-234. Youdim KA, Martin A, Joseph JA (2000). Incorporation of the elderberry anthocyanins by endothelial cells increases protection against oxidative stress. Free Radic Biol Med 29(1):51-60. Zakay-Rones A, Varsano N, Zlotnik M, Manor O, Regev L, Schlesinger M, Mumcuoglu M 1995) Inhibition of several strains of influenza virus in vitro and reduction of symptoms by an elderberry extract (Sambucus nigra L.) during an outbreak of influenza B Panama. J Altern Complement Med 1(4):361-369. Roxas M, Jurenka J. Colds and influenza: a review of diagnosis and conventional, botanical, and nutritional considerations Altern Med Rev. 2007;12(1):25-48. Zakay-Rones A, Thom E, Wollan T, Wadstein J (2004) Randomized study of the efficacy and safety of oral elderberry extract in the treatment of influenza A and B virus infections. J Int Med Res 32(2):132-140. Manganelli REU, Zaccaro L, Tomei PE (2005) Antiviral activity in vitro of Urtica dioica L., Parietaria Diffusa M. et K. and Sambucus nigra L. J Ethnopharmacol 98(3):323-327. Barak V, Halperin T, Kalickman I (2001) The effect of Sambucol, a black elderberry-based, natural product, on the production of human cytokines: I. Inflammatory cytokines. Eur Cytokine Netw 12(2):290-6. Barrett B. Medicinal properties of Echinacea: a critical review. Phytomedicine. 2003 Jan;10(1):66-86. Review. PMID: 12622467 Schoop R, Klein P, Suter A, Johnston SL. Echinacea in the prevention of induced rhinovirus colds: a meta-analysis. Clin Ther. 2006 Feb;28(2):174-83. Review. Saunders PR, Smith F, Schusky RW. Echinacea purpurea L. in children: safety, tolerability, compliance, and clinical effectiveness in upper respiratory tract infections. Can J Physiol Pharmacol. 2007 Nov;85(11):1195-9. PMID: 18066121 Senchina DS, McCann DA, Flinn GN, Wu L, Zhai Z, Cunnick JE, Wurtele ES, Kohut ML. Echinacea tennesseensis ethanol tinctures harbor cytokine- and proliferation-enhancing capacities. Cytokine. 2009 Mar 13. [Epub ahead of print] PMID: 19286391 Ghaemi A, Soleimanjahi H, Gill P, Arefian E, Soudi S, Hassan Z. Echinacea purpurea Polysaccharide Reduces the Latency Rate in Herpes Simplex Virus Type-1 Infections. Intervirology. 2009 Apr 17;52(1):29-34. [Epub ahead of print] PMID: 19372701 Binns SE, Hudson J, Merali S, Arnason JT. Antiviral activity of characterized extracts from echinacea spp. (Heliantheae: Asteraceae) against herpes simplex virus (HSV-I). Planta Med. 2002 Sep;68(9):780-3. PMID: 12357386 Shah SA, Sander S, White CM, Rinaldi M, Coleman CI. Evaluation of echinacea for the prevention and treatment of the common cold: a meta-analysis. Lancet Infect Dis. 2007 Jul;7(7):473-80. Review. Erratum in: Lancet Infect Dis. 2007 Sep;7(9):580. PMID: 17597571 Zhen H, Fang F, Ye DY, Shu SN, Zhou YF, Dong YS, Nie XC, Li G. Experimental study on the action of allitridin against human cytomegalovirus in vitro: Inhibitory effects on immediate-early genes. Antiviral Res. 2006 Oct;72(1):68-74. Epub 2006 Apr 27. PMID: 16844239 Ankri S, Mirelman D. Antimicrobial properties of allicin from garlic. Microbes Infect. 1999 Feb;1(2):125-9. Review. PMID: 10594976 Josling P. Preventing the common cold with a garlic supplement: a double-blind, placebo-controlled survey. Adv Ther. 2001 Jul-Aug;18(4):189-93. PMID: 11697022 Choi EM, Kim AJ, Kim YO, Hwang JK. Immunomodulating activity of arabinogalactan and fucoidan in vitro. J Med Food. 2005 Winter;8(4):446-53. Currier NL, Lejtenyi D, Miller SC Effect over time of in-vivo administration of the polysaccharide arabinogalactan on immune and hemopoietic cell lineages in murine spleen and bone marrow. Phytomedicine. 2003 Mar;10(2-3):145-53. Friel H, Lederman H. A nutritional supplement formula for influenza A (H5N1) infection in humans. Med Hypotheses. 2006;67(3):578-87. Epub 2006 Apr 18. PMID: 16624496 Beck MA. Selenium and vitamin E status: impact on viral pathogenicity. J Nutr. 2007 May;137(5):1338-40. Review. PMID: 17449602 Beck MA. Antioxidants and viral infections: host immune response and viral pathogenicity. J Am Coll Nutr. 2001 Oct;20(5 Suppl):384S-388S; discussion 396S-397S. Review. PMID: 11603647 Friel H, Lederman H. A nutritional supplement formula for influenza A (H5N1) infection in humans. Med Hypotheses. 2006;67(3):578-87. Epub 2006 Apr 18. PMID: 16624496 Nandi BK, Subramanian N, Majumder AK, Chatterjee IB. Effect of ascorbic acid on detoxification of histamine under stress conditions. Biochem Pharmacol. 1974 Feb 1;23(3):643-7. Johnston CS. The antihistamine action of ascorbic acid. Subcell Biochem. 1996;25:189-213. Johnston CS, Martin LJ, Cai X. Antihistamine effect of supplemental ascorbic acid and neutrophil chemotaxis. J Am Coll Nutr. 1992 Apr;11(2):172-6. Wintergerst ES, Maggini S, Hornig DH. Immune-enhancing role of vitamin C and zinc and effect on clinical conditions. Ann Nutr Metab. 2006;50(2):85-94. Carcamo JM, Pedraza A, Borquez-Ojeda O, Golde DW. Vitamin C suppresses TNF alpha-induced NF kappa B activation by inhibiting I kappa B alpha phosphorylation. Biochemistry. 2002 Oct 29;41(43):12995-3002. Kimbarowski JA, Mokrow NJ. Colored precipitation reaction of the urine according to Kimbarowski (FARK) as an index of the effect of ascorbic acid during treatment of viral influenza. Dtsch Gesundheitsw. 1967;22:2413-2418. [Article in German] Cannell JJ, Hollis BW. Use of vitamin D in clinical practice. Altern Med Rev. 2008 Mar;13(1):6-20. Review. PMID: 18377099 Cannell JJ, Zasloff M, Garland CF, Scragg R, Giovannucci E. On the epidemiology of influenza. Virol J. 2008 Feb 25;5:29. Review. PMID: 18298852 Cannell JJ, Vieth R, Umhau JC, Holick MF, Grant WB, Madronich S, Garland CF, Giovannucci E. Epidemic influenza and vitamin D. Epidemiol Infect. 2006 Dec;134(6):1129-40. Epub 2006 Sep 7. Review. PMID: 16959053 Beck MA. Selenium and vitamin E status: impact on viral pathogenicity. J Nutr. 2007 May;137(5):1338-40. Review. PMID: 17449602 Friel H, Lederman H. A nutritional supplement formula for influenza A (H5N1) infection in humans. Med Hypotheses. 2006;67(3):578-87. Epub 2006 Apr 18. PMID: 16624496 Arroll B. Non-antibiotic treatments for upper-respiratory tract infections (common cold). Respir Med. 2005 Dec;99(12):1477-84. PMID: 16291073
Monday, April 20, 2009
There are theoretical risks for isolated folic acid in high doses. But these supposed risks fly in the face of established science and are controversial, not at all conclusive. There is also confusion over the significance of the supposed risks of high dose isolated folic acid in test tube and animal studies which do not identify a danger for moderate level supplementation - or even higher dose supplementation if combined with multivitamins or vitamin B-12. In other words, if the theoretical risks do not reflect real world human activities and the way that people actually obtain essential vitamins from their diet, including supplementation, aren’t these improbable risks really irrelevant to us? On the other hand, these negative reports may stop people from taking essential vitamins in quite reasonable amounts even though they are known to promote human health. Published human clinical science has determined that folic acid can reduce birth defects and has been proven to do so. Clinical science has also found mechanisms by which folic acid can prevent cancers, as well as the theoretical possibility that very high doses given in isolation can stimulate colorectal cancers including prostate cancer. There is stronger evidence that taking B-12 or a multivitamin along with high folic acid actually reduces rates of prostate and colon cancers. For example, in one human clinical trial where food intake, blood and plasma levels of folic acid were considered, Multivitamin users had about 2/3 the risk of subsequent prostate cancer as Non-Multivitamin users; only the independent use of folic acid was considered a risk factor. The report concluded, “…on the whole, the biological and epidemiological evidence supports the potential for folate supplementation to prevent colorectal neoplasia in humans.” (Cole) This shows that single nutrient studies, especially if unpublished and not peer reviewed or subjected to subsequent comments by experts in the field, should not be given overinflated importance when they are merely preliminary studies that may conflict with more relevant published human clinical studies. In the case of such conflicts, the human clinicals should bear more weight and be seen as more convincing, especially those that mimic the full range of variables (nutrients) in the human diet. Folic acid itself is considered non-toxic. Also, “data from in vitro and in vivo studies indicate that folic acid is not genotoxic [damaging to genetic material]”. (UK Food Standards Agency) There have been reports of levels as high as 50,000 micrograms per day given with no signs of toxicity in humans. There are accepted problems associated with levels exceeding 5,000 micrograms a day, which resulted in a far more conservative Upper Limit of 1,000 micrograms daily being set. This effect has been demonstrated in patients suffering from pernicious anemia taken off of their successful medicine (vitamin B-12), which was replaced by 5,000 mcg/day of folic acid. The substitution of one vitamin for another was unsuccessful in treating pernicious anemia, but did mask some symptoms. This test – and a large safety margin - provided the rationale given for the current Upper Limit. But it does not logically imply danger to those who are not severely anemic and who obtain B-12 in adequate amounts. (Oakley) It is very uncommon for people to take folic acid singly in doses of thousands of micrograms daily, but this is the method which test tube and animal studies often use. Overemphasizing unproven cancer risks requires ignoring valid studies showing reductions of cancers by taking folic acid and multivitamins. Needlessly scaring people from taking their vitamins, which have in human clinical trials shown significant improvements in birth defect and cancer rates, is not helpful to our common goal of protecting public health. Neil E. Levin, CCN, DANLA QUOTES & REFERENCES: Dr. Gideon Koren, director of the Motherisk Program at the Hospital for Sick Children in Toronto , note that rates of birth defects such as spina bifida and cancers such as neuroblastoma have plummeted since folic acid supplementation was begun. He believes that the known benefits outweigh theoretical risks. "I think it is very important to remember that the scares about cancer are mostly from animal studies and laboratory studies, not from human experience," he says. "We are still awaiting to see such human experience." http://www.ctv.ca/servlet/ArticleNews/story/CTVNews/20090417/folic_acid_090418/20090419?hub=SciTech Health Canada recommends all women of childbearing age take 0.4 mg of folic acid a day, but says taking more than 1 mg a day of folic acid without the advice of a doctor is not recommended. "We continue to encourage all women who could become pregnant to take a daily supplement," the agency says on its website. "We caution against taking more than one multivitamin tablet a day, as excess amounts of certain vitamins can be toxic." http://www.ctv.ca/servlet/ArticleNews/story/CTVNews/20090417/folic_acid_090418/20090419?hub=SciTech “All women who could become pregnant should take a multivitamin containing 0.4 mg of Folic Acid every day. To help reduce the risk of NTDs, you should start taking the vitamin supplement at least three months before you get pregnant and continue through the first three months of your pregnancy. Talk to your health professional to find the supplement best for you…If you have had a previous pregnancy affected by an NTD or have a family history of this problem, see your doctor. You may be advised to take a higher dosage of Folic Acid. If you have diabetes, obesity or epilepsy, you may be at higher risk of having a baby with an NTD, and you should see your doctor before planning pregnancy… Do not take more than one daily dose of vitamin supplement as indicated on the product label. Increasing your dose of Folic Acid beyond 1 mg per day without the advice of a doctor is not recommended.” (Public Health Agency of Canada , 2/27/08; http://www.phac-aspc.gc.ca/fa-af/index-eng.php) The NIH’s Office of Dietary Supplement reports on the prevention of cancer with the use of supplemental folic acid as part of a multivitamin: “Over 88,000 women enrolled in the Nurses' Health Study who were free of cancer in 1980 were followed from 1980 through 1994. Researchers found that women ages 55 to 69 years in this study who took multivitamins containing folic acid for more than 15 years had a markedly lower risk of developing colon cancer.” (Giovannucci E, et al. Multivitamin use, folate, and colon cancer in women in the Nurses' Health Study. Ann Intern Med 1998;129:517-24; http://ods.od.nih.gov/factsheets/folate.asp) Cole BF, et al. Folic acid for the prevention of colorectal adenomas: a randomized clinical trial. Polyp Prevention Study Group. JAMA. 2007 Jun 6;297(21):2351-9. PMID: 17551129 Figueiredo JC, et al. Folic acid and risk of prostate cancer: results from a randomized clinical trial. J Natl Cancer Inst. 2009 Mar 18;101(6):432-5. Epub 2009 Mar 10. PMID: 19276452 Folic Acid, CASRN: 59-30-3. NLM TOXNET Hazardous Substances Database accessed online 28 March, 2009. http://toxnet.nlm.nih.gov/cgi-bin/sis/search/r?dbs+hsdb:@term+@na+folic+acid Lonn E, Yusuf S, Arnold MJ, Sheridan P, Pogue J, Micks M, McQueen MJ, Probstfield J, Fodor G, Held C, Genest J Jr; Heart Outcomes Prevention Evaluation (HOPE) 2 Investigators. N Engl J Med. 2006 Apr 13;354(15):1567-77. Epub 2006 Mar 12. Erratum in: N Engl J Med. 2006 Aug 17;355(7):746. PMID: 16531613 Oakley GP Jr. When will we eliminate folic acid-preventable spina bifida? Epidemiology. 2007 May;18(3):367-8. PMID: 17435446 http://www.food.gov.uk/multimedia/pdfs/evm_folicacid.pdf
Wednesday, April 15, 2009
"Pay no attention to the drugs behind the mirror." What some physicians do in excusing drug side effects while pointing fingers at dietary supplements; with apologies to the Wizard of Oz.
Monday, April 13, 2009
Saturday, February 21, 2009
All grains contain gluten; some forms are just more allergenic or more difficult to process than others, which can vary from individual to individual. Wheat is the most common gluten reaction; which is also possible for rye, oats, barley and buckwheat. Some people are sensitive to certain proteins because of leaky gut, a condition where digestion is impaired because of GI tract disorders. Non-allergenic "delayed sensitivity reactions" to proteins may be caused by leaky gut and the specific immune cells reacting to these specific proteins can be reprogrammed to be non-reactive to them by completely avoiding these specific foods for at least 6 weeks. Not so for true food allergies, which can be permanent and trigger ever-increasing reactions with every occasional exposure. People's abilities to digest proteins vary with genetics, immune system capacity and probiotics present in the gut. There is even current research on specific bacteria that prevent the damage caused by wheat in susceptible people's guts. Only about 1% of the population tests as truly allergic to wheat protein, between 1-2% for dairy protein. Obviously, many more are (temporarily) sensitive to these proteins based on gut dysbiosis and leaky gut tissues failing to completely digest these foods. The issue of lactose intolerance is another possible cause of gas or bloating after consuming non-fermented dairy products (except for low-lactose products like whey protein isolate). The use of antacids is a major factor reducing digestion of proteins and minerals in the stomach, as well as reducing the essential acidic barrier against pathogenic organisms that may be present in our food and water; even from dirty hands that we use to eat. Stress and improper chewing may also contribute to the presence of extra undigested proteins in the gut, composed of undigested food and undesirable microbes. Who's left to clean up the mess and try to get some badly needed nutrients into the bloodstream? The immune system, though imperfectly. A major part of immune cell counts and activity is in the GI tract for exactly this reason, consuming a lot of energy. If digestion fails and the GI tract contains an unhealthy mixture of organisms and large protein masses, the result is a significant immune challenge by every measure, leading to inflammation and fatigue. Glutamine is an amino acid present in most protein-containing foods that is essential to brain and nerve function. Magnesium, other amino acids (ie taurine) and antioxidant co-factors render it far less overexciting to neurons. MSG and aspartame are additional proteins that can cause nerve overstimulus in some circumstances. There are ways to reduce these reactions, as described thoroughly by Dr. Russell Blailock in his books, lectures and articles. The bottom line: No need for most people to avoid soy, milk or grains if they can maintain the intregrity of their digestive and GI tracts properly. Most of those whose systems aren't in such good health can utilize fairly effective means of correcting these issues and eventually resuming the use of these foods in their diets, unless they are the relatively few with true allergies.
The International Federation for Produce Coding (IFPC) creates Price-Look Up (PLU) codes for fresh fruits and vegetables. These four-digit codes are put on stickers and applied to the produce items. Organic and genetically engineered produce are identified by a fifth PLU digit on the sticker. You can identify organic items by the number "9" leading the five-digit PLU, and you can identify genetically engineered items by the number "8" leading a five-digit PLU number. Both of these categories will have five digits instead of the standard four. The four-digit code remains the same even if a fifth digit (8 or 9) is added. In the following example, conventional bananas have a standard PLU code of 4011. Organic bananas are coded 94011 and genetically engineered bananas are coded 84011. For me, the 9 prefix (for organic produce) is desirable and the 8 (for genetically engineered) is not. I use this rhyme to remind myself of the difference: “I hate eight, but nine is fine.” For more information about PLU codes, visit www.plucodes.com/plucodesfaq.asp
Sleep allows an overactive adrenal to rest overnight, also allowing your melatonin to give you a good night's sleep. Cortisol and melatonin are agonists, and fight for dominance. Cortisol is a stress hormone made by the adrenal gland and melatonin is an antioxidant sleep hormone produced by the pineal gland at night, in darkness. Normally melatonin takes over the night, slowing down cortisol production in the adrenal gland and encouraging proper rest and repair cycles. Then it wanes and cortisol and other adrenal hormones take over during the day, giving you energy. They should switch off in a normal daily cycle. If the adrenal won't shut down properly overnight due to stress, one may have inadequate melatonin resulting in an improper rest and repair cycle wearing you down. High cortisol levels are also associated with encouraging the depositing of fat in the abdomen, specifically. So reducing cortisol may also inhibit the formation of abdominal fat.
My experience with dietary supplements is that analysis of products with multiple ingredients, especially those at low concentrations, is very difficult and requires experience with the particular supplement matrix (formula plus excipients). Random testing of products off the shelf is fraught with technical difficulties. In addition, many ingredients lack standard, universally accepted testing methods within a dietary supplement matrix, which can result in confusion. These are sophisticated issues, whose resolution sometimes is difficult for anyone trying to ascertain product quality based on limited testing and lack of relevant experience. That is why most labs prefer to test single ingredient products, a tacit admission of the uncertainties involved in testing complex formulations. Testing is not as black and white as news releases often indicate or imply. Further, extrapolation of analytical results to nutrition, health and safety issues also requires expertise in these sometimes controversial areas, which very few labs have. It is important to verify label claims, but sometimes the manufacturer's validated procedures for qualification of an individual ingredient - combined with appropriate quality controls to assure that a proper mixture has been made - may more accurately represent the quality and quantity of that ingredient in a formula than any lab results obtained by applying a single analytical test to vastly different formulations containing that ingredient.
Monday, February 16, 2009
More nonsense in vitamin research By Neil E. Levin, CCN, DANLA A report in Archives of Internal Medicine, an AMA journal, tells us that “the Women’s Health Initiative study provided convincing evidence that multivitamin use has little or no influence on the risk of common cancers, CVD, or total mortality in postmenopausal women.” [i] A closer look at that report reveals serious shortcomings in its references and logic, leading to questions about its validity. In spite of these defects, this report got extensive press coverage (“Study Says Multivitamins Not Effective”[ii]) to promote the view that multivitamins are worthless. Having read the report and reviewed its references, I have serious questions about its importance, which I can back up by reviewing some of its own references. First of all, on what basis do the authors base their assertion that this report was needed? Actually, on pretty flimsy grounds. They list two references to justify the belief that there is a common “belief that these preparations will prevent chronic diseases, such as cancer and cardiovascular disease (CVD)”, which this report claims to disprove. Their first reference (by the lead author of the current report) actually states that multivitamin nutrients have been effective and accepted in medical practice for the prevention of other conditions: “First, research findings published throughout the past 10–20 y have established that some supplements are very effective for disease prevention and their use has become a part of routine clinical practice [e.g., folic acid during the periconceptional period to reduce the risk of neural tube defects and iron to prevent or treat anemia during pregnancy].” This statement indirectly undermines the underlying argument in the current report that vitamins are worthless against chronic disease. This same reference directly undermines the current report by asserting that most people use multivitamins for general health, not for prevention of serious diseases as is claimed in the current report: “Multivitamins (with or without minerals), the supplements most commonly used by American women, are most likely to be used to maintain general good health.” While this reference mentions that most American women with cancer do take vitamins, it does not pretend to know why they do so. In fact, there is no assertion that people claim to take vitamins to prevent cancer and CVD, and this reference actually gives alternative reasons for that use by patients with those conditions. This reference, like the current study by the same lead author, is dismissive of a law (DSHEA) regulating dietary supplements; and while it decries this law as reducing regulation in some areas, it ignores significant increases in scrutiny that the same law establishes, which I will explore in a subsequent section. To me, for the lead author to twice publish reports focusing on perceived negatives in the law while ignoring its clear positives and other applicable laws that increase federal regulation - implies an agenda that goes beyond scientific inquiry. 1 [iii] [iv] [v] The second reference listed for justifying the report also does not provide the supposed justification. On the contrary, it states, “Generally, participants took multivitamins to feel better… Nearly half of participants reported that they take multivitamins because it is hard to eat a balanced diet.” [vi] An objective observer reading these two references finds that they do not provide the promised justification for testing their own assertion that people take multivitamins to prevent cancer and CVD. Obviously, the current authors have not provided adequate references to support their claimed hypothesis; their own references betray them. Next, the authors claim that dietary supplements are “an industry that is largely unregulated owing to the 1994 Dietary Supplement and Health Education Act [sic].” Two references are listed to defend this assertion. The first is the law itself, which actually creates clear new authority for federal regulation of supplement manufacturing, federal regulation of labels and health claims, federal regulation of new ingredients, making illegal any mislabeled or adulterated products, etc. A fair reading of this law, and of the subsequent regulations that have been written to enforce it, including the mandatory Good Manufacturing Practices currently being implemented, do not support the authors’ claim. [vii] [viii] The second reference given also fails to support its use as a justification for the belief that supplements are largely unregulated: “DS are regulated under food law, but with certain provisions that apply only to DS…Health claims have already been authorized for folic acid and calcium, but not for several others. In 1994, when the Dietary Supplement Health and Education Act (DSHEA) was passed, it expanded and clarified the definition of DS, specified additional requirements for safety and provided for four types of claims of nutritional support…Although S/F [affecting the structure and functions of the body] effects result from both foods and drugs, representation that a product will treat, cure, mitigate or diagnose a disease is reserved for drugs.” [ix] The current report also fails to note industry-supported legislation that now requires serious adverse events to be reported to the FDA’s MedWatch system, which serves as an early warning system for safety problems. [x] We have seen that the first two claims in the current report, namely that people take multivitamins to prevent certain chronic major diseases and that dietary supplements are largely unregulated, are not supported by the report’s own selected references. In other words, there is not any real justification provided to support the need for this particular report. How could the authors cite references that don’t really support their claims? How does this undermine their reasons for doing this study? Another problem is that the current authors rather arbitrarily ignore numerous FDA-approved health claims for dietary supplements in their argument against the use of multivitamins to prevent chronic diseases, including the benefits of calcium for osteoporosis, fiber to prevent coronary heart disease, soy protein to prevent coronary heart disease, plant sterol/stanol esters and risk of coronary heart disease, potassium and the risk of high blood pressure and stroke; claims that already have met the agency’s Significant Scientific Agreement (SSA) standard. [xi] Even more bizarrely, they ignore substantial scientific agreements that were mentioned in the lead author’s own previous publication (which is referenced by the current report) which identified an accepted use of “iron to prevent or treat anemia during pregnancy” and reported “at least 35 randomized-controlled trials have shown that supplemental calcium or calcium–vitamin D combinations increase bone mass and decrease fracture risk in adult females.” 6 Yet the current authors claim: “Despite the widespread use of supplements and the strong consumer beliefs about benefits, convincing scientific data to support efficacy are lacking. With the exception of recommending a folic acid–containing supplement to women of childbearing potential and advising avoidance the use of high-dose beta carotene supplements by smokers, current data are insufficient to formulate public health recommendations for dietary supplement use for otherwise healthy persons.” Also, the FDA has also approved a number of less definitive Qualified Health Claims (QHCs) including calcium and colon/rectal cancer & calcium and recurrent colon/rectal polyps, green tea and cancer, selenium and cancer, antioxidant vitamins & cancer, omega-3 fatty acids & coronary heart disease, B vitamins & vascular disease, phosphatidylserine & cognitive dysfunction and dementia, chromium picolinate & diabetes, calcium & hypertension, pregnancy-induced hypertension and preeclampsia. [xii] The FDA-Approved Health Claims and QHCs are the only disease claims authorized for dietary supplements in the United States, with all others prohibited under the supposedly deregulating DSHEA law. 7 Another reference mischaracterization is the authors’ statement that “One study of more than 1 million Americans reported no association of multivitamin use with total mortality, coronary heart disease mortality, or cancer mortality.” [xiii] If, in fact, one were to read the reference carefully, one might find a more contradictory and less definitive tone: “Because CPS-II collected information on vitamin supplement use only once, in 1982, our measurement of duration of use is imprecise, and we potentially misclassify people who changed their use of multivitamin during the 7-year follow-up. This is an important limitation and may explain why we did not find a reduced risk of colon cancer among women with long duration of multivitamin use, as was found in the Nurses’ Health Study, which had repeat assessments of multivitamin use.” The imprecise nature of this reference must be emphasized. The Cancer Prevention Study II (CPS-II), which relied on a single survey of multivitamin use to classify as users those who claimed to have taken a multivitamin of any strength at least once during the month preceding the survey, was likely to be more and more inaccurate over time, and wherein only about half of the people surveyed claimed to have taken their multivitamin supplement daily during the previous month, is not a strong reference because its weak design does not establish any definitive effects clearly attributed to multivitamins. 13 Contrast this with the admittedly more rigorous Nurses’ Health Study, showing benefits in those taking supplements that were validated by repeatedly assessing whether or not the subjects kept taking their vitamins. [xiv] While the current report has an 8-year follow up period, the Nurses’ Health Study reported significant benefits only after 15 years of multivitamin use, concluding that such “Long-term use of multivitamins may substantially reduce risk for colon cancer.” This is another indication that the current report’s authors have failed to design their study in such a way as to follow previous successes and avoid known shortcomings of previously published studies; surprisingly, not even the ones that they themselves have referenced or written. By looking at only half as much time as was previously shown to be effective, they have produced a far less rigorous and less convincing report. The incubation period of cancers and heart disease is often estimated to be many years. As the National Cancer Institute reports, “Prostate cancer often does not cause symptoms for many years.” [xv] Other sources confirm the lengthy breeding time of cancers. Mouth cancer has a ten-year incubation period. [xvi] Because “the “incubation period between HPV infection and development of invasive cervical cancer is long, prevention of cancer by a vaccination programme will not be obvious for 10 to 20 years.” [xvii] Asbestos dust can cause lung cancer some 10 to 30 years after exposure. [xviii] Cervical cancer “has a long incubation period, between three to 17 years.” [xix] Likewise, “the ‘incubation period’ between exposure to major coronary risk factors and the maximum effects on mortality may be 10 years or more.” [xx] In the current report, “stress multivitamins” [sic] consisting of B-Complex vitamins along with additional factors such as vitamin C or single minerals were classified as multivitamins, though they could lack essential vitamins A, D, and E, as well as most or all of the essential minerals. This is not a normal definition of a multivitamin formula. Stress formulas are normally considered B-Complex supplements that are fortified with one or more additional nutrients to help the body deal with stress, but not as a general all-in-one daily nutritional supplement. People tend to take stress supplements because they feel under stress, not as a general insurance against incomplete diets as multivitamins are taken. 3,6 While the percentage of subjects in this category is small, I question why they would be included as multivitamin users in the current report at all. Perhaps this design flaw betrays a lack of understanding of the topic being investigated, with a strangely unscientific willingness to throw too many doses and formulas in the supposedly controlled mix of variables. In the case of multivitamins, most studies have shown overwhelmingly positive effects; such as one report evidencing reduced infections in nursing homes with vitamins over placebo (73% vs. 43%). Intervention was with a multivitamin containing beta-carotene. Infection-related absenteeism was higher in the placebo group than in the treatment group (57% vs. 21%). Perhaps most importantly, 93% of participants with diabetes mellitus reported an infection versus only 17% of those receiving supplements. [xxi] Interesting, the current report being reviewed also indicates that nonusers had a higher rate of diabetes treatment than multivitamin users; nonusers were treated at a rate of 5.2% while users ranged only from 2.7 to 3.5%. Nonusers also had slightly lower rates (81.4%) of mammograms compared with users (85.7 to 87.2%), which could imply greater rates of undetected breast cancer that may confound comparisons. 1 Another study reported in the Journal of the National Cancer Institute looked at death rates in a population given multivitamins or other nutrients. [xxii] After supplements were given for 5.25 years in the general population trial of 30,000 people, significant reductions in total [relative risk (RR) = 0.91] and cancer (RR = 0.87) mortality were observed in subjects receiving beta-carotene, alpha-tocopherol, and selenium combined. These nutrients are common in multivitamin formulas. The same researchers reported on a subgroup of 3,318 persons with esophageal Dysplasia (a precursor to esophageal cancer) that was given either a multiple vitamin-and-mineral supplement or a placebo for 6 years. In this portion of the trial, a trend towards small reductions in total (RR 0.93) and cancer (RR = 0.96) mortality were observed that did not reach statistical significance. In any case, no increase in cancer rates was noted in the group taking multivitamins; there was actually a possible small benefit in terms of reducing this risk. The participants getting the multivitamin took a daily beta-carotene capsule along with two multivitamin tablets. This was a group of subjects at high risk of getting throat cancer. [xxiii],[xxiv] Another problem with the current study is that these are nutrients and there are several important yet uncontrolled variables preventing meaningful conclusions: * The same nutrients are found in people’s diet, confounding researchers more used to novel drug studies who may be unfamiliar with the need to control additional variables in nutrient study design * The variety of formulations and nutrients included prevent a meaningful comparison by individual or groups of vitamins or minerals, present or absent * The potency of various nutrients taken could vary from absent to very high; there is no dose-dependent data possible in this particular study design that lumped together a wide range of non-homogenous dietary supplements In conclusion, there are many basic omissions and errors in this report’s rationale and design that should have dramatically reduced its importance and avoided a media frenzy over its flimsy conclusions. Unfortunately, nutrient studies often lack adequate critical review and the researchers tend to jump to unsupported conclusions by ignoring important variables. In this case, one problem was the design of a study that was simply too short to show any benefits. Another is the absolute lack of control over potencies and nutrient content. Rather than blaming the vitamins, it was probably pre-existing conditions and supplemental intervention was too little, too late. This report’s authors seem to lack objectivity by referring to an industry that has had numerous new regulatory controls imposed as “unregulated”. They have also chosen to ignore numerous approved health claims for vitamins, as well as evidence of benefits for those suffering from diseases other than cancer and cardiovascular disease. Additionally, they have described unsubstantiated motives for why people take vitamins, designing a study that was too short and included too many uncontrolled variables to be definitive, thus undermining their entire project’s basis and conclusions. Nutrient studies are simply more complex than drug studies and require a much higher level of careful planning to ensure meaningful results and eliminate as many variables as possible. In this case, I fear that the current report failed to do this, in the process generating much heat but little light on the topic.REFERENCES [i] Neuhouser ML, et al. Multivitamin Use and Risk of Cancer and Cardiovascular Disease in the Women's Health Initiative Cohorts. Arch Intern Med. 169(3), 294-304. FEB 9, 2009 [ii] WSAV-3 TV, NBC affiliate: http://www.wsav.com/sav/news/science/health_med_fit/article/study_says_multivitamins_not_effective/9446/ [iii] Neuhouser ML. Dietary supplement use by American women: challenges in assessing patterns of use, motives and costs. J Nutr. 2003 Jun;133(6):1992S-1996S. Review. PMID: 12771352 [iv] http://www.fda.gov/opacom/laws/pl109462.html [v] http://www.cfsan.fda.gov/~dms/ds-labl.html [vi] Neuhouser ML, Patterson RE, Levy L. Motivations for using vitamin and mineral supplements. J Am Diet Assoc. 1999 Jul;99(7):851-4. PMID: 10405685 [vii] Dietary Supplement and Health Education Act of 1994, Pub L No. 103-417, 103rd Cong (1994). [viii] http://www.cfsan.fda.gov/~dms/supplmnt.html [ix] Hathcock J. Dietary supplements: how they are used and regulated. J Nutr. 2001 Mar;131(3s):1114S-7S. Review. PMID: 11238828 [x] http://www.cfsan.fda.gov/~dms/ds-rept.html [xi] http://www.cfsan.fda.gov/~dms/flg-6c.html [xii] http://www.cfsan.fda.gov/~dms/qhc-sum.html [xiii] Watkins ML, Erickson JD, Thun MJ, Mulinare J, Heath CW Jr. Multivitamin use and mortality in a large prospective study. Am J Epidemiol. 2000 Jul 15;152(2):149-62. PMID: 10909952 [xiv] Giovannucci E, Stampfer MJ, Colditz GA, Hunter DJ, Fuchs C, Rosner BA, Speizer FE, Willett WC. Multivitamin use, folate, and colon cancer in women in the Nurses' Health Study. Ann Intern Med. 1998 Oct 1;129(7):517-24. PMID: 9758570 [xv] National Cancer Institute: http://www.cancer.gov/cancertopics/factsheet/Detection/early-prostate [xvi] Mouth Cancer Foundation: http://www.rdoc.org.uk/chewing_tobacco_risk.html [xvii] Lowndes CM, Gill ON. Cervical cancer, human papillomavirus, and vaccination. BMJ. 2005 Oct 22;331(7522):915-6. No abstract available. Erratum in: BMJ. 2005 Nov 12;331(7525):1120. PMID: 16239668 [xviii] Ministry of Environment of the Republic of Korea: http://eng.me.go.kr/docs/sub2/policy_view.html?topmenu=C&cat=250&class=14 [xix] Indonesian Cancer Foundation: http://www.cvcradio.in/news/blogs/eye-on-indonesia/cervical-cancer-the-number-one-killer-of-indonesian-women [xx] Rose G. Incubation period of coronary heart disease. 1982. Int J Epidemiol. 2005 Apr;34(2):242-4. Epub 2005 Mar 11. PMID: 15764698 [xxi] Liu BA, et al. Effect of multivitamin and mineral supplementation on episodes of infection in nursing home residents: a randomized, placebo-controlled study. J Am Geriatr Soc. 2007 Jan;55(1):35-42. Erratum in: J Am Geriatr Soc. 2007 Mar;55(3):478. PMID: 17233683 [xxii] Blot WI, Li IY, Taylor PR, et al. Nutrition intervention trials in Linxian, China: supplementation with specific vitamin/mineral combinations, cancer incidence, and disease-specific mortality in the general population. J Natl Cancer Inst 1993:8ı:1483-92 [xxiii] Li JY, Taylor PR, et al. Nutrition intervention trials in Linxian, China: multiple vitamin/mineral supplementation, cancer incidence, and disease-specific mortality among adults with esophageal dysplasia. J Natl Cancer Inst. 1993 Sep 15;85(18):1492-8. PMID: 8360932 [xxiv] Blot WI, et al. The Linxian trials: mortality rates by vitamin-mineral intervention group. Am J Clin Nutr. 1995 Dec;62(6 Suppl):1424S-1426S. PMID: 7495242