"Health warning" over vitamin pills

Reply Wed 16 Apr, 2008 03:36 am
Both the Mail and the Telegraph (UK papers) lead with the results of a Danish study that found vitamin pills "can increase the risk of early death".

The Telegraph: Vitamin pills 'increase risk of early death'
Researchers at Copenhagen University carried out a review of 67 studies on 230,000 healthy people and found "no convincing evidence" that any of the antioxidants helped to prolong life expectancy. But some "increased mortality".
Antioxidants, including vitamins A, E, C and beta-carotene and selenium, are said to mop up compounds, called free radicals, which cause disease. It is this action that researchers believe may cause problems with the defence system.

The Danish research, released by the influential Cochrane Library, applied only to synthetic supplements and not to vitamins that occur naturally in vegetables and fruit.

It found that vitamin A supplements increased the risk of death in healthy people by 16 per cent. Taking beta-carotene was linked to a 7 per cent increased risk, while regular users of vitamin E supplements increased the risk of an early death by four per cent.

Although the review found no significant detrimental effect caused by vitamin C, it found no evidence that it helped ward off disease. Millions take it in the hope of avoiding a common cold.

Goran Bjelakovic, who led the review, said: "We could find no evidence to support taking antioxidant supplements to reduce the risk of dying earlier in healthy people or patients with various diseases.

"If anything, people in trial groups given the antioxidants beta-carotene, vitamin A, and vitamin E showed increased rates of mortality."

But Patrick Holford, a nutritionist who has formulated supplements for the company Biocare, said: "Antioxidants are not meant to be magic bullets and should not be expected to undo a lifetime of unhealthy habits.

"When used properly, in combination with a healthy diet full of fruit and vegetables, getting plenty of exercise and not smoking, antioxidant supplements can play an important role in maintaining and promoting overall health."

Daily Mail: Vitamins A, C and E are 'a waste of time and may even shorten your life'
Although the authors claimed to be assessing antioxidant supplements for the prevention of mortality, they excluded all studies - 405 of them - which reported no deaths.

Mr Holford said: 'Antioxidants are not meant to be magic bullets and should not be expected to undo a lifetime of unhealthy habits.

'But when used properly, in combination with eating a healthy diet full of fruit and vegetables, getting plenty of exercise and not smoking, antioxidant supplements can play an important role in maintaining and promoting overall health.

'I take, and will continue to take an all-round antioxidant supplementing containing these nutrients as well as CoQ10, lipoic acid and resveratrol - the "red wine" factor - and also eat a diet high in fruit and vegetables.'

Pamela Mason, of the industry-backed Health Supplements Information Service, said: 'Antioxidant vitamins, like any other vitamins, were never intended for the prevention of chronic disease and mortality.

'They are intended for health maintenance on the basis of their various physiological roles in the body and in the case of antioxidant vitamins, this does, in appropriate amounts, include a protective antioxidant effect in the body's tissues.

'These vitamins are essential for health and many people in the UK do not have an adequate intake.

'A vitamin supplement taken in recommended amounts can be beneficial for health, especially for those people whose intakes are poor.
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Walter Hinteler
Reply Wed 16 Apr, 2008 03:37 am
The Cochrane Library, 2008, Issue 2:
Antioxidant supplements for prevention of mortality in healthy participants and patients with various diseases (Review)
No evidence to support antioxidant supplements to prevent mortality in healthy people or patients with various diseases

Previous research on animal and physiological models suggest that antioxidant supplements have beneficial effects that may prolong life.
Some observational studies also suggest that antioxidant supplementsmay prolong life, whereas other observational studies demonstrate
neutral or harmful effects. Randomised trials have largely been neutral.We need evidence fromrandomised trials to decide if antioxidant
supplements should be used for prevention.
The present systematic review includes 67 randomised clinical trials. In total, 232,550 participants were randomised to antioxidant
supplements (beta-carotene, vitamin A, vitamin C, vitamin E, and selenium) versus placebo or no intervention. Twenty-one trials
included 164,439 healthy participants. Forty-six trials included 68111 participants with various diseases (including gastrointestinal,
cardiovascular, neurological, ocular, dermatological, rheumatoid, renal, endocrinological, or unspecified diseases).
Overall, the antioxidant supplements did not seem to reduce mortality. A total of 17880 of 136,023 participants (13.1%) randomised
to antioxidant supplements and 10136 of 96527 participants (10.5%) randomised to placebo or no intervention died. In the analyses
of the trials with low risk of bias, beta-carotene, vitamin A, and vitamin E significantly increased mortality. There were no significant
differences between the effects of antioxidant supplements in healthy participants (primary prevention trials) or participants with
various diseases (secondary prevention trials). Randomised trials with adequate bias control found no significant effect of vitamin C.
In some of our analyses, selenium seems to reduce mortality.
The current evidence does not support the use of antioxidant supplements in the general population or in patients with certain diseases.
The combined evidence suggests that additional research on antioxidant supplements is needed. The evidence on vitamin C and
selenium was not conclusive. Future trials could focus on vitamin C and selenium and should assess both potential beneficial and
harmful effects. Conduct of additional primary and secondary prevention trials on vitamin A, beta-carotene, and vitamin E seems
questionable, at least in the dosage range examined.
The present review does not assess antioxidant supplements for treatment of specific diseases (tertiary prevention), antioxidant supplements
for patients with demonstrated specific needs of antioxidants, or the effects of antioxidants contained in fruits or vegetables.
Further research and systematic reviews on these types of interventions are therefore warranted.

(more: see link above)
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Reply Wed 16 Apr, 2008 04:46 am
I read ulterior motives in these studies, which could help explain why there are so many varied opinions. Besides eating relatively healthy, I take vitamins and other supplements every day, and, since I began to do so, my health has improved greatly. One acquaintance asked me, "What did you do - find a fountain of youth?" Whether or not it will prolong my life I won't hazard to guess.
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Reply Wed 16 Apr, 2008 05:33 am
I used to be a food supplement (vitamin) aficionado!

As of some 20 years ago, I stopped taking supplements entirely because I became rather suspect of some of the claims.

I have not noticed any decease in health, nor any other signs which would suggest in any way that not taking supplements has been negative for my health. A wholly subjective assessment admittedly.

I am however ultra-picky as to my diet, sleep, exercise etc.

It's my contention that most pets eat a more balanced diet than most people in North America, because most pet food is rather complete (for each kibble) but most people tend to gorge-out on one food source to the exclusion of others, and thus often eat far too much refined carbohydrates, fats, proteins and sugars.
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Reply Wed 16 Apr, 2008 06:27 am
and liverwurst sammiches Laughing
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Reply Wed 16 Apr, 2008 06:38 am
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Reply Wed 16 Apr, 2008 06:52 am
farmerman wrote:
and liverwurst sammiches Laughing
I love liverwurst sammiches especially with a few drops of Tabasco.
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Walter Hinteler
Reply Wed 16 Apr, 2008 07:26 am
Liverwurst sammiches are high in natural vitamines - that's only why I prefer them.
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Reply Wed 16 Apr, 2008 07:28 am
Gotta have a slice of Sweet Walla Walla Onion. Im a Tabasco nut. Id put that **** on ice cream . Those other hot sauces pfft. Tabasco has flavor , which is what distinguishes it from other hot sauces.

Im seeing whether theres a product highlite for TAbasco.
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Walter Hinteler
Reply Thu 17 Apr, 2008 12:55 am
Hard to swallow
A report saying that certain dietary supplements may do more harm than good has prompted howls of outrage from the vitamin and health-food lobby. So who exactly should we believe? Sarah Boseley reports

Sarah Boseley
The Guardian, Thursday April 17 2008

Every vitamin devotee in the country will be outraged. Anyone who has ever pondered the life-enhancing claims on the seductive tubs of supplements lining the shelves of Boots must be doing a double take. According to a group of scientists, some should come with a health warning: These Supplements Could Shorten Your Life.

The five scientists in the Cochrane review team, based in Denmark, say that certain antioxidants, which many have speculated could hold the answer to longer life, actually endanger it. Beta-carotene, vitamin A and vitamin E, "given singly or combined with other antioxidant supplements significantly increase mortality," they conclude.

Vitamin C comes out of it better, although the team says there is no evidence it increases lifespan. "We lack evidence to refute a potential negative effect of vitamin C on survival," it says. Selenium, the fifth antioxidant in the analysis, appeared to reduce mortality, but the researchers cast doubt on the quality of the evidence.

The findings have been met with howls of protest from the vitamin and health-food lobby who make a living by promoting supplements. Their denials are likely to give comfort to the large numbers of people who want to think vitamins make them healthier. We are all urged to eat more fruit and veg, we know that vitamins are essential to our wellbeing, so how can this bunch of scientists possibly be right?

Make no mistake, the Cochrane team is a heavyweight bunch, enjoying great respect in scientific circles. It searched for every published paper it could find on the five antioxidants - and wrote to the manufacturers in case they were sitting on unpublished data (none replied). This turned up references to 815 trials. The vast majority were excluded from the review - only 67 made it.

"The paper's conclusions are drawn on less than 9% of available evidence," complained the Health Food Manufacturers' Association. "In no way can this review be considered comprehensive." But these charges miss the point: only studies that had been adequately run were included. The 67 were selected because they were randomised controlled trials - the so-called gold standard, in which half the participants are randomly given a drug (or in this case vitamin) and the other half are given a

placebo. If the trial is good, it is double blind, so that nobody knows who has taken what. At the end of the trial, the blind is broken and statisticians can work out how well the drug or vitamin performed.

Trade bodies such as the Council for Responsible Nutrition refuse to accept the Cochrane methodology and believe a witch hunt is going on. "This latest attempt to discredit antioxidants does nothing to change the practical implications for consumers, specifically a generally healthy population, that uses antioxidant supplements as part of their proactive optimum health regimen in an attempt to fill nutrient gaps or help reduce the risk of chronic disease," it says in a statement.

It's not the first time the Cochrane team has turned its guns on antioxidants. It started with a review of supplements used to try to prevent gastrointestinal cancers, which was published in the Lancet medical journal in 2004. The team found 14 trials of generally high quality - and found that antioxidant supplements, far from preventing these cancers, made it more likely people would die of them.

"We were told in an editorial published in the Lancet that this was not anything other than a haphazard and random error," said Christian Gluud, one of the group. "We were criticised that we didn't look at all trials, so we took that criticism as a challenge to go out and look for the trials."

The result was the latest paper, an updated form of a study that was originally published a year ago in the Journal of the American Medical Association. It has also now been officially released by the Cochrane Library.

The idea that vitamins could lengthen life is, as are all good theories, based on perfectly reasonable observations. Antioxidants fight cell damage. Their name is much taken in vain by the beauty industry, which also has scant proof that its creams and potions containing antioxidants and vitamins do any good.

The Food Standards Agency says that a healthy diet should give anybody who is well all the antioxidants they need, and warns that high levels of some vitamins can be damaging. Most of us in the well-fed developed world probably do not need extra vitamins or minerals. But a lot of us can't shake what we heard at our granny's knee - that vitamin C prevents a cold, for instance (recently disproved by yet another Cochrane review). Until now, most of us have thought that a few added vitamins can't do any harm. The supplements industry, accordingly, is flourishing and worth billions.

Vitamins have a reputation for being natural and healthy. They are trusted by those who have deep suspicions of the pharmaceutical industry. They may not know that the two are intimately connected. In 1999, vitamin manufacturers were forced to pay the biggest fines ever imposed in the US for forming a price-fixing cartel - $1bn to settle an antitrust suit. The ringleader was Roche, the multinational drug company based in Switzerland, which has the cancer drugs Herceptin and Avastin to its credit. Implicated with Roche were Rhône-Poulenc of France, BASF AG of Germany and Takeda of Japan, as well as others of the world's biggest pharmaceutical companies. These were the manufacturers of the raw vitamins, and they had been steadily hiking prices throughout the previous decade.

Vitamins are, after all, a business, but they have attracted a cult-like following. Linus Pauling, the US scientist who won two Nobel prizes, famously extolled vitamin C, convinced that large doses (more than 1g a day) would cure cancer. An institute in his name at Oregon University pursues his theories still. It has to admit that studies at the Mayo clinic showed cancer patients taking 10g of vitamin C did not survive any longer than others. The institute suggests maybe that was because they were injected with it, rather than being asked to swallow it.

And so the debate goes on, with large numbers of people convinced a bit more of what is good for you can't do you any harm and scientists using methodological techniques that only scientists understand to prove them wrong - only to be disbelieved. In the end, maybe the safest thing is just to eat a better diet.
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Reply Thu 17 Apr, 2008 08:24 am
I've been taking multivitamins for 20 years and I feel quite healthy and
see no need to stop.

Liverwurst of course, but only the good German kind.
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Reply Thu 17 Apr, 2008 04:46 pm
Liverwurst of course, but only the good German kind.

make it "gaenseleberwurst" (gooseliver sausage) for me :wink:
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