RAW DEAL ON VITAMINS
By Neil Levin, Certified Clinical Nutritionist (CCN), April 3, 2005
Note: This article is an expanded update of an earlier rebuttal by the author to an article in The Daily Herald. A link to the original article is included at the end of this rebuttal. The opinions expressed in this article are those of the author alone.
I was dismayed to see such a shallow view of vitamin safety in your article “The Real Deal on Vitamins” (3/24/05).
Statistical experts have discredited the extremely poor meta-analysis that re-analyzed only 19 studies on Vitamin E, with responses posted on the journal’s web site. These studies did not use uniform forms or doses, unfairly adding variables while ignoring positive effects of the vitamin. The authors acknowledge that their findings do not apply to healthier populations and are not definitive.
A more recent JAMA article on Vitamin E is also guilty of using very sick patients and subjects positive data on Vitamin E’s benefits to more stringent standards than the skimpy negative data. The national Institute of Medicine’s safe upper limit of 1,500 I.U. per day of natural Vitamin E is based on their own review of hundreds of well-designed studies.
The National Institutes of Health (NIH) supports the ongoing Selenium and Vitamin E Cancer Prevention Trial (SELECT), a multi-center long-term double-blind randomized trial that includes 35,534 men age 55 and older taking 400 IU of vitamin E daily to verify earlier evidence of it preventing prostate cancer. Researchers carefully examined the data from these negative reports and decided not to change their protocol, still believing that Vitamin E is not likely to cause any harm to their patients.
Beta-carotene is cited as putting smokers at greater risk of lung cancer, but a follow up study revealed that the real danger was due to low total antioxidant levels. There is no published evidence that the average person taking a mixture of antioxidants is at greater risk of any disease, and plenty that they are protective.
The scientific method of giving large doses of one isolated supplement is more likely to cause statistically minor negatives, especially when variables are introduced by poor study protocols.
In your article the opinion that “vitamins are largely unregulated” is repeated. Medical interests are asking for dietary supplements to be treated like drugs. This is contrary to the relative safety of these two classes of products. There are few deaths attributed to dietary supplements despite an estimated 85% of the public using them; most of these haven’t been scientifically proven.
Just because supplements are not regulated like drugs, are they “unregulated”? Adverse reactions to “properly prescribed drugs” cause over 100,000 deaths and a million hospitalizations per year; taking a dietary supplement is statistically safer than a meal. Why should we treat them the same?
The FDA acknowledges its responsibility to assure the safety and accurate labeling of all dietary supplements, requiring pre-market approval of new ingredients. All vitamin companies are subject to FDA inspections, and many by independent certifiers.
Neil E. Levin
Certified Clinical Nutritionist
St. Charles (IL)
REFERENCES
1. July 2004 American Journal of Epidemiology Development of a Comprehensive Dietary Antioxidant Index and Application to Lung Cancer Risk in a Cohort of Male Smokers
Margaret E. Wright , Susan T. Mayne, Rachael Z. Stolzenberg-Solomon, Zhaohai Li, Pirjo Pietinen, Philip R. Taylor, Jarmo Virtamo and Demetrius Albanes
http://aje.oupjournals.org/cgi/content/abstract/160/1/68?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=1&andorexacttitle=and&andorexacttitleabs=and&fulltext=beta+carotene&andorexactfulltext=and&searchid=1100534768534_1530&stored_search=&FIRSTINDEX=0&sortspec=relevance&fdate=7/1/2004&tdate=7/31/2004&journalcode=amjepid
2. High-dose vitamin E supplementation may increase all-cause mortality, a dose response meta-analysis of randomized trials; To be published in Annals of Internal Medicine:
Online: Nov. 10, 2004:
http://www.annals.org/cgi/content/full/0000605-200501040-00110v1
http://www.annals.org/cgi/eletters/0000605-200501040-00110v1
Print: 4 January 2005 | Volume 142 Issue 1
3. Am Journal Preventive Medicine 24:43-51, January 2003, Dietary supplement use and medical conditions Satia-Abouta J, Kristal AR, Patterson RE, Littman AJ, Stratton KL, White E, http://www.ajpm-online.net/article/PIIS0749379702005718/fulltext
4. J Nutr. 2003 Oct;133(10):3137-40 Huang HY, Appel LJ Supplementation of diets with alpha-tocopherol reduces serum concentrations of gamma- and delta-tocopherol in humans.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=14519797
5. The Lewin Group, DaVanzo, J. et al, "Improving Public Health, Reducing Health Care Costs: An Evidence-Based Study of Five Dietary Supplements," September 22, 2004.
http://www.supplementinfo.org/contentman/anmviewer.asp?a=156&z=14
6. The Lewin Group, Al Dobson, Ph.D., et al, A Study of the Cost Effects of Daily Multivitamins for Older Adults. Prepared for: Wyeth Consumer Healthcare
http://www.lewin.com/NR/rdonlyres/exul3vts44kvq5kr35iw6vt3sc6nhtmj3hwope245srdtp3iw7bco4dctska6gilvhewvhivcbujnl/StudytheCostEffectsDailyMultivitaminsforOlderAdult.pdf
7. Richer S, Stiles W, Statkute L et al. Optometry. 2004;75:216-30. Double-masked, placebo-controlled, randomized trial of lutein and antioxidant supplementation in the intervention of atrophic age-related macular degeneration: the Veterans LAST study (Lutein Antioxidant Supplementation Trial)
http://www.nutrition4health.org/NOHAnews/Biographies/April%202004%20Optometry%20LAST%20Study.pdf
ORIGINAL ARTICLE:
http://www.organicstyle.com/feature/0,8028,s1-41-30-34-1016,00.html
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