To Your Health: Vitamins & Supplements, Yes Or No?

I am asked nearly everyday by patients and friends alike whether or not to take vitamins and supplements. As it turns out, nutrient supplements are a double-edged sword, so it’s worth exploring the risks and benefits to help everyone decide whether and how to wield them.

 

This?

Choose this?

 

Or this?

Or this?

First, it’s important to realize we all have different diets and may be deficient in different nutrients. The medical community is not yet sufficiently advanced to know which nutrients to extract from particular foods and put into vitamins. There are hundreds of phytochemicals that are biologically active in fruits and vegetables (comparatively few in the animal kingdom), but these chemicals are generally absent from our daily multivitamins. The scientific community has not yet developed the tools and know-how to extract the most advantageous phytochemicals from a blueberry or strawberry, for instance, and add them to multivitamin. As a consequence, we should all be focused on obtaining our nutrients from whole foods rather than supplements.

Contrary to popular beliefs, population research on the health effects of vitamins is beginning to reveal their limited utility. A study of 182,000 middle-aged people showed that those taking multivitamins received no benefit with regards to longevity, cancer, or cardiovascular disease. Another study of postmenopausal women (161,000 subjects) showed no benefit in prevention of breast, ovarian, colorectal, or others cancers. The Physicians Health Study of 83,000 physicians also revealed no benefit among the doctors taking multivitamins in preventing coronary heart disease or stroke.

And it’s not only the big diseases that are unperturbed by multivitamin supplementation. No scientific study has revealed any effect on the prevention of infections or even common colds. Nor do vitamins benefit memory or cognitive skills, unless the user had a specific nutritional abnormality such as B-12 deficiency.

This is not to say that we shouldn’t be attentive to the levels of nutrients in our system. To the contrary. We should have, as part of our health care checkups, regular blood work to assess our levels of  Vitamin D (25-hydroxy. Vit. D), B-12 (especially after age 50), and iron. Remember there are risks associated no only with nutrient deficiency, but also in having too much Vitamin D, calcium, and iron in our systems. We do not know of significant risks with folic acid or B-12 excessive supplementation at this point. Our bodies are meant to obtain a balance of nutrients through food intake – not too little and not too much — and there’s a risk that in taking supplements, we overload our systems with more of these nutrients than our bodies can effectively handle.

A recently published study provides a great example of whole foods benefits that we cannot get from supplements. The study specifically illustrates the extraordinary health benefits of naturally occurring red, blue, and purple pigments called anthocyanins, which are present in high concentrations in blueberries and strawberries.

The Nurses’ Health Study followed 93,600 women, who were 25 to 42 years old at the time the study began. After 18 years, the risk of heart attack in those who got the most anthocyanins from their food (at least 25 milligrams a day) was 32 percent lower than the risk in those who got the least (2.5 mg a day or less). Sixty percent of the anthocyanins consumed by the women in the study came from blueberries.

Which foods have the most anthocyanins? These super foods include: blueberries (which average about 530 mg per cup), strawberries (35 mg per cup), blackberries (355 mg per cup), cherries (175 mg per cup), raspberries (115 mg per cup), red cabbage (115 mg per cup), red grapes (45 mg per cup), and black plums (35 mg each). Remember, we only need to take in at least 25 mg a day to obtain the benefits of these chemicals.

Pretty impressive results for just plain old fruits, and they have many other benefits as well.

So what are some of the other risks of supplements? Increased risk of heart failure and of certain cancers may be among them. A study in 2005 gave vitamin E (400 IU a day) or a placebo to roughly 10,000 people with diabetes or a history of heart attack, stroke, or peripheral artery disease. The researches reported a 13 percent higher risk of heart failure in the vitamin E takers.

New data (Selenium and Vitamin E Cancer Prevention Trial (SELECT), 2014), confirms that both antioxidants can be risky business for men. The results of this 2014 study showed no protective effect from selenium and suggested that vitamin E increased prostate cancer risk.

After two years of follow-up, the men who took vitamin E had a statistically significant 17% increased risk for prostate cancer. Men with high selenium levels at baseline who took selenium supplements increased their risk for high-grade cancer by 91% ( P = .007). In other words, the levels of selenium in these men became toxic. Specifically, in the men with low levels of selenium randomized to receive vitamin E alone, the total risk for prostate cancer increased by 63% (P = .02) and the risk for high-grade cancer increased by 111% ( P = .01). In prior studies Vit. E supplementation increased all-cause mortality 10 percent at 400 IU and 20 percent at 800 IU.

What’s the take away? The medical community needs to do a better job of emphasizing adequate medical screening for deficiencies, as well as the tremendous benefits of whole fruits and vegetables. We will discuss suggestions for appropriate medical evaluations at different ages in future articles.

It is going to be the season for multiple claims about preventing viral illnesses. Make sure to wash your hands frequently, get your flu shot (early indications are that it will be more effective this year), use disinfectant wipes on airplane arm rests and tray tables, eat a diet rich in whole fruits and vegetables, and stay away from sick people as much as possible. Get plenty of sleep, since this may be one of your most effective tools in avoiding viral illnesses this winter. And keep in mind there have never been any quality studies showing benefits from Vitamin A, C, D, E, or Zinc supplementation in preventing upper respiratory illnesses or colds.

Editor’s Note:

Our relationship with Dr. Alan Safdi started several years ago when we attended a Wellness Conference at The Peaks Resort & Spa. Dr. Safdi, is a gastroenterologist with a talent for offering evidence-based medical findings for healthy living in easily digestible sound bytes. We next heard him speak at Telluride First’s inaugural Integrative Wellness Conference, where the audience got just taste of his encyclopedic knowledge on mind-body wellness. To fill in the gaps, Telluride Inside… and Out plans to post nuggets from Dr. Safdi regularly.

More about Dr. Alan Safdi: 

 

Dr. Alan Safdi

Dr. Alan Safdi

Dr. Alan Safdi is a speaker, contributor and serves on the advisory board of the Telluride First Foundation.

He is board certified in Internal Medicine and in Gastroenterology and is a Fellow of the American College of Gastroenterology. A proven leader in the healthcare arena, he has been featured on the national program, “Medical Crossfire” and authored or co-authored numerous medical articles and abstracts. He has been an investigator in over 581 studies and is President of both the Consultants For Clinical Research and the Ohio Gastroenterology and Liver Institute.

Dr. Safdi has been involved in grant-based and clinical research for about 35 years and is passionate about disease prevention and wellness, not just fixing what has gone wrong. He is an international lecturer on the subjects of wellness, nutrition, and gastoenterology.

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