Copyright © 1996 by Jack Challem, The Nutrition Reporter™
All rights reserved.
This article originally appeared in Let's Live magazine
Vitamins-they captivate, and they cure. Or so people say.
Few newspaper headlines grab a person's attention faster than those describing the often "miraculous" benefits of vitamins. Are they as good as they've been cracked up to be?
The answer, in a nutshell, is yes. Each year, now, thousands of medical journal articles report new findings related to vitamins, minerals, and other nutrients. But it's also easy to become overwhelmed and confused by all the information. What follows are answers to some basic questions about vitamins and other supplements.
Why should a person take vitamin supplements?
There are a number of reasons. Despite official proclamations that Americans have the best food supply in the world, large number of people don't obtain sufficient amounts of essential nutrients.
One reason is most people simply don't select very nutritious foods. For example, do you eat the five officially recommended daily servings of fruit and vegetables? According to researchers at the University of California, Berkeley, only an estimated 9 percent of people do.
Another reason relates to extensive food handling and processing that reduces vitamin levels from the farm to the fork. Several years ago, U.S. Department of Agriculture researchers found that conventional nitrogen fertilizer reduced vitamin C levels in some food crops by as much as one-third. Further nutrient losses have been documented during the transportation, storage, and processing of produce and during repeated heating and cooling. So even if your intentions are good, it's often hard to walk out of a supermarket with nutritious foods.
Nutritional surveys have found that 50 percent of Americans consume less than 50 mg. and 25 percent consume less than 39 mg. of vitamin C daily-far below the Recommended Dietary Allowance (RDA) of 60 mg. Furthermore, studies have found that half of the population consumes only 950 IU of vitamin A (19 percent of the RDA), and 4 IU of vitamin E (40 percent of the RDA) or less daily. The same pattern applies to the consumption of other micronutrients as well, meaning that large numbers of people are malnourished.
Is the situation really that bad?
It may even be worse. Many physicians and researchers consider the RDA an overly conservative and antiquated dietary standard. If that's the case, people malnourished by RDA standards are in very bad shape. If they were cars, they'd be driving on fumes.
The RDA was designed by the federal government as a guideline for "practically all healthy persons," but it's easy to question whether Americans can be considered healthy-and, therefore, adequate. For example, Paul Lachance, Ph.D., of Rutgers University, has pointed out that 30 percent of Americans smoke, and many drink too much alcohol. Others suffer from diabetes, high cholesterol levels, or hypertension. "After age 45, most people are not 'healthy' in the strict sense of the word and relatively few qualify as having no chronic or acute problem," LaChance recently explained in a recent issue of Nutrition Reviews.
In fact, the very concept of an RDA may be flawed. Forty years ago, Roger Williams, Ph.D., who discovered the B-vitamin pantothenic acid, developed the concept of "biochemical individuality." Williams contended that people need the same nutrients-but that they are highly individualistic in the amounts they need. For one person, 100 milligrams daily of vitamin C might be sufficient for health; for another, 3,000 milligrams.
What's a better way to assess a person's nutritional needs?
Instead of minimum or recommended levels of nutrients, the late Nobel laureate Linus Pauling, Ph.D., emphasized the concept of optimal nutrition-that is, providing the body's cells with levels of vitamins and minerals that help them function at their best-kind of like using premium instead of regular fuel.
For example, Pauling often recommended that people take anywhere from 100 to 300 times the RDA level of vitamin C for optimal health. The value of optimal intake was illustrated when Meir Stampfer, M.D., of Harvard University, reported that 400 IU of vitamin E-40 times the RDA-substantially reduced the risk of coronary heart disease. Determining your optimal intake requires a little experimentation-everyone is a little different.
What if I eat a natural diet and organic foods-do I still need supplements?
You're off to a great start. A couple of small studies have reported that organic produce contains higher levels of vitamins and minerals than do supermarket foods. However, Emanuel Cheraskin, M.D., D.M.D., professor emeritus of the University of Alabama has pointed out that we live in an unnaturally polluted and stressful world. He has suggested that supplements be considered "heroic countermeasures" to protect the body against this environment. If you eat organically or are a vegetarian, you probably need fewer supplements because you've got fewer bad dietary habits to compensate for.
There are so many supplements, where do I start?
First, you need to set some clear objectives that you want to achieve with supplements. Second, you need to assess whether specific supplements help you feel better.
For example, if you're in your 20s, eat well, and are in good health, your objective might be "dietary insurance." You may not need much more than a multivitamin supplement and a little extra vitamin C.
On the other hand, if you're in your 30s and face a lot of stress at home or at work, "stress management" might be an objective. In this case, you might do well taking a high-potency B-complex supplement. The B-complex has long been considered the anti-stress supplement.
Coronary heart disease and cancer run in my family-will vitamin supplements reduce my risk of developing these diseases?
Reducing the risk of disease is a very clear objective. There is also strong evidence that a diet high in vitamins C and E and beta-carotene reduces the risk of both of these diseases.
I know people who actually suffer from coronary heart disease and cancer. Can vitamins help them?
Evan Shute, M.D., pioneered the treatment of heart disease with vitamin E in the 1930s. Most physicians thought it was worthless until Harvard University researchers confirmed its value in 1993. Now, vitamin E for the heart isn't all that controversial, and many cardiologists take it themselves. Other important heart nutrients include vitamin C, coenzyme Q10, magnesium, and calcium.
In the 1970s, Ewan Cameron, M.D., of Scotland treated terminal cancer patients with large doses of vitamin C. In general, they lived longer than did patients not given vitamin C. Over the past few years, Abram Hoffer, M.D., of Victoria, Canada, has treated terminal cancer patients with large doses of vitamin C and other vitamins and minerals. Many of these patients have lived much longer, and Hoffer considers many of them "cured" because they have not had a relapse in five years.
While I believe everyone has an inalienable right to treat themselves, it's always best to work with a physician when treating a specific disease. At the very least, read up on the subject-public libraries, book stores, and health food stores carry many health books.
What are free radicals and antioxidants?
Free radicals are damaged molecules missing an electron. Because electrons prefer to come in pairs, free radicals steal electrons from healthy molecules. This may not seem like a big deal, but it adds up. Oxygen free radicals are the most dangerous type because they can damage deoxyribonucleic acid (DNA), the genetic program in every cell, and cause cancerous changes. Free radicals also oxidize cholesterol, making it more dangerous.
Forty years ago, Denham Harman, M.D., Ph.D., proposed the free radical theory of aging. He said-and the evidence backs him up-that free radicals inevitably accumulate and age the body. This is significant because the risk of disease increases with both age and large numbers of free radicals. Researchers have documented that free radicals are involved in more than 50 diseases.
Antioxidant nutrients quench many of these free radicals by donating extra electrons. As a result, the aging process slows and the risk of disease decreases. Some of the best nutritional antioxidants are vitamins C, E, beta-carotene, alpha-carotene, selenium, coenzyme Q10, and flavonoids.
Do I need an antioxidant supplement?
If you're already taking a high-potency multivitamin, or individual antioxidants, you probably don't need an actual antioxidant supplement. If you aren't taking any supplements at all, an antioxidant formula is a good way to start. If you're shopping for an antioxidant formula for the first time, think in terms of this easy-to-remember suggestion: ACES, for vitamin A (or beta-carotene), vitamin C, vitamin E, and selenium.
How much should I take?
This is the most common question I'm asked-and the most difficult to answer. I'm not a physician, and even if I were, I don't know anything about your medical history.
Two years ago, the nonprofit Alliance for Aging Research, a group of progressive nutrition experts, recommended that generally healthy people take 100-400 IU of vitamin E, 200-1,000 mg. of vitamin C, and 17,000-50,000 IU of beta-carotene daily.
If you can afford to experiment, you might consider taking a little more vitamin C, taking a mixed-carotene supplement instead of just beta-carotene, and adding 10-30 mg. of coenzyme Q10. When in doubt about dosage, follow the directions on the product label.
When is the best time to take supplements?
Opinions differ, but here are my recommendations:
Most vitamins and minerals should be taken with food to enhance their absorption. This is particularly true of oil-soluble vitamins, such as vitamins A and E, coenzyme Q10, and the carotenes. In addition, protein in the diet helps mineral absorption. This doesn't mean you need a full meal with your vitamins. A few bites or a piece of fruit are just as good.
The water-soluble vitamins, such as the B vitamins, are generally well-absorbed without food-but I would still recommend taking them with food. Vitamin C, which is water-soluble, can be taken with or without food.
If you take large amounts of any particular vitamin, such as vitamin C, divide up the dose so you take it two to four times a day. This improves absorption and minimizes the amount excreted.
The big exception to the "eat with food" rule is amino acid supplements. These are best taken at least 30 minutes before any other food. Amino acids in food compete with amino acid supplements, lowering their absorption.
Is there really a difference between natural and synthetic vitamins?
It depends on the vitamin. Natural-source vitamin E is more potent than synthetic vitamin E. The natural vitamin E is identified by the term "d-alpha," whereas the synthetic is identified with "dl-alpha" on the label. Natural-source beta-carotene (from D. salina algae) also contains other important carotenes, which synthetic beta-carotene does not.
Virtually all vitamin C is ascorbic acid made from corn sugar, and most of the B vitamins are produced through bacterial fermentation, kind of like how yogurt is made. All vitamins undergo considerable chemical processing to put them in a tablet or capsule. They are not squeezed out of food like juice from grapes.
So, is there a difference between the supplements sold in health food stores and drug stores?
You'll find greater diversity in the forms of vitamins and minerals in health food stores, and some of these forms are better absorbed than others. For example, the pyridoxyl-5'-phosphate form of vitamin B6 is better absorbed than the calcium pantothenate form. It's generally not available at drug stores. So you have broader choices and the opportunity to experiment at a health food store that you just don't have at a drug store.
There's another big difference, though. Health food brands generally avoid the use of sugar, lactose, artificial colors, and common allergens as excipients-that is, the non-nutritional substances that hold tablets together. Drug store brands are generally not as discriminating in the types of excipients used.
What won't supplements do?
Supplements won't make up for a bad diet. If you eat only hamburgers, supplements can't provide you with every nutrient found in salads. As the terms suggests, supplements are supplements to-not replacements for-food. So, eat a good diet with a lot of fruits and vegetables and a moderate amount of protein.
Taking a lot of supplements can get expensive. If money is limited-what should I take?
Whether you're buying a house, a car, or vitamins, you always have to balance cost versus benefit. When in doubt, stick with the basics, which include vitamin C, vitamin E, the carotenes, and the B-complex. You need to build a nutritional foundation before you build the rest of the house. Later on, if you want, you can experiment with other types of supplements.
How do I know if the supplements are working?
You'll probably feel better. If you suffer from allergies, symptoms will probably lessen. If you catch colds, you'll probably have fewer-or at least they won't be as bad. Often, the worse a person's health, the more dramatic the response to supplements.
When adding supplements, other than a multivitamin, add only one supplement at a time. Buy enough for only a month or two, and decide at the end of that time whether you feel better, worse, or no different. If you feel better you're right on track. If you feel worse, maybe that specific supplement isn't for you. And if you don't feel any different, stop taking the supplement. If you think you felt better while taking the supplement, try it again.
The information provided by Jack Challem and The Nutrition Reporter™ newsletter is strictly educational and not intended as medical advice. For diagnosis and treatment, consult your physician.