Are Vitamins Just a Placebo?

Do we all really need to take multi-vitamin/ mineral supplements as the supplement sellers suggest? This has been a debatable topic with nutritionists for the past few years. Some studies suggest that they are really not necessary unless you are diagnosed with a particular vitamin/mineral deficiency or underlying health issue. Others say that vitamins are only placebos and are marketed to the “walking well” population. In other words, they show no benefits when taken by healthy people.

Supplements can be very expensive and some studies say they only add to the profits of the vast supplement industry. Every supplement consumer should be aware of these realities and make their own educated health care decisions.

Dietary Supplement Realities: What Consumers Need to Know

  • FDA does not approve, test, or regulate the manufacture or sale of dietary supplements.
  • The FDA has limited power to keep potentially harmful diet supplements off the market.
  • Dietary supplements may not have been tested for safety or effectiveness before they are sold.
  • Dietary supplements often do not list side effects, warnings, or drug or food interactions on product labels.
  • Ingredients listed on supplement labels may not include all active ingredients.
  •  Dietary supplements may not relieve problems or promote health and performance as advertised. Claims on labels are often vague and unsubstantiated by clinical trials.
  • Studies have shown that the multivitamin/mineral pills that most people take provide plenty of B vitamins and vitamin C, but little calcium. The intake of both calcium and Vitamin D may be less than optimum and should be discussed with your doctor.

One of the most serious consequences of supplements results when they are used as a remedy for health problems that can be treated, but not by vitamins or minerals. Vitamin and mineral supplements have NOT been found to prevent or treat heart disease, cancer, diabetes, hypertension, premature death, behavioral problems, sexual dysfunction, hair loss, autism, chronic fatigue syndrome, obesity, cataracts or stress. Some such as vitamin E, vitamin C and beta-carotene may be harmful to certain groups of people. If taken, dosages should not be excessive.

Who may benefit from vitamin and mineral supplements? 

People with diagnosed vitamin and/or mineral deficiencies

Vegans (vitamin B12 and D)

Pregnant women (folate and iron)

Elderly persons on limited diets (multivitamin/minerals)

People on a restricted diet (multivitamins/minerals)

People at risk for osteoporosis (calcium, vitamin D)

People with alcoholism (multivitamin/minerals)

Elderly people diagnosed with vitamin B12, vitamin D and/or folate deficiency

  • Guidelines for Using Vitamin and Mineral Supplements
    Purchase products with USP (U.S. Pharmacopeia or the CL symbol (Consumer Laboratories) – tested for purity, ingredients, and dose.
    Choose supplements containing 100% of the Daily Value or less. Megadoses are not recommended.
    Take supplements with meals.
    Tell your health care provider about the supplements you take.

Source: Judith Brown, Nutrition Now, 2013.

Lori A. Smolin and Mary B. Grosvenor, Nutrition: Science and Applications, Third Edition.

What Else Is In Your Food?

Twenty five years ago, It was largely assumed that the health benefits in foods came from the vitamin and mineral content of fruits and vegetables. That conclusion turned out to be incorrect because supplementation with specific vitamins and minerals failed to yield the same health benefits as did diets rich in fruits and vegetables. In addition, use of individual vitamin and mineral supplements was found to increase health risks in some studies. So what else was in the foods themselves that made them “healthier” than others?

The subjects of many current studies are plant chemicals known as phytochemicals or phytonutrients. Phytochemicals are not considered essential nutrients because deficiency diseases do not develop when we fail to consume them. They are considered to be nutrients however, because they are biologically active and perform health promoting functions in the body. Most of these bioactive food constituents are derived from plants. 

Phytochemicals play a variety of roles in plants as they provide protection against bacterial, viral, fungal infections; Ward off insects; and prevent tissue damage due to oxidation. Some operate as plant hormones or participate in the regulation of gene function, while others provide plants with flavor and color. Recently, more than 2000 types of phytochemicals that act as pigments have been identified and give plants with a wide variety of colors. Some of these phytochemicals have been identified: beta-carotene (orange), lycopene (red), anthocyanins (blue to purple), allicin (white), and lutein (yellow-green). Many of them function as antioxidants.

The following are examples of vegetables you can buy or plant in the garden that provide some specific health benefits that are thought to be due to either established nutrients or phytochemicals. Keep in mind that some have more research behind their claims; however, many do not and simply rely on presumed health benefits.

  1. Kale is a member of the cabbage family and is known to contain vitamins A, K, and C, as well as essential minerals like potassium, calcium, and magnesium. It is also rich in fiber and acts as a prebiotic that increases nutrient absorption in the gut. Kale also contains antioxidants that protect against oxidative damage and chronic disease. Its nutrient density exceeds that of other vegetables like carrots, sweet potatoes, or those of the onion family.
  • Onion have been known for their healing properties for centuries. One study compared wound healing results after the daily application of onion gel and found that scars were significantly less noticeable after just four weeks of use. Recent research has suggested that onions contain compounds useful for the treatment and prevention of cardiovascular disease, high blood pressure, diabetes and inflammatory diseases. Most of these benefits can be traced to onion’s high concentration of sulfur amino acids,  phytochemicals such as flavonoids, phytosterols, and saponins – compounds that have anticancer, antibiotic, and antithromboitic activity.
  • Potatoes are a rich source of potassium, fiber, vitamin C. Little attention is paid to potatoes recently due to their high calorie density and their relationship with obesity and diabetes. If they are eaten in whole form and not as French fries or chips, they can be healthy due to their high potassium content. Often, they are the only source of potassium for many people including children. Adequate potassium can protect us from hypertension. P
  • Tomatoes contain the phytochemical, lycopene, the carotenoid responsible for its red color and acts as an strong antioxidant. An increased intake has been associated with a decreased risk of prostate and breast cancers.
  • Cauliflower in both forms, white or purple are high in phenolic compounds (a phytochemical) and antioxidant. Purple cauliflower is especially high in anthocyanins and is an potent anti-inflammatory and antiviral compound.
  • Bell Peppers are antioxidants that may protect against Alzheimer’s disease. Green, yellow, and red peppers are all high in phenolic compounds and vitamin C.

So, the secret of healthy and colorful fruits and vegetables lies in the fact that they not only provide essential vitamins and minerals, but that they also become protective against the chronic diseases of aging that have become the leading causes of illness and death in the developed world.

Bon appetit!!!

Antioxidant Supplements: Do We Need Them?

Antioxidant Foods

Antioxidants and Free Radicals

All cells face constant threats from what are known as free radicals.  We obtain these potential scoundrels from the metabolism of the food we eat, the air we breathe and from sunlight’s action. Free radicals are in varying chemical states, but their main danger lies in their need for obtaining electrons for stability. In order to do this, they “steal” electrons from nearby substances such as body cells and DNA, causing potential damage and destruction. They may damage the instructions in a DNA strand creating a harmful mutation or create  low-density lipoproteins (LDL) that could increase heart disease risk in an artery of the heart, or alter a cell membrane that could affect what enters or leaves a body cell. The body also uses free radicals in a necessary way as part of the immune system to help destroy foreign invaders such as bacteria, viruses, and toxins.

Antioxidants are found naturally in the body such as glutathione, coenzyme Q10, superoxide dismutase among other systems. We obtain many from various foods in the form of vitamins (C, E, beta-carotene and related carotenoids), minerals (selenium, manganese) and various phytonutrients such as flavonoids, phenols, polyphenols, phytoestrogens, and many more found in many plant foods.

Antioxidants probably number in the hundreds or thousands of different substances. Their main function is to act as an electron donor to help squelch the actions of harmful free radicals. Some antioxidants in certain situations can be called prooxidants – electron grabbers. This is likely to be the method found in the defense of the body (e.g. immune system)  Nevertheless, they are all considered to be unique with different roles. “So, no single antioxidant can do the work of the whole crowd.” We obviously need a variety of foods to provide as many as we need to get the job done.

Health Benefits of Antioxidants – What’s the Hype?

Antioxidants came into attention when the research suggested that free radical damage may be involved in chronic diseases such as heart disease, cancer, and vision loss. Studies initially indicated that people who ate the most fruits and vegetables had lower risk of these diseases than people who ate lesser amounts. Clinical trials began to test individual nutrients found in fruits and vegetables that were known antioxidants (vitamin C, E, and beta-carotene) to test their efficacy against these diseases. This took the food and supplement industry and media by storm for a long time with proclaiming protection against diseases by consuming large amounts of antioxidants provided by their products.

However, despite these results and disappointments, antioxidant supplements represent a $500 million-dollar industry that continues to grow. Antioxidants continue to be added to cereals, sports and energy bars and drinks, and other processed foods. Lately, however, the hype appears to have abated somewhat due to the reports of no effects of these vitamins and minerals, and phytochemicals (my opinion).

Heart Disease and Antioxidants

In the Women’s Health Study, 39,876 women took 600 IU of natural vitamin E or a placebo every other day for 10 years. The results? At the end, the rates of major cardiovascular events and cancer were no lower among those taking vitamin E than they were among those taking the placebo.  One large study (the HOPE Trial) found that those taking Vitamin E versus a placebo showed no benefits vs the placebo and vitamin E and that those in the Vitamin E group actually had higher risks of heart failure and hospitalization for heart failure.  Not all trials were negative, however. In a recent trial of vitamin E in Israel, there was a market reduction in coronary heart disease among people with type 2 diabetes.

In the Women’s Antioxidant Cardiovascular Study, vitamin E, vitamin C and/or beta-carotene had much the same effect as a placebo on myocardial infarction, stroke, coronary revascularization, or cardiovascular death, although there was a modest and significant benefit for vitamin E among women with existing cardiovascular disease.

Age-Related Eye Disease and Antioxidants

Some good news for  antioxidant supplements was found in a six-year trial, the Age-Related Eye Disease Study (AREDS). The results were that a combination of vitamin C, vitamin E, beta-carotene, and zinc offered some protection against the onset of advanced age-related macular degeneration in people who were high risk for the disease.

Potential Hazards of Antioxidants

Several studies have raised some concerns about supplemental beta-carotene.  One study even found that when smokers were fed beta-carotene supplements, the chances of developing lung cancer were increased.  Follow-up studies reported the same results. Another possible caution: In the SU.VI.MAX Trial, rates of skin cancer were higher in women assigned to take vitamin C, vitamin E, beta-carotene, selenium, and zinc supplements.

The studies so far have been inconclusive and are far from providing strong evidence that supplementation with antioxidants have much impact on chronic disease prevention. There was some positive benefits of beta-carotene on cognitive function in the Physicians’ Health Study after 18 years of follow-up; however most studies are of shorter duration, so few comparisons can be made.

What to do? There is abundant evidence that the first observations of fruit, vegetable and whole grain consumption were correct since subsequent studies have supported the fact that consumption of antioxidants via eating natural whole foods provides protection against many of our common chronic diseases.

Bottom Line: Get your antioxidants from whole, natural foods, not supplements. Research is still limited and results are not conclusive, but supplement companies still claim benefits even though more evidence of safety and efficacy is sorely needed.