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Vitamins

Everyone needs vitamins.  Too little Vitamin C and you get scurvy.  Not enough B1 and you come down with beriberi.  But even a halfway balanced diet provides you with enough essential nutrients to avoid vitamin deficiency diseases, so scurvy and beriberi aren't things for most of us to worry about. A more important question for us developed world types is, Can large doses of vitamins help prevent other chronic conditions, like cancer and heart disease?  The New York Times says no:

The latest news came last week after researchers in the Women’s Health Initiative study tracked eight years of multivitamin use among more than 161,000 older women. Despite earlier findings suggesting that multivitamins might lower the risk for heart disease and certain cancers, the study, published in The Archives of Internal Medicine, found no such benefit.

Last year, a study that tracked almost 15,000 male physicians for a decade reported no differences in cancer or heart disease rates among those using vitamins E and C compared with those taking a placebo. And in October, a study of 35,000 men dashed hopes that high doses of vitamin E and selenium could lower the risk of prostate cancer.

....“I’m puzzled why the public in general ignores the results of well-done trials,” said Dr. Eric Klein, national study coordinator for the prostate cancer trial and chairman of the Cleveland Clinic’s Glickman Urological and Kidney Institute. “The public’s belief in the benefits of vitamins and nutrients is not supported by the available scientific data.”

Eating leafy greens is good for you, but apparently getting megadoses of the same vitamins in pill form doesn't do squat.  In fact, they even have some negative side effects.  Bottom line: have a salad tonight and skip the multivitamins.

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Comments
Keith G

Knowing Squat

Eating leafy greens...

Yeah, but what about those late-night advertised colon cleansers?

anandine

There have been a number of

There have been a number of studies showing that eating a diet high in any of several vitamins improves health, but eating those vitamins by themselves doesn't much.

There are, however supplements that do have effects. Folic acid added to bread has cut certain birth defects dramatically, and Vitamin D added to milk really does make bones stronger.

I've wondered if naturally derived vitamins are different from synthetic ones, presumably because they might include more stuff than the simple chemical, contaminant. Anybody know if synthetic Vitamin C is identical to what is in Vitamin C pills derived from rose hips?

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with food

Somewhere, a long time ago, I read the trick is to always take vitamins with food, or your digestion doesn't properly kick in.

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Nutricuticles

What I always find kind of odd is the convergence of small, local organic food store/co-ops and phoney snake oil vitamin dispenseries. Sure, it seems kind of obvious since a lot of the same people who are into healthy eating and organic produce are also into a lot of new age "health" bullcrap. But the two don't necessarily go hand-in-hand and are actually in many ways in conflict.

If you eat a reasonablly healthy diet that regularly includes vegetables and fruits, you have no need of special vitamin suplements. And the idea that you can extract out the health chemical from a natural food and jam it into your body in massive doses in pill form is, well, kind of corporate for the food co-op world, if you think about it.

Also, I wonder how the placebeo worked. You should know immediately if you are slipped a multivitaman because your pee will turn deep orange.

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hmmmm?

It's a combo of looking for a magic bullet (a la Linus Pauling) and Pascal's wager.

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You should know immediately

You should know immediately if you are slipped a multivitaman because your pee will turn deep orange.

As a non-vitamin-popping English friend once told me, "Americans have the most expensive urine in the world."

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Still, taking a multivitamin

Still, taking a multivitamin when you are not eating a full days' worth of calories is probably a good idea, or when you don't have access to fresh foods, or are injured.

Also, you can make people's pee turn orange with simple dyes.

...Though my urine doesn't turn orange after taking a multivitamin...

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What about prenatal vitamins?

What do the studies of prenatal vitamin use show?

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Eff the leafy greens, how

Eff the leafy greens, how about having a nice big juicy well marbled steak, a baked potatoe loaded with sour cream and bacon and, for veggies, creamed spinach.

"Anybody know if synthetic Vitamin C is identical to what is in Vitamin C pills derived from rose hips?" - anandine.

anandine - Vitamin C is ascorbic acid. Ascorbic acid is ascorbic acid regardless of whether a chemist made it in a beaker or an tree made it in an orange.

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a multi is not a mega

Kevin,

You confuse multivitamins with megavitamin dosages. There are hundreds of studies showing remarkable results from taking megadoses of vitamins and other supplements. For those skeptics who claim that vitamins simply result in expensive urine suspend your closed minds and read a few abstracts at www.vitasearch.com.

This week alone showed a study that folic acid REGRESSSES carotid plaque. If this was a patent medication every paper in the country would have this on the front page (with a little help from the marketing dept at a big pharma company) but since there are no monopoly profits to be gained it's utterly ignored.

It's sad that even sophisticated folks who read this blog are brainwashed by MSM propaganda.

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When expressing bafflement

When expressing bafflement about public perceptions, Klein is, I think, ignoring the long-term effect of constant advertising. Supplement manufacturers carefully avoid language that legally commits them to claims about the effectiveness of their products, but the regulations allow plenty of room for *implying* effectiveness -- and most people don't sit around carefully parsing the language in ads. It's unsurprising that a given consumer's impressions are more heavily affected by eight thousand exposures to ads than by two exposures to news stories about scientific trials (alas).

I wonder what the legal implications would be if some non-profit organization were to run counter-ads -- ones not designed to sell a product, but rather to make the point in public that a category of products doesn't really work. If a broadcaster refused to air them on the grounds that it might make other sponsors angry, could the refusal be treated the same as a refusal to air an ad for or against national health care, or coal-fired plants, etc.?

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Look at Vitamin D.

Kevin - see the commenter a couple of comments up. A number of studies point to a very important role for Vitamin D in preventing a number of diseases, including cancer, MS, etc..., especially in higher latitudes where people tend to have chronic Vitamin D deficiency. The most striking was a study a couple of years ago that involved a randomized clinical trial in the U.K. where women were given either a dose of Vitamin D and Calcium daily or a placebo. even though the goal of the study was to test supplementation as a means of increasing bone density, they also found that the group that had received the treatment showed a 60% reduction in incidence of cancers over a 5-year period.

A lot more research needs to be done to establish effects, mechanisms, and necessary dosage for this type of protective effects, but it's very promising. And if you're wondering about multivitamins, the 400 IU dose they typically carry is pitifully small relative to the levels needed to keep blood concentrations at "natural levels". Supplementation in these studies is usually in the 1000s of IUs per day.

Sadly, Vitamin D supplements are dirt-cheap (literally) to make, so it's definitely not in the pharma industry's interests to look into this, and, indeed, they have an interest in suppressing any promising findings.

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how it is done

The study in question doesn't look at how the individuals took the multi-vitamins, just that they took them. The important thing is to take them with food.

Because food is more complex than a simple homogenous gob of powder.

Additionally, the study in question followed older women, who only, presumably, started taking the multi-vitamin after they were already older. Heart disease and cancer can take decades to develop so many of these women may already have been in the early stages when they started.

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Vitamin D is important; nothing else makes much sense

Most people don't get enough Vitamin D, which makes sense from an evolutionary perspective: Vitamin D is generated by the body as a result of being in the sun, and people these days (a) stay indoors or in vehicles most of the day; (b) wear clothes when outside; (c) don't live in the equatorial regions (more intense sunlight, year-round) where humans and their ancestors evolved.

For everything else - why in the world would human bodies respond positively to megadoses of something that (evolutionarily) human beings have *never* experienced? Or even to doses beyond what human beings have been able to get via diet (nuts, berries, some meat, etc.) for tens of thousands of years?

Chris Brown

Oderb is Right

The NYT report ignores the distinction. It compares Paulings advocacy of "megadoses" to the "multivitamin use" of the subjects of the study. Strange that, though the reporter referred to both, the distinction seems to have escaped her.

"Ever since the Nobel Prize-winning biochemist Linus Pauling first promoted 'megadoses' of essential nutrients 40 years ago, Americans have been devoted to their vitamins. Today about half of all adults use some form of dietary supplement, at a cost of $23 billion a year.

"But are vitamins worth it? In the past few years, several high-quality studies have failed to show that extra vitamins, at least in pill form, help prevent chronic disease or prolong life.

"The latest news came last week after researchers in the Women’s Health Initiative study tracked eight years of multivitamin use among more than 161,000 older women. Despite earlier findings suggesting that multivitamins might lower the risk for heart disease and certain cancers, the study, published in The Archives of Internal Medicine, found no such benefit. "

None-the-less, my first reaction when I read reports of the results of any study is dismissal.

I choose to listen to my body; and I know that taking one gram of vitamin C, other anti-oxidants, and milk thistle for my compromised liver have caused me to feel healthier now, at almost 60, than I did thirty years ago.

Strive For The Ideal, But Deal With What's Real

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Not all vitamins are created equal

There's been some shoddy pontificating about science today, Kevin. (e.g., "Eugenics? I don't see what the problem is!")

Also, your linking to the NYT study on the unproven benefits of many vitamins may be harmful to the extent that it discourages women from taking pre-natal vitamins, which have demonstrated benefits as advocated here by the Mayo Clinic:

http://www.mayoclinic.com/health/prenatal-vitamins/PR00160

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older women

This was a study of older women.

Cancer and heart disease take a long time to develop so a large percentage of these women may well have had incipient illnesses at the time they started taking the supplement.

And they don't mention how the supplements were taken. Taking them with food really is important.

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This is old news to doctors

This is old news to doctors and medical researchers. But you will never catch me advising a patient to stop her vitamins. Supplement-people are zealots, and come at you with wide eyes and piles of poorly performed studies.

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" “The public’s belief

" “The public’s belief in the benefits of vitamins and nutrients is not supported by the available scientific data."

Ge. Unlike the public's keen concern for the scientific underpinnings of, I don't know,
- astrology
- homeopathy
- various diets
- various educational strategies

The public consists of freaking morons. 50%+ of them voted for GWB twice, and 30% of them still, after 8 years, think the guy is a genius. Why would you expect these Einstein's to do anything based on science, as opposed to what their guru told them?

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Yeah, I'm puzzled by his

Yeah, I'm puzzled by his puzzlement. People want to believe in magic.

It doesn't matter how much we are told, for example, that you don't need to drink 75 gallons of water per day, and that tap water is perfectly good for you - advertising and the need for magic mean that otherwise intelligent people carry designer water around with them as if they are crossing the Gobi desert, instead of walking around the block.

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It seems hard to believe

It seems hard to believe that 15,000 doctors took a pill every day for 10 years without knowing whether it was a multivitamin or a placebo.

The way I see it, until some similar studies show a definite harmful effect for vitamins, it's worth taking them. As for the $23B -- we need some recession-proof industries, and those jobs are mostly in the US I believe.

anandine

Optical weenie: anandine -

Optical weenie: anandine - Vitamin C is ascorbic acid. Ascorbic acid is ascorbic acid regardless of whether a chemist made it in a beaker or an tree made it in an orange.

I understand that. What I don't understand is whether the process that derives Vitamin C from organic sources ends up with pure ascorbic acid, or if the pill has other compounds in it.

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Fruits and Veggies Give You Cancer

We get a reversal on nutrition every ten years without fail. If it tastes good, eat it.

From Popular Science:

"The man who upset the apple cart

Twenty years ago, maverick biochemist Brace Ames warned against the health hazards of manmade chemicals in our foods and in the environment. Now he says most of the effort to control those cancer-causing substances is a waste of time and money, and that such "natural" foods as oranges and peanut butter are just as—or more—dangerous. What's up, doc?

By EDWARD EDELSON

Bruce Ames is eating an orange, methodically chewing the slices in the hope it will help fight his cold. He looks at it and says reflectively, "D-limonene. That's the main ingredient in citrus oil; it gets into all the orange juice. It's a carcinogen."

[...]

It's a controversial position—all the more controversial because not much more than a decade ago Ames was preaching just the opposite in equally fervent terms. Renowned as the inventor of the Ames test, a quick and cheap way to identify industrial carcinogens, Ames began as a crusader against the dangers of food additives and other man-made chemicals."

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I've wondered if naturally

I've wondered if naturally derived vitamins are different from synthetic ones, presumably because they might include more stuff than the simple chemical, contaminant. Anybody know if synthetic Vitamin C is identical to what is in Vitamin C pills derived from rose hips?

Anything that is called synthetic must be, by definition, chemically identical to the natural molecule. Calling it synthetic just means it was man made. As another poster said, abscorbic acid is the same no matter where it came from. Artificial compounds, however, are not the same. They typically mimic another compound but aren't the same. Take for example a synthetic v. artificial diamond. A synthetic diamond is a real diamond, just grown in a lab. An artificial diamond would be a different material altogether, like glass.

As far as vitamins are concerned, the source of the molecules themselves are not the cheif concern, although most would not want to know where niacin comes from. The problem is the impurities in the pills and the complete lack of regulation by the FDA. Vitamins are not regulated as medicine by the FDA, so they have the latitude to put whatever they want in their pills. Sometimes they don't even have to disclose the formula, claiming it is proprietary. Putting the efficacy of taking high doses of vitamins to improve health aside (mostly because it's never been demonstrated), there is a chance that your vitamin contains thing that are not even vitamins.

The biggest questions to ask before taking any kind of pill is: What is it I'm taking, (do you know what Vitamin A, B12, C actually are?) what is it supposed to do and why do I think I need it? Most people have a vague sense they need more vitamins, but few know what they are and if they actually need them. The evidence seems to point to the conclusion that a healthy person eating a normal diet, sometimes even a bad one, does not have any need for additional vitamins. More is not always better.

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B12

B12 is pretty cheap. Buy some and take three, see if you feel better.

B12 is used in all parts of the body and older people lose their ability to absorb it from their diets leading to B12 deficiency.

It's the principal vitamin Vegans are missing.

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good

Yeah, but what about those late-night advertised colon cleansers?

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