Anti-Oxidants and Vitamin Pills: What are the Facts?
By Dr. L. William Lauro
I have read so many articles of late promoting antioxidants and vitamin pills. I, like you, have been bombarded with advertising about what a “cure-all” they can be. I have read opinions that claim antioxidants and vitamin supplements can reduce your risk of cancer and heart disease. I have read claims that taking antioxidants is one of the best things you can do for your health.
Having read these claims and having been subjected to a barrage of advertising, I decided to do some basic literature review and see what the facts are regarding antioxidant and vitamin pill supplements, which are being thrust upon the public to the tune of ten billion dollars a year.
Before I begin let me say that no one has been more hopeful than I that antioxidants and vitamin pills might just be the miracle drugs we have been looking for in preventing cancer and heart disease. The whole concept of taking a pill a day to ward-off the three biggest killers in America is very appealing. Heck, I have been taking vitamin supplements myself for years in this hope.
But is it possible that the effectiveness of vitamin supplements and antioxidants has been grossly exaggerated? Is it possible that this has been a case of “wishful thinking” on the part of the general public? I know that over the years I have been led to believe that these compounds are somehow magical.
But, like so many other claims in life, it might just be too good to be true. Don’t get me wrong-there is no disputing the fact that vitamins and supplements are invaluable when prescribed for a specific deficiency, or when advocated as a way to reduce the risks of certain diseases (such as the use of vitamin D in osteoporosis). But can these pills, when taken by generally healthy persons, reduce our chances of cancer and heart disease/stroke?
The Evidence
Let’s look at some evidence. Last summer the US Preventative Services Task Force reported their recommendations on antioxidant and vitamin supplements. Their findings were based on their in-depth review of several large clinical trials, many of which had recently been completed. The Task Force’s conclusion was that there simply is no data at this point to justify the taking of antioxidants and vitamin pills by the general public to prevent cancer and cardiovascular disease. That is not to say that as more research is done the experts might not change their opinion. But at the present time there just does not seem to be any significant data which supports the use of these compounds.
Now, I know some of my colleagues in the alternative medicine field will argue that they have studies which prove the Task Force wrong and will point to some small study done in some far away place that proves their conclusions. That may be, but I personally can only speak to the research done at mainstream medical centers in the industrialized west, and report to you their findings.
But, you may argue, what is the harm in taking these supplements and hoping that by some chance they might just work for you? Well, for one thing they are expensive. You could be wasting a lot of your hard-earned money.
But my greater concern is that some people are relying so heavily upon supplements and pills to prevent these diseases that they neglect doing other things that have been proven to help reduce cancer and vascular disease, such as exercising and eating a healthy diet.
And then there are the people who are taking way too high a dose of these compounds and actually putting themselves at risk by going “beyond the mark.”
So without further adieu, here are the Task Force’s conclusions:
Vitamin A (taken alone): Studies showed no effect on reducing cancer for men. The studies done in women showed some minor reductions in cancer rates for colon and breast cancer, but it was not clear if this could be attributed just to the vitamin A or to other factors. Regardless, it was not great enough to recommend taking the vitamin.
Regarding vitamin A use and heart disease reduction, it was essentially useless.
Vitamin C (taken alone): No significant reductions in breast, prostate, colon, or lung cancer. Results of studies regarding cardiovascular disease were mixed: some suggested reduced risk while others could not confirm this.
Vitamin E (taken alone): One study showed a reduction in prostate cancer, but no help for lung cancer. Primary prevention trials showed no benefit in preventing cardiovascular disease. Six of seven secondary trials showed no benefit in reducing the risk of cardiovascular death. One study showed slight benefit in reducing colon cancer.
Vitamin E was also studied regarding cataract formation and found to be useless.
Beta-Carotene: Trials did not show any reductions in lung, prostate, colon, or breast cancer. Conversely, two studies showed that beta-Carotene actually increased the risk of lung cancer when smokers took it.
Trials showed no improvement in risk reduction for cardiovascular disease by taking beta- Carotene.
Folic Acid: studies showed a significant reduction in colon cancer. Studies are mixed in cardiovascular disease (both heart attack and stroke) but tend overall to be positive for risk reduction. So this one seems to be a winner.
Well, you might argue, these compounds alone might not work but surely if you took them all together they are more likely to help.
The Task Force looked at this and here is the conclusion:
Antioxidant Compounds with the combination of vitamins C, E, and beta- Carotene showed no significant effect on cancer prevention. One study showed a slight benefit for cardiovascular risk reduction, but this could not be confirmed by other studies. Conversely, one trial showed an increase in all-cause morbity in women who took the combination. I will point out that one study I came across suggested that the combination of vitamins E and C slightly reduced the chances of Alzheimer’s disease.
Now, let me be clear about this: I am not trying to take sides in this debate-I just want all of us to stop and think for a minute about what we are doing so automatically each morning when we pop a bunch of vitamin pills with our Wheaties. Are they really helping us? Are we relying too much on them? Are we taking too much of them?
Some Suggestions
I am not going to leave you hanging. I have some suggestions:
1) Taking an inexpensive multivitamin pill does not appear to cause any harm (at least in non-smokers). It may help, but probably not much. But please, do not think that I am advocating that we all stop taking our multi-vitamins. I am just suggesting we step back and take a look at the scientific evidence and not just swallow a lot of pills (and advertising). I am asking people not to rely on supplements too heavily for good health-rather, go out and exercise, and for sure eat a healthy diet rich in vegetables and fruits and fibers, and low in saturated fat. Remember this: God did not make vitamin pills but he did a great job on tomatoes. I am not joking-some studies indicate that when you ingest antioxidants in their natural form (such as eating your five helpings of vegetables and fruits each day) they are more effective in cancer risk reduction versus simply popping a vitamin pill. Quick example: I know a lot of advertising is currently being done advocating compounds like lycopene (a chemical in tomatoes) and suggesting that it can reduce cancer rates. But once again the data does not indicate (at least at the present) that this does any good at all. However, eating the tomato itself does appear to reduce your risk of cancer.
2) Never take more than the recommended dose of vitamin pills. I know many people who are taking way to much in antioxidants like vitamin A and C. This can be toxic; and again the studies have not shown any significant benefit in reducing cancer rates and heart disease.
3). One exception to rule #2: Taking additional doses of Folic Acid appears to be helpful in both cancer and heart disease/stroke prevention. Talk to your doctor about the proper dose for you.
4) Taking Vitamin D and calcium is not only helpful but necessary for the prevention of osteoporosis in the right patient. Also, there is some evidence that these two compounds reduce the risk of colon polyps and multiple sclerosis. Again, ask your doctor for your correct dose.
5) Men: adding extra Selenium to your standard vitamin pill might help reduce prostate cancer. The SELECT study is still ongoing, so don’t do it yet, but talk to your doctor in the near future about this.
In summary, I believe that the answer to risk reduction for the most serious (and most prevalent) disease in our society lies not in a pill bottle but rather in the way we Americans live our lives. We must get serious about weight reduction and exercise. We must stop smoking (hopefully Meridian readers have already quit by now!). We must try and reduce the stress in our lives. These things will go a long way to helping us live a long and healthy life. Good luck.
