BodyLogicMD Chief Medical Officer, Dr. Alicia Stanton Responds to Reader’s Digest Article

Reader’s Digest recently published an article entitled 5 Vitamin Truths and Lies. Vitamins are essential for each of us to be able to carry out all of the various chemical reactions in our bodies. They are known as cofactors, so they make reactions happen. One can think about vitamins and micronutrients as the various pieces of a car in an assembly line. If a protein or hormone in our body can be thought of as the final product or car off of an assembly line, it is easy to see how you need all of the pieces in the right amounts to make the necessary product. What would happen if you had everything you needed to make 1000 cars except that you only had two steering wheels? How many complete cars could you make? Only two complete cars could be made which is far fewer than you need and the parts for the other 998 cars are just sitting around waiting. That is an example of what it is like in a body with a micronutrient deficiency, almost everything is there to make the body run smoothly except for one little thing – but, that makes all of the difference.

 

Although the data on multivitamin use is mixed, there are actually a number of studies that demonstrate the benefits of multivitamin use. There are also a number of difficulties in interpreting the studies themselves. What kinds of supplements were used? High quality, pharmaceutical grade supplements or lower quality, over the counter supplements. Was there any assurance that the supplements were actually being taken? Did they get blood and tissue levels of the various nutrients that they were testing for to see if there was and actual increase in the nutrient before they decided if it was effective or not? What other lifestyle factors were present in the study participants? Were they smokers? Smoking lowers the amount of available vitamin C in the blood by 40% because of the significant oxidative stress smoking produces. (1) Therefore, if the studies were looking at effective doses of vitamin C relating to colds and flu and didn’t take into account smoking versus non-smoking, they might not see an effect because the amount of available vitamin C in the smokers would be so much lower.

 

Another very important point is that nutrients do not work on their own in our bodies; they work in concert with other nutrients. Therefore, if you give someone a large dose of a single nutrient looking for an effect, you may through everything else out of balance and negate any effect you might have otherwise seen. This concept may explain the fact that some of the studies with vitamin E and beta-carotene actually showed an increase in disease risk. Vitamin E and beta-carotene are known as antioxidants. They work to neutralize free radicals; the same things that cause an apple to turn brown or metal to rust. Free radicals are actually molecules that are very unstable because they are missing an electron. Antioxidants work by donating their electron to neutralize or stabilize the free radical so it can’t do any damage. However, once the antioxidant (such as vitamin E) donates its electron, IT becomes a free radical and needs another antioxidant (such as vitamin C) to neutralize it. This sequence continues among the antioxidants until they reach the strongest antioxidant, glutathione, which finally neutralizes everything. This is an important concept to understand. If you give someone a high dose of a single antioxidant, as they did with vitamin E in one study, all you are doing is creating more oxidation and free radicals because there are not enough other antioxidants present to neutralize vitamin E once it has done its job.

 

A healthy, balanced diet is the best way to get your vitamins and nutrients. The whole, raw plants are the best sources. However, it has been clearly demonstrated that there is nutrient depletion in the soil so the food grown may have fewer nutrients. Also, due to pesticide use and some of the farming techniques that make it easier for a plant to grow, the plants don’t struggle as much and may build up fewer antioxidants as they grow leading to less nutritious foods. Lastly, the way that we ship, package and cook our food contributes to nutrient depletion as well. Therefore, even the minority that actually eats the recommended amount of fruits and vegetables might not be getting enough micronutrients. As for the majority of the population that does not eat the recommended amounts of fruits and vegetables, their chances of getting the proper amount of micronutrients are much lower. This should not discourage the need for everyone to focus on a healthier diet full of lean proteins (chicken, fish, nuts, beans, tofu, turkey and lean beef), fruits and vegetables. This type of diet is crucial for overall health and hormone balance.

 

A study published in February, 2010 by Wang et al focused on obese individuals. Since the majority of our population is overweight or obese, this study is incredibly timely. They stated that “obese individuals are more likely to have either lower blood concentrations or lower bioavailability of minerals and/or vitamins.” They started patients on a multivitamin and measured a number of parameters before and after the study. After 26 weeks on the multivitamin, the group showed a significantly lower body weight, lower BMI (body mass index), increased lean body mass, lower cholesterol, lower LDL (bad cholesterol), higher energy expenditure and higher HDL (good cholesterol). They felt that it might be due to improved ability to burn fat – which goes back to the concept that missing micronutrients might otherwise be stopping the bodies’ ability to burn fat. Their conclusion was “the results suggest that, in obese individuals, multivitamin and mineral supplementation could reduce body weight and fatness and improve serum lipid profiles.” (2) Another study by Wang from 2009 showed that “supplementation with adequate multivitamin and mineral supplement could reduce blood pressure and serum C-reactive protein in obese women with increased cardiovascular disease risk.” (3) The key to that conclusion is the word “adequate”. The multivitamin and mineral supplement must be of good quality!

 

The Reader’s Digest article discussed the fact that vitamin C didn’t do a great job of preventing the common cold but it did reduce the duration by a small amount. Again, it may be difficult to interpret these studies due to the inclusion of smokers and the lack of measurement of actual tissue sample of vitamin C. However, in 2003, Barringer et al published a study entitled “Effect of a multivitamin and mineral supplement on infection and quality of life. A randomized, double-blind, placebo controlled trial.” This type of study is known as the “gold standard” in research. He put 130 people on a multivitamin or a placebo for one year (and he didn’t know which person got). During the year, 73% of those on placebo got an infection versus only 43% on multivitamin; 57% of those on placebo reported being absent from work due to that infection versus only 21% who were on the multivitamin. The most startling finding was among his 51 patients with Type II diabetes. He found that 93% of his diabetic patients on placebo got an infection versus only 17% of the diabetics getting the multivitamin. (4) There is such a high prevalence of Type II diabetes in this country. Think of how much money, time and antibiotic use would be saved if the Type II diabetics all took a multivitamin each day and reduced their risk of infection from 93% to 17% over the course of a year!

 

Another important population is our children – multivitamins have been shown to help with them as well. In 2001, Benton evaluated 13 studies that looked at micro-nutrient supplementation and the intelligence of children. He stated that “in 10 out of 13 studies, a positive response has been reported with non-verbal measures of intelligence.” He does note that “not all children respond to supplementation, rather there is a minority whose diet offers low amounts of micronutrients.” (5) The amount of obesity in our children has significantly increased since the paper was first published in 2001. It is safe to say that the number of children with diets low in micro-nutrients has increased as well. Another interesting study regarding children was published in 2000 by Schoenthaler et al. He states that “poor nutritional habits in children that lead to low concentrations of water soluble vitamins in blood impair brain function and subsequently cause violence and other various anti-social behaviors.” They looked at 468 students ages 6 to 11 and randomized them to receive a multivitamin or placebo then measured the number of times that they were disciplined during the course of the school year. His conclusion was that “children who took active tablets produced lower rates of anti-social behavior in 8 types of recorded infractions: threats/fighting, vandalism, being disrespectful, disorderly conduct, defiance, obscenities, refusal to work or severe, endangering others.” (6)

 

At the end of the day, it’s true that the data on vitamin and mineral supplementation are “mixed”. But, are they really? When you consider the issues of soil depletion, population-wide obesity increase, overall health deterioration and the inconsistency of many of the studies, it becomes easy to see how complicated this really is. More importantly, since nutrients work in concert with each other, simply studying large doses of one particular vitamin at a time may throw everything else out of balance and create more harm than good. Since the RDA requirements of vitamins are just above the levels needed to prevent diseases such as scurvy and beriberi, there truly is little risk to a good quality multivitamin every day. However, there may be some significant benefits; especially to the overweight, the Type II diabetics and our children.

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References:
1.Institute of Medicine Food and Nutrition Dietary Reference Intakes for Vitamin C, Vitamin E, Selenium and Carotinoids. National Academy Press Washington, DC. 2001
2.Wang el al. Effects of multivitamin and mineral supplementation on adiposity, energy expenditure and lipid profiles in obese Chinese women. Int J Obes (London). 2010 Feb 9 (Epub ahead of print)
3.Wang et al. Effects of supplementation with multivitamin and mineral on blood pressure and C-reactive protein in obese Chinese women with increased cardiovascular risk. Asia Pac J Clin Nutr. 2009; 18(1): 121-130
4.Barringer et al. Effect of a multivitamin and mineral supplementation on infection and quality of life. A randomized, double0bind, placebo-controlled trial. Ann Intern Med. 2003 Mar 4; 138 (5):365-71
5.Benton D. Micro-nutrient supplementation and the intelligence of children. Neurosci Biobehav Rev. 2001 Jun;25(4):297-309
6.Schoenthaler et al. The effect of vitamin-mineral supplementation on juvenile delinquency among American schoolchildren: a randomized, double-blind, placebo-controlled trial. J Altern Complement Med. 2000 Feb;6(1):7-17