New Studies Confirm Supplements Enhance Health By Dr. Allen S. Josephs - 07/10/2008
I get so tired of responding to vitamin naysayers. The latest one is Dr. Eric Rimm, Associate Professor of Epidemiology and Nutrition at Harvard. He reportedly told ABC television that dietary supplements will not provide the nutritional boost a poor diet requires. He does correctly state that a change in diet and lifestyle will improve health, although adds that "fundamentally unhealthy people seeking dietary remedial actions through supplementation are wasting their time". He also adds, "Indeed, dietary supplements used in this way may provide little more than expensive urine."
Obviously, optimizing your diet and exercise plans is a great way to improve your health. Even so, I take issue with Dr. Rimm uniformly slamming nutritional supplementation. Dr. Michael Holick who wrote a wonderful review article1 on vitamin D deficiency last year in The New England Journal of Medicine, noted that 40% of Americans are vitamin D deficient. It is clear that the nutritional value of our food has diminished over the last few decades.
The top researches studying vitamin D have indicated that the optimal level required is several times the current RDA/DV of only 400 IU per day. In fact, the optimal levels appear to be in the 2,000 – 4,000 IU range. There is no reasonable way diet alone can provide anywhere close to this level. If Dr. Rimm would have said the typical multi-vitamin with only 400 IU per day is a waste of time, I would have respected that. But to inaccurately say that generally all vitamins are a waste of money is absurd.
There have been many impressive studies in the medical literature supporting the benefits of supplementation. For instance, in 1996, there was a double blinded randomized study2 published in JAMA (Journal of the American Medical Association) involving over 1,300 patients that compared 200 mcg per day of selenium in the form of selenomethionine versus placebo. The study reported that the selenium group had a 37% reduction in all cancers, with a 50% decrease in mortality. Again, the typical diet does not provide this level of selenium nor does the typical multi-vitamin.
Another example relates to Parkinson's disease. The Archives of Neurology published a study3 several years ago indicating Parkinson's patients supplemented with 1,200 mg per day of coenzyme Q10 (CoQ10) had a 50% reduction in the progression of their disease. There are no drugs available proven to provide this benefit, nor could you ever have this amount of CoQ10 in your diet. Dr. Rimm is providing wrong and misleading advice that will continue to bankrupt America with out of control health care costs related to cancer, heart disease, stroke, osteoporosis, diabetes, obesity, Alzheimer's, Parkinson's and many other diseases which may benefit, or experience reduced risk, from proper dietary supplementation.
Moving on, there have been several new studies, either published or presented, highlighting the benefits of supplementation. One such study4, presented last week at the International Association for Dental Research Meeting in Toronto, Canada, involved 206 women during their second trimester of pregnancy (which is around the time that primary teeth begin to develop and calcify in the fetus). Researchers measured vitamin D blood levels at the time of enrolment and followed the women until their infants were about one year old. Of the 206 women, only 21 (about 10%) were found to have adequate vitamin D levels. The average woman had vitamin D levels that were only about half of what would be considered adequate.
The teeth of 135 infants that were subsequently born were evaluated by this dental team. Amazingly, about 22% had noticeable enamel defects and about one third already had early childhood tooth decay. It was found that those women with lower vitamin D levels had children who were much more likely to develop the early tooth decay. The lead author of the study, Dr. Schroth, did indicate that the study group was urban aboriginal and that the results may not be completely applicable to the public at large.
In another study5 published in the July 2008 edition of the prestigious journal, Pediatrics, a group of pregnant women were randomly assigned to receive four different types of probiotics or inactive placebo four weeks prior to delivery. The infants also received the same friendly bacterial mix along what is known as pre-biotics (nutrients that help friendly bacteria to grow) or placebo daily for six months. The researchers then followed the infants for two years. It was found that of the infants given placebo, 28% of them required antibiotics in the first six months of their lives, compared to 23% given probiotics. Likewise, the infants who were given the probiotics had about 12 % reduction in respiratory infections in the first two years of their lives compared to the placebo group.
Finally, the journal Nutrition Research also published an interesting study6 in its July 2008 issue. Researchers from the University of Toronto noted that patients with elevated blood sugar could have some memory impairment after ingesting heavy meals. They felt that this may in some way be related to oxidative damage.
In the study, 16 men and women with elevated blood sugar, aged 50 years or older, were asked to eat three different meals at three separate weekly sessions: the first one was a high fat meal consisting of a Danish, cheddar cheese and yogurt with whipped cream; the second meal consisted of only water; and the third meal included the first high fat meal, but this time it was supplemented with 1,000 mg of vitamin C and 800 IU of vitamin E.
Afterwards, it was noted that people performed poorly on verbal recall and working memory for up to 105 minutes after eating the high fat meal. However, when they took the vitamins along with the meal, they did just as well on the testing as those individuals who just drank water. Dr. Greenwood, the lead author of the study, indicated, "The cognitive effects observed in the study were subtle but large enough to impair performance. It kind of makes the 50-year old brain more like the 75-years old brain."
About the author
Dr. Allen S. Josephs is currently in private practice in neurology with Essex Neurological Associates and is Section Chief of Neurology at St. Barnabas Hospital, a 600-bed hospital in Livingston, New Jersey. Dr. Josephs served his neurology residency at Mt.SinaiHospital in New York, where he also served as Chief Resident in Neurology. In addition, he has served as the Chairman of the Ethics Committee of Beth Israel Hospital. Dr. Josephs is board certified in Internal Medicine and Neurology. He is a member of the AmericanAcademy of Neurology, the Essex County Medical Society, and Alpha Omega Honour Medical Society.
1. Holick MF, Vitamin D Deficiency, The
New England Journal of Medicine, 2007; Volume 357:266-281, July 19, 2007.
2. Clark LC, Combs Jr GF, Turnbull BW, Slate EH, Chalker DK, Chow J, Davis LS, Glover RA, Graham GF, Gross EG, Krongrad A, Lesher Jr JL, Park HK, Sanders Jr BB, Smith CL and Taylor JR, Effects of selenium supplementation for cancer prevention in patients with carcinoma of the skin. A randomized controlled trial. Nutritional Prevention of Cancer Study Group, Journal of the American Medical Association, Vol. 276 No. 24, December 25, 1996.
3. Shults CW, Oakes D, Kieburtz K, Beal F, Haas R, Plumb S, Juncos JL, Nutt J, Shoulson I, Carter J, Kompoliti K, Perlmutter JS, Reich S, Stern M, Watts RL, Kurlan R, Molho E, Harrison M, Lew M, and the Parkinson Study Group, Effects of Coenzyme Q10 in Early Parkinson Disease, Archives of Neurology, October 2002, Vol. 59, No. 10, pp. 1541-1550.
4. Schroth R, Lavelle C and Moffatt ME, Influence of Maternal Vitamin D Status on Infant Oral Health, International Association for Dental Research Meeting, Toronto, Canada, July 2-5, 2008.
5. Kukkonen K, Savilahti E, Haahtela T, Juntunen-Backman K, Korpela R, Poussa T, Tuure T and Kuitunen M, Long-Term Safety and Impact on Infection Rates of Postnatal Probiotic and Prebiotic (Synbiotic) Treatment: Randomized, Double-Blind, Placebo-Controlled Trial, Pediatrics, Vol. 122 No. 1 July 2008, Pp. 8-12, published online July 1, 2008.
6. Chui MH and Greenwood CE, Antioxidant vitamins reduce acute meal-induced memory deficits in adults with type 2 diabetes, Nutrition Research, Volume 28, Issue 7, Pages 423-429 (July 2008).