Advising Patients Who Use Dietary Supplements

Physicians Bias Against Nutritional Supplements

As I reflect back on my first years of medical practice, I clearly remember my own bias against nutritional supplements. So I don’t have to look any further than myself when it comes to understanding the basic prejudice doctors have.

• I am sure that my past feelings are not too different from those of the majority of physicians practicing medicine today. I remember telling my patients that they could get everything that they needed from their food if they would just eat a healthy diet.
• “You just go down to your local grocery store and buy the right kind of foods, and you don’t have to take any of those supplements,” I would insist. “Taking vitamins is a waste of money.”

Read And Learn More: Nutrition Medicine Physicians Defense Notes

• If that didn’t convince them, I would share a study or two that showed a vitamin to be harmful. I remember that the negative studies were really the only ones on vitamins of which I was really aware.
• After all, when negative studies were publicized in the lay media or medical journals, I would tell myself, “See, you were right all along about those vitamins. It’s a shame that these charlatans have played such scams on my patients.”
• Part of the reason I have changed my mind about vitamins is the quality of our diet.

The Typical American Diet

I have a confession to make right here, right now: I have actually eaten out in a fast-food restaurant. All right, if you must know the gritty details, I had a Big Mac, French fries, a large Coke-super-sized, even-and a hot apple pie.

• But you must also know that that was years ago. I have learned a little something about eating since then. Did you find yourself chuckling at the thought of a person confessing to something we all have done more often than we want to admit?
• In spite of the knowledge that fast food is the worst excuse for fuel we can ingest into our bodies, we line up by the fryer vat, waiting to pay our hard-earned cash for the detriment of our future health.
• Friends, knowing, and doing are two different realities. As much lip service as we give to losing weight and eating healthy, in reality, it’s just not happening.
• Approximately 40 percent of our calories in the typical American diet come from fat, and most of this is saturated fat (the bad stuff).
• The September 1997 issue of the medical journal Pediatrics reported that only 1 percent of children in the United States get the proper RDA levels of the essential nutrients from their diets.
• Not only are children not getting proper nutrition for their grow- ing bodies, they are establishing poor eating habits in childhood that usually persist into their adult years.
• It has amazed me how many of these young teenagers already have full-blown insulin resistance. The Second National Health and Nutritional Survey evaluated twelve thousand American adults and their eating habits.

Here are some of their findings:

• Seventeen percent of the population did not eat any vegetables.
• Excluding potatoes and salads, 50 percent of the population did not eat any vegetables. In other words, only half of the population ate garden vegetables.
• Only 41 percent consumed any fruit or fruit juices.
• Only 10 percent of the population met the USDA guideline of eating a minimum of five servings of fruits and vegetables a day. Among African Americans, only 5 percent ate the recommended amounts.

Even though physicians and registered dieticians recommend that we consume multiple servings of fruits and vegetables daily, our society is falling woefully short.

• This study shows us that if we exclude French fries and baked potatoes, more than half of the population is not eating any vegetables.
• Worse yet, almost 60 percent of the population is not eating any fruits. In truth, Americans are not eating a healthy diet even though they know better.
• Is it any wonder that more than 50 percent of our nation is now considered to be significantly overweight? When you combine these poor eating habits with high-glycemic foods.
• It is no wonder that we have an epidemic of insulin resistance and diabetes in the U.S. If I were to challenge you to go out and not eat any white bread, white flour, pasta, or rice.
• And potatoes for two weeks, you would quickly realize why so many people (more than 80 million Americans) have developed insulin resistance known as Syndrome X.

Quality Of Food In The US

No other nation on the face of the earth has produced the abundance of food that America has over the past half-century. But when you look at the quality of our food from a health perspective, there are definite concerns.

• The processes used to produce and preserve our foods today have had a serious effect on the quality of this tremendous food supply. Rex Beach wrote in his report to the U.S. Senate:
• Do you know that most of us today are suffering from certain dangerous diet deficiencies, which cannot be remedied until the depleted soils from which our foods come are brought into proper mineral balance?
• The alarming fact is that foods-fruits and vegetables and grains now being raised on millions of acres of land that no longer contain enough of certain minerals, are starving us no matter how much we eat.
• Beach made this statement in 1936. And in the almost seventy years since Beach’s plea to the Senate, little has been done to improve our nation’s depleted soil; in fact, the situation is much worse today than ever before in history.

Five major minerals (calcium, magnesium, chloride, phosphorous, and potassium) and at least sixteen trace minerals are essential for optimal health. Plants cannot create minerals.

• They must absorb them from the soil. And if our soils do not have these minerals, our plants will not have them either. And they don’t. Why? Organic fertilizers that contain these minerals are expensive and difficult to obtain.
• U.S. farmers manage their costs by using fertilizers that replenish the soil with only nitrogen, phosphorous, and potassium (called NPK).
• With these NPK fertilizers, farmers are able to grow good-looking grains and produce, though the crops remain depleted in all the other necessary minerals.
• Unfortunately, economics is the driving force behind American agriculture, causing farmers to be more concerned about bushels per acre than the nutrient content of the food they harvest.
• Few would argue about the quality of our foods and their decline compared to foods of a generation or two ago. Hybrid grains, vegetables, and fruits have increased in popularity.

These hybrid seeds boast big, luscious products that are more resistant to diseases. The nutrient content of hybrids, however, is significantly less than that of their natural counterparts.

• The farmer is paid according to bushels per acre-not for the quality of his produce. Agriculture too has become a demanding and politically charged industry.
• In spite of our need for nutrition, the bottom line for farmers is making a living, and hybrid produce makes it possible.
• Our food industry, due to special transportation and storage techniques, has been able to make a wide variety of fruits and vegetables available nationwide throughout the year. The variety is good.
• But these are made available at a sacrifice. Green harvesting means picking fruits and vegetables before they are mature. Shipping food over long distances requires cold storage and other preservation methods, which allow for the depletion of vital nutrients.
• Our food is also highly processed. For example, the refinement process of our flour to create white bread removes more than twenty-three essential nutrients, magnesium being one of the most important.

Our food industry then puts about eight of these nutrients back into our bread and calls it “enriched.” Did you know?

• In the process of making white flour, our removing the germ from the outer portion of the grain costs us more than 80 percent of the flour’s magnesium.
• The processing of our meats removes 50 to 70 percent of vitamin B6.
• Cold storage removes up to 50 percent of tangerines’ vitamin C.
• Asparagus stored for just one week can lose 90 percent of its vitamin C.

It is a fact that our food is significantly deficient in vital nutrients, even at the time we purchase them; however, the way we prepare our foods is perhaps even more critical. Overcooking, delays in preparing fresh foods, and freezing foods are some of the reasons our foods lose nutritional value. For example:

• Fresh salads and cut vegetables and fruits lose more than 40 to 50 percent of their value if they sit for more than three hours.
• Vitamin C is vulnerable to both heat and cold, and prolonged storage depletes it.
• The preparation of food significantly decreases folic acid.
• Freezing meats can destroy more than 50 percent of the B vitamins.
• We began with depleted nutrients in our soils, which NPK fertilizers made worse. Then came the hybrid grains that produced nutrient-depleted foods.

Modern processing and food storage caused further depletion of the quality of our foods. We then take these foods home and continue to create further depletion because of storage and preparation.

• These all make good, solid arguments as to why we should be supplementing our diets with high-quality nutritional supplements. You must understand, however, that these are not the primary reasons I recommend the use of nutritional supplementation.
• Though these conditions have proven to be detrimental to our American health, our understanding of nutrition has been equally if not more harmful. We must rethink the meaning of RDAs-recommended daily allowances.

Optimal Levels Versus Rda Levels

First, you must understand how recommended daily allowances were developed in the first place. The RDAs started in the early 1920s and 1930s as minimal requirements of ten essential nutrients that could help us avoid acute deficiency diseases.

• These are diseases like scurvy (deficiency of vitamin C), rickets (deficiency of vitamin D), and pellagra (deficiency of niacin). In other words, if you consumed the RDAs for vitamin C, vitamin D, and niacin, you would not develop any of these illnesses.
• Admittedly, the recommended daily allowances have done their job. In my three decades of clinical practice, I have never seen one of these diseases. They still occur, but they are rare.
• In fact, the Centers for Disease Control does not even track these diseases anymore. The list of nutrients included in the RDAs grew over the next two decades.
• And in the early 1950s, the definition of RDAS expanded to include the amounts of nutrients needed for normal growth and development.
• Despite the fact that RDAS have proved useful, most physicians and laypeople tend to assign more meaning to RDA standards than they should.
• This is due in part to the U.S. government’s requiring that all food and supplement labels give their percentages according to the RDAs.
• But after spending the past several years learning about nutritional supplementation and its effect on chronic degenerative diseases, I have become convinced of one overriding truth: RDAS has absolutely nothing to do with chronic degenerative diseases.

I believe this one simple truth is the cause of more confusion about the health benefits of nutritional supplementation than any other fact.

• Physicians are trained to believe that the RDAs are the level of nutrients that are needed by the body for optimal health.
• This false assumption is the main reason I believe physicians, registered dietitians, nutritionists, and the healthcare community in general show such resistance to nutritional supplementation.
• As you search the medical literature about oxidative stress and the amount of nutrients needed to prevent it, the level of nutritional supplementation is significantly greater than RDA levels.
• A good example of this is vitamin E. The recommended daily allowance of vitamin E is 10 IU, and in some schedules as high as 30 IU. The average American diet contains 8-10 IU.
• According to medical literature, you do not begin to see any health benefits until ingesting 100 IU of vitamin E in supplementation. This health benefit seems to improve all the way up to 400 IU and even higher.
• (Most physicians who understand supplementation would agree that one must consume at least 400 IU of vitamin E daily.) The RDA for vitamin C is 60 mg, even though discussions over the past few years suggest this needs to be increased to 200 mg daily.
• The medical literature, on the other hand, indicates that our bodies need at least 1,000 mg of vitamin C before health benefits result. This benefit improves even more as we reach 2,000 mg.
• I could go through all the major nutrients and list the optimal levels shown to provide health benefits in the medical literature. In each case, there is no relationship to the RDAs.

Again, recommended daily allowances have nothing to do with chronic degenerative diseases. To get an idea of how much food we’d need to consume in order to achieve these optimal levels of nutrients.

Amount Of Food Needed To Achieve These Optimal Levels Of Nutrients

Vitamin E (450 IU)

• 33 heads of spinach
• 27 pounds of butter
• 80 medium avocados
• 80 mangos
• 2 lbs. of sunflower seeds
• 23 cups of wheat germ
• 1.5 quarts of corn oil

Vitamin D (600 IU)

• 22 large egg yolks
• 6 cups of fortified milk
• 30 tablespoons of margarine
• 15 ounces of shrimp

Vitamin C (1300 mg)

• 17 medium kiwifruit
• 16 medium oranges
• 160 medium apples (including the skin)
• 10.5 cups of fresh orange juice
• 16 cups of raw chopped broccoli

Folate (1 mg)

• 3.8 cups of cooked asparagus
• 4 cups of black beans
• 20 medium oranges
• 10 cups of Brussels sprouts
• 3.8 cups of cooked spinach

Vitamin B6 (27 mg)

• 41 medium bananas
• 38 medium-baked potatoes with skin
• 77 cups of lentils
• 15 lbs. of chicken breast
• 18 cups of wheat germ

Riboflavin (27 mg)

• 22 ounces of beef liver
• 16 cups of low-fat yogurt
• 9 dozen eggs
• 3.25 gallons of low-fat milk
• 64 cups of cooked spinach

Thiamin (27 mg)

• 135 cups of brown rice
• 2 lbs. of ham
• 3 lbs. of sunflower seeds
• 64 cups of green peas
• 12 cups of wheat germ

There is simply no way to achieve these optimal levels of nutrients through food. If you desire to decrease your risk of developing a chronic degenerative disease, you must supplement your diet.

• You may be heaving a sigh of relief, thinking, Oh, good. I’m covered because I take a multivitamin. Don’t relax just yet. Taking a daily multivitamin cannot protect you from degenerative disease either. Multivitamins are primarily based on RDAs.
• It is rare to see any reference in the medical literature to a health benefit in patients who are simply taking a multivitamin.
• You must take significant amounts of high-quality antioxidants and minerals if you have any desire to prevent or slow down the chronic degenerative diseases described in this book.
• The obvious next question should be, Is it safe to take these supplements at these optimal levels? As a physician who was not always convinced that taking supplements was a good idea, I would frequently discuss such dangers with my patients.
• I’m sure your physician can quote a few studies that showed harm in taking supplements. Are there dangers? Sure there are. We need to discuss these in detail.

Dangers Versus Safety Of Nutritional Supplements

Throughout this book, I have related medical evidence that demonstrates the effectiveness of nutritional supplements in preventing and/or slowing the progression of degenerative diseases. For these supplements to be effective for this purpose, we must take them over a lifetime. We’ll want to use them at much higher levels than the RDAs.

• And we’re already an unhealthy population, so it is critical these nutrients be virtually free of any toxic effects and safe for use in strong doses.
• Antioxidants are certainly safe when taken correctly. Nutritional supplements are simply nutrients we get from our foods, only at a higher level than is possible from regular eating.
• On the other hand, pharmaceutical drugs may possess some clinical benefits in preventing some chronic diseases, but they inherently create a risk to the patient.
• Every time a physician prescribes a medication, especially if it is for the treatment of a chronic illness, he must explain the potential danger of the use of that drug.
• “The medications we prescribe,” said Dr. Bruce Pomeranz in the April 15, 1998, Journal of the American Medical Association, “cause over 100,000 deaths a year.”
• He also states that another 2.1 million patients have serious complications because of medications.’ Nutrients carry no such dangers.
• In my next book titled Death by Prescription (to be released by Thomas Nelson, Inc. in 2003), I explain the inherent dangers of all medication and the pitfalls in determining potential side effects of medication.

There you will find a very practical and understandable guideline for avoiding suffering and possibly death from an adverse drug reaction.

Since properly prescribed and administered medication is the fourth leading cause of death in the U.S., it is time physicians and healthcare providers begin to face this major health crisis.

• Medical professionals speak out and fight to decrease the risk of heart disease, stroke, and cancer. But why don’t we talk about helping our patients decrease their risk of suffering or dying from the medications we prescribe?
• While our profession essentially ignores this significant cause of death, I find it terribly ironic that physicians continue to discourage their patients from taking supplements on the premise that supplements could be dangerous to their health!
• Only a handful of deaths have been reported in the last several years related to supplements. And these have been cases in which individuals have taken many times the amounts recommended in this book of a particular nutrient such as niacin.
• Other reports involved an accidental overdose of supplements in children. Nonetheless, we still must be aware of the fact that nutritional supplements can be toxic if taken in very high amounts.
• Let’s take a look at the main toxic effects of individual nutrients.

Dangers Versus Safety Of Nutritional Supplements Vitamin A

Of all the nutritional supplements, straight vitamin A causes the most concern. Vitamin A toxicity can occur in adults who take in excess of 50,000 IU per day for a prolonged period of time.

• A lower dose may also create toxicity if the patient has liver disease. Signs of vitamin A toxicity include dry skin, brittle nails, hair loss, gingivitis, anorexia, nausea, fatigue, and irritability.
• Accidental ingestion of a single large dose of vitamin A by children (100,000-300,000 IU) can cause acute toxicity. This may present as headache, vomiting, and stupor because of the increase in intracranial pressure.
• A study reported in the January 2, 2002, issue of the Journal of the American Medical Association indicates that vitamin A can be harmful to normal bone function, leading to an increase in hip fractures.
• Women must avoid vitamin A supplementation during pregnancy. Dosages as low as 5,000-10,000 IU are believed to have caused birth defects.10
  I never recommend taking straight vitamin A in supplements.
• We can meet the need for vitamin A within the body by simply taking beta-carotene and mixed carotenoids. These are very safe, and the body is able to turn beta-carotene into vitamin A as the need arises without any risk of toxicity.

Dangers Versus Safety Of Nutritional Supplements Beta-Carotene

• Beta-carotene has been used in high doses over several years without a single reported adverse effect.
• Some individuals develop a yellowing of the skin called carotenemia, but this is totally benign and reverses completely once the beta-carotene is reduced or discontinued.

Dangers Versus Safety Of Nutritional Supplements Vitamin E

• Although vitamin E is a fat-soluble vitamin, it has a fantastic safety record. Clinical trials of vitamin supplementation as high as 3,200 IU per day have not shown any adverse effects.
• In addition, studies have shown that vitamin E inhibits platelet aggregation and decreases the risk of blood clots in much the same way aspirin does.
• This property of vitamin E is actually a benefit in reducing heart disease. Researchers believe that vitamin E actually improves the effectiveness of aspirin in patients with heart disease.

Dangers Versus Safety Of Nutritional Supplements Vitamin C

• Vitamin C is safe even at very high doses, although some people may experience abdominal bloating, gas, or diarrhea.
• At one point, there was concern that vitamin C supplementation might increase the risk of kidney stones. This was found in only one clinical trial, however, and the last four similar trials did not substantiate this concern.

Dangers Versus Safety Of Nutritional Supplements Vitamin D

• Vitamin D has great potential to cause toxicity. Dosages greater than 1,500 IU are not recommended. In most cases, I do not recommend supplementing with vitamin D in doses greater than 800 IU per day.
• Vitamin D toxicity may increase the blood levels of calcium, cause deposits of calcium in internal organs, and increase the risk of kidney stones.
• Interestingly, recent studies reported in the New England Journal of Medicine have shown that 93 percent of the people in Boston are deficient in vitamins D-even those taking multivitamins.
• Other studies are now revealing that the RDA of vitamin D is too low (200 IU) and patients need to take 500-800 IU of vitamin D, which is again an optimal level. This dosage is still considered to be well within a safe range.

Dangers Versus Safety Of Nutritional Supplements Niacin (Vitamin B3)

• High doses of niacin supplementation may create flushing to the skin, nausea, and liver damage. Clinical studies have shown that slow-released products with niacin may decrease the risk of flushing, but they may also increase the risk of liver damage.
• Many people use high doses of niacin as a natural way to decrease their cholesterol levels. Using pharmaceutical levels of niacin supplementation should always be done under the direction of a physician.
• The levels of niacin are in a very safe range. Niacin is now also being used along with statin drugs, which are especially effective in lowering cholesterol.
• Vitamin B6 (Pyridoxine)
• Vitamin B6 is one of the few water-soluble vitamins with a possible risk of toxicity. Doses greater than 2,000 mg can cause symptoms of nerve toxicity.
• But people using doses between 50 and 100 mg daily have not reported any cases of toxicity.” Definitely be careful when using higher doses of vitamin B6.

Dangers Versus Safety Of Nutritional Supplements Folic Acid

• Folic acid supplementation may mask an underlying vitamin B12 deficiency. Therefore, people should always take vitamin B12 supplements in tandem with folic acid.
• However, there have not been reported any serious problems with taking folic acid even up to 5 grams per day. This is another reason that cellular nutrition is a safe way to supplement your diet.

Dangers Versus Safety Of Nutritional Supplements Choline

Choline is generally well tolerated, although, at very high doses (20 g per day), it can create a fishy odor and cause some nausea, diarrhea, and abdominal pain.

Dangers Versus Safety Of Nutritional Supplements Calcium

• People tolerate doses of calcium supplements of up to 2,000 mg. It was once thought that high levels of calcium supplementation could lead to an increase in kidney stones.
• However, a recent study showed that higher levels of calcium actually decreased the risk of kidney stones. In other words, those patients who had the highest intake of calcium actually had the lowest risk of kidney stones.

Dangers Versus Safety Of Nutritional Supplements Iodine

Iodine supplementation greater than 750 mcg can suppress thyroid hormone secretion. Reports have also been made of acne-like skin eruptions at higher levels of iodine intake.

Dangers Versus Safety Of Nutritional Supplements Iron

• Concern about the use of iron-especially inorganic iron-in supplementation has increased. Americans generally get plenty of iron, and supplementation of this nutrient may create an iron overload.
• which has been associated with an increased risk of heart disease in males. There is some concern iron supplementation may actually increase oxidative stress.

Dangers Versus Safety Of Nutritional Supplements Manganese

• Manganese taken in supplementation is very safe, although there are reports of people who develop manganese toxicity from their environment.
• This is usually seen in those who mine manganese or are exposed to high levels in the environment. These individuals may begin to hallucinate and become very irritable.

Molybdenum

Molybdenum is quite safe. A daily intake of greater than 10-15 mcg, however, may lead to gout-like symptoms.

Selenium

• Several clinical trials, which used doses in the range of 400-500 mcg daily, have found selenium to be safe. I believe, however, doses of selenium supplementation should be less than 300 mcg daily.
• Symptoms of selenium toxicity include depression, irritability, nausea, vomiting, and hair loss.
• No toxic effects have been associated with the supplementation of vitamin K, vitamin B1 (thiamin), vitamin B2 (riboflavin), biotin, vitamin B5 (pan-teething), inositol, vitamin B12, chromium, silicon, CoQ10, boron, and alpha- lipoic acid.

A Physicians Defense

I am certain my medical training was not much different from that of the overwhelming majority of physicians practicing medicine today. I essentially received no formal medical training in nutrition. It was not a required class at my medical school. This is not shocking, since, a course in nutrition is still required in only a few of the medical schools around the country.

• Elective courses in nutrition are offered in about 50 percent of medical schools; however, as I mentioned in the introduction, recent studies have shown that only about 6 percent of the graduating medical students have received any training in nutrition.
• I would boldly state that even those students who received a course in nutrition did not study much about nutritional supplementation. This simply is not the focus of our medical training.
• Physicians learn about the diagnosis and treatment of diseases. It wasn’t until I spent the last seven years devouring the medical literature on this subject that my opinion changed.
• For the first twenty-three years of my practice, I was a typical physician in regard to my knowledge and opinion about nutritional supplements.
• My opinions about vitamins were strong and filled with emotion, and my patients truly believed me. Maybe that was because I was an M.D., and we are supposed to know everything about health. We don’t!
• Physicians base their use of medications, and in turn nutritional supplements, on reliable clinical trials reported in the medical literature.
• And not every study involving nutritional supplements has shown significant benefits. In some cases, they’ve actually shown potential harm. Both the public media and medical literature publicize these negative studies.
• As I described in the introduction of this chapter, when I was not a fan of nutritional supplementation, I knew about these negative studies and quoted them frequently to my patients.
• At that time, one negative study seemed to negate hundreds of good-quality studies that showed supplements’ health benefits.
• Because any individual who reads the medical literature will encounter several of these studies, I feel it is important to address a few of the most publicized ones.

The Case Against Nutritional Supplements

The Finnish Study

This study based in Finland is probably one of the most-quoted when it comes to nutritional supplementation. Nearly thirty thousand heavy smokers participated in this. They were divided into four equal groups.

• Group 1 did not receive anything.
• Group 2 received dl-alpha-tocopherol (synthetic vitamin E).
• Group 3 received synthetic beta-carotene.
• Group 4 received both dl-alpha-tocopherol and beta-carotene.
• Researchers followed these subjects over a period of five to eight years. Most of these smokers did not quit smoking during the trial. The study showed no reduction in the incidence of lung cancer in any of the groups receiving the supplements.
• But even more of a concern was the fact that those individuals who were taking the beta-carotene supplementation actually showed an increase in the incidence of lung cancer.
• This came as a shock to the investigators because several earlier studies had shown a reduced risk in those patients who had high levels of vitamin E and beta carotene in their diets or bloodstreams.

The Caret Study

• This study involved eighteen thousand smokers and asbestos workers who lived in Washington State. These patients received 15 mg of beta-carotene and 25,000 IU of straight vitamin A.
• Researchers monitored these patients over a four-year span, and again no decrease in the risk of cancer occurred in patients who were taking the supplements.
• Again, there was actually an increase in the incidence of lung cancer in the group that was taking beta-carotene and vitamin A.

The Physicians’ Health Study

• This study followed more than twenty-two thousand U.S. healthy male physicians who took either 50 mg of beta-carotene or a placebo every other day for twelve years.
• The supplementation showed no benefit or negative effect when it came to lung cancer or heart disease.

My Response

Are the findings of these studies unsettling for you? At first glance, they seem disappointing, but let’s take a closer look. All of these studies clearly show that if you are a smoker or are at high risk of developing lung cancer, you should not take beta-carotene alone.

• I often look for principles that become evident in the medical literature. Here is a perfect example: you should not take a single nutrient at very high levels, especially if you are a smoker.
• Beta-carotene and other antioxidants have the potential to become pro-oxidants in these situations. A pro-oxidant is a nutrient that can actually cause an increase in the number of free radicals you produce.
• Rather than discouraging supplement use altogether, these studies indicate that using beta-carotene alone or with just vitamin E with smokers is not wise.
• Also, the fact that the Finnish Study used dl-alpha-tocopherol, synthetic vitamin E, concerns me. Other studies have shown this synthetic vitamin E to cause problems rather than reduce them.
• Instead, most studies reported in the medical literature use d-alpha-tocopherol, which is a natural vitamin E.
• I have already shared my concern that most studies are done with just one or two antioxidants, with researchers looking for the “magic bullet.
• But an understanding of oxidative stress and how it can damage the body forces us to realize that a one-or two-nutrient approach is like trying to bring down a locomotive with a rifle.
• We must also consider the known fact that lung cancer takes twenty to thirty years to develop, so in reality the Finnish Study was destined to fail from the beginning.
• These patients were heavy smokers who were placing their bodies under tremendous oxidative stress.
• These patients and all of those in the studies cited needed cellular nutrition (supplementation of complete and balanced antioxidants and minerals at optimal levels), not magic bullets.

A More Recent Study

Another study reported in the November 29, 2001 issue of the New England Journal of Medicine has also received fairly heavy media attention. The Simvastatin (Zocor) and Niacin Study involved 160 patients with elevated cholesterol levels and hardening of the arteries who were assigned to one of four groups:

• Group 1 was the control group and so received nothing
• Group 2 received Zocor and niacin
• Group 3 received vitamin E, vitamin C, selenium, and beta-carotene.
• Group 4 received Zocor, niacin, vitamin E, vitamin C, selenium, and beta-carotene.
• Group 2 did the best and actually showed some minor reversal of the hardening of their arteries. The antioxidant group (Group 3) was the next best with significant improvement.
• But Group 4, which received a combination of Zocor and antioxidants, did not see as much of a rise in their HDL (good) cholesterol. This finding was a marginal finding and was not statistically significant.

Yet the negative press that has come from these marginal findings has led the overwhelming majority of doctors to quickly claim that taking vitamin E with their prescription cholesterol-lowering drugs blocks the beneficial effects of their drugs.

• Physicians tend to ignore the hundreds of studies that show significant health benefits of nutritional supplements not only for heart disease but for all chronic degenerative diseases.
• As you have learned throughout this book, heart disease is not a disease of cholesterol but rather an inflammatory disease of the artery.
• This same study also showed that the LDL cholesterol showed a 35 percent increase in resistance to oxidation in the antioxidant group than in the groups taking the “statin” drugs.
• The media did not pick up this finding, nor did they announce it to the whole world. They also do not tell you that patients who are taking statin drugs significantly decrease the CoQ10 levels of the body.
• Many researchers feel the underlying reason why some of the patients who are taking “statin” drugs develop muscle pain and even muscle destruction is because of these very low CoQ10 levels in the muscle.
• Physicians will usually base their decision about the health benefits of nutritional supplements on a study such as this. However, they totally ignore the hundreds of studies that show health benefits with the use of nutritional supplements.