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Antioxidant supplementation, exercise and insulin resistance
There have been a number of negative reports on the health effects of vitamin/mineral
supplements. Several studies concluded that supplements were either ineffective or
made matters worse. The latest negative article on this topic claims that taking
vitamins C and E suppresses the health benefits of exercise (1).
How could this be? After all, exercise does create free radials, and free radicals do cause damage. Since I too take supplements, I decided to have a closer look.
The title of the article, "Antioxidants prevent health-promoting effects of physical exercise in humans", is actually misleading. The investigators really set out to determine if and how antioxidant supplementation interferes with the beneficial effect of physical exercise on insulin resistance. Here is how they went about it.
Forty healthy non-diabetic young men were recruited for a two-part trial. Sixteen of the 40 completed the first part; the rest were used in the second stage. Each exercise session consisted of running or cycling (20 min), circuit training (45 min), and warm-up and cooling off periods (20 min). All 40 volunteers were randomly assigned to receive either placebo or 2×500 mg vitamin C and 1×400 IU vitamin E per day.
The first trial part was designed to test whether the chosen exercise regimen generated reactive oxygen species (ROS) — popularly known as free radicals — and whether the chosen antioxidant cocktail suppressed them. The sixteen participants, half getting placebo, exercised on three consecutive days. Muscle tissue samples were taken before and after the intervention and analyzed for ROS content. This stage confirmed that the chosen exercise protocol generated ROS, and that the antioxidants suppressed these ROS, i.e. that the experimental setup worked.
The second trial part was designed to answer the question if and how ROS formation improved insulin sensitivity, and if and how antioxidant supplementation interfered with that effect. In this trial part the remaining 24 recruits completed four weeks of exercise, five days per week. Blood and muscle tissue samples were taken before and after the intervention.
Analysis of the blood samples established that the 4-week exercise regimen improved insulin sensitivity, but only in the placebo group. No significant improvement was observed in the supplement group, i.e. the antioxidant cocktail suppressed the exercise effect on insulin sensitivity.
Analysis of the tissue samples revealed the reason why. In the placebo group, exercise strongly increased the gene expression of known molecular regulators of insulin sensitivity. In the supplement group this effect was much smaller. In other words, antioxidant supplementation largely eliminated the exercise-induced increase in insulin sensitivity.
Interestingly, ROS formation also increased the production of the antioxidant enzymes superoxide dismutase (SOD) and glutathione peroxidase (GPx). If the exercise-generated free radicals aren′t suppressed by antioxidant supplementation, the body will generate its own defenses against them — while simultaneously improving insulin sensitivity.
In summary, this study convincingly demonstrated that, and why, supplementation with antioxidant vitamins C and E suppresses a valuable exercise effect — improved insulin sensitivity.
Does all this mean that supplementation with vitamins C and E is useless? Not at all. These two antioxidants are after all vitamins, which are defined as substances that we need but cannot make at all or only in insufficient amounts. Nothing can take their place where they are needed, but they cannot be used like drugs. In this particular case the exercise-induced free radicals actually played a vital regulatory role — suppressing them backfired.
As the authors put it:
"… antioxidant supplements prevent the induction of molecular regulators of insulin sensitivity and endogenous antioxidant defense by physical exercise"
and
"… we propose that transiently increased levels of oxidative stress reflect a potentially health-promoting process at least in regards to prevention of insulin resistance and type 2 diabetes mellitus"
Sources:
How could this be? After all, exercise does create free radials, and free radicals do cause damage. Since I too take supplements, I decided to have a closer look.
The title of the article, "Antioxidants prevent health-promoting effects of physical exercise in humans", is actually misleading. The investigators really set out to determine if and how antioxidant supplementation interferes with the beneficial effect of physical exercise on insulin resistance. Here is how they went about it.
Forty healthy non-diabetic young men were recruited for a two-part trial. Sixteen of the 40 completed the first part; the rest were used in the second stage. Each exercise session consisted of running or cycling (20 min), circuit training (45 min), and warm-up and cooling off periods (20 min). All 40 volunteers were randomly assigned to receive either placebo or 2×500 mg vitamin C and 1×400 IU vitamin E per day.
The first trial part was designed to test whether the chosen exercise regimen generated reactive oxygen species (ROS) — popularly known as free radicals — and whether the chosen antioxidant cocktail suppressed them. The sixteen participants, half getting placebo, exercised on three consecutive days. Muscle tissue samples were taken before and after the intervention and analyzed for ROS content. This stage confirmed that the chosen exercise protocol generated ROS, and that the antioxidants suppressed these ROS, i.e. that the experimental setup worked.
The second trial part was designed to answer the question if and how ROS formation improved insulin sensitivity, and if and how antioxidant supplementation interfered with that effect. In this trial part the remaining 24 recruits completed four weeks of exercise, five days per week. Blood and muscle tissue samples were taken before and after the intervention.
Analysis of the blood samples established that the 4-week exercise regimen improved insulin sensitivity, but only in the placebo group. No significant improvement was observed in the supplement group, i.e. the antioxidant cocktail suppressed the exercise effect on insulin sensitivity.
Analysis of the tissue samples revealed the reason why. In the placebo group, exercise strongly increased the gene expression of known molecular regulators of insulin sensitivity. In the supplement group this effect was much smaller. In other words, antioxidant supplementation largely eliminated the exercise-induced increase in insulin sensitivity.
Interestingly, ROS formation also increased the production of the antioxidant enzymes superoxide dismutase (SOD) and glutathione peroxidase (GPx). If the exercise-generated free radicals aren′t suppressed by antioxidant supplementation, the body will generate its own defenses against them — while simultaneously improving insulin sensitivity.
In summary, this study convincingly demonstrated that, and why, supplementation with antioxidant vitamins C and E suppresses a valuable exercise effect — improved insulin sensitivity.
Does all this mean that supplementation with vitamins C and E is useless? Not at all. These two antioxidants are after all vitamins, which are defined as substances that we need but cannot make at all or only in insufficient amounts. Nothing can take their place where they are needed, but they cannot be used like drugs. In this particular case the exercise-induced free radicals actually played a vital regulatory role — suppressing them backfired.
As the authors put it:
"… antioxidant supplements prevent the induction of molecular regulators of insulin sensitivity and endogenous antioxidant defense by physical exercise"
and
"… we propose that transiently increased levels of oxidative stress reflect a potentially health-promoting process at least in regards to prevention of insulin resistance and type 2 diabetes mellitus"
Sources:
- Ristow M, Zarse K, Oberbach A et al. Antioxidants prevent health-promoting
effects of physical exercise in humans. Proc Nat Acad Sci, published online before
print May 11, 2009;
doi:/10.1073/pnas.0903485106
Vegetables - should you eat them raw or cooked?
Are vegetables more nutritious raw or cooked? If you are an omnivore, you probably don′t care — you are used to cooked food. Meat eaters may eat raw vegetables in salads, with dips, or possibly juiced. But we eat our meat cooked, and we want the rest of our dinner cooked as well.
Vegetarians are a different story. If you are a firm believer in the health benefits of a vegetarian diet, you probably want to know if cooking enhances or diminishes the nutritional value of food. Of course, raw foodists are already convinced that raw is the way to go. So what is more nutritious, raw or cooked vegetables? It turns out that there is no simple answer to that question.
There are advantages and disadvantages to cooking vegetables (1,2). On one hand, cooking softens food by breaking down plant cell walls, making nutrients more accessible. Cooking also denatures proteins and softens starches, making them more digestible. On the other hand, heating damages some vitamins and phytonutrients, as well as destroying vegetable enzymes. Frying does more damage than steaming or boiling; the higher temperatures can damage unsaturated fats, which in turn uses up antioxidants. So what′s better, raw or cooked? It′s pretty well a toss-up.
Given today′s industrial food production and distribution system, I doubt very much that we can get enough vitamins and minerals from our vegetables, no matter how we eat them. I am convinced that eating vegetables is more important for their effect on macronutrient intake — carbohydrates, proteins, and fats — that for their micronutrient content.
You can always compensate for what you should have gotten from your food but didn′t — vitamins and minerals; you can take supplements. You′ll end up paying twice for your nutrients, first for food and then again for the supplements. But at least you eat right.
It is a good deal more difficult to compensate for what you ate but shouldn′t have — excess calories. The best way to cut back on high-calorie foods is to add more vegetables to your diet. Vegetables are excellent sources of dietary fiber. Soluble fiber gives you a sense of fullness — you′ll likely eat less. They also slow nutrient digestion and absorption. Insoluble fibers help keep you "regular".
The bottom line? Eat your vegetables any way you like them, but eat them! Learning to prepare tasty vegetable side dishes may well be the easiest way to control your waist-line.
But add a quality nutritional supplement to your diet to ensure that you are getting the vitamins, minerals, and phytonutrients you need.
Sources
Vegetarians are a different story. If you are a firm believer in the health benefits of a vegetarian diet, you probably want to know if cooking enhances or diminishes the nutritional value of food. Of course, raw foodists are already convinced that raw is the way to go. So what is more nutritious, raw or cooked vegetables? It turns out that there is no simple answer to that question.
There are advantages and disadvantages to cooking vegetables (1,2). On one hand, cooking softens food by breaking down plant cell walls, making nutrients more accessible. Cooking also denatures proteins and softens starches, making them more digestible. On the other hand, heating damages some vitamins and phytonutrients, as well as destroying vegetable enzymes. Frying does more damage than steaming or boiling; the higher temperatures can damage unsaturated fats, which in turn uses up antioxidants. So what′s better, raw or cooked? It′s pretty well a toss-up.
Given today′s industrial food production and distribution system, I doubt very much that we can get enough vitamins and minerals from our vegetables, no matter how we eat them. I am convinced that eating vegetables is more important for their effect on macronutrient intake — carbohydrates, proteins, and fats — that for their micronutrient content.
You can always compensate for what you should have gotten from your food but didn′t — vitamins and minerals; you can take supplements. You′ll end up paying twice for your nutrients, first for food and then again for the supplements. But at least you eat right.
It is a good deal more difficult to compensate for what you ate but shouldn′t have — excess calories. The best way to cut back on high-calorie foods is to add more vegetables to your diet. Vegetables are excellent sources of dietary fiber. Soluble fiber gives you a sense of fullness — you′ll likely eat less. They also slow nutrient digestion and absorption. Insoluble fibers help keep you "regular".
The bottom line? Eat your vegetables any way you like them, but eat them! Learning to prepare tasty vegetable side dishes may well be the easiest way to control your waist-line.
But add a quality nutritional supplement to your diet to ensure that you are getting the vitamins, minerals, and phytonutrients you need.
Sources
- Sushma Subramanian. Fact or fiction: Raw veggies are healthier than cooked ones. Scientific American March 31, 2009.
[Full Text} - Jon Barron. Food – raw versus cooked. Jon Barron′s Alternative Health Newsletter March 16, 2009.
[Full Text]
Vegetarianism - healthy eating or fad diet?
A recent issue of the NutraIngredients newsletter summarized a strange-sounding article on vegetarianism and weight control behaviours among young people (1,2). About 2,500 youths, 15 to 23 years of age, were enrolled in a study, about 15% of whom were current or former vegetarians. Investigators compared the subjects′ dietary habits and body weight.
What they found was that the vegetarians in the group were less likely to be overweight or obese, but more likely to engage in "binge eating" or "extreme unhealthful weight-control behavior" (2). Interestingly, meat — the food group that sets vegetarians apart from non-vegetarians — wasn′t even mentioned in the abstract (2), which is all I read of the paper.
It turns out that this is not the first time that eating disorders in young vegetarians have been noted:
"Vegetarian diets are somewhat more common among adolescents with eating disorders than in the general adolescent population. … vegetarian diets may be selected to camouflage an existing eating disorder." (3)
I rather suspect that these young people tried a vegetarian diet to get their weight under control. The binge eating episodes presumably involved a perfectly vegetarian "food group" — sweets.
I have no interest in binge eating among vegetarians; the report simply made me look at what′s known about the comparative health benefits of vegetarian and non-vegetarian diets. I found three recent review articles on the topic, published in 2003 (3), 2006 (4), and 2008 (5), respectively. I only had access to the abstract of the 2008 paper.
All three review articles made the point that a vegetarian diet is healthy and suitable for all age groups, but that overall health outcomes are comparable in vegetarians and health-conscious non-vegetarians, with a couple of exceptions.
All three articles reported that vegetarians had a moderately lower death rate from ischemic heart disease than non-vegetarians. This was attributed (3) to lower blood cholesterol levels, which in turn could be due to lower dietary cholesterol and higher fiber intake; plant foods don′t contain cholesterol, and fiber reduces cholesterol absorption. Higher antioxidant consumption from fruits and vegetables is expected to reduce the rate of LDL-cholesterol oxidation, which would further lower the risk of atherosclerosis.
There was disagreement on the effect of a vegetarian diet on death rates from cancer. It was generally agreed that the death rates from most cancers were comparable between vegetarians and non-vegetarians, but the 2003 review reported significantly lower prostate and colon cancer rates in vegetarians. The lower colon cancer rates were attributed to greater fiber intake, lower concentrations of potentially carcinogenic bile acids and fewer intestinal bacteria.
Interestingly, an analysis of a recently completed large-scale prospective study involving more than 60,000 men and women in the U.K (6) found higher colorectal cancer rates in vegetarians than in non-vegetarians; all other cancer rates were somewhat lower among the vegetarians. The authors point out that cancer rates in both the vegetarians and non-vegetarians they studied were below national averages (6).
The reviews (3-5) also noted lower obesity rates, cholesterol levels, blood pressure and saturated fat intake among vegetarians, as well as higher antioxidant, fiber, and phytonutrient consumption.
There is of course no question that fruits and vegetables are an important part of a healthy diet. The question is though whether the health benefits of vegetarianism are due to greater fruit and vegetable consumption or to the avoidance of meat. I tend to agree with the author of the 2008 review:
"Very probably, an ample consumption of fruits and vegetables and not the exclusion of meat make vegetarians healthful. … Vegetarianism is a form of food restriction; and in our overfed society, food restriction is a plus unless it results in a nutritional deficiency “ (5).
Sources:
What they found was that the vegetarians in the group were less likely to be overweight or obese, but more likely to engage in "binge eating" or "extreme unhealthful weight-control behavior" (2). Interestingly, meat — the food group that sets vegetarians apart from non-vegetarians — wasn′t even mentioned in the abstract (2), which is all I read of the paper.
It turns out that this is not the first time that eating disorders in young vegetarians have been noted:
"Vegetarian diets are somewhat more common among adolescents with eating disorders than in the general adolescent population. … vegetarian diets may be selected to camouflage an existing eating disorder." (3)
I rather suspect that these young people tried a vegetarian diet to get their weight under control. The binge eating episodes presumably involved a perfectly vegetarian "food group" — sweets.
I have no interest in binge eating among vegetarians; the report simply made me look at what′s known about the comparative health benefits of vegetarian and non-vegetarian diets. I found three recent review articles on the topic, published in 2003 (3), 2006 (4), and 2008 (5), respectively. I only had access to the abstract of the 2008 paper.
All three review articles made the point that a vegetarian diet is healthy and suitable for all age groups, but that overall health outcomes are comparable in vegetarians and health-conscious non-vegetarians, with a couple of exceptions.
All three articles reported that vegetarians had a moderately lower death rate from ischemic heart disease than non-vegetarians. This was attributed (3) to lower blood cholesterol levels, which in turn could be due to lower dietary cholesterol and higher fiber intake; plant foods don′t contain cholesterol, and fiber reduces cholesterol absorption. Higher antioxidant consumption from fruits and vegetables is expected to reduce the rate of LDL-cholesterol oxidation, which would further lower the risk of atherosclerosis.
There was disagreement on the effect of a vegetarian diet on death rates from cancer. It was generally agreed that the death rates from most cancers were comparable between vegetarians and non-vegetarians, but the 2003 review reported significantly lower prostate and colon cancer rates in vegetarians. The lower colon cancer rates were attributed to greater fiber intake, lower concentrations of potentially carcinogenic bile acids and fewer intestinal bacteria.
Interestingly, an analysis of a recently completed large-scale prospective study involving more than 60,000 men and women in the U.K (6) found higher colorectal cancer rates in vegetarians than in non-vegetarians; all other cancer rates were somewhat lower among the vegetarians. The authors point out that cancer rates in both the vegetarians and non-vegetarians they studied were below national averages (6).
The reviews (3-5) also noted lower obesity rates, cholesterol levels, blood pressure and saturated fat intake among vegetarians, as well as higher antioxidant, fiber, and phytonutrient consumption.
There is of course no question that fruits and vegetables are an important part of a healthy diet. The question is though whether the health benefits of vegetarianism are due to greater fruit and vegetable consumption or to the avoidance of meat. I tend to agree with the author of the 2008 review:
"Very probably, an ample consumption of fruits and vegetables and not the exclusion of meat make vegetarians healthful. … Vegetarianism is a form of food restriction; and in our overfed society, food restriction is a plus unless it results in a nutritional deficiency “ (5).
Sources:
- Benefits and detriments of vegetarian diets may not balance out: Report. NutraIngredients-usa.com Apr 1, 2009.
[Full Text] - Robinson-O′Brien R et al. Adolescent and young adult vegetarianism: Better dietary intake and weight outcomes but increased risk of disordered eating behaviors. J Am Diet Assoc 2009;109:648-655.
[Abstract] - Position of the American Dietetic Association and Dietitians of Canada: Vegetarian diets. J Am Diet Assoc 2003;103:748-765.
[Full Text] - Key TJ, Appleby PN, Rosell MS. Health effects of vegetarian and vegan diets. Proc Nutr Soc 2006;65:35-41.
[Full Text] - Ginter E. Vegetarian diets, chronic diseases and longevity. Bratisl Lek Listy 2008;109:463-466.
[Abstract] - Key TJ, Appleby PN, Spencer EA, Travis RC, Roddam AW, Allen NE. Cancer incidence in vegetarians: results from the European Prospective Investigation into Cancer and Nutrition (EPIC-Oxford). Am J Clin Nutr 2009;.
[Abstract]
Vitamin A revisited
In my recent post "Why taking cod liver oil is not a good idea" (1) I made the point that vitamin D supplementation is vital in the winter months, but that getting the sunshine vitamin from cod liver oil is not a good idea. Cod liver oil contains high amounts of vitamin A as preformed retinol. Taking it in amounts necessary to reach effective vitamin D levels can therefore lead to vitamin A toxicity (hypervitaminosis A). In addition, high levels of vitamin A actually negate the effect of vitamin D, the very reason for taking cod liver oil in the first place.
A reader pointed out that this advice is at odds with Adelle Davis′ vitamin A recommendations. In her book "Let′s get well", she apparently claimed that vitamin A deficiency is more widespread than is generally admitted, and that amounts of up to 50,000 IU/day are quite safe and often useful for fighting infections.
I have to admit that I had never heard of Adelle Davis; I had never come across any of her books. According to Wikipedia (2), Adelle Davis (1904 - 1974) was a pioneer in the American health movement, a trained dietitian with a degree in biochemistry. She published a number of books on health and nutrition, the last of which, "Let′s get well", came out in 1965. Nobel laureate and vitamin C guru Linus Pauling acknowledged that "… she was essentially correct in almost everything she said" (2). High praise indeed.
I didn′t find her book at the local library and I therefore don′t know where she got her numbers from. They are much higher, though, than today′s recommendations.
How widespread is vitamin A deficiency?
Vitamin A deficiency is endemic in developing countries and causes a variety of health problems (3). A lack of vitamin A is the leading cause of blindness in the Third World. In those countries carotenoids from plant foods are the principal sources of vitamin A, and carotenoids are less well absorbed than preformed retinol. Malnutrition often compounds the problem.
In industrialized countries, on the other hand, people generally take in enough preformed retinol from fortified foods and multivitamins to reach effective vitamin A levels (3). In fact, observational studies suggest that 75% or more of Americans may routinely ingest more than the recommended dietary allowance for vitamin A, much of it as preformed vitamin A (4). Getting vitamin D from retinol-rich cod liver oil can therefore easily lead to vitamin A overload.
What are the current vitamin A recommendations?
The Food & Nutrition Board of the U.S. Institute of Medicine currently recommends 900 μg (3,000 IU) per day for men and 700 μg (~2,300 IU) for women, with lower values for infants and children, and somewhat higher amounts for nursing women (5). 0.3 μg of vitamin A equals 1 IU (6).
Are these values too low? The Independent Vitamin Safety Review Panel, an independent panel of physicians, academics and researchers, doesn′t think so. In their October 2007 call for a reassessment of vitamin and mineral recommendations they specifically exempt vitamin A:
“Government-sponsored nutrient recommendations, such as the US RDA/DRIs, are not keeping pace with recent progress in nutrition research. While current official recommendations for vitamin A, iron, calcium, and some other nutrients are generally adequate, the public has been asked to consume far too little of many other key nutrients. Inadequate intake, and inadequate standards to judge intake, have resulted in widespread nutrient inadequacy, chronic disease, and an undernourished but overweight population.” [emphasis added] (7)
What evidence is there for vitamin A toxicity?
The main concern with excess vitamin A intake is its possible adverse effect on bone mineral density (BMD), which in turn can lead to an increased risk of hip fractures (3,4). There is sound biochemical evidence for the involvement of vitamin A in bone metabolism. Vitamin A is known to interfere with vitamin D and with calcium-regulating hormones (3,4).
Clinical observations, on the other hand, have shown mixed results (3,4). Some investigators found bone toxicity effects at vitamin A levels as low as twice the daily dietary allowance, whereas others found no correlation between vitamin A intake and hip fractures (3,4). There is enough evidence though for a link between high vitamin A levels and an increased risk of fractures to advise caution (3,4). The Linus Pauling Institute, which certainly supports vitamin/mineral supplementation, also warns against taking excessive amounts of retinol:
"The RDA for vitamin A (2,300 IU/day for women and 3,000 IU/day for men) is sufficient to support normal gene expression, immune function, and vision. However, following the Linus Pauling Institute’s recommendation to take a multivitamin/multimineral supplement daily could supply as much as 5,000 IU/day of vitamin A as retinol, the amount that has been associated with adverse effects on bone health in older adults. For this reason, we recommend taking a multivitamin/multimineral supplement that provides no more than 2,500 IU of vitamin A or a supplement that provides 5,000 IU of vitamin A, of which at least 50% comes from beta-carotene. High potency vitamin A supplements should not be used without medical supervision due to the risk of toxicity". [emphasis added] (6)
All in all, the advice to avoid cod liver oil because of its high vitamin A content seems sound. I could find no support among today′s experts for Adelle Davis′ high vitamin A levels.
Sources:
A reader pointed out that this advice is at odds with Adelle Davis′ vitamin A recommendations. In her book "Let′s get well", she apparently claimed that vitamin A deficiency is more widespread than is generally admitted, and that amounts of up to 50,000 IU/day are quite safe and often useful for fighting infections.
I have to admit that I had never heard of Adelle Davis; I had never come across any of her books. According to Wikipedia (2), Adelle Davis (1904 - 1974) was a pioneer in the American health movement, a trained dietitian with a degree in biochemistry. She published a number of books on health and nutrition, the last of which, "Let′s get well", came out in 1965. Nobel laureate and vitamin C guru Linus Pauling acknowledged that "… she was essentially correct in almost everything she said" (2). High praise indeed.
I didn′t find her book at the local library and I therefore don′t know where she got her numbers from. They are much higher, though, than today′s recommendations.
How widespread is vitamin A deficiency?
Vitamin A deficiency is endemic in developing countries and causes a variety of health problems (3). A lack of vitamin A is the leading cause of blindness in the Third World. In those countries carotenoids from plant foods are the principal sources of vitamin A, and carotenoids are less well absorbed than preformed retinol. Malnutrition often compounds the problem.
In industrialized countries, on the other hand, people generally take in enough preformed retinol from fortified foods and multivitamins to reach effective vitamin A levels (3). In fact, observational studies suggest that 75% or more of Americans may routinely ingest more than the recommended dietary allowance for vitamin A, much of it as preformed vitamin A (4). Getting vitamin D from retinol-rich cod liver oil can therefore easily lead to vitamin A overload.
What are the current vitamin A recommendations?
The Food & Nutrition Board of the U.S. Institute of Medicine currently recommends 900 μg (3,000 IU) per day for men and 700 μg (~2,300 IU) for women, with lower values for infants and children, and somewhat higher amounts for nursing women (5). 0.3 μg of vitamin A equals 1 IU (6).
Are these values too low? The Independent Vitamin Safety Review Panel, an independent panel of physicians, academics and researchers, doesn′t think so. In their October 2007 call for a reassessment of vitamin and mineral recommendations they specifically exempt vitamin A:
“Government-sponsored nutrient recommendations, such as the US RDA/DRIs, are not keeping pace with recent progress in nutrition research. While current official recommendations for vitamin A, iron, calcium, and some other nutrients are generally adequate, the public has been asked to consume far too little of many other key nutrients. Inadequate intake, and inadequate standards to judge intake, have resulted in widespread nutrient inadequacy, chronic disease, and an undernourished but overweight population.” [emphasis added] (7)
What evidence is there for vitamin A toxicity?
The main concern with excess vitamin A intake is its possible adverse effect on bone mineral density (BMD), which in turn can lead to an increased risk of hip fractures (3,4). There is sound biochemical evidence for the involvement of vitamin A in bone metabolism. Vitamin A is known to interfere with vitamin D and with calcium-regulating hormones (3,4).
Clinical observations, on the other hand, have shown mixed results (3,4). Some investigators found bone toxicity effects at vitamin A levels as low as twice the daily dietary allowance, whereas others found no correlation between vitamin A intake and hip fractures (3,4). There is enough evidence though for a link between high vitamin A levels and an increased risk of fractures to advise caution (3,4). The Linus Pauling Institute, which certainly supports vitamin/mineral supplementation, also warns against taking excessive amounts of retinol:
"The RDA for vitamin A (2,300 IU/day for women and 3,000 IU/day for men) is sufficient to support normal gene expression, immune function, and vision. However, following the Linus Pauling Institute’s recommendation to take a multivitamin/multimineral supplement daily could supply as much as 5,000 IU/day of vitamin A as retinol, the amount that has been associated with adverse effects on bone health in older adults. For this reason, we recommend taking a multivitamin/multimineral supplement that provides no more than 2,500 IU of vitamin A or a supplement that provides 5,000 IU of vitamin A, of which at least 50% comes from beta-carotene. High potency vitamin A supplements should not be used without medical supervision due to the risk of toxicity". [emphasis added] (6)
All in all, the advice to avoid cod liver oil because of its high vitamin A content seems sound. I could find no support among today′s experts for Adelle Davis′ high vitamin A levels.
Sources:
- Helmut Beierbeck. Why taking cod liver oil is not a good idea.
http://healthcomments.info/2009/01/27/why-cod-liver-oil-is-not-a-good-source-of-vitamin-d.aspx - Adelle Davis. Wikipedia.
http://en.wikipedia.org/wiki/Adelle_Davis - Cannell JJ et al. Cod liver oil, vitamin A toxicity, frequent respiratory infections, and the vitamin D deficiency epidemic. Ann Otol Rhinol Laryngol 2008;117(11):864-870.
- Penniston KL, Tanumihardjo SA. The acute and chronic effects of vitamin A. Am J Clin Nutr 2006;83:191-201.
http://www.ajcn.org/cgi/reprint/83/2/191 - Dietary Reference Intakes: Vitamins. http://www.iom.edu/Object.File/Master/7/296/webtablevitamins.pdf
- Vitamin A. Micronutrient Information Center. Linus Pauling Institute.
http://lpi.oregonstate.edu/infocenter/vitamins/vitaminA/ - Doctors say, raise the RDAs now. Orthomolecular Medicine News Service, October 30, 2007.
http://orthomolecular.org/resources/omns/v03n10.shtml
HFCS-sweetened foods may contain mercury
High fructose corn syrup (HFCS) has taken much of the blame for America′s health problems, since its introduction coincided with a sharp rise in obesity rates. However, a closer look at the situation shows that is is the rapid rise in soft drink consumption, rather than HFCS itself, that is responsible for this trend. I have discussed this matter elsewhere (1) in some detail, so I am just going to summarize the main points here.
HFCS is made from corn starch, a glucose polymer. The starch is hydrolyzed to free glucose, which is then enzymatically converted to a fructose/glucose mixture. This mixture is adjusted to either 55% (HFCS-55) or 42% (HFCS-42) fructose. Soft drinks are sweetened with HFCS-55, whereas HFCS-42 is used to sweeten food products.
By comparison, table sugar (sucrose) is a dimer consisting of one molecule each of glucose and fructose, digestion of which gives 50% glucose and 50% fructose. In fact, sucrose also ends up largely hydrolyzed in soft drinks, because of their low pH. HFCS and sucrose therefore really aren′t all that different.
The problem with the high consumption of sucrose or high fructose corn syrup is the metabolic fate of fructose. While fructose can be converted to glucose, it is preferentially diverted to fatty acid synthesis. Converted to glucose, it adds to the satiety signals generated by elevated glucose levels. Metabolized to fatty acids, it bypasses these controls and leads to overeating.
Interestingly, people seem to react differently to HFCS-sweetened drinks and solid foods. Subject eating HFCS-sweetened foods before a meal compensated for the extra calories by reducing subsequent food intake. When they were given HFCS-sweetened soft drinks instead, no such compensation was observed. In other words, HFCS in soft drinks, but apparently not in solid food, leads to overeating and weight gain.
One would think, therefore, that HFCS-sweetened foods don′t pose much of a problem. Unfortunately, this is not the case, and for a rather unexpected reason. HFCS-sweetened foods may be contaminated with mercury; this seems to be less of a problem with soft drinks.
Where does the mercury come from? Various steps in the conversion of corn starch to the fructose/glucose mixture HFCS use caustic soda (NaOH) and hydrochloric acid (HCl) to adjust the pH of the reaction mixtures. NaOH and HCl are made in chlor-alkali plants, some of which still use antiquated processes involving mercury, even though mercury-free methods are available.
When those chlor-alkali companies couldn′t account for their mercury losses, an Environmental Health Officer at the U.S. Food and Drug Administration (FDA) decided to look for the missing mercury in a food product made with NaOH and HCl input — HFCS (2). Twenty HFCS samples in all were collected, five HFCS-55 and five HFCS-42 samples from one company, five HFCS-55 samples from a second, and five HFCS-42 samples from a third manufacturer. These samples were then analyzed for their total mercury content.
The results were sobering. Only one of the ten samples from the first company showed traces of mercury, but eight of the other ten were contaminated, some containing as much as 0.57 ppm (parts per million) of mercury. Given the high HFCS intake in the U.S. — an average of 49.8 g/person/day — this can lead to a potential average mercury intake of 28.4 μg/day. Remember too that many people, especially the young, consume above average amounts. To put this into perspective, Health Canada estimates that dental fillings in children discharge 0.79 to 1.91 μg/day of mercury, not even a tenth the estimated average amount from HFCS-sweetened treats (2).
To verify that mercury from HFCS sources indeed makes it into food products, a group of researchers at the Institute for Agriculture and Trade Policy in Minneapolis collected commercial food products listing HFCS as first or second ingredients and had them analyzed for their mercury content (3). In all, 55 name brand beverages, dressings, dairy products (chocolate milk), snacks and desserts, soups and entrees, syrups and jellies were tested. Of those 55 samples, 17 contained mercury. Most of the contaminated samples were foods; the soft drinks turned out to be mostly mercury-free. You can find the list of tested products and the test results in their paper (3).
Mercury obviously occurs naturally, and we cannot eliminate all natural hazards. However, knowingly introducing one of the most toxic metals into the food supply is inexcusable. HFCS manufacturers must know where their chemicals come from, how pure they are, and what their own products will be used for. Mercury is an extremely potent neurotoxin and a particular threat to the unborn and to small children, whose brains are still developing. There is no safe level and no safe form of mercury. Even regular exposure at low levels is dangerous, since organometallic mercury accumulates in fatty tissues. Talk about corporate irresponsibility!
Read the labels when you buy packaged foods. If HFCS is listed first or second, there is every chance that you are about to buy a product laced with mercury.
Sources
HFCS is made from corn starch, a glucose polymer. The starch is hydrolyzed to free glucose, which is then enzymatically converted to a fructose/glucose mixture. This mixture is adjusted to either 55% (HFCS-55) or 42% (HFCS-42) fructose. Soft drinks are sweetened with HFCS-55, whereas HFCS-42 is used to sweeten food products.
By comparison, table sugar (sucrose) is a dimer consisting of one molecule each of glucose and fructose, digestion of which gives 50% glucose and 50% fructose. In fact, sucrose also ends up largely hydrolyzed in soft drinks, because of their low pH. HFCS and sucrose therefore really aren′t all that different.
The problem with the high consumption of sucrose or high fructose corn syrup is the metabolic fate of fructose. While fructose can be converted to glucose, it is preferentially diverted to fatty acid synthesis. Converted to glucose, it adds to the satiety signals generated by elevated glucose levels. Metabolized to fatty acids, it bypasses these controls and leads to overeating.
Interestingly, people seem to react differently to HFCS-sweetened drinks and solid foods. Subject eating HFCS-sweetened foods before a meal compensated for the extra calories by reducing subsequent food intake. When they were given HFCS-sweetened soft drinks instead, no such compensation was observed. In other words, HFCS in soft drinks, but apparently not in solid food, leads to overeating and weight gain.
One would think, therefore, that HFCS-sweetened foods don′t pose much of a problem. Unfortunately, this is not the case, and for a rather unexpected reason. HFCS-sweetened foods may be contaminated with mercury; this seems to be less of a problem with soft drinks.
Where does the mercury come from? Various steps in the conversion of corn starch to the fructose/glucose mixture HFCS use caustic soda (NaOH) and hydrochloric acid (HCl) to adjust the pH of the reaction mixtures. NaOH and HCl are made in chlor-alkali plants, some of which still use antiquated processes involving mercury, even though mercury-free methods are available.
When those chlor-alkali companies couldn′t account for their mercury losses, an Environmental Health Officer at the U.S. Food and Drug Administration (FDA) decided to look for the missing mercury in a food product made with NaOH and HCl input — HFCS (2). Twenty HFCS samples in all were collected, five HFCS-55 and five HFCS-42 samples from one company, five HFCS-55 samples from a second, and five HFCS-42 samples from a third manufacturer. These samples were then analyzed for their total mercury content.
The results were sobering. Only one of the ten samples from the first company showed traces of mercury, but eight of the other ten were contaminated, some containing as much as 0.57 ppm (parts per million) of mercury. Given the high HFCS intake in the U.S. — an average of 49.8 g/person/day — this can lead to a potential average mercury intake of 28.4 μg/day. Remember too that many people, especially the young, consume above average amounts. To put this into perspective, Health Canada estimates that dental fillings in children discharge 0.79 to 1.91 μg/day of mercury, not even a tenth the estimated average amount from HFCS-sweetened treats (2).
To verify that mercury from HFCS sources indeed makes it into food products, a group of researchers at the Institute for Agriculture and Trade Policy in Minneapolis collected commercial food products listing HFCS as first or second ingredients and had them analyzed for their mercury content (3). In all, 55 name brand beverages, dressings, dairy products (chocolate milk), snacks and desserts, soups and entrees, syrups and jellies were tested. Of those 55 samples, 17 contained mercury. Most of the contaminated samples were foods; the soft drinks turned out to be mostly mercury-free. You can find the list of tested products and the test results in their paper (3).
Mercury obviously occurs naturally, and we cannot eliminate all natural hazards. However, knowingly introducing one of the most toxic metals into the food supply is inexcusable. HFCS manufacturers must know where their chemicals come from, how pure they are, and what their own products will be used for. Mercury is an extremely potent neurotoxin and a particular threat to the unborn and to small children, whose brains are still developing. There is no safe level and no safe form of mercury. Even regular exposure at low levels is dangerous, since organometallic mercury accumulates in fatty tissues. Talk about corporate irresponsibility!
Read the labels when you buy packaged foods. If HFCS is listed first or second, there is every chance that you are about to buy a product laced with mercury.
Sources
- Beierbeck H. Why soft drinks contribute to obesity. Natural News Sep 1, 2009, and references therein.
http://www.naturalnews.com/024046.html - Dufault R, LeBlanc B, Schnoll R et al. Mercury from chlor-alkali plants: Measured concentrations in food product sugar. Environmental Health 2009;8:2.
http://www.ehjournal.net/content/pdf/1476-069X-8-2.pdf - Wallinga D, Sorensen J, Mottl O, Yabloa B. Not so sweet: Mixing mercury and high fructose corn syrup. IATP Jan 2009.
http://www.healthobservatory.org/library.cfm?refid=105026
Why taking cod liver oil is not a good idea
I recently wrote an article on the importance of vitamin D in the fight against influenza (1). The discussion focused mainly on the role of vitamin D in supporting innate immunity, but adaptive immunity obviously plays a role in the battle against infection as well. The innate branch of the immune system produces so-called anti-microbial peptides (AMPs), compounds with broad-spectrum effectiveness against bacteria, viruses, and fungi. Vitamin D is necessary for the expression of some of these AMPs.
The cells of the lining (endothelium) of the upper airways produce AMPs constitutively, i.e. regardless of whether or not pathogens are present. These anti-microbial peptides are released into a thin layer of fluid above the endothelium; this layer in turn is covered with mucus. When a pathogen penetrates the mucous layer and encounters anti-microbial peptides, the AMP molecules bind to its glycoprotein coat, effectively destroying the invader.
If a pathogen makes it past this protective coating and binds to the endothelium, this initiates the synthesis of high concentrations of specific inducible AMPs, thus providing a backup anti-microbial shield. The expression of the genes coding for these inducible AMPs requires vitamin D.
Unfortunately, it is virtually impossible to get adequate amounts of vitamin D from the diet. In the winter it is also impossible to make enough vitamin D by exposing the skin to the sun. In fact, vitamin D deficiency is now even a problem during the summer months, because of widespread sun avoidance. Vitamin D supplementation is therefore essential.
How much vitamin D do we need? It is now believed that serum 25(OH)D (25-hydroxyvitamin D) levels of 50 ng/mL (nanograms per milliliter) or more are required to ensure adequate vitamin D stores. To get to this level, adults would need to take 2,000 IU/day or more. These levels are considered quite safe — the tolerable upper intake level is now believed to be at least 10,000 IU/day (1).
What kind of vitamin D supplement should you take? In my article I recommended getting vitamin D from cod liver oil. No sooner had I written this than I came across a paper warning against cod liver oil (2). The problem? Cod liver oil contains excessive amounts of vitamin A. For every 1 IU of vitamin D, cod liver oil contains at least 10 IU of vitamin A. If you were to take enough to get 2,000 IU of vitamin D, you′d get 20,000 IU or more of vitamin A as retinol. This amount is well above the tolerable upper intake level (UL) of 3,000 μg/day (10,000 IU/day) set by the Food and Nutrition Board of the U.S. Institute of Medicine (3). 0.3 μg equals 1 IU of vitamin A (4).
In contrast to vitamin D, vitamin A is readily available in the diet in the form of provitamin A — carotenoids in coloured vegetables. Consequently, excess vitamin A intake is much more widespread in developed countries than vitamin A deficiency. Taking cod liver oil is therefore a recipe for subclinical vitamin A toxicity. Not only that, but its vitamin A content actually masks the effect of its vitamin D. In other words, the vitamin A in cod liver oil defeats the very purpose of taking it for its vitamin D content.
Of course, the warning against cod liver oil does not apply to fish or krill oil. Fish oil is extracted from the body of the fish and contains neither vitamin A nor D in any meaningful amount. It is, however, an important source of the polyunsaturated omega-3 fatty acids EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid). In fact, fish (or krill) oil is one of the most important supplements you can take!
Forget about cod liver oil and take vitamin D3 (cholecalciferol) supplements instead!
Sources:
The cells of the lining (endothelium) of the upper airways produce AMPs constitutively, i.e. regardless of whether or not pathogens are present. These anti-microbial peptides are released into a thin layer of fluid above the endothelium; this layer in turn is covered with mucus. When a pathogen penetrates the mucous layer and encounters anti-microbial peptides, the AMP molecules bind to its glycoprotein coat, effectively destroying the invader.
If a pathogen makes it past this protective coating and binds to the endothelium, this initiates the synthesis of high concentrations of specific inducible AMPs, thus providing a backup anti-microbial shield. The expression of the genes coding for these inducible AMPs requires vitamin D.
Unfortunately, it is virtually impossible to get adequate amounts of vitamin D from the diet. In the winter it is also impossible to make enough vitamin D by exposing the skin to the sun. In fact, vitamin D deficiency is now even a problem during the summer months, because of widespread sun avoidance. Vitamin D supplementation is therefore essential.
How much vitamin D do we need? It is now believed that serum 25(OH)D (25-hydroxyvitamin D) levels of 50 ng/mL (nanograms per milliliter) or more are required to ensure adequate vitamin D stores. To get to this level, adults would need to take 2,000 IU/day or more. These levels are considered quite safe — the tolerable upper intake level is now believed to be at least 10,000 IU/day (1).
What kind of vitamin D supplement should you take? In my article I recommended getting vitamin D from cod liver oil. No sooner had I written this than I came across a paper warning against cod liver oil (2). The problem? Cod liver oil contains excessive amounts of vitamin A. For every 1 IU of vitamin D, cod liver oil contains at least 10 IU of vitamin A. If you were to take enough to get 2,000 IU of vitamin D, you′d get 20,000 IU or more of vitamin A as retinol. This amount is well above the tolerable upper intake level (UL) of 3,000 μg/day (10,000 IU/day) set by the Food and Nutrition Board of the U.S. Institute of Medicine (3). 0.3 μg equals 1 IU of vitamin A (4).
In contrast to vitamin D, vitamin A is readily available in the diet in the form of provitamin A — carotenoids in coloured vegetables. Consequently, excess vitamin A intake is much more widespread in developed countries than vitamin A deficiency. Taking cod liver oil is therefore a recipe for subclinical vitamin A toxicity. Not only that, but its vitamin A content actually masks the effect of its vitamin D. In other words, the vitamin A in cod liver oil defeats the very purpose of taking it for its vitamin D content.
Of course, the warning against cod liver oil does not apply to fish or krill oil. Fish oil is extracted from the body of the fish and contains neither vitamin A nor D in any meaningful amount. It is, however, an important source of the polyunsaturated omega-3 fatty acids EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid). In fact, fish (or krill) oil is one of the most important supplements you can take!
Forget about cod liver oil and take vitamin D3 (cholecalciferol) supplements instead!
Sources:
- Helmut Beierbeck. Why you need extra vitamin D during the flu season. Natural News Dec. 2, 2008, and references therein.
[Full Text] - Cannell JJ et al. Cod liver oil, vitamin A toxicity, frequent respiratory infections, and the viamin D deficiency epidemic. Ann Otol Rhinol Laryngol 2008;117:864-870.
- Dietary Reference Intakes – vitamins. [Table}
- Vitamin A. Micronutrient Information Center. Linus Pauling Institute. http://lpi.oregonstate.edu/infocenter/vitamins/vitaminA/ (accessed Jan. 15, 2009)
Pharma tricks - ghostwriters
The subject of medical ghostwriting is in the news again. On December 13, 2008, the NY Times reported on the continuing investigation by Senator Charles E. Grassley, a member of the U.S. Senate Finance Committee, into drug industry influence on medical doctors (1,2). The stories center on the pharmaceutical giant Wyeth and its marketing of the hormone replacement therapy (HRT) drug Prempro, but the practice of using ghostwriters is by no means restricted to Wyeth.
What is medical ghostwriting?
Pharmaceutical companies generate medical articles presenting their products in a favourable light. They then hire medical doctors — ghostwriters — to claim to be the authors of these articles.
Here is how Wyeth worked the scam, according to the NY Times (1):
It is fraud, plain and simple!
By posing as authors, these medical doctors claim the findings and conclusions in the ghostwritten articles as their own. This is a barefaced lie; they have no way of knowing if the data they present are real or fabricated. And the conclusions favourable to the drugs are dictated by the company. That is the purpose of these articles, and that′s what the "authors" are paid for.
Doctors posing as authors clearly collude with company officials in committing fraud. It is ludicrous to assume that medical doctors deemed credible enough to front for a drug company are too naive to understand what they are doing — fooling the readers into mistaking company spin for objective scientific/medical reporting.
In Sen. Grassley′s words:
"Any attempt to manipulate the scientific literature, that can in turn mislead doctors to prescribe drugs that may not work and/or cause harm to their patients, is very troubling." (1).
The World Association of Medical Editors calls the practice of ghost authorship "dishonest and unacceptable" (1).
The pharmaceutical industry has no credibility left, and they know it. The drug companies admit this by the very fact of using ghostwriters — bribing "independent" medical doctors to front for them.
Sources:
What is medical ghostwriting?
Pharmaceutical companies generate medical articles presenting their products in a favourable light. They then hire medical doctors — ghostwriters — to claim to be the authors of these articles.
Here is how Wyeth worked the scam, according to the NY Times (1):
- Company executives came up with ideas and specifications for articles for publication in medical journals
- A medical writing company was hired to prepare the manuscripts to the company′s specs
- Medical doctors with academic credentials were recruited to put their names on the finished papers — for a handsome fee you can be sure.
- The drug company′s name, or the names of the people who actually wrote the articles, didn′t appear anywhere in the publications.
It is fraud, plain and simple!
By posing as authors, these medical doctors claim the findings and conclusions in the ghostwritten articles as their own. This is a barefaced lie; they have no way of knowing if the data they present are real or fabricated. And the conclusions favourable to the drugs are dictated by the company. That is the purpose of these articles, and that′s what the "authors" are paid for.
Doctors posing as authors clearly collude with company officials in committing fraud. It is ludicrous to assume that medical doctors deemed credible enough to front for a drug company are too naive to understand what they are doing — fooling the readers into mistaking company spin for objective scientific/medical reporting.
In Sen. Grassley′s words:
"Any attempt to manipulate the scientific literature, that can in turn mislead doctors to prescribe drugs that may not work and/or cause harm to their patients, is very troubling." (1).
The World Association of Medical Editors calls the practice of ghost authorship "dishonest and unacceptable" (1).
The pharmaceutical industry has no credibility left, and they know it. The drug companies admit this by the very fact of using ghostwriters — bribing "independent" medical doctors to front for them.
Sources:
- Wyeth′s Use of Medical Ghostwriters Questioned. Duff Wilson. NY Times December 13, 2008.
- From Agenda Item to Published Medical Article. Duff Wilson. NY Times December 13, 2008.
A drink or two a day raises long-chain omega-3 fatty acid levels
You probably know that moderate alcocol consumption — one daily drink for women and two for men — protects your heart (1). People who regularly drink a modest amount of alcohol are healthier than teetotalers or heavy drinkers. It was thought that the alcohol (ethanol) itself was responsible for these health benefits. Its cardioprotective effect was attributed to improvements in insulin sensitivity and HDL ("good" cholesterol) levels (1).
A new study suggests yet another way in which moderate drinking may benefit your heart — it increases omega-3 polyunsaturated fatty acid levels (2). European investigators asked 1604 men and women from Belgium, England and Italy, 26 to 65 years of age, to recall their dietary intakes over the course of one year. An analysis of their answers showed that
The fact that only wine raises long-chain polyunsaturated fatty acid levels suggests that factors other that alcohol may be responsible. Polyphenolic compounds like resveratrol are obvious candidates.
Remember that these heart health benefits are only observed with regular moderate alcohol use — about one drink per day for women and two for men. An occasional drink has no noticeable health benefit. At the other extreme, excessive drinking is obviously a major health hazard. All things in moderation.
Cheers
Sources:
A new study suggests yet another way in which moderate drinking may benefit your heart — it increases omega-3 polyunsaturated fatty acid levels (2). European investigators asked 1604 men and women from Belgium, England and Italy, 26 to 65 years of age, to recall their dietary intakes over the course of one year. An analysis of their answers showed that
- In women, alcohol consumption raised EPA and DHA levels in plasma as well as in the membranes of red blood cells
- In men, only EPA plasma and red blood cell levels increased with alcohol use; there was no corresponding DHA increase.
- Only wine increased fatty acid levels; beer and hard liquor had no such effect.
The fact that only wine raises long-chain polyunsaturated fatty acid levels suggests that factors other that alcohol may be responsible. Polyphenolic compounds like resveratrol are obvious candidates.
Remember that these heart health benefits are only observed with regular moderate alcohol use — about one drink per day for women and two for men. An occasional drink has no noticeable health benefit. At the other extreme, excessive drinking is obviously a major health hazard. All things in moderation.
Cheers
Sources:
- O′Keefe JH, Bybee KA, Javie CJ. Alcohol and cardiovascular health. The razor-sharp double-edged sword. J Am Coll Cardiol 2007;50:1009-1014.
http://content.onlinejacc.org/cgi/reprint/50/11/1009.pdf - di Giuseppe R, de Lorgeril M, Salen P et al. Alcohol consumption and n-3 polyunsaturated fatty acids in healthy men and women from 3 European populations. Am J Clin Nutr 2008;
[Abstract]
What is Orthomolecular Medicine?
In my post "Flu shots for the elderly — a waste of time and money?" I mentioned the Orthomolecular Medicine News Service. This news service provides regular health-related reports from a website called orthomolecular.org, a site dedicated to Therapeutic Nutrition Based Upon Biochemical Individuality (1). It is managed by an organization called The Center For The Improvement Of Human Functioning International. This is one of the best websites on health and nutrition that I have come across.
What is orthomolecular medicine?
The term orthomolecular medicine was introduced by the late Linus Pauling in his 1968 article Orthomolecular Psychiatry (2). Orthomolecular.org defines it like this:
"Orthomolecular medicine describes the practice of preventing and treating disease by providing the body with optimal amounts of substances which are natural to the body."
Many diseases are manifestations of nutritional imbalances or deficiencies. Doctors practising orthomolecular medicine aim to uncover these deficiencies and correct them. Drugs may suppress symptoms in these cases, but only the correction of the underlying problem, by dietary changes or supplementation, offers any real hope for a recovery.
As Dr. Abram Hoffer puts it:
"Orthomolecular treatment does not lend itself to rapid drug-like control of symptoms, but patients get well to a degree not seen by tranquilizer therapists who believe orthomolecular therapists are prone to exaggeration. Those who′ve seen the results are astonished."
Sources
- It has an editorial board consisting of scientists and medical doctors
- Its articles are professionally written, yet understandable by the non-expert
- New articles are emailed to you as they become available, and the service is free
- Past articles are archived and also freely accessible on their website
- They don′t inundate you with a daily stream of drivel
What is orthomolecular medicine?
The term orthomolecular medicine was introduced by the late Linus Pauling in his 1968 article Orthomolecular Psychiatry (2). Orthomolecular.org defines it like this:
"Orthomolecular medicine describes the practice of preventing and treating disease by providing the body with optimal amounts of substances which are natural to the body."
Many diseases are manifestations of nutritional imbalances or deficiencies. Doctors practising orthomolecular medicine aim to uncover these deficiencies and correct them. Drugs may suppress symptoms in these cases, but only the correction of the underlying problem, by dietary changes or supplementation, offers any real hope for a recovery.
As Dr. Abram Hoffer puts it:
"Orthomolecular treatment does not lend itself to rapid drug-like control of symptoms, but patients get well to a degree not seen by tranquilizer therapists who believe orthomolecular therapists are prone to exaggeration. Those who′ve seen the results are astonished."
Sources
- Orthomolecular.org. Therapeutic Nutrition Based Upon Biochemical Individuality.
http://www.orthomolecular.org - Pauling L. Orthomolecular Psychiatry. Varying the concentrations of substances normally present in the human body may control mental disease. Science 1968;160:265-271.
http://www.sciencemag.org/cgi/content/abstract/160/3825/265
Flu shots for the elderly — a waste of time and money?
"Flu Shots For The Elderly Are Ineffective". That′s the headline of an Oct. 23, 2008 release from the Orthomolecular Medicine News Service (1). The article picks up on a Sep. 2, 2008 report in the NY Times which claimed that "Doubts Grow Over Flu Vaccine in Elderly" (2).
"A growing number of immunologists and epidemiologists say the vaccine probably does not work very well for people over 70, the group that accounts for three-fourth of all flu deaths." (2)
The evidence for and against the flu shot′s effectiveness
Flu shots are effective if you believe the results of dozens of observational studies carried out over the last forty years or so. These studies seemed to show that flu shots cut the risk of dying in winter from any cause by almost 50% and reduced the need for hospitalization by nearly 30%. It should be pointed out that unambiguous evidence is hard to come by in this field, since doctors rarely confirm influenza with lab tests.
The only randomized placebo-controlled trial to date, a study published by a Dutch group in 1994, found that the vaccine prevented the flu in about 57% of patients in their sixties. For patients past seventy the rate dropped to just 23% — a far cry from 50%, but still better than nothing.
A 2005 article, on the other hand, painted quite a different picture. That paper pointed out that, even though the percentage of elderly getting an annual flu shot more than tripled from 1980 to 2001, there was no corresponding drop in the death rate. The authors concluded that the flu probably causes just 5 - 10% of all winter deaths in the elderly.
Now a new 2008 Lancet article questions the interpretation of earlier findings. These authors suggest that the very decision to get vaccinated simply sets healthy seniors apart from the sick and frail. They theorize that healthier and health-conscious patients are more likely to take the initiative to get a flu shot. Seniors who may have trouble taking care of themselves, and who might have led a less than healthy lifestyle, might simply not get to a doctor′s office for the shot. In other words, lower influenza rates in the vaccinated may have little to do with the vaccine′s effectiveness; seniors who bother to get vaccinated may simply be healthier to begin with.
Needless to say, this view isn′t universally shared by the health care community. Proponents of immunization maintain that any reduction in the number of influenza cases has to be welcome, even if there is no sound evidence that this reduction is due to the flu shot. Doubters, on the other hand, simply see this attitude as a triumph of marketing over science.
Why would flu shots be ineffective?
First, there are some 200 to 300 different influenza virus strains, but the vaccine usually contains antigens of only a few. Preparing vaccines for the coming flu season is an annual guessing game. More often than not the vaccine doesn′t contain antigens of the most virulent strains.
Secondly, our immune system weakens with age; older adults do not respond as well as younger people to vaccines. For example, elderly patients may need as much as four times the amount of antigen for the same immune response as people under forty.
Thirdly, flu shots and other vaccines have harmful side effects. The Vaccine Adverse Effect Reporting System (VAERS) of the U.S. Food & Drug Administration (FDA) receives around 11,000 serious adverse reaction reports per year. Serious reactions are defined as death, life-threatening illness, hospitalization, or disability resulting from a vaccine. The FDA admits that in all probability only about 10% of adverse reactions are reported. The U.S. National Vaccine Information Center puts that ratio at only 3%.
In addition, the elderly take more medications than younger people. Combined with an already weakened immune system and potential vaccine side effects, the risk of adverse reactions can only grow with age.
What can you do to protect yourself?
Whether or not you decide to get the flu shot, you should do everything you can to strengthen your immune system. As the article from the Orthomolecular Medicine News Service puts it:
"Is there an available alternative? Yes, there may be: give the elderly more nutrients, rather than more needles. Older people often have inadequate diets. With ageing and illness, their bodies′ need for vital nutrients goes up, yet frequently their intake actually goes down." (1)
and
"Over-reliance on vaccinating the elderly ignores their fundamental problems of poor diet and vitamin/mineral deficiencies. These are underlying reasons for a susceptible immune system. Supplemental nutrition is the "other" immune system booster. It is time to use it." (1)
The authors point out that high doses of vitamin C have been shown to reduce the frequency and severity of influenza. Vitamin D and the minerals selenium and zinc have also been found effective. I would add that a number of soluble fibers are known to strengthen the immune system as well.
The nutritional approach shouldn′t just be seen as a replacement for immunization. Even an effective vaccine still requires a functioning immune system. A vaccine presents the patient′s immune system with a weakened or dead virus. The immune system responds to that viral preparation in exactly the same way as it does to the real thing. By trial and error, the adaptive immune response develops antibodies and memory B cells against the viral strains it encounters; this process may take several days.
The difference between the live virus and the vaccine — and the idea behind vaccination — is that during that delay the real virus multiplies furiously and may overwhelm the patient, whereas the weakened or dead strain cannot. If the vaccination worked, the patient′s immune system is fully prepared to react immediately when it encounters the live virus.
So, do everything you can to strengthen your immune system, whether you decide to get a flu shot or not!
Sources
"A growing number of immunologists and epidemiologists say the vaccine probably does not work very well for people over 70, the group that accounts for three-fourth of all flu deaths." (2)
The evidence for and against the flu shot′s effectiveness
Flu shots are effective if you believe the results of dozens of observational studies carried out over the last forty years or so. These studies seemed to show that flu shots cut the risk of dying in winter from any cause by almost 50% and reduced the need for hospitalization by nearly 30%. It should be pointed out that unambiguous evidence is hard to come by in this field, since doctors rarely confirm influenza with lab tests.
The only randomized placebo-controlled trial to date, a study published by a Dutch group in 1994, found that the vaccine prevented the flu in about 57% of patients in their sixties. For patients past seventy the rate dropped to just 23% — a far cry from 50%, but still better than nothing.
A 2005 article, on the other hand, painted quite a different picture. That paper pointed out that, even though the percentage of elderly getting an annual flu shot more than tripled from 1980 to 2001, there was no corresponding drop in the death rate. The authors concluded that the flu probably causes just 5 - 10% of all winter deaths in the elderly.
Now a new 2008 Lancet article questions the interpretation of earlier findings. These authors suggest that the very decision to get vaccinated simply sets healthy seniors apart from the sick and frail. They theorize that healthier and health-conscious patients are more likely to take the initiative to get a flu shot. Seniors who may have trouble taking care of themselves, and who might have led a less than healthy lifestyle, might simply not get to a doctor′s office for the shot. In other words, lower influenza rates in the vaccinated may have little to do with the vaccine′s effectiveness; seniors who bother to get vaccinated may simply be healthier to begin with.
Needless to say, this view isn′t universally shared by the health care community. Proponents of immunization maintain that any reduction in the number of influenza cases has to be welcome, even if there is no sound evidence that this reduction is due to the flu shot. Doubters, on the other hand, simply see this attitude as a triumph of marketing over science.
Why would flu shots be ineffective?
First, there are some 200 to 300 different influenza virus strains, but the vaccine usually contains antigens of only a few. Preparing vaccines for the coming flu season is an annual guessing game. More often than not the vaccine doesn′t contain antigens of the most virulent strains.
Secondly, our immune system weakens with age; older adults do not respond as well as younger people to vaccines. For example, elderly patients may need as much as four times the amount of antigen for the same immune response as people under forty.
Thirdly, flu shots and other vaccines have harmful side effects. The Vaccine Adverse Effect Reporting System (VAERS) of the U.S. Food & Drug Administration (FDA) receives around 11,000 serious adverse reaction reports per year. Serious reactions are defined as death, life-threatening illness, hospitalization, or disability resulting from a vaccine. The FDA admits that in all probability only about 10% of adverse reactions are reported. The U.S. National Vaccine Information Center puts that ratio at only 3%.
In addition, the elderly take more medications than younger people. Combined with an already weakened immune system and potential vaccine side effects, the risk of adverse reactions can only grow with age.
What can you do to protect yourself?
Whether or not you decide to get the flu shot, you should do everything you can to strengthen your immune system. As the article from the Orthomolecular Medicine News Service puts it:
"Is there an available alternative? Yes, there may be: give the elderly more nutrients, rather than more needles. Older people often have inadequate diets. With ageing and illness, their bodies′ need for vital nutrients goes up, yet frequently their intake actually goes down." (1)
and
"Over-reliance on vaccinating the elderly ignores their fundamental problems of poor diet and vitamin/mineral deficiencies. These are underlying reasons for a susceptible immune system. Supplemental nutrition is the "other" immune system booster. It is time to use it." (1)
The authors point out that high doses of vitamin C have been shown to reduce the frequency and severity of influenza. Vitamin D and the minerals selenium and zinc have also been found effective. I would add that a number of soluble fibers are known to strengthen the immune system as well.
The nutritional approach shouldn′t just be seen as a replacement for immunization. Even an effective vaccine still requires a functioning immune system. A vaccine presents the patient′s immune system with a weakened or dead virus. The immune system responds to that viral preparation in exactly the same way as it does to the real thing. By trial and error, the adaptive immune response develops antibodies and memory B cells against the viral strains it encounters; this process may take several days.
The difference between the live virus and the vaccine — and the idea behind vaccination — is that during that delay the real virus multiplies furiously and may overwhelm the patient, whereas the weakened or dead strain cannot. If the vaccination worked, the patient′s immune system is fully prepared to react immediately when it encounters the live virus.
So, do everything you can to strengthen your immune system, whether you decide to get a flu shot or not!
Sources
- Flu Shots For The Elderly Are Ineffective. Orthomolecular Medicine News Service, Oct. 23, 2008, and references therein.
- Doubts Grow Over Flu Vaccine in Elderly. Goodman B. NY Times Sep. 2, 2008.