[another_someone]

http://news.bbc.co.uk/1/hi/health/6399773.stm

Taking certain vitamin supplements may adversely affect people's lifespan, researchers have suggested.

Millions worldwide use antioxidant supplements such as vitamins A and E, and beta-carotene.

Looking at dozens of previous studies, Copenhagen University researchers suggested these appeared to raise, not lower, the risk of early death.
The Copenhagen team reviewed more than 815 clinical trials into the benefits of vitamins A, E, and C, alongside beta-carotene and selenium - all commonly-used supplements.

They selected 68 whose methods were more likely to produce an accurate picture of vitamin benefits, then added their results together to form one, large-scale study.

This overview suggested that taking antioxidant supplements neither increased, nor reduced, the risk of early death.

However, when the researchers eliminated a further 21 trials which had a slightly higher possibility of producing a skewed result, the picture changed considerably.

While the risk of death was unchanged among selenium and vitamin C users, a statistically significant increase in risk emerged for the other three supplements.

Beta-carotene produced an approximate 7% increased risk, vitamin E a 4% increase and vitamin A, a 16% increase.

The researchers wrote: "Our findings contradict the findings of observational studies claiming that antioxidants improve health.

"Considering that 10% to 20% of the adult population in Europe and North America may consume the supplements, the public health consequences may be substantial."

They said there were several different explanations for this increase in risk - and suggested that knocking out 'free radicals' might actually interfere with a natural defence mechanism within the body.

The team called for more research into the effects of vitamin supplements on health.

http://jama.ama-assn.org/cgi/content/abstract/297/8/842

Conclusions  Treatment with beta carotene, vitamin A, and vitamin E may increase mortality. The potential roles of vitamin C and selenium on mortality need further study.

[iko]

Vitamins 'could shorten lifespan'...
...may be they don't!
I'll try to read the complete report, then
I might be able to comment on this.
For now I just note that vitamin C didn't
do bad things and vitamin D is not mentioned.

ikod

[another_someone]

As you say, it needs closer reading.

I was putting up here for comment, not because I assume it to be the definitive final word on the matter.

Then again, most things, if they are capable of doing you good, are also capable of doing you harm.

[iko]

Of course I agree with you,
we are all different and have various defects and ailments...
and some nutrient good for one is harmful for others.
Not to mention dosages, mixtures and eccipients!
Far away from any standard condition needed in research!
We definitely need INBRED humans. []

ikod

[Zoey]

Quote
"Conclusions  Treatment with beta carotene, vitamin A, and vitamin E may increase mortality. The potential roles of vitamin C and selenium on mortality need further study."
-------

  Reports like this are very suspicious because they draw conclusions without presenting information that justifies them. It reads like propaganda\marketing; designed to have an emotional impact on the reader via sensationalism. In this instance it may serve to steer disaffected patients to choose drugs over supplements. I would like to know who financed this study and if any of the researchers have ties to the drug industry.
   I smell something fishy here. Consider these quotes (*s are mine):

"The researchers wrote: "Our findings contradict the findings of *observational* studies claiming that antioxidants improve health."
 
Yet in the beginning of the review, "The Copenhagen team reviewed more than 815 *clinical trials* into the benefits of vitamins A, E, and C, alongside beta-carotene and selenium - all commonly-used supplements."
Why did a review of *clinical studies* conclude their findings contradict those of *observational* studies? Does this not imply that their findings don't contradict those of clinical studies?
    One way to increase the market for drugs is to discredit the competition [in this case vitamins used medicinally].  This review has much the same flavor as sensational campaigns backed by drug companies to convince people they have an illness which can only be treated by the drug being marketed in the campaign.
  Not everyone is swallowing the conclusions of this study "hook, line, and sinker." Headlines do affect sales, and before the truth comes out, misleading advertising presented as news may succeed in hurting the market of it's competitors. Apparently this "review" is much like a similar one from 2005.  This quote is from an article questioning this study:
    "The earlier meta-analysis, published in the Annals of Internal Medicine (142(1):37-46), has been highly criticised and discredited as flawed, but sales of vitamin E, particularly in the US, declined significantly in the wake of its publication.

The new pooled analysis has already drawn criticism from both inside and outside the dietary supplements industry concerning the methodology applied, and the conclusions drawn.

The most prevalent criticism of the study has come from the diverse nature of the studies pooled together, described by one industry expert as comparing "apples and oranges".

Moreover, Meir Stampfer, a professor of nutrition and epidemiology at the Harvard School of Public Health who was not connected to the meta-analysis, told the Associated Press that the studies reviewed were too different to be able to pool them together."
 Link to Full Article:
http://www.nutraingredients.com/news/ng.asp?n=74582-antioxidants-meta-analysis-mortality
 Others also question the validity of this study. This from another news article:
"Some experts who reviewed the research were dismissive of the increased death risk and the analysis overall, saying it pooled studies that were too diverse.

However, the study's senior author, Dr. Christian Gluud of Copenhagen University Hospital, said, "The main message is that prevention by beta carotene, vitamin A and vitamin E cannot be recommended. These three antioxidant supplements may increase mortality."

Gluud said most of the studies didn't reveal why those taking supplements died, but "in all likelihood, what they died from is what people normally die from, maybe accelerated artherosclerosis, maybe cancer."
Link to Full article:
 http://www.sci-tech-today.com/story.xhtml?story_id=130002R08KHG

So if my mother dies from artherosclerosis, and she was taking vitamin E, we should conclude that vitamin E caused her death?
   
The study is presented so much like a scare campaign about vitamins perhaps it is best taken with a pillar of salt.
 



 

 

 

[Zoey]

 The Scientific American also has an article on this study:
"Balz Frei, director of the Linus Pauling Institute at Oregon State University, said the study and the data studied are both flawed because more than two-thirds of the previous research that was examined involved people with heart disease, cancer or other risks who were being treated to see if the supplements worked."

http://www.sciam.com/article.cfm?chanID=sa003&articleID=16B2399CCD1419DE9E098D7ABF025EB6

[Zoey]

1: Am J Med. 2007 Feb;120(2):180-4.

Risk of mortality with vitamin E supplements: the Cache County study.

Hayden KM, Welsh-Bohmer KA, Wengreen HJ, Zandi PP, Lyketsos CG, Breitner JC;
Cache County Investigators.

Department of Psychiatry and Behavioral Sciences, Duke University Medical
Center, Durham, NC, USA. khayden@duke.edu

PURPOSE: A recent meta-analysis reported increased mortality in clinical trial
participants randomized to high-dose vitamin E. We sought to determine whether
these mortality risks with vitamin E reflect adverse consequences of its use in
the presence of cardiovascular disease. METHODS: In a defined population aged 65
years or older, baseline interviews captured self- or proxy-reported history of
cardiovascular illness. A medicine cabinet inventory verified nutritional
supplement and medication use. Three sources identified subsequent deaths. Cox
proportional hazards methods examined the association between vitamin E use and
mortality. RESULTS: After adjustment for age and sex, there was no association
in this population between vitamin E use and mortality (adjusted hazard ratio
[aHR] 0.93; 95% confidence interval [CI], 0.74-1.15). Predictably, deaths were
more frequent with a history of diabetes, stroke, coronary artery bypass graft
surgery, or myocardial infarction, and with the use of warfarin, nitrates, or
diuretics. None of these conditions or treatments altered the null main effect
with vitamin E, but mortality was increased in vitamin E users who had a history
of stroke (aHR 3.64; CI, 1.73-7.68), coronary bypass graft surgery (aHR 4.40;
CI, 2.83-6.83), or myocardial infarction (aHR 1.95; CI, 1.29-2.95) and,
independently, in those taking nitrates (aHR 3.95; CI, 2.04-7.65), warfarin (aHR
3.71; CI, 2.22-6.21), or diuretics (aHR 1.83; CI, 1.35-2.49). Although not
definitive, a consistent trend toward reduced mortality was seen in vitamin E
users without these conditions or treatments. CONCLUSIONS: In this
population-based study, vitamin E use was unrelated to mortality, but this
apparently null finding seems to represent a combination of increased mortality
in those with severe cardiovascular disease and a possible protective effect in
those without.

PMID: 17275460 [PubMed - indexed for MEDLINE]

Related Links

    Insulin-based regimens decrease mortality rates in critically ill patients:
a systematic review. [Diabetes Metab Res Rev. 2006] PMID:17089369
   
    Vascular risk factors for incident Alzheimer disease and vascular dementia:
the Cache County study. [Alzheimer Dis Assoc Disord. 2006] PMID:16772744
   
    Vitamin supplement use in a low-risk population of US male physicians and
subsequent cardiovascular mortality. [Arch Intern Med. 2002] PMID:12090883
   
    Higher baseline serum concentrations of vitamin E are associated with lower
total and cause-specific mortality in the Alpha-Tocopherol, Beta-Carotene Cancer
Prevention Study. [Am J Clin Nutr. 2006] PMID:17093175
   
    Vitamin E in the primary prevention of cardiovascular disease and cancer:
the Women's Health Study: a randomized controlled trial. [JAMA. 2005]
PMID:15998891
   

[iko]

Hi Zoey,
thank you for putting all these bits together!
I am skeptical too about this particular study but this gives us the idea of the problem here.
My enthusiasm is not exactly gone, but it's true, I'm looking more critically at the whole thing, now that I almost wrote everything in this forum (finding this NKS was great).
And I actually see what I have got in my hands to try convincing people (parents) about it.

No reply from Finland (M.Tolonen).
Any sign of interest on your side?
We definetly need authority from some wise nutrition scientist (Wisdom in Medicine Panel!)

ikod

Alice Lichtenstein, a professor of nutrition science and policy at Tufts University who was not involved with the research, said the study's main message is: "Rely on food to get your nutrients."

...CLO better than single purified components!

[Zoey]

 I find the problem with reality, is we keep trying to make it static, concrete, a thing, when it is a process. If what I posted last night is refuted, or, if future studies validate the premature conclusions, I will have to accept that. The trick is, to be always a little skeptical, another way of saying open minded and able to make a paradigm shift as information is learned. Don't put your faith in solid objects.
   The first two COL companies investigated do look promising, but I want to check them out further, and consider some options [like having more information together before contacting them].
  When researching a story on men and osteoporosis, I found a report from a marketing firm that would instruct me, as a phramceutical company, in how to create a  market for my drug [how to 'invent' or manipulate the issue of osteoporosis in men in such a way as to expand the sales of my drug to this market.
  I could not afford the several thousand dollars for this report, and I don't sell drugs, just encourage people to take their COL & muli vitamins daily.
  However, I think we should strategize a bit and then go right on sending out letters and cultivating interest in this important COL issue. I would like to see if it is possible to locate anyone connected with the Shanghai report and find out if any further work or study was done in this area that we do not know about yet.
  While we need to be skeptical, I hope you won't let the dogmatists and propagandists discourage you.
Zoey

[iko]

Hi Zoey,
I'm suddenly more thoughtful than usual...a bit of 'autocriticism' from time to time.
Today my 'little' boy is up on the Alps skiing with his friends in a gorgeous day: maybe I should be satisfied with what I had in terms of luck and quit all this fuss about his daily 'cod'.  My collegues hematologists here tolerate me when I recall this story (a 'dingdong' from the blood bank!).  I don't even know if any of them checked this forum out.  People are always too busy for thinking about basic questions here.

As I wrote before, we do need an authority from somewhere and we should go on 'fishing' through the web: this forum plus e-mails and things.

I would like to see if it is possible to locate anyone connected with the Shanghai report and find out if any further work or study was done in this area that we do not know about yet.

I got in touch ages ago with the Shanghai team: the main Author was very kind and replied quickly to my letter (quite a miracle!)

It's all in the short essay:

…In 1999 an italian doctor reads the article and decides to get more information writing a letter to the Author (who moved to USA in the meantime).  He basically asks two questions:
 1) are there further studies to confirm a protective effect of cod liver oil?
 2) was the protective effect stronger in older children, suspected to develop leukemia after an overidden immune response to a common pathogen? (Mel Greaves’s hypothesis: “the final hit may be infectious”).
  He gets a kind reply from the Author in a short while, but the content is pretty dismal for human science as a whole.
No further data are available to confirm those results: cod liver oil is not anymore commonly used.  The over ten year old study is unfortunately “buried” in 5 inches diskettes and a detailed revision of those data is almost impossible.


Tricky Note:
The "Shanghai report" is almost unreachable by a rough search through Medline databases. A peculiar text-string: "cod liver oil containing vitamins A and D" makes it impossible to find it out just crossing "leukemia" and "vitamin d"...you have to go for cod liver.

The Author moved to the USA (I recall Vanderbilt Univ.) and so she should be much closer to you!

It may take time...may be prof. Holick is actually thinking about this issue...
Boston is a great place for Medicine (MGHospital, NEJMed.) wow...it would be GREAT!

(I wrote to him a few months ago and got a reply)

ikod
 

[Zoey]

 The response from "Shanghai" must have been somewhat discouraging. I'm going to do more searching, thinking, and then some strategizing on how to reach any possible contacts that turn up in the searching.
Zoey

[Zoey]

This quote is from the same BBC article which began this discussion. Too bad it was left out.
Zoey
"Ellen Mason, of the British Heart Foundation, said: "We would recommend that you only take substances to protect against heart disease, whether dietary supplements or drugs, that have been proven in well conducted clinical trials."

However, Dr Ann Walker, of the Health Supplements Information Service, said the findings of the study were "worthless".

She said some of the studies which had been examined by the Copenhagen team involved patients who were already seriously ill.

"How sensible scientists can suggest that a modest intervention of a single antioxidant supplement, can have a major effect in reversing life-threatening pathology, where patients already have advanced cardiovascular disease, is ridiculous.

"Vitamin, mineral and dietary supplements not only have proven health benefits, they are essential to the maintenance of good health and can help bridge the nutritional gap for many people in the UK whose diets are often lacking in essential nutrients."

http://news.bbc.co.uk/2/hi/health/6399773.stm

[another_someone]

Another similar report - but again, this is not from a specialist medical source but the general media:

http://news.bbc.co.uk/1/hi/health/6657795.stm

Taking lots of multivitamins may increase the risk of deadly prostate cancer, say US researchers.

Their study showed taking multivitamins more than seven times a week was associated with an increased risk of advanced and fatal prostate cancer.

There was no link with early cancer or localised prostate cancer, the researchers wrote in the Journal of the National Cancer Institute.

Experts advised men to eat a healthy diet to reduce their risk of cancer.

The findings, based on data on nearly 300,000 men, indicated the risk of advanced prostate cancer is 32% higher in men who take multivitamins more than once a day than in those who do not take them at all.

Risk of fatal prostate cancer was almost double.

The correlation was strongest for men with a family history of the disease, and who also took selenium, beta-carotene or zinc supplements.

It is unclear why the multivitamins may increase the risk of certain types of prostate cancer.

Study leader Dr Karla Lawson from the US National Cancer Institute said: "The possibility that men taking high levels of multivitamins along with other supplements have increased risk of advanced and fatal prostate cancers is of concern and merits further evaluation."

Because multivitamins contain so many different components and men taking a lot of them were more likely to be taking other supplements, the researchers were unable to tease out what was causing the association.

In an accompanying editorial, European researchers said a high intake of fruit and vegetables has been shown to reduce the risk of cancer.

But it is not clear which nutrients have a positive effect.

Antioxidants

There has been a lot of research into antioxidants such as vitamin C and E because it is believed they may protect cells against damage.

However, some analyses have suggested that beta-carotene, vitamin A and vitamin E supplements may shorten life rather than extend it.

The amounts of antioxidants needed to offer any potential protection are not known and may differ between individuals.

Liz Baker, science information officer at Cancer Research UK, said: "It's still not entirely clear what factors can affect a man's risk of developing prostate cancer.

"And there is conflicting evidence on the pros and cons of vitamin supplements.

"These products don't seem to give us the same benefits as vitamins that naturally occur in our food.

"We encourage people wanting to reduce their risk of cancer to eat a diet rich in fibre, vegetables and fruit, and low in red and processed meat."

Georgia Diebel, a specialist nurse at the Prostate Cancer Charity said: "With all vitamins, we recommend that men do not exceed the daily recommended dose stated on the bottle.

"People often think of them as something 'natural' and do not understand that they still have to be metabolised and used by the body - a study like this suggests they are not safe in larger quantities."

Prostate cancer is the second leading cause of cancer death in men. It kills one man every hour in the UK.

[iko]

Let's hope to see more precise correlations in the future...

ikod

Another similar report - but again, this is not from a specialist medical source but the general media:

http://news.bbc.co.uk/1/hi/health/6657795.stm

Because multivitamins contain so many different components and men taking a lot of them were more likely to be taking other supplements, the researchers were unable to tease out what was causing the association.

[rgreenman]

I am of the opinion that it is not the nutrients themselves that may be causing negative effects, but the form in which these nutrients are administered. Multivitamins and vitamin tablets and supplements are not natural. A multivitamin is a conglomeration of individual nutrients, mostly synthetic, combined together in theoretical ratios and glued together. Whether by evolution or creation, we were designed to get all required nutrition from our food supply. However, there is much evidence that our farm soils are depleted of minerals and trace elements by years of maximum-yield farming. And we all know about insecticides, herbicides, etc. routinely sprayed on our fruits and vegetables. I say, throw out your multivitamins and start buying organic produce and sea vegetables (seaweed). Seaweed does not suffer from depleted soils and contains practically the entire spectrum of known essential nutrients. If you can't stand the smell or taste of seaweed, you can buy it in capsules, but make sure it's not an extract or a combination of other things. (I don't want to mention my favorite here, because I don't want the spam-police to arrest me!) What are some thoughts on this?

"The most difficult thing in the world is to abandon one's beliefs in the face of irrefutable evidence against them."

-Rob

[iko]

Hi rgreenman,

I see your point about 'innatural' vitamins.
I still think is almost impossible to make this type of studies without risking gigantic 'biases'. Surely I'm not aware of any study confirming that some of those artificial mix of cofactors has been able to do something, even just rise a cofactor plasmatic level! Assumption that 'it must be good' is quite evident.
I have a totally different opinion about cod liver oil, the natural mix.
There vitamins and special oils seem to help each other in doing good things for the body: either the fish itself, or the lucky humans who manage to reach it.
Take care

ikod

[iko]

Hi there,

An interesting book about this topic's issue has been reviewed in today's
New England Journal of Medicine, 356;25 June 21, 2007:

"Natural causes: Death, Lies, and Politics
in America's Vitamin and Herbal Supplement Industry."

by Dan Hurley.  336 pp. New York, Broadway Books, 2006  $23.95

ISBN 978-0-7679-2042-1.

in the end of the note by Donald Marcus MD:

...
It is a much needed corrective to the promotion
of so-called natural treatments by the integrative
medicine programs at some medical schools and by
health care professionals who believe incorrectly
that herbal remedies and dietary supplementsare
harmless.  The book deserves a wide audience.

I may try to grab it by Amazon&things
              

[iko]

Vitamins 'could shorten lifespan'...
...may be they don't!
I'll try to read the complete report, then
I might be able to comment on this.
For now I just note that vitamin C didn't
do bad things and vitamin D is not mentioned.

ikod

...I'm not sure, really, that vitamin supplements could 'shorten' lifespan...
at least at the very beginning of life!
Canada rules.

Prenatal multivitamin supplementation and rates of pediatric cancers: a meta-analysis.

Goh YI, Bollano E, Einarson TR, Koren G.
Department of Pharmaceutical Sciences, University of Toronto, and The Motherisk Program, Division of Clinical Pharmacology/Toxicology, The Hospital for Sick Children, Toronto, Ontario, Canada.

Prenatal supplementation of folic acid has been shown to decrease the risk of several congenital malformations. Several studies have recently suggested a potential protective effect of folic acid on certain pediatric cancers. The protective role of prenatal multivitamins has not been elucidated. We conducted a systematic review and meta-analysis to assess the potential protective effect of prenatal multivitamins on several pediatric cancers. Medline, PubMed, EMBASE, Toxline, Healthstar, and Cochrane databases were searched for studies published in all languages from 1960 to July 2005 on multivitamin supplementation and pediatric cancers. References from all articles collected were reviewed for additional articles. Two blinded independent reviewers assessed the articles for inclusion and exclusion. Rates of cancers in women supplemented with multivitamins were compared with unsupplemented women using a random effects model. Sixty-one articles were identified in the initial search, of which, seven articles met the inclusion criteria. There was an apparent protective effect for leukemia (odds ratio (OR)=0.61, 95% confidence interval (CI)=0.50-0.74), pediatric brain tumors (OR=0.73, 95% CI=0.60-0.88) and neuroblastoma (OR=0.53, 95% CI=0.42-0.68).
In conclusion, maternal ingestion of prenatal multivitamins is associated with a decreased risk for pediatric brain tumors, neuroblastoma, and leukemia. Presently, it is not known which constituent(s) among the multivitamins confer this protective effect.

Clin Pharmacol Ther. 2007 May;81(5):685-91.

[iko]

So what about Vitamin D3? The scientific evidence is stacking up that it can prevent cancer and a multitude of diseases and that middle aged and older folks just can't make enough from sun exposure.

You name it!   [] [] []

A little help from the sun, probably working in the long run, in a limited number of patients...why not?
It certainly wouldn't be such a "New!!!" discovery.

http://www.thenakedscientists.com/forum/index.php?topic=4987.0