Controversy in Vitamin Research

Why so much controversy about vitamin supplements lately? Do vitamins help make you healthy or not? More and more Health Professions are raising doubts according to new results from research, especially longer term studies. 

Perhaps to better understand this issue, some background information should help. Let's break up vitamin research over the years into three waves.

FIRST WAVE for VITAMIN RESEARCH

The first Vitamin research wave started after vitamins were discovered. Scientists analyzed food to discover vitamin content. Then scientists compared the diets between healthy and sick people to see if the food vitamin loads were different. Sick people had lower levels of many vitamins. The natural assumption from this data lead to the theory that higher vitamin containing foods in the diet prevented diseases. 

The SECOND WAVE

After isolated synthetic vitamins were created in the lab and natural vitamins were extracted out of foods, Scientists set up studies to test these new vitamin forms with groups of people taking different amounts of vitamins compared to people not taking any lab vitamins. The results were not as positive as the studies of vitamins in food. Some study results were positive, some were neutral, and some revealed slightly negative results. Thus, the controversy began.

One such study called the SELECT study is typical. The SELECT study looked at the possibility of synthetic vitamin E (dl'alpha tocopherol) and Selenium to prevent prostate cancer. Eariler food study rssults showed this could be the case. But at the mid-point evaluation of the SELECT study, the vitamin E only group exhibited a slightly elevated cancer rate while the selenium only group had a tiny elevated risk for diabetes. These results stopped the study.

CAUTION: Science can be Manipulated. article  Results of studies can be influenced by select criteria chosen by Scientists as well as the population tested. This manipulation can occur in both directions. A popular vitamin E analysis study at Johns Hopkins Medical in 2004 arrived at a result that Vitamin E over 400 IUs increases mortality risk. Almost every Newspaper headline in the World reported this finding. What was not mentioned was the follow up work by other Scientific groups that exposed this work as having numerous flaws. One might imagine that the Johns Hopkins study would mention the cause of death in the Vitamin E group used to determine findings. But, no causes were listed. Someone who dies in an auto accident counts the same weight as one who falls and breaks a hip and later dies, regardless of whether or not a relationship to vitamin E is a factor.  article 

The THIRD WAVE of Vitamin Research

Now, over the last 15 years, a new third wave of vitamin research has quietly entered the scene. While a few are larger long term studies, many are smaller and less well published than earlier large study results. This smaller scientific research lacks grant money and the Scientific method dictates more and larger works are needed to verify the smaller study results before they are accepted. Plus, so far, many of these new vitamin results are not even getting acknowledged. Media outlets usually go for dramatic negative results rather than smaller positive ones. This could also be due to the fact that many of these new study results are challenging traditional and long held nutritional theories.

Examples from the large SELECT Study on Prostate Cancer

Using the SELECT study from above, new wave research findings splashed across Media headlines that vitamin supplements don't reduce prostate cancer. But it's the WHY part from the SELECT study that the media missed from many smaller studies explaining the slightly negative results.

First, what the Government allows to be called vitamin E represents only one out of 8 related vitamin E family factors in nature. It turns out that just before the SELECT study began, another smaller prostate study found that the prostate needs to be protected against both oxygen as well as nitrogen radicals. The form of vitamin E used in the SELECT study only handles oxygen radicals. It is action from the other seven of Nature's vitamin E family members that stop nitrogen radicals, largely d'gamma tocopherol.

For the Selenium effects, it turns out this issue is exactly opposite of the actions of vitamin E above. The body generates a radical to help with the uptake of insulin and glucose into cells. This helps to control against diabetes. One of the function of the mineral Selenium is to build a radical antioxidant fighter (GPx). Too much of this Selenium produced radical fighter would destroy the radicals before they could perform their necessary work for the body of moving insulin and glucose into cells. This action reveals that there is a delicate balance needed in the body between oxidation and reduction, a redox balance. If the body is already sufficient in Selenium, supplemental Selenium could tip over this balance.

There are numerous examples of this new wave of vitamin studies upsetting nutritional establishment apple carts. While the background and behind the scenes smaller studies are painting a slightly different picture for many traditional vitamins, the real work is pointing out lesser known vitamins impact on major vitamin functions. Below presents a fundamental vitamin D body process with many related parts and vitamins working discovered from this new wave of research.

Of Interest: To discover many of the new third wave type vitamin research, it was necessary to look near the end of Google search listings. Some topics have over 200 pages of listings. Evidently, not many Professionals look that deep since this information is lacking in most health discussions and not yet reflected in most vitamin products. Today (Jan 2024), Google only lists about 7 to 8 pages of websites from a search. Not enough! Good luck finding real truthful vitamin studies..

Vitamin D more than just for Bones

In order for vitamin D bone building functions to occur, vitamin D first has to change into a 1000 times stronger acting form. This requires the mineral magnesium and some Kidney enzymes. Then this form picks up and reacts and combines with these elements as it enters into cells: DBP (vitamin D binding protein in blood), VDR (Vitamin D Receptors), RXR (special vitamin A form 9-cis retinic acid and its 9-cis receptor), and last with VDRE (Vitamin D Reactive Elements). This complex then stimulates genes in the cells to build proteins. One of these proteins, Osteocalcin, a hormone, then initiates a process to combine with calcium and other minerals to form mineral crystals which enter into and become new bone. Osteocalcin is first produced by vitamin D in a non-acting form. Vitamin K2 is necessary to change this osteocalcin form into an action form.

FACTS OF INTEREST (This is huge)

Most if not all bone studies are designed to fail if all the nutrients that participate in forming active vitamin D actions are not acknowledged. Vitamin K2 and 9-cis retinoic acid status are rarely considered. THE BONE BUILDING PROCESS MIGHT BE LIMITED WITHOUT ENOUGH VITAMIN K2. Doctors have for a very long time measured the blood levels of the vitamin K2 activated form of osteocalcin. This information served as a marker for the level of activity for the bone building process. But, never was the story told that this osteocalcin form was linked to and a measure for vitamin K2 activity. Why?

Vitamin D actions have now expanded to include many immune system functions, especially on certain cancers, and blood sugar control or insulin resistance, a marker for diabetes. This new wave of studies also discovered this tidbit of information about the two forms of osteocalcin.

In a test tube study, the actions of the two different forms of osteocalcin on prostate cancer cells were measured. The non-active form stopped cancer cell growth while the active form of osteocalcin promoted cancer growth. Other studies found that each form also had a different direct action on blood sugar control. There must be a critical and optimal relationship between the active and non-active forms of osteocalin that should be respected. That balance point is not known yet. The body needs some of each form.

These smaller new wave studies may have critical implications and immediately need further testing, especially in controlled human work. Sometimes test tube actions are not duplicated the same in humans. Plus, certain facts have to be considered. Cancer cells produce an enzyme that destroys vitamin D. Scientists comparing vitamin D levels between cancer victims and healthy controls obviously found lower vitamin D levels in cancer patients. This prompted the assumption that increasing vitamin D levels in healthy people would stop cancer. This new knowledge that cancer cells lower vitamin D levels modifies that assumption somewhat.

These and other new wave vitamin work should at the very least bring about a precautionary approach to supplement protocols. Bone formulas need vitamin K2 unless vitamin K levels are known. Vitamin K2 supplement amounts need some precautions unless osteocalcin form levels are measured. (Vitamin K2 also has another vital function that limits the calcification of artery walls).

Nature has a few different forms of vitamin A or Beta Carotene. One important form, 9-cis, is only in a few supplements. Since vitamin D processes rely on this 9-cis form, this could be another limiting factor. While it is possible the body can make some 9-cis form from the all-trans form, the exact conversion process and amounts are not known yet. But the known facts discovered about this conversion reveal that it is more likely than the 9-cis form will convert to the all-trans form than the all-trans form will build the 9-cis form, at least as determined by analyzing blood levels of each after consuming each separately. 

 A Grain of Salt 

The controversy continues in the two articles below. Other articles on this website reveal some very interesting shortcomings concerning the information as well. Here is one with research analysis with a new perspective on flawed study methods.

Interesting that within the same web page on Medscape.com, these two articles appeared. You be the Judge!

Article 1:    "Trash the Vitamins: Convince Your Patients

A Best Evidence Review

Charles P. Vega, MD; Veena Kulchaiyawat, DO

Authors and Disclosures         Posted: 01/05/2012

Best Evidence Review of Dietary Supplements and Mortality Rates in Older Women

Mursu J, Robien K, Harnack LJ, Park K, Jacobs Jr DR. Dietary supplements and mortality rate in older women. Arch Intern Med. 2011;171:1625-1633.

Dietary supplements are widely used by older adults, even though the effectiveness of these supplements in preventing illness is questionable. But can dietary supplements actually promote a higher risk for death? A new study suggests that the answer is yes for some of the most common supplements. This Best Evidence Review describes the findings of this study and puts these results in context.

Background

Vitamins and dietary supplements play an important role in the health and health care of many adults, and the business of supplements constitutes a multibillion-dollar industry worldwide. Based on the Third National Health and Nutrition Examination Survey, 40% of men and 50% of women older than 60 years of age consume at least 1 vitamin or mineral supplement.[1] A national survey by the US Food and Drug Administration found that 73% of US adults were found to use dietary supplements in 2002, providing annual sale costs in 2005 of over $20 billion.[2,3]

The widespread use of dietary supplements is not supported by practice guidelines. The US Preventive Services Task Force (USPSTF) states that there is insufficient evidence to recommend for or against the use of vitamins A, C, E, or multivitamins with folic acid or antioxidants.[4] Specifically, the USPSTF cites concerns regarding the balance of benefits vs harms of these supplements. The American Medical Association recommends supplements specifically for seniors who have generalized decreased food intake, while the American Dietetic Association advises low-dose multivitamin and mineral supplements depending on individualized dietary assessment.[5] The American Heart Association emphasizes healthy eating patterns rather than supplementation with specific nutrients.[6]

These recommendations against the routine use of supplements are grounded in good evidence. A Cochrane intervention review of 77 randomized controlled trials with 232,550 participants found no evidence to recommend antioxidant supplementation for primary or secondary prevention of mortality.[7] Moreover, there is the possibility of harm related to the use of some supplements. For example, the Alpha-Tocopherol Beta-Carotene Cancer Prevention Trial demonstrated that beta-carotene supplements increased the risk for lung cancer among male smokers.[8]"   -end of article

 **** Now compare this result to another article before you make any rash decisions that appeared recently on the same website page in Medscape.com:

Article 2:    Vitamin E May Affect the Life Expectancy of Men, Depending on Dietary Vitamin C Intake and Smoking

Harri Hemilä; Jaakko Kaprio

Authors and Disclosures

Posted: 02/23/2011; Age and Ageing. 2011;40(2):215-220. © 2011 Oxford University Press

Abstract and Introduction

Background: antioxidants might protect against oxidative stress, which has been suggested as a cause of aging.
Methods: the Alpha-Tocopherol-Beta-Carotene (ATBC) Study recruited males aged 50–69 years who smoked at least five cigarettes per day at the baseline. The current study was restricted to participants who were followed up past the age of 65. Deaths were identified in the National Death Registry (1,445 deaths). We constructed Kaplan–Meier survival curves for all participants, and for four subgroups defined by dietary vitamin C intake and level of smoking. We also constructed Cox regression models allowing a different vitamin E effect for low and high age ranges.
 Results: among all 10,837 participants, vitamin E had no effect on those who were 65–70 years old, but reduced mortality by 24% when participants were 71 or older. Among 2,284 men with dietary vitamin C intakes above the median who smoked less than a pack of cigarettes per day, vitamin E extended lifespan by 2 years at the upper limit of the follow-up age span. In this subgroup, the survival curves of vitamin E and no-vitamin E participants diverged at 71 years. In the other three subgroups covering 80% of the participants, vitamin E did not affect mortality.
Conclusions: this is the first study to strongly indicate that protection against oxidative stress can increase the life expectancy of some initially healthy population groups. Nevertheless, the lack of effect in 80% of this male cohort shows that vitamin E is no panacea for extending life expectancy. (especially if vitamin E contains only one of the E family)   -end of article

Analysis:  The first article ends by referencing the Finnish smokers study that found an increased mortality rate for smoker's taking vitamin E and or beta carotene.  While in the second study, vitamin E reduced mortality in older smokers by 24%. And if vitamin C levels were over median, extended lifespan of less than a pack a day smokers by 2 years. Is it any wonder that Doctors are giving up and creating headlines like the first article.

Follow this logic. A vitamin E heart attack study (CHAOS) found a 71% reduction of second survivable heart attacks in the vitamin E group during the study period. But there also was an unexplained dozen more deaths in the vitamin E groups when followed after the study that also needs an explanation. Check out this reference that adds some clarity to how vitamin E protects arteries.  ref 

There are better answers when the true facts are known. Sometimes the issue is the use of synthetic vitamin E versus natural from vitamin E, other times it is dosages out of balance, or even working with faulty theories, such as the antioxidant free radical theory without considering the antioxidant load balance factor. Science has lost touch with the original definitive meaning of the scientific method with it's very precise reporting or interpretation for results of nutritional studies. If synthetic vitamin E is used, the term synthetic has to be included when mentioning results. article YES, in the case of vitamin E, the synthetic is quite different from the natural form. Science knew about this difference from day one in the 1940's. This website tells more of the correct story than you will find on any other vitamin website. And gives a better explanation to understand the preceding study results that is logical and science supported.

NOTE: A couple of years ago this headline appeared: Are your vitamins killing you?  ref When you read the article, it sounds very logical, BUT, it is only part of the story and knowing the complete story again leaves you with a different view. You will have to search some to find this info, it is on this website in numerous articles.

IOWA WOMEN'S HEALTH STUDY

Another detrimental research against the use of vitamins comes from the Iowa Women's Study. The results need some explanation to understand exactly what and how these negative results and one positive result were uncovered.

ANALYSIS: The results are logical and supported by this website's new vitamin standards, like NO iron except for those who are anemic and iron should always be taken separate from other vitamins. The other nutrients showing a pronounced association, folic acid, copper, vitamin B6 are mentioned on this website with necessary precautions. Magnesium and zinc reveal the least negative association while Calcium was associated with a slight positive reduced mortality. Calcium actually participates in the natural death process for some types of cancer cells and this may prolong life. ref

The most significant fact not mentioned in this study is the cause of death. Maybe those who became ill during the 16 years started taking more vitamins after that discovery. Vitamin use was self reported at years one, ten, and 16. Deaths were recorded up to year 20. No mention of vitamins A, E, D, C, and the other B vitamins.