Do Vitamin Supplements increase Mortality?

October 2011 Study says Vitamin Supplements increase MORTALITY

Scientists analyzed data from the Iowa's Women’s Health Study and found certain vitamins and minerals (folic acid, vitamin B6, iron, magnesium, zinc, copper) increased mortality by 2.3 to 15% over 20 years, with multiple vitamin users increasing 2.4%, usually to Scientists a non-significant difference.

Another report from a follow up of the SELECT study testing vitamin E and selenium on prostate health said that even on follow up after the vitamin E users stopped taking vitamin E, their prostate cancer risk was still slightly elevated.

One needs to, of course, put things in perspective. NOT mentioned in the Iowa's study was that mortality was reduced by some of the other nutrients in multiples not listed in these studies. Lots of number juggling here to arrive at these conclusions as well. There are far too many positive studies of supplements that prove the opposite. One study mentioned above used a less that reliable scientific method of just having people report what supplements they took and this recall without any given specifics was then used to link with mortality rates. Without knowing the cause of mortality (death), it is difficult to establish if there is a plausible link to vitamin actions.

Food for Though: Is it acceptable to assume a little risk from vitamin use when benefits are so plentiful?

 Back to these studies, no explanations could be offered by the study authors as to the mechanisms driving these findings. If you have already read the Vitamin Criteria on this website, you would have gained some of the knowledge that will most likely be the future findings of scientific research. These include NO IRON, unless anemic and under MD's care, to limit the free radical negative oxidizing effects of iron. Next, limit Folic Acid to 200 mcg for Seniors since folic acid could increase tumor growth rates, and high folic acid with low vitamin B12 also has contra-indications in Seniors for dementia and anemia. For magnesium, there is more science for an increased mortality at lower levels, but also some at higher than normal levels in this reference.* Obviously there are always some exceptions due to genetics, lifestyle, and environmental influences. Zinc is mostly positive for reduced mortality, especially due to wound healing and infection fighting. Then there is also the possibility that higher dosage vitamin E might act as a blood thinner increasing Hemorrhagic or bleeding strokes while reducing Ischemic or clotting strokes.

*In this reference, the term Hypomagnesemia is used that needs an explanation. Hypomagnesemia means magnesium is low in the BLOOD. Low blood levels can occur even if body levels of magnesium are normal. Hypomagnesemia may result from a number of conditions including inadequate intake of magnesium, chronic diarrhea, malabsorption, alcoholism, chronic stress, and medications such as diuretic use among others

The Women's study has at least 2 assumptions that need to be examined. Remember the Women's results are just associations and not cause and effects. First, the causes of death need to be mentioned to see if there is a possibility of a vitamin or mineral connection. At the start of the study only about 60% of women took one supplement, while at the end it was 85%. Did they start taking vitamins after a health condition developed? This alone could be responsible for a significant part of the results.

Next, it is important to know what vitamins and the dosages and forms they took to gain insight to increase future safety. This website's precautionary principles for vitamin supplement consumption could potentially prevent or significantly reduce most of these known vitamin adverse effects, even though the scientific community doesn't officially recognize them yet. There are certain beneficial windows of dosages as well as forms that are involved.

Counter Mineral Study

Check out the results of this study, ref. Higher magnesium means lower mortality while higher copper equates to higher mortality. Not much weight can be given this study because mineral blood levels for magnesium, zinc, and copper were only recorded once at start. They could have been influenced by particular foods eaten in the diet before that were higher for some minerals but the diet changed after test. "Conclusions: High serum copper, low serum magnesium, and concomitance of low serum zinc with high serum copper or low serum magnesium contribute to an increased mortality risk in middle-aged men."

TAKE AWAY: Yes, some vitamins in certain dosages and forms may have adverse effects on health or disease conditions. Stay within a certain dosage range and use proper forms and one is protected against many diseases. It all has to do with an optimal range, maintaining nutrient ratios, and proper nutrient forms according to body wisdom. WHY is this concept so difficult for Science to comprehend? BECAUSE the proper dosage range varies in different subsets of people and at different ages and nutrients can play different roles before a disease is present compared to after it develops. Some changes are actually generated by the disease condition.

Example: Tumors can speed up the breakdown of the active form of vitamin D into a non-active form. Plus they prevent the further activation of new active vitamin D, since Vitamin D activities are destructive against infections and tumors.

More on this topic is coming as well as can be found in other articles on this website.

Why Do Scientists Set Up Vitamin Studies to Fail

Imagine a study using contradictory nutrients hoping to find a beneficial value for one of them. Below is copy from just such a study abstract. ref

"Eur J Prev Cardiol. 2013 Jun 17. [Epub ahead of print]
No effect of n-3 (Omega 3) fatty acids on high-sensitivity C-reactive protein after myocardial infarction: The Alpha Omega Trial.
Hoogeveen EK, Geleijnse JM, Kromhout D, Giltay EJ.
Source
Department of Internal Medicine and Nephrology, Jeroen Bosch Hospital, Den Bosch, The Netherlands.
Abstract
BACKGROUND:
Persistent inflammation plays a role in the pathogenesis of atherosclerosis. n-3 Fatty acids may have anti-inflammatory effects. This study examined the effect of plant-derived alpha-linolenic acid (ALA) and marine n-3 fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) on high-sensitivity C-reactive protein (hsCRP), a systemic marker of (low-grade) inflammation.

DESIGN/METHODS:
A supplementary study in the Alpha Omega Trial: a multicenter, double-blind, randomized, placebo-controlled trial of low-dose n-3 fatty acids. Patients were enrolled from 2002 to 2006 and followed for 40 months. A total of 2425 patients, aged 60-80 years (79% men), with a history of myocardial infarction, were randomly assigned to margarines supplemented with a targeted additional intake of 400 mg/day EPA and DHA, 2 g/day ALA, EPA-DHA plus ALA, or placebo for 40 months.

RESULTS:
Patients consumed on average 19.8 g margarine/day, providing an additional amount of 238 mg/day EPA with 158 mg/day DHA, 1.98 g/day ALA, or both, in the active treatment groups. In the placebo group, the geometric mean hsCRP (95% confidence interval (CI)) was 1.84 mg/l (95% CI: +1.70 to +2.00) at baseline and 1.98 mg/l (95% CI: 1.82 to 2.15) after 40 months (p < 0.0001). hsCRP levels were not affected by ALA (-5% versus placebo; 95% CI: -14% to +6%, p = 0.37), EPA-DHA (-8% versus placebo; 95% CI: -17% to +2%, p = 0.13), or EPA-DHA plus ALA (-3% versus placebo; 95% CI: -12% to +8%, p = 0.62).

CONCLUSIONS:
Long-term supplementation with modest amounts of EPA-DHA, whether or not in combination with ALA, did not affect hsCRP levels in patients with a history of myocardial infarction. TRIAL REGISTRATION CLINICALTRIALS.GOV NUMBER: NCT00127452.

KEYWORDS:
alpha-linolenic acid, docosahexaenoic acid, eicosapentaenoic acid, high-sensitivity C-reactive protein, n-3 Fatty acids, randomized double-blind placebo-controlled trial

PMID: 23774275 [PubMed - as supplied by publisher]" --end copy

ANALYSIS: Many studies have shown positive results for omega 3 fatty acids on curbing inflammation. ref  While this study attempts to measure the anti-inflammatory abilities of omega 3 as EPA and DHA, the Scientists set up a very strange scenario. They used a large amount of margarine to carry these omega 3's into the body. This is like a fireman using gasoline to put out a fire. Margarines generally supply mostly omega 6 fatty acids which on breakdown in the body can generate inflammation if not enough omega 3 as EPA is present to balance this effect. (the margarine may also have contained trans-fats) So it is quite puzzling why such a little amount at 400 mg of omega 3 was tested while giving such a large dose at 19.8 grams of margarine which probably contains a significant amount of omega 6. The Scientists that conducted this study surely are not ignorant of the balance the body needs between omega 3 and omega 6 in controlling the inflammatory response? A healthy ratio is under 5 to 1, omega 6 to omega 3. ref This study used a 20-35 to 1 ratio, depending on if the margarine was low fat or not. Some Margarines today have added omega 3 in an attempt to overcome this unhealthy ratio. 

So the question that has to be asked; did they set out to fail?

Regarding the Scientists of this article, they conducted a similar study 2 years before this one and somehow arrived at a positive result. So it was logical to continue with another similar study. ref 

A Final Test of Analytical Skill

DO VITAMIN SUPPLEMENTS HELP REDUCE CVD OR OTHER MAJOR DISEASES?

This research under analysis appears to represent a real challenge. Here is the article that reviews the effects of vitamin studies to improve health in people who suffer with CVD or other major conditions. The results, NO improvements and the conclusion is that vitamins have NO benefits and it is time to stop wasting money on vitamins that don't work.

Analysis: For once in this section, this author is almost 100% in agreement with these results. BUT, the conclusions these highly respected Medical Professionals draw from this meta-analysis approach needs some clarification, or more understanding. The real conclusion, according to Scientific Method Protocols, should be that the vitamin dosges and forms tested DID NOT exhibit value under these disease conditions to elicit health benefits.

WERE THE WRONG FORMS AND DOSAGES USED?

Next are the reasons the form of vitamins used did not produce benefits with the corrected forms that should be tested.

1. Beta Carotene: There are over 600 forms in the carotenoid family. To rely on just one proved in these studies to not show value by itself. The only form tested was the synthetic form, all-trans beta carotene. There exists a natural product of beta carotene, an algae called D. SALINAS that contains many forms of beta carotene similar to what nature puts together in plant foods. Also included with all-trans are the 9-cis and the 13-cis beta carotene forms. Plus some other carotinoids as well, such as alpha carotene, lutein, and zeaxanthin. Maybe it is time to drop the synthetic only all-trans form and just use natural sources for beta carotene that include related carotenoid factors.  

2. Vitamin E (alpha tocopherol) used in studies represents just one form out of 8 family members that exist in nature. Plus, most often the synthetic form is used. It is far past time to retire the synthetic form of dl'alpha tocopherol with it's multitude of failed study results. Even the isolated natural form should be limited and only used with the other 3 tocopherols also present.

Here is a surprising study by a Doctor. The study meausred blood levels of vitamin E forms in heart patients compared to healthy controls for the four tocopherols found together in many vitamin E foods. The alpha tocopherol blood levels were the same in both groups. Since only alpha tocopherol is called vitamin E, it seems strange to believe that adding more would be of value when it was not lower than the amount in healthy people. It was another form of the vitamin E group from nature that was lower in heart patients than in healthy people, gamma tocopherol. Wouldn't this imply that gamma tocopherol might be the one to supplement?

There is a unique twist here that could explain the real facts. The body can convert the 3 other forms of tocopherols, beta, delta, and gamma, into alpha tocopherol if more of it is needed. Obviously, the body knows the value of alpha tocopherol in protecting the blood against oxygen radicals. Thus, more alpha tocopherol is probably needed in heart conditions, but it may be wise to supplement the whole family of vitamin E since all the forms have unique as well as similar functions. The gamma tocopherol form is needed to neutralize and prevent damage from nitrogen radicals since the alpha form does not work against them. 

To be continued.