Ruminations

Blog dedicated primarily to randomly selected news items; comments reflecting personal perceptions

Sunday, September 17, 2017

To Vitaminize Oneself -- or Not

"We take multiple different ones [supplemental vitamins], in combination with whatever prescription drugs we might also be taking."
"We've bought into the idea that these products are simultaneously miraculous and entirely safe."
"Wrapped in with all of that is the desire for longevity . . . to just feel good."
"It gets tricky to determine which ones [vitamins] have good science behind them and which don't."
Catherine Price, journalist, writer, Philadelphia

"What's the best available evidence? Is there good evidence that taking these things helps or improves outcomes?"
"There is very good evidence. People have studied this over and over and over again. And in otherwise healthy people, [vitamin supplementation] appears to do virtually nothing."
"It's not a definitive thing that they definitely increase mortality [people using antioxidant supplements]. But they shouldn't even have a hint of increasing mortality, because the whole point of taking them is to live healthier and longer."
"I don't have any skin in this game. I wish they worked. Who wouldn't?"
"It's a two-edged sword. They might think, 'I guess I don't need to eat properly anymore, because I'm taking these vitamins'."
"The best way to get your nutrients is through foods. If there's one [supplement] that has at least some evidence for benefit -- and likely no harm, unless used in mega-doses -- you could go ahead and take some calcium and vitamin D. But choose the least expensive you can find. And don't get too neurotic about it."
James McCormack, professor, faculty of pharmaceutical sciences, University of British Columbia
Woman looking at shelves of dietary supplement bottles
"B12 is another one that, as we get older, we may not be able to get sufficient food sources of."
"I don't think there's any evidence that an older person needs more vitamins [unless a specific health problem requiring supplemental nutrients exists]."
"I think people don't understand that they just take the supplements to be sure they are getting enough."
Stephanie Atkinson, professor, department of pediatrics, McMaster University

"There are the classic tea-and-toasters, where people [elderly retired on fixed incomes] are just having essentially tea and white bread with not much on it."
"Those are the people at really high risk for nutritional insufficiency."
"It's the purified capsules that really haven't shown to be beneficial [as opposed to an adequate, balanced diet]. Probably because there are multiple nutrients present in food, and recapitulating exactly which ones might be the best is kind of a false hope."
Dr. Mark Tarnopolsky, expert, neuromuscular diseases, McMaster University, Hamilton


A recent University of Alberta research team's goal studying whether there was evidence to support the belief that vitamin D substantially improves health outcomes, its devoted use reducing falls, fractures, rheumatoid arthritis, cancer and risk of early death led them to the conclusion that calcium-absorption vitamin D does have some benefit in the prevention of fractures and falls, but marginally. Of a study group of 45 to 57 people using vitamin D and calcium daily over a decade, one only would benefit from fracture avoidance. Additionally a small reduction in mortality risk was found in people aged 70 and older.      
Most people do not need to take vitamin supplements,  but in some situations, taking the pills may provide health benefits.  Image: Thinkstock

In searching for reliable scientific evidence to support the use of vitamin D supplements in the prevention of cancer, respiratory infections or rheumatoid arthritis or for the maintenance of mental well-being "no other effects are proven", the researchers stated. What they did discover was that on the evidence mega-doses of vitamin D could presage unexpected outcomes, inclusive of a potential increased risk of early death; now that's mind-fixing.

According to Statistics Canada, about 16 million Canadians, representing almost 50 percent of the entire population, made use of at least one nutritional supplement -- while in the U.S., dietary supplements are known to represent a $36-billion industry, amply demonstrating the generalized trust in the power of vitamins and dietary supplements for enhanced health and longevity. It isn't just vitamin D, of course, but the belief in marketing claims that antioxidants or omega 3s are hugely beneficial, burden our lives as well in the thought that they are disease-preventives and guard against premature death.

In genuine instances of vitamin deficiencies, the most common of which is scurvy or rickets, vitamin supplementation has proven to be hugely effective; in fact there are thirteen vitamins that the human body does require, to live healthily, that become confused in people's minds with the add-ons that are in fact, redundant if people consume a wide range of whole foods in moderation. Health Canada informs us that a balanced diet is capable of providing all the nutrients required to sustain good health for most people.

And it is people age 50 and up who most benefit from taking additional vitamin D. A 'moderate' daily dose of under 800 IU of vitamin D daily in combination with about 500 mg of calcium results in a reduction in fractures, osteoporosis, so that Health Canada cites a maximum daily dosage of vitamin D age 50 and up to be 4,000 IU as long as the users speak to their family doctor before embarking on regular supplemental use. The older we get the less able we are to synthesize vitamin D from exposure to the sun. And in northern climates like Canada's, winter exposure to sun diminishes our vitamin D intake.

B12 on the other hand is necessary to ensure normal nerve function and healthy red blood cells. Pernicious anemia can result from low levels of B12, a blood disorder causing fatigue and mental imbalance in thought and concentration. Again, it is older people whose absorption of B12 from foods becomes impaired, and even more so in the presence of regular antacid use. The propensity is of people geared feel that if the use of a vitamin is recommended, then perhaps increasing the dosage would be even more beneficial.

Yet the body can be overtaxed when people indulge in the belief that more is better, when it results in issues such as hypercalcemia; abnormal calcium levels in the blood as a result of taking excessive amounts of vitamin D. Too much vitamin A intake has been linked to bone loss, on the other hand, along with an increase in hip fractures. Dr. McCormack emphasizes that no absolute and consistent evidence can be relied upon that vitamin supplements will benefit healthy people.

Studies published in the journal Annals of Internal Medicine in 2013 found:
  • taking a daily multivitamin for 12 years failed to slow cognitive decline in male physicians age 65 and older;
  • high doses of multivitamins and minerals did not associate with reduced risk of a second heart attack, stroke or hospitalization for angina in people age 50 and older with previous myocardial infarction;
  • a review involving over 400,000 community groups randomly assigned to multivitamin supplements or single or paired vitamins discovered no clear evidence of a beneficial effect on cardiovascular disease, cancer or death from any cause.
On the other hand, an Iowa Women's Health Study found that multivitamin use was associated with a 2.4 percent increased absolute risk in mortality when 39,000 older women were studied. The Cochrane collaboration produced a 2012 report on antioxidants covering 78 randomized trials in which 300,000 people were studied to find no evidence exists in support of the use of antioxidant supplements to prolong life. Those using antioxidant supplements, in fact, were found to be marginally likelier [1.03 times as likely] to die early as opposed to those not using these supplements for it seems that beta-carotene and possibly vitamin E and A appear to increase mortality while vitamin C or selenium do not.

Credit: © ISTOCKPHOTO.COM/MARCEL NIJHUIS

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