Blind World

Do you need more vitamins?
Why the medical jury is still out on benefits of supplements.

June 15, 2004.

By Mary Beth Faller,
Arizona Republic.

We all know we should eat our vegetables - five servings a day, according to the government's food guidelines. That provides the minimum amount of vitamins, minerals and other nutrients that scientists say the human body needs to work at peak efficiency.

But let's face it, most adults don't do it.

In a landmark recommendation in 2002, the American Medical Association acknowledged that most people don't eat enough fruits and vegetables, and adults should take a multivitamin supplement every day.

But what about beyond that once-a-day pill? Will extra vitamins help? The body produces many amino acids, hormones and other substances in amounts that begin to decrease after age 45. Should they be artificially replaced?

"We were only designed to last until about 45," says Ronald Klatz, a doctor and president of the American Academy of Anti-Aging Medicine in Chicago. "We're living in a synthetic environment and because of that we're able to live not one lifespan but two or three."

Slowing aging process.

Klatz and other advocates believe supplements - lots of them - can help delay some of the natural effects of aging and ease the symptoms of aging-related disorders.

"The optimal daily requirements of vitamins were only established to prevent disease," he says. "That's like saying two cups of water a day will prevent you from dying of dehydration. You need two to five times the recommended daily allowances for health."

No pill can reverse aging. The body ages at the cellular level, because of oxidation, when cells break down and damage other cells. The body's ability to repair this damage decreases with age, but powerful substances called antioxidants may slow that process. Fruits and vegetables contain antioxidants, such as vitamin C and beta carotene.

Doctors who advocate supplements say that even if people eat well, they can't get enough nutrients.

"You would need to eat 30 heads of broccoli a day" to get enough antioxidants, says Alan Miles, an anti-aging physician in Sun City. "It would be impossible to get the quantity of nutrients you need . . . to prevent oxidation."

But beyond the daily multivitamin, many doctors are loath to recommend anything that hasn't been backed up by the results of several controlled studies, and most supplements have not been subjected to rigorous study.

Klatz says that's because many studies are funded by the pharmaceutical industry, which has little interest in discovering whether non-regulated supplements have healing powers.

Another reason is that good studies take many years, and the supplement industry is relatively recent. The Journal of the American Medical Association reported that sales of herbal supplements have doubled since 1985.

But people in the throes of hot flashes or a painfully enlarged prostate don't want to wait years for study results. They want relief, and many take supplements without their doctor's recommendation.

Studies inconclusive.

Some supplements have been proven to help. There is no dispute that calcium supplements help to prevent osteoporosis, and vitamin A tablets can slow the progression of retinitis pigmentosa, an incurable disease that gradually destroys the retina and optic nerve. In 2003, a University of Kentucky scientist reviewed 22 studies and found that supplements of glucosamine, a substance found in the body's joints, significantly helped ease knee pain and increase mobility in people who had osteoarthritis.

Some results are hard to pin down. A widely publicized study published in JAMA in 1997 showed that gingko biloba appeared to boost memory in older people with dementia. But in 1998, researchers in Oregon looked at 50 studies of ginkgo biloba, including the one published in JAMA, and found serious flaws in all of them that cast doubt on whether the herbal supplement really works.

St. John's Wort is a popular herb taken to ease depression. Results of several studies on whether it works are mixed, but a 2000 study by scientists in Sweden found that taking it interfered with anti-rejection medication as well as drugs taken by people with HIV.

But the popularity of supplements has launched more studies. The National Institutes of Health started a large six-year study in 1999 on gingko biloba and dementia. Saw palmetto was the fifth most common herbal remedy sold in the United States in 2002, according to the National Institute of Diabetes and Digestive and Kidney Diseases. The Office of Dietary Supplements is running a large study on whether saw palmetto eases urinary-tract problems in men with benign prostate disorders.

Doesn't replace diet.

The AMA and the American Dietetic Association discourage the use of supplements for several reasons, including the potential to interfere with prescription medicine, questions about purity, and the fear that people who take supplements will think diet is less important.

Johanna Donnenfield, a registered dietitian and teacher at Scottsdale Community College, says that while she would recommend calcium and a multivitamin, supplements don't provide everything that food does, such as fiber and moisture.

"Supplements should never be a substitute for a poor diet," she says. "I want people to eat a lot of fruits and vegetables and I don't want to give them an excuse to not do it. Nutrition is a new science, and there's a lot we don't know about how the nutrients in food are absorbed compared with supplements.

"Do the healthy lifestyle first before you go spend a fortune on supplements. Calcium supplements help prevent osteoporosis, but maybe that's because we're not getting enough exercise. St. John's Wort has been shown to bring some relief from mild cases of depression, but so does exercise."

But many people are believers.

Trish Clark, 49, of Phoenix, has taken supplements on and off for several years, and said she was tested recently at Advanced Health and Wellness Center in Phoenix, where the pharmacist found she was deficient in potassium. She started making mineral water from a kit containing drops of several minerals and now feels more energetic and alert. She also takes antioxidants, as well as ginkgo biloba for mental clarity.

"I see a huge difference between when I take them and when I don't," she says. "I've noticed a lot of improvement."

John Villegas-Grubbs, 48, of Phoenix, takes niacin to balance his prescription for a cholesterol-lowering drug.

"My father died at age 41 of a heart attack, and the disease runs in my family, so I take high levels of vitamin E and selenium as well as co-enzyme Q10."

Villegas-Grubbs says niacin improved his skin and hair in two weeks.

"People can't believe I'm 48 years old," he says.

He also takes the supplement S-Adenosylmethionine, or SAM-e, which improves joint and liver function as well as enhances mood, and says that when he stops taking it, he's much more irritable.

His doctor, Gregory Johnston, has an anti-aging practice in Phoenix.

"It still gets down to weight loss and diet and exercise and the things that are obvious, like keeping your cholesterol down and watching your blood pressure," Johnston says. "The vitamins can't be seen in a vacuum. If I just gave you hormones and supplements and you did nothing else, you're not going to get as good results as if you exercise as well."

There's no one-size-fits-all supplement regimen, doctors say, because each patient is unique.

The lack of studies doesn't keep Johnston from encouraging supplements.

"There's a lot more art to this than science." Copyright 2004,

End of article.

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