Healthy Blessings,
Cheryl.
**********
Dear
Some of you may have been asking me about the November
2010 article in Prevention Magazine titled "Should You
Kick the Multivitamin Habit?"
In short, the article concluded that multivitamins
provide no proven benefit and may actually cause harm.
The readers of prevention were encouraged instead to
focus on supplements containing vitamin D, omega-3
fatty acids and calcium.
So, the question becomes "Are multivitamins dead?"
Should we ignore the old advice that a multivitamin is
a good insurance policy.
Let me put this article in perspective by making a few
observations.
1) It is very difficult to prove that any intervention
is beneficial in an essentially healthy population.
Prevention magazine cited a large meta-analysis and a
very large study of post-menopausal women as providing
evidence that multivitamins provide no benefit.
These are both what scientists call primary prevention
trials, meaning that you are asking whether the
intervention provides significant benefits to an
essentially healthy population. And it is very
difficult to demonstrate benefit in a primary prevention
study.
Let's review the evidence on statin drugs, for example.
Statin drugs are considered by most physicians to be
very effective at preventing heart attacks and are
recommended for virtually everyone with elevated
cholesterol.
But, as I mentioned in a recent "Tips From the
Professor", a recent meta-analysis of primary
prevention studies of statin drugs for patients who had
elevated cholesterol levels but were otherwise healthy
found that the statin drugs provided no measurable
reduction in either deaths from heart attacks or deaths
from any cause (Archives of Internal Medicine, June 28,
2010 issue).
If you can't show that statin drugs provide any benefit
in a healthy population with elevated cholesterol
levels, is it any wonder that it is difficult to show
benefits of multivitamin supplementation in healthy
populations with no apparent risk factors of disease?
I don't hear any clamor to stop prescribing statin
drugs. I wonder why there is such a hue and cry to stop
using multivitamins. Is it possible that some
individuals and organizations have an anti-supplement
bias?
2) If you wish to demonstrate the effectiveness of an
intervention, you need to focus on those individuals
who are actually at risk.
For example, statin drugs are clearly effective at
reducing heart attack risk if you focus on populations
who have already had one heart attack or who are
otherwise at high risk of having a heart attack.
Similarly, vitamin E at levels commonly found in
multivitamins cannot be shown to decrease the risk of
heart attacks in healthy women as a whole, but it
significantly reduces the risk of heart attacks in
women over 65 - which is the population group that is
at high risk of heart attacks (JAMA, 294:56-65, 2005).
Similarly, folic acid, at levels commonly found in
multivitamins did not reduce the risk of heart attack or
stroke in men and women with adequate folic acid levels
in their blood, but did reduce the risk of both for
those individuals with inadequate levels in their blood
(New England Journal of Medicine, 354: 1567-1577,
2006).
I have given other examples in my previous "Tips From
the Professor", but I think you get my point.
The Prevention article made the point that most
multivitamin users are healthy individuals who are
taking good care of themselves. That raises the
question of whether multivitamin use is only needed by
those individuals who are in poor health and/or are not
taking care of their health - in short, those who are
at high risk of disease.
My perspective is that very few of us do ALL the right
things.
And there are often environmental or genetic risk
factors that we are totally unaware of. All too often
the first indication of heart disease risk is sudden
death!
...To be continued....
Next week's topics:
3) Not all multivitamins are the same.
4) Multivitamins are good, but you can do better.
5) The risks of multivitamin use have been over-hyped.
To Your Health!
Dr. Stephen G Chaney
****ABOUT DR CHANEY:
Dr. Stephen Chaney, Phd
Dr. Chaney has a BS in Chemistry from Duke University and a PhD in Biochemistry from UCLA. He currently holds the rank of Professor at a major university.
Dr. Chaney has taught biochemistry to medical and dental students for more than 30 years and has won several awards for teaching excellence.
He runs an active cancer research program and has published over 100 scientific articles and reviews in peer-reviewed scientific journals. He has also written two chapters on nutrition for a popular medical biochemistry textbook.
Dr. Chaney and his wife have also built a business part time that has earned them a 6 -figure income for the past 15 years and he has spent the last 10 years teaching other people how to do the same.
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