Showing posts with label Are multivitamins safe?. Show all posts
Showing posts with label Are multivitamins safe?. Show all posts

04 February 2013

Ian Gawler Blog: Do supplements shorten lifespan?

Could taking a daily multivitamin and multimineral pill shorten your life? Not many in the public would seem to think so given that these pills are the most common form of supplements taken in the world. Yet several large studies from 5 to 10 years ago were pretty clear; such pills could take up to 7 or 8 years off your life!

Now a new study from Melbourne throws new light on the question – a must read for health practitioners and people generally. But first

Thought for the day
Dream the impossible. 
Know that you are born in this world to do something wonderful and unique. 
Do not let this opportunity pass by. 
Give yourself the freedom to dream and think big.
                                                                Ravi Shankar

The right question to begin with is why take a generalised multivitamin/multimineral supplement at all? For most the answer would seem to start with their knowledge that the quality of our food has been degraded by commercial growing practices. Then there is the environmental pollution we all face, coupled with the stresses and strains of a modern, busy life. Fast food, junk food, eating in a rush, eating what happens to be there. Lots of concerns, and then the hope that extra vitamins and minerals taken via a pill will at least compensate, maybe even be good for us.

Seems like a reasonable proposition. But then in 2003 large meta-analyses (the collated results of many individual studies) began to be published and continued to appear over the next 5 years with findings that showed a shorter life span was associated with popping these particular pills.

Needless to say there was a big discussion. Advocates of supplementation came out strongly, claiming the individual studies had a range of flaws. Poor sample selection was discussed, the health of those studied and synthetic vitamins were blamed (chemically produced vitamins rather than naturally derived versions). 

At the centre of it all, Vitamins A and E seemed to be the main culprits, but to my knowledge no manufacturer has come forward and offered to produce a multivitamin/mineral supplement without A and E. Of course, some people may well benefit from specific supplements such as selenium, iodine, iron, magnesium, vitamins D and B12 etc; but that is where specific advice from a doctor trained in nutritional medicine or a good naturopath comes into their own and may well need to be consulted.

In 2009, with a good deal of input from my colleague Prof George Jelinek, I co-authored a discussion paper focussed on the key articles available at the time, (to view, click here) and concluded the following:

1. Food is the best source of human nutrition. 

2. People eating a healthy diet and living a healthy lifestyle are rarely likely to need nutritional supplements. 

3. There is strong evidence that taking supplements of vitamins E and A shortens life. 

4. More research is needed in this field. 

5. There may be a case for a multivitamin/mineral supplement that does not contain vitamins E or A.

In the new edition of You Can Conquer Cancer, which includes recommendations on food and supplements for people who are basically healthy, as well as for those with cancer, I commented further:

“I know of no studies being published regarding the long-term use of Vitamins A and E by people affected by cancer, and maybe they are OK short term, but the caution (for those who are well and take them long-term) needs to be stated”.

However, what we do know (as reported in a July 2012 blog), is that a study in 2011 found that for women with breast cancer who consistently used multivitamins before and after diagnosis and ate more fruits and vegetables, as well as being more physically active had better overall survival. As well, these researchers concluded multivitamin use along with the practice of other health-promoting behaviours may be beneficial in improving breast cancer outcomes in select groups of survivors. Since that blog, more research relating to cancer has come to light, so next week I will update that specific area.

But now we have a new, large meta-analysis involving twenty-one studies which generated a total pooled sample of 91,074 people. The people studied were all independently living adults (not having cancer), their average age was 62 years, a general supplement was taken daily, and the average duration of supplementation was 43 months (so not a very long time for this type of trial). 

The results?
Across all the studies examined, there was no demonstrable effect of multivitamin-multimineral supplementation on all-cause mortality. However, there was a trend for a reduced risk of all-cause mortality across primary prevention trials. Multivitamin-multimineral supplementation had no effect on the risk of dying due to vascular causes or cancer. 

The Conclusion? The researchers state: multivitamin-multimineral treatment has no effect on mortality risk.

So what to do?
If you are well, stick with point one and two from Plan A above, – as much as possible, rely upon good food – it needs to be organic to qualify – and a healthy lifestyle. If travelling or under stress, a general supplement may make sense until things are back in balance again. 

If you are recovering from injury or illness, a high quality general supplement from natural sources may make sense, but food is still number one. Good supplements will never make up for bad food. And juices are a great way to add extra nutrients to your diet from natural, well balanced sources. 

RESOURCES
1. The reference for this latest article:  McPherson H et al;  Multivitamin-multimineral supplementation and mortality: a meta-analysis of randomized controlled trials.  Am J Clin Nutr February 2013 97: 437-444

2. You Can Conquer Cancer. The new edition has an extra chapter on nutrition and much more detail on the whys and hows of healthy eating – for wellness or for recovery.

3. CDs Eating well, Being well: Details the Wellness Diet 

Eating for Recovery: Details recommendations for those with cancer. This Cd builds on the previous one, so people with cancer are advised to study both.

RELATED BLOG

Multivitamins and cancer

NEWS
Lord Maurice Saatchi, co-founder of the famous advertising agency Saatchi and Saatchi, recently supported his beloved wife through a tough and fatal cancer. Now he wants the English laws regarding cancer research to be changed to allow for more sensible experimentation in cancer research. Citing the lack of progress in this field, and the tough treatments he saw his wife endure unsuccessfully, he is a powerful advocate for a new approach. Not for the faint hearted, but a compelling interview on the BBC, December 2012. For a transcript or to view the interview – link here.




17 July 2012

Ian Gawler Blog: Multivitamins and cancer –

This week a very interesting piece of new research concerning multivitamins and breast cancer, and a little more of the travels, but first,

Thought for the day:

We believe nothing so firmly
 as what we least know
                                    Michael de Montaigne

Multivitamins improve some breast cancer outcomes 
– The Life After Cancer Epidemiology study.

Given how many people believe in and take multivitamins, it is a remarkable fact that little research has been published that scientifically investigates the relationship between multivitamin use and cancer outcomes.

Remarkable too, given this lack of research evidence, that many patients are told by oncologists that they are harmful, especially when taken with chemotherapy or radiotherapy. How do they know this? What is the evidence?

A new study, one of the first of its kind, provides some answers; answers that strongly suggest multivitamins may be helpful for women with early breast cancer, especially if they do have chemotherapy or radiotherapy. It also demonstrated that a healthy lifestyle extended survival.

In this study, 2,236 women diagnosed from 1997 to 2000 with early-stage breast cancer were questioned about their multivitamin use pre-diagnosis and post-diagnosis.

Outcomes were then tracked yearly by self-report and verified by medical record review. The results were analysed, adjusting for socio-demographic, tumour, and lifestyle factors.

Overall, 54% of the women reported using multivitamins pre- diagnosis, and 72% of them post-diagnosis.

The use of multivitamins after diagnosis was not associated with any outcome – good or bad.

Persistent use of multivitamins before and after diagnosis was associated with a decreased risk of recurrence and total mortality that was not statistically significant.

However, protective associations from the multivitamins were found amongst those women who had been treated after initial surgery with radiation only, and both radiation and chemotherapy. To be clear, this research showed that multivitamins were not harmful, but actually improved outcomes when radiation or radiation and chemotherapy was given.

The research also demonstrated that women who consistently used multivitamins before and after diagnosis and ate more fruits and vegetables, as well as being more physically active had better overall survival.

The researchers concluded multivitamin use along with the practice of other health-promoting behaviours may be beneficial in improving breast cancer outcomes in select groups of survivors.

REF: Kwan ML et al, Breast Cancer Res Treat. 2011 Nov;130(1):195-205. Epub 2011 May 11.

 2. Moscow is red.

We hear from the house sitter that the Yarra Valley continues to be cold and wet. Pardon me, but Russia’s weather was delightful – mid 20s and 5 minutes of rain in 2 weeks.

Who knew that in Russia, red means beautiful?

So the Red Square is the beautiful square. But it is next door to the Kremlin, which means fortress, and as we stroll across it like A-grade tourists, I cannot help thinking of James Bond and cold wars and Nikita Kruschev with his finger on the trigger of nuclear annihilation being stared down by JFK over the Cuban missile crisis.

It is a strange thing to be in this part of the world. The sun is shining. People are walking and talking. Children are laughing and playing. No obvious signs of revolutions past, of Stalin’s savage repression, of the communist regime’s days of power, or even of the Russian mafia and the move to democracy and a more capitalistic way of life. Just heaps of tourists, lots of work going into restoring things that interest tourists, incredibly clean streets, people getting on with their lives. As simple as that really.

And we walked through the Kremlin and across Red Square.

Then we did what so many of Russia’s Jews did – moved on to Israel.

NEWS

 Israel workshops etc July 18 - 28

It will be a great pleasure to be back in Israel once more where I have been invited to make a variety of presentations. If you know anyone in Israel who may be interested, please forward the details.

i) Wednesday July 18th, 19:30-22:00, Evening Talk 
The Art of Living and Dying: contemplation, meditation and healing
Seminar Hakibutzim, Tel-Aviv
Sponsored by Tovana, Israel Insight Meditation Association

ii) Friday July 20th, 09:00-14:00, Master Class Workshop for Health Professionals 
An Integrative Approach for Major Illness - Applications of Meditation and Mind-Body Principles
Rabin Medical Center
Sponsored by the Integrative Medicine Department, Davidoff Cancer Center, Beilinson Hospital

iii) Friday July 27th, 09:00-16:00,One Day Workshop for the General Public
Health, Healing and Well-being: the Healing Power of the Mind
Beit Rishonim, Bitan Aharon
Sponsored by Taatzumot Association

iv) By Invitation Only:

Wednesday July 18th, 16:00-18:30: A meeting with leading Dharma teachers.

Saturday July 28, 19:00-22:00: An evening with leading integrative therapists and physicians.

For more information or registration:

Dr. Nimrod Sheinman, 0544-797466, nimush@zahav.net.il

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