Vitamin Information Center

Having too little vitamin D in the body might raise the risk of premature death, a study by Johns Hopkins researchers shows.

It follows other recent studies showing that low amounts of vitamin D are linked to certain cancers, diabetes, and bone and immune system problems, but this is the first research to connect vitamin D deficiency to a higher risk of death, said the study’s co- author Erin Michos, an assistant professor of cardiology at Johns Hopkins School of Medicine in Baltimore.

The study appears in this week’s Archives of Internal Medicine.

Michos and her colleagues analyzed data from a large government observational survey of more than 13,000 people who represented a realistic, diverse swath of U.S. adults ages 20 or older. Participants’ vitamin D amounts were determined through blood tests from 1988 through 1994.

By 2000, Michos said, 1,807 deaths had occurred, including 777 from cardiovascular disease.

The researchers divided the total population into four groups based on their amounts of vitamin D. One group included people with the least vitamin D, 17.8 ng/mL (nanograms/milliliter) or less.

A normal vitamin D test result for both children and adults is 30 ng/mL or more. Less than 20 ng/mL is considered deficient, and results between 20 and 30 ng/mL are labeled insufficient, said Catherine Gordon, director of the bone health program at Children’s Hospital Boston.

In the study, Michos said, people who had low vitamin D — 17.8 ng/mL or less — were 26 percent more likely to be dead at the end of the study than those with more.

Michos now suspects that low vitamin D is related to heart disease deaths, but that theory has to be tested in further studies, she said.

Originally published by USA TODAY.

(c) 2008 Tulsa World. Provided by ProQuest LLC. All rights Reserved.

Source: Tulsa World

Taking vitamin supplements does not improve health and may increase the risk of premature death, according to media reports.

A review of 67 randomised trials found that taking the supplements vitamin A, vitamin E and beta-carotene could lead to premature death.

The evidence for vitamin C and selenium suggested that the pills did not increase the risk of death, but there was no benefit in taking the pills compared with a placebo.

The researchers concluded that the current evidence does not support the use of antioxidant supplements in a healthy population.

There is no suggestion from the review, however, that a diet rich in natural sources of antioxidants could be damaging to health, say the papers.

Around 12 million people in Britain are taking vitamin supplements fuelling a £330 million industry.

What is the research?
The reports are based on the findings of a Danish study into the impact of antioxidant supplements on mortality rates.

A search of published literature and other studies held by manufacturers identified 815 trials. But only 67 were considered to be adequately run randomised controlled trials. These included 232,550 people aged an average of 62 years.

Twenty-one of the trials focused on the use of supplements in healthy individuals, while the rest tested patients with a range of diseases. Trials including children, pregnant women or patients with acute conditions, such as cancer, were excluded.

Antioxidant supplements were found to increase the risk of premature death in 47 trials.

Overall, antioxidant supplements were linked to a 4 per cent increased risk of death compared with placebo.

But when antioxidants were assessed separately, the researchers found that vitamin A was linked to a 16 per cent increased risk of premature death. For beta-carotene there was a 7 per cent increased risk of death and for vitamin E a 4 per cent increased risk of death.

The use of vitamin C or selenium did not increase the risk of death but showed no beneficial health effects compared with placebo.

Antioxidant supplements could lead to early death by eliminating too many free radicals, suggest the researchers. This could interfere with some essential defensive mechanisms such as apoptosis and detoxification, they say.

What do the researchers say?
Lead author Dr Christian Gluud, from the centre for clinical intervention research at Copenhagen University, called for better regulation of antioxidant supplements.

‘If a patient can eat a healthy, varied diet, then there is no need to take vitamin supplements. According to our results this may even be harmful.

‘Based on our results, as well as the results from other studies, it seems that these supplements might increase the progression of cardiovascular diseases and certain cancers.

‘It seems that the increased mortality comes from an acceleration of disease progression rather than from the development of new diseases.’

The team has not looked at whether a diet rich in natural antioxidants could be harmful to health but it would be good to conduct some large scale trials into this, said Dr Gluud.

What do other experts say?
Anne Sidnell, nutrition scientist at the British Nutrition Foundation, said: ‘The findings of this study are in line with other studies that have shown that antioxidants have no health benefits when consumed as supplements rather than through food.

‘Our bodies are designed to take in the correct amounts of nutrients from food, but there is a danger of overdosing when using supplements.’

There may be occasions when supplements are needed, such as vitamin D supplements for the elderly or folic acid for pregnant women, but overall a balanced diet is the best way to stay healthy, she added.

But Pamela Mason, nutritionist and spokeswomen for the Health Supplements Information Service, said: ‘Trials using antioxidant supplements have shown inconsistent findings and yet another review or meta-analysis is not going to tell us anything at this stage.

‘Antioxidants, including these noted in the Cochrane review, are essential for health and UK national dietary surveys have shown that some people have poor intakes of such nutrients.’

Antioxidants are not ‘magic bullets’ and were never intended for the prevention of chronic disease and mortality but for health maintenance, she added.

ONE in three of us takes them in a bid to boost our health and the UK market alone is worth £300million a year.

But now a major new study warns people who take vitamin supplements may not only be wasting their money, but SHORTENING their lives.

Brazil nuts … selenium

The review of 67 studies involving 230,000 people found that taking some vitamin pills could increase the risk of premature death by up to 16 per cent.

Researchers believe they may interfere with our bodies’ natural defence mechanisms.

Carrots … beta-carotene

Other supplements, including vitamin C, were found to have no effect, good or bad. Experts say a healthy, balanced diet should provide everything our bodies need.

Dietician Catherine Collins of the British Dietetic Association says: “It’s actually very hard to become deficient in most vitamins and minerals.

“For something like vitamin C, for example, it’s virtually impossible because it’s found in so many foods. And the body only absorbs the amount it needs, so more is not necessarily better.”

Here Sun Health looks at the study verdicts on key vitamins and minerals, and expert Catherine gives advice on how to get them from your diet.

VITAMIN A: Boosts immune system, helps with vision.

Study said: Supplements can increase risk of death by 16 per cent.

Found in: Animal products, eg milk, cheese and red meat, especially liver.

Catherine says: “Dairy foods in your diet should give you all you need.

“In fact, eating liver more than three times a week could mean you overdose on vitamin A.”

VITAMIN E: Protects fat in cells against damage that can lead to disease. Keeps the blood thin.

Study said: Supplements can raise risk of dying by four per cent.

Cheese … vitamin A

Found in: Seeds, nuts, corn oil and sunflower oil.

Catherine says: “Very easy to get in everyday foods. Even red meat and chicken has small amounts of it.”

VITAMIN C: Helps body absorb iron, speeds up repair process after injury.

Study said: Supplements won’t harm you, but no evidence they help either.

Found in: Oranges, kiwi, broccoli and peppers.

Catherine says: Five portions of fruit or veg a day will give you three times the amount that your body needs.”

BETA-CAROTENE: Powerful antioxidant that protects DNA in cells.

Study said: Supplements may raise risk of death by seven per cent.

Fish … selenium rich

Found in: Carrots, tomatoes, butternut squash and cabbage.

Catherine says: “The amount of betacarotene your body needs every day is very small. A little bit of cheese or cooking oil is probably enough.”

SELENIUM: Protects body against free radicals, the harmful molecules that attack and destroy healthy cells.

Study said: Supplements make no difference to health or life expectancy.

Found in: Brazilnuts, fish, wholegrains and meat.

Catherine says: “It’s incredibly rare to get selenium deficiency in the UK. Your body uses up very little of it so you need only tiny amounts.”

People who take vitamin supplements may not benefit their health and could increase the risk of premature death, according to a new report.

Danish researchers found that antioxidants do not prolong life expectancy as some may hope and that beta-carotene, vitamin A and vitamin E may actually increase the risk of death.

They did not uncover evidence that vitamin C and selenium have either positive or negative effects.

Their findings are based on a review of data from 67 randomised trials that involved just under a quarter of a million people and were released today by the Cochrane Library.

“We could find no evidence to support taking antioxidant supplements to reduce the risk of dying earlier in healthy people or patients with various diseases,” said Goran Bjelakovic, who performed the systematic review at the Copenhagen Trial Unit at the Copenhagen University Hospital in Denmark.

“Regarding these antioxidants we need more data from randomised trials. The bottom line is that current evidence does not support the use of antioxidant supplements in the general healthy population or in patients with certain diseases.”

Commenting on the review, the UK’s Food Standards Agency said: “Most people should be able to get all the nutrients they need by eating a varied and balanced diet.

“If consumers do choose to take supplements, it is important they are informed and they may also wish to also consult with their GP. For some vitamins and minerals, taking too much or taking them for too long can cause harmful effects.

Thousands of people pop vitamin pills every day in the hope of warding off that nasty bug, making themselves look better or even live longer.

But do these “magic” tablets really work?

The jury’s out but some studies suggest they could be a waste of money… and even do us harm.

And with Britons spending £300million a year on vitamin and mineral supplements, it’s a huge industry.

“The problem is that supplements are new, so there isn’t much research into their long-term effects,” says nutrition consultant Ian Marber.

However, there is some evidence of shortterm effects. Last year, Copenhagen University reviewed more than 815 clinical trials of the antioxidant vitamins A, C, E, betacarotene and the mineral selenium.

And produced some alarming results…

While vitamin C and selenium had no effect on lifespan, supplements of vitamins A, E and beta carotene actually seemed to raise the risk of premature death.

So what must you know?

Cancer danger

Worryingly, some studies have found links between supplements and cancer.

Researchers looking at whether supplements of beta carotene could reduce the risk of lung cancer gathered 18,000 American smokers in the 1990s.

Half were given beta carotene and vitamin A, while the others received a dummy pill.

“But researchers had to make the supplement group stop taking the vitamins two years early because there was a greater incidence of the disease in the group,” says dietitian Catherine Collins.

“A follow-up six years later found the risk continued even after people had stopped taking supplements.”

Last month, another study found that people who took vitamin E supplements - particularly smokers - may be at a 28 per cent increased risk of lung cancer.

But those results are not as clearcut as they first appear. Dr Ann Walker, adviser to the Health Supplements Information Service, says: “People on a lower dose of vitamin E had a lower risk of lung cancer and we don’t know whether those taking the higher doses were already ill.”

And she argues that there is evidence that a multivitamin may reduce cancer risk. “A study in 1997 found that people taking multivitamins were at lower risk of colon cancer,” she says.

But Henry Scowcroft, senior science information officer at Cancer Research UK, says that although some studies suggest supplements help, many suggest they don’t. Current advice remains that the best way to reduce your risk of getting cancer is by giving up smoking and following a healthy, balanced diet.

Heart help?

So, can supplements reduce the risk of heart disease? “We don’t recommend supplements,” says Victoria Taylor, senior dietitian at the British Heart Foundation.

“A 2005 review concluded that as high doses of vitamin E and beta carotene were linked with a higher risk of mortality, they shouldn’t be recommended.

“And the Women’s Health Study in 2005 found no benefits for the heart from taking vitamins A, C and E.

“Overall, there’s no evidence to support taking vitamins. Eating fruit and vegetables has heart benefits but it may be the plant nutrients and fibre that helps - we can’t assume it’s specific vitamins.”

General health

But what about overall well-being - should we take vitamins for immunity?

For most of us, no, says Catherine. “There’s no evidence the general population benefits.

“Our food today is of better quality and with more variety than ever before. There are arguments that poor soil quality from intensive farming means food doesn’t contain all the nutrients but there’s no evidence - if soil was that low quality, a plant wouldn’t grow.”

Pregnancy and childhood

There is solid proof, however, that certain people do benefit from some supplements.

If you’re trying to conceive or are in the first 12 weeks of pregnancy, the Department of Health recommends 400mcg of folic acid each day, to help prevent birth defects of the spine and brain.

But always take a supplement designed for pregnancy - a standard multivitamin can contain more nutrients than stated on the label, and high doses of vitamin A have been linked with birth defects.

“Young children can also benefit from a multivitamin, especially as we’re so cautious with the sun - we need sunlight to make vitamin D, essential for immunity and healthy bones, and low levels have been linked with conditions including multiple sclerosis,” says Catherine.

“Ensure they have a supplement designed for youngsters.”

SUPPLEMENT SAFETY

If you really want a supplement Catherine Collins suggests a multivitamin and mineral. “Nutrients work together and multivitamins contain them at a safe dose.”

However, don’t think you can survive on junk food topped up with huge doses of individual nutrients.

While excess water-soluble vitamins like vitamin C and the B vitamins will just be excreted, the fat-soluble vitamins A, D, E and K, are stored in the body and can accumulate. And the longterm effect isn’t known.

And avoid extra supplements on top of your multivitamin. “If you have specific needs, like PMS, look for a formulation designed for your condition,” advises dietitian Nigel Denby.

And if you’re on medication, check with your GP.

In human beings, coenzyme Q10 is the most common occurring form of coenzyme Q, needed by and found in every cell in the body. Perhaps its primary function is to ensure the production of adequate energy within the cell mitochondria, but coenzyme Q10 is also a powerful anti-oxidant, and is particularly important because it is the only fat-soluble anti-oxidant which can be manufactured within the body. Like other fat-soluble anti-oxidants, such as vitamin E, coenxyme Q10 is vital for the protection of fatty structures within cells from the damage and degeneration which may be caused by oxidative reactions and free radical activity.
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