Vitamin supplements: finally … advice for the really confused

Do vitamin study flip-flops have you totally confused? To help you sort things out, we've scrutinized the research and weighed the conflicting evidence. And now, we're confused too.

If you take vitamin E to ward off heart disease, you were likely shocked by the study published June 14 in The Lancet. Researchers reported that vitamin E capsules have no effect on the risk of death from cardiovascular disease--or on the risk of death from any other cause, for that matter.

So is vitamin E a waste of time and money? The answer is simple. Yes and no.

The numerous patients studied indicated some risk factor for a pre-cardiac condition. In other words, they weren't necessarily free of heart disease. So the study suggests that if you already have heart disease, taking vitamin E won't prolong your life.

But if you have a healthy heart, will long-term vitamin E supplementation actually keep you from acquiring cardiovascular disease? OK ... that we still don't know.

Right Is Wrong

Meanwhile, experts say vitamin E ingested in the form of food is absorbed much more readily than from capsules. So we should eat more walnuts and other E-rich foods, right? Right. And then, we wouldn't need vitamin E capsules, right? Wrong.

The National Academy of Sciences (NAS) says we don't need supplements if we're getting a minimum of 15 milligrams (mg) of vitamin E a day--as long as that intake is coming from better-absorbed food sources. The catch? The NAS also says most people get only half that amount from their diets.

So unless you double your intake of vitamin E-rich foods, there's only one answer: vitamin E capsules.

But vitamin E won't help with whiplash--which many readers got doing a double-take after a large study on seniors appeared July 6, 2002, also in The Lancet.

Oxford University researchers found that taking several different antioxidant vitamins--C, E and beta-carotene--produces no health effect. So these vitamins are useless? Well, not exactly.

Doses were too small for an effective test. The 250 mg dose of vitamin C is too little to measure disease-prevention effects--except maybe for scurvy.

Also, the study was not conducted over a long enough period of time. Finally, only seniors participated in the study.

Both and Neither

But then a similar study appeared 2 days later. In the July 8, 2002 issue of the Archives of Internal Medicine, researchers found that vitamins E and C and multivitamins do not reduce heart-related deaths. So these supplements don't help the heart, right? Let's back up a bit.

Oxidation of fat particles in the blood leads to hardening of the arteries. Antioxidants retard this process.

Numerous lab tests, animal studies and a few--unfortunately small--human studies confirm this benefit, especially in the case of vitamin E.

Also, a study in the June 26, 2002 Journal of the American Medical Association (JAMA) concluded that "high dietary intake of vitamins C and E may lower the risk of Alzheimer's." So at least for Alzheimer's, vitamin pills work, right?

Well, not necessarily. You see, this study referred to "dietary intake"--in other words, vitamins found in food. So the study does not mean that Alzheimer's risk can be prevented by vitamin supplements. Then again, a study in the June 29, 2002 JAMA--yup, just 3 days later--concluded that vitamin E supplements actually do, indeed, decrease the risk of Alzheimer's disease.

Maybe these two teams should compare notes--you know, get fax machines.

Previous studies showing health benefits from vitamin supplements were, admittedly, smaller samplings. But they also used longer terms or higher doses. And that's a crucial difference.

Definitely Perhaps

With so much confusion, scientists analyzed all vitamin studies from 1966 through January 2002 to see which way the wind blows. Their June 19, 2002 JAMA meta-study--yes, that's three studies in the same month--concluded, "Some are at higher risk for ... sub-optimal vitamin status ... linked to coronary heart disease, cancer and osteoporosis." That suggests vitamins are needed for insurance against these diseases. Think that clears things up? Scientists also say there's no proven benefit from taking vitamins as insurance. And a June 24, 2003 JAMA study reported increased osteoporosis risk from both too much vitamin A--and too little.

That July 6, 2002 autioxidant study in The Lancet concluded we should get vitamins from produce, not pills. But hold the phone.

On July 5, 2002--a day earlier--Canadian scientists reported that vitamin A content in produce has plummeted 68 percent in 50 years. Iron content dropped by 76 percent, among others.

Modern farming is cited as the culprit. You'll need six oranges to get the nutrition of one orange from the past--unless it's been in your fridge since the 1950s. Without supplements, you'd need to eat a whole lot more to get the same vitamins.

A Solid Maybe

But something nags me about increasing food intake, as I sit here on stacks of studies about rampant obesity. Obesity increases the risk of--you guessed it--cancer and heart disease.