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Recommends Against Routine Use of Vitamins, Minerals
Dr. David Lipschitz
More than half of
the American population
takes at least one nutritional
supplement daily. The
hope is that life will
be prolonged, disease
prevented, vim and vigor
improved, and a better
sex life achieved. Many
and other “anti-aging” experts
maintain that the right
concoction of these
minerals and other nutrients
will improve and prevent
many physical and other
problems that impair
our quality of life.
The United States Preventive Services Task Force has just presented its evaluation
of multivitamin, vitamin or mineral supplements on the promotion of health and
the prevention of disease. Its report, published in the Annals of Internal Medicine,
indicates that there is insufficient information either for or against the use
of vitamins or minerals to prolong life or prevent cancer or heart disease.
The report did note that beta carotene and vitamin E can do more harm than good.
Beta carotene can increase the risk of lung cancer in susceptible individuals,
and there is no evidence that vitamin E can prevent any disease. Not mentioned
in this report is evidence that vitamin A, E and C in very large doses can increase
cancer risk, Alzheimer’s and even shorten life expectancy.
Iron is another mineral that, when taken in excess, can cause more harm than
good. Prior to 1970, iron deficiency was epidemic in the United States, with
30 percent of women having too little iron in store, which made them more susceptible
to becoming iron deficient. A further 20 percent of women had so little iron
that their red blood cells were abnormal and their iron stores were totally depleted.
Another 5 percent were so deficient that they became anemic. The cause of poor
iron stores and anemia is excessive menstrual blood loss. To attack this problem,
a major nutritional program was developed where many foods were fortified with
iron. Increased iron intake from the diet in combination with the use of contraceptives
and fewer pregnancies, has led to the virtual eradication of iron deficiency.
Over the last 50 years, the amount of iron in the body has gradually increased.
Iron is a potent oxidant and increased iron concentrations can damage cells,
leading to a higher risk of heart disease, cancer and Alzheimer’s. For
this reason, iron supplements or multivitamins with iron should only be used
if suggested by a physician, because the patient is at risk of becoming iron
deficient, either due to pregnancy or from blood loss.
Because of the lack of beneficial evidence and the potential harm in some circumstances,
the United States Preventive Services Task force suggests that rather than using
supplements try to eat a well-balanced, prudent diet containing appropriate fats,
carbohydrates and protein.
Should vitamins or minerals ever be used? A major indication for the use of a
specific vitamin or mineral is a test that has identified a proven deficiency.
For example, about 20 percent of those over the age of 70 are vitamin B12 deficient
due to irritation of the surface of the stomach. Here taking a vitamin B12 supplement
can prevent problems in the future. Similarly, if vitamin D concentration in
the blood is measured and found to be deficient, supplement use should be considered.
There are also many experts who believe that everyone over the age of 75 should
take a multivitamin tablet that does not contain iron. The rationale is that
many older persons’ diets contain less than the recommended daily allowance
(RDA) of many nutrients. Frank deficiency is rare as the RDA is calculated to
be twice the amount of a specific nutrient, which assures that 95 percent of
the population does develop evidence of deficiency. However, if someone is consuming
less than the RDA, they are much more likely to develop serious problems should
they develop an illness associated with declines in food intake or increased
loss of a specific nutrient due to the illness.
In America, our serious nutritional problem is not under nutrition or too little
vitamins and minerals but over nutrition and too many vitamins and minerals.
There are no magic bullets that will prolong life or prevent disease. The answer
is to strive to be healthy by eating right, exercising, being happy, and having
regular medical checkups.
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