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Vitamin C Can Protect the Heart

Claus Hancke

December 20, 2004

A new meta-analysis was published some weeks ago with the positive conclusion that high doses of Vitamin C can reduce the risk of coronary thrombosis (blood clots) in the heart by 25%.

Nine scientific studies with a total of 290,000 people who did not suffer from cardiac disease were thoroughly analysed by a group of researchers from several large centres in Denmark, Sweden, Finland, Israel, and the USA.

In this group, during the course of ten years, approx. 4600 large coronary thromboses were discovered. Then, various factors that could influence this result were analysed.

Documentation that large amounts of fruit and vegetables reduce this cardiovascular risk is vast, and therefore, it was important to the researchers to distinguish between the ones who had only received their vitamins through their diet and the ones who had supplemented their diet with dietary supplements.

The research group found out that a daily dietary supplement with a high dose of Vitamin C with large statistic certainty (p<0.001) could reduce the risk of coronary thrombosis with 25% compared to the ones who did not take any supplements.

The dose of vitamin C to take for this reduced risk to set in was more than 700 mg. a day. This more or less equals the amount of Vitamin C that can be found in: 15 fresh oranges, 35 fresh apples, 75 fresh bananas, or ½ kg. of fresh blackcurrant. These amounts of fruit should be eaten every day – so there must be an easier way!

Moreover, the analysis confirms the results of a study that was made earlier this year that showed that Vitamin C reduces hs-CRP (high-sensitive C-reactive protein), which is a blood test that can predict the cardiac risk in a much more secure way than any cholesterol values in the world.

The analysis could only give weak support to the hypothesis that Vitamin E reduces the risk of coronary thrombosis. This result was not statistically certain.

By: Vitality Council

Reference:
Knekt P, Heitmann Berit L, Augustsson Katarina et al: Antioxidant vitamins and coronary heart disease risk: a pooled analysis of 9 cohorts.American Journal of Clinical Nutrition (vol. 80, issue 6, pp1508-1520, 2004).

www.ajcn.com
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Folic Acid is Still Healthy

Claus Hancke

December 11, 2004

New media storm has no basis in the scientific data. To the long list of cheap and trashy attacks on dietary supplements another one can be added for folic acid, which is a recent hit-and-run victim of the Danish newspaper B.T. with its screaming headline: ”Supplement can cause cancer.”

To make such a sensational claim, this tabloid ignored the authors’ very clear statement that it may only be a statistical fluke. But we have seen this kind of cut-and-slash media coverage before.

The article actually covers an old study from 1967, which was dug up from its grave and published in the British Medical Journal. [1] It seems that some 3,000 women participated in this study, which was not double-blind controlled.

Instead, the supplements were given to the subjects using six different tablets, separately colored, and taken from numbered drawers. Of these 3,000 women, 31 died from breast cancer during the 37 years that had passed, and of these 31, 6 women got 0.2 mg folic acid, 8 got 5 mg folic acid, and 17 got a placebo.

Clearly, no statistical certainty follows from this result, which means that it may only be an accidental incident. The study was supported financially by the pharmaceutical company, GlaxoSmithKline.

As mentioned, the authors themselves stated that the result may be accidental.

Many earlier scientific studies had shown the contrary to be true. In fact, the official comment by the professors Oakley and Mandel in the British Medical Journal [2] clearly dissociates them from the media-sensationalized conclusion, when they write that these earlier studies taken together actually demonstrate that higher supplementation of folic acid would decrease, rather than increase, the risk of cancer.

Furthermore, they draw attention to the fact that every single year folic-acid enrichment of American foods alone saves more people from blood clots in the brain and heart than the number of people dying from traffic accidents in the USA.

Be wary of this study, which is old. Its proponents are trying to have their cake and eat it too because when old scientific studies speak of the benefits of dietary supplements or natural medicine, they are often accused of being based upon an ”old standard,” and of not ”living up to the present standard.”

In decency the same can be said about old studies that are negative towards dietary supplements. These days a lot are dragged out from the old moth bag.

The problem is not so much these old studies, as it is the media, which smell sensationalism and thereby frighten the population from taking these supplements that are so important, when taken properly. But proper use demands information, and the population is not allowed to be informed.

By: Vitality Council

References:
1. Charles D, Ness AD, Campbell D, Smith GD, Hall MH. Taking folate in pregnancy and risk of maternal breast cancer. BMJ 2004:329:1375-6.
2. Ockley GP, Mandel JS. Commentary: Folic acid fortification remains an urgent health priority. BMJ 2004;349;1376.

bmj.bmjjournals.com
www.iom.dk

Broccoli and Spinach are Not Likely to Affect INR Blood Test

Claus Hancke

December 10, 2004

Promising Dutch study of Vitamin K. The somewhat cryptic headline is probably nonsense to most people, but nevertheless has great importance to all those taking blood-thinning (anticoagulating) medicines such as Marevan (Warfarin) and who are doing the regular blood test control, called INR.

If you are undergoing treatment with anticoagulant drugs such as Marevan, you should regularly be tested with a blood test called INR.

This blood test is designed to estimate if the dose you receive is correct, but it should also prevent overdosing in which the blood would get “too thin”. This condition is dangerous and can result in internal bleeding.

12 healthy volunteers were included in a study in which they were given a correct dosage of anticoagulants for 13 weeks and adjusted to a maintenance dose with a constant and stable INR value that would prevent them from forming blood clots.

Then, they were given increasingly large daily doses of vitamin K from 50 mcg. to 500 mcg. during the course of one week. Not until the dose reached 150 mcg. of vitamin K a day taken as a dietary supplement, was any effect on INR observed. Even at this dose, INR was only affected in 3 out of the 12 trial subjects.

When the trial subjects were given food that is particularly rich in vitamin K, i.e. broccoli and spinach, there was no clinically relevant effect on INR because the effect was so transient, and the authors suggest that the reason might be a poor bioavailability of the vegetables. This may be surprising, as kale, spinach, and broccoli can contain up to 400 mcg. of vitamin K per 100 g.

Doses of 100 mcg. vitamin K as an easily absorbable dietary supplement had no effect on INR.

If this study on healthy, young trial subjects can be repeated with the same result on patients with a predisposition to forming blood clots, it would make life significantly easier on a great number of people who every day stare in despair at the long list of foods containing vitamin K that they are not allowed to eat while taking Marevan.

By: Vitality Council

Reference:
Schurgers LJ, Shearer MJ, et al: Effect of Vitamin K Intake on the Stability of Oral Anticoagulant Treatment. Dose-Response Relationships in Healthy Subjects. Blood 2004;104(9):2682-2689.

www.bloodjournal.org
www.iom.dk

Antioxidants Relieve the Adverse Effects of Chemotherapy

Claus Hancke

November 15, 2004

Children suffering from leukaemia tend to be more ill and be hospitalized longer if they are not given antioxidants.

The primary effect of chemotherapy is not through free radical activity but it does strain the organism with free radicals. Free radicals are combatted by antioxidants like vitamin C and -E. This piece of information is important, because not taking enough antioxidants while going through chemoterapy will result in more adverse effects and the treatment results can be delayed.

American doctors from several universities have published these results after having studied 103 children receiving chemotherapy for leukaemia. An evaluation of the children’s diet showed that they usually only got 1/3 – 2/3 of the recommended or normal amounts of various antioxidants. The reason for this is probably the treatment causing general malaise and reduced appetite.

The children who got the most vitamin C were hospitalized for a significantly shorter period and the children who got the most vitamin E suffered fewer infections and fewer adverse effects of the chemotherapy. The doctors conclude that a low intake of antioxidants results in more negative effects of the treatment.

The results can be related to a study of 49 American women who received chemotherapy for breast cancer and were asked about their use of dietary supplements. Multivitamins and vitamin E were the preferred supplements among the 35 women who did use supplements.

The women who took these vitamins maintained a better immune defence during the treatment – i.e. the number of white blood cells in their blood was less reduced during treatment compared to the women who did not use vitamin supplements. On the other hand, the number of white blood cells was more reduced in women taking relatively large amounts of the vitamin B9, folic acid.

It is very common for cancer patients to use dietary supplements. More than every other cancer patient at a hospital clinic in London used supplements, but less than half of them had told their GP about it.

By: Vitality Council

Source:
Kennedy DD, Tucker KL, Ladas ED, et al. Low antioxidant vitamin intakes are associated with increases in adverse effects of chemotherapy in children with acute lymphoblastic leukemia. Am J Clin Nutr (United States), Jun 2004, 79(6) p1029-36.

www.ajcn.org
www.iom.dk

Vitamin E or false product description

Claus Hancke

November 12, 2004

Calculations on the basis of old studies leads to claim of increased mortality by antioxidants and vitamin E, but is in reality based on studies with beta-carotene.

Recently, researchers published a study on beta-carotene, but called it antioxidants. Now there is a new study of beta carotene, but this time it is called vitamin E. Both studies are so-called meta-analyzes, ie. calculations of previous research.

The two studies claim to show that respectively antioxidants and vitamin E increase mortality, but they are both based on the results of old beta-carotene tests. Since 1994, it has been known that beta-carotene can cause cancer and increase mortality in at least male smokers.

The latest meta-analysis originates from Johns Hopkins University in the USA. Here, the mortality rate in a total of 19 old treatment trials with vitamin E was investigated. Apparently, doses above 400 units per day slightly increased mortality, although it was decreased in the trial where the dose was the highest (2,000 units/day). There were 11 trials where more than 400 units were used per day. At a lower dose, there was a tendency for decreased mortality.

However, of the 11 trials, the so-called Heart Protection Study (HPS) from the year 2000 is by far the largest. In fact, so large that it completely dominates the calculation. In HPS, almost twice as many died as in all the other 10 trials combined – and more than four times as many as in the other trials with increased mortality. The problem with this is that in HPS, in addition to vitamin E, the treatment consisted of vitamin C and beta-carotene!

Of course, one cannot comment on the risk of vitamin E based on an experiment in which both vitamin E and C and beta-carotene were used. You can only comment on vitamin E and C and beta-carotene!

Also, in the trial in question (HPS), synthetic vitamin E was used. It consists of eight different chemical compounds, only one of which is found in nature. That makes it even more difficult to comment on vitamin E, which most people buy in its natural form.

There are many other objections to the new meta-analysis. If you e.g. arrange the numbers just a little differently, but still fairly, the excess mortality disappears entirely. That happens if you ignore the misleading HPS study and include trials using over 300 units instead of just over 400. That would be entirely plausible.

This and much else may be why several independent statisticians told the New York Times that they did not believe the conclusion.

One can debate whether there is a real need for these sometimes arbitrary concoctions of old experiments, which easily lead to misinterpretations. Far greater is the need for large-scale investigations into whether, for example, a combination of natural vitamin E and C prevents atherosclerosis in people who are not overwhelmingly atherosclerosis already. This is where one can expect an effect, but these experiments have not been carried out.

Sales of vitamin E are increasing in the United States, where many doctors in particular take it. The combination of vitamin E and C can be seen i.a. as a competitor to the tremendous expensive, but almost ineffective, prescription drugs for Alzheimer’s. According to a report earlier this year – also from Johns Hopkins – users of both of these vitamins have approx. 80% reduced risk of getting Alzheimer’s – compared to those who get only one of them or none at all.

Most recently, the Nobel laureate Louis Ignarro, based on his own experiments, strongly recommended the same combination as prevention against atherosclerosis.

By: Vitality Council

 

References:
1) Metaanalysis: High-dosage vitamin E supplementation may increase all-cause mortality. Ann Int Med 2004;142.
2) Bjelakowic G, Nikolova D, Simonetti R G, Gluud C. Antioxidant supplements for prevention of gastrointestinal cancers: a systematic review and meta-analysis. The Lancet 2004;364:1219-28.
3) Ignarro L J et al. “Long Term Beneficial Effects of Physical Training and Metabolic Treatment on Atherosclerosis in Hypercholesterolemic Mice. PNAS 2004 (May 24).
4) Zandi PP et al. Reduced risk of Alzheimer disaease in users of antioxidant vitamin supplements. Arch Neurol 2004;61:82-88.
5) Gina Kolata: Large Doses of Vitamin E May Be Harmful. New York Times 11.11.04.

Vitamin E Competes with Viagra

Claus Hancke

October 26, 2004

Diabetic mice who are not able to obtain erection are helped nearly as well by taking vitamin E as with taking Viagra. A combination is even better, and the treatment is recommended for diabetic men with the same problem.

Based on animal studies, Canadian researchers believe that male diabetics suffering from erectile dysfunction can be helped with vitamin E.

Diabetic men must, due to a weak erection, often resort to Viagra. However, despite the widespread use of this preparation, its effect is not rarely inadequate.

A supplement with a high dose of vitamin E might help, according to researchers at the Urology Department at St. Joseph Health Care, University of Western Ontario (Canada).

By: Vitality Council

Reference:
De Young L, Yu D, Bateman RM, Brock GB. Oxidative stress and antioxidant therapy: their impact in diabetes-associated erectile dysfunction. J Androl. 2004 Sep-Oct;25(5):830-6.

www.andrologyjournal.org
www.iom.dk

Breast Cancer may be Caused by Vitamin D Deficiency

Claus Hancke

October 19, 2004

Women who do not utilize vitamin D well enough will often get breast cancer and fibrocystic breasts are a sign of calcium and vitamin D deficiency.

Much suggests that vitamin D prevents breast cancer. If so, sunlight, which is the overall dominant source of vitamin D, can significantly prevent breast cancer.

The theory is now supported by a new English study that has shown that women who utilize vitamin D badly have doubled the risk of getting breast cancer.

Researchers from St. George’s Hospital in London compared tissue from approx. 400 women with breast cancer with tissue from an equal number of healthy women. In doing so, they discovered that women with aberrant receptors for vitamin D appeared twice as often in breast cancer statistics as others.

It is known that vitamin D exerts a normalizing effect on the cells in e.g. breast tissue. When the vitamin activates a receptor, a regulatory and growth-reducing effect is triggered inside the cell. Experiments have further shown that breast tissue can activate vitamin D so that it chemically matches the receptors. Previously, it was thought that this only happened in the kidneys.

The connection between vitamin D and breast cancer is supported by a new Canadian study of more than 500 40-60-year-old women. Mammograms showed that women with low vitamin D status have four times as many small nodules in their breasts as those who are better supplied with the vitamin.

Both a high intake of vitamin D and plenty of calcium in the diet were statistically very reliably associated with a tendency to nodules. It is already known that lumpy breasts are a pronounced risk factor for breast cancer.

The scientific interest in vitamin D as a remedy against cancer is increasing rapidly. In November, a three-day conference will be held in Maryland, supported by the American Institute of Health (NIH), with numerous presentations from the USA, Canada, France, England, Germany, Belgium, Austria and others. on this subject alone.

The interest was initially stimulated by the fact that the frequency of, among other things, cancer of the colon, prostate and breast is significantly less in sunny countries than in e.g. Denmark, where the sun is so low from October to May that the skin does not produce vitamin D.

Among researchers, strong voices have advocated for several years that the intake of vitamin D should be raised from the 10 micrograms per day recommended for the elderly (younger people are recommended half), to 25 micrograms per day or even more. The 25 micrograms correspond to the content in 10 ml of cod liver oil. Normal Danish diet contains only a few micrograms.

By: Vitality Council

 

References:
1. Guy M, Lowe LC, Bretherton-Watt D et al. Vitamin D receptor gene polymorphisms and breast cancer risk. Clin Cancer Res. 2004 Aug 15;10(16):5472-81.
2. Bérubé S et al. Vitamin D, calcium, and mammographic breast densities. Cancer Epidemiology, Biomarkers & Prevention. 2004;13(9):1466-72.

clincancerres.aacrjournals.org
www.cbcrp.org/research/PagePeriodical.asp
www.iom.dk

Vitamin E Against Alzheimer’s Disease and Colds

Claus Hancke

October 11, 2004

The World’s leading experts in vitamin E participated in a congress in New York in the spring which was sponsored by the New York Academy of Sciences. The last time such a congress was held was in 1989 and some of the news have now been described in the October issue of the Academy’s scientific magazine.

It is astounding that we are still discussing nature’s purpose of Vitamin E. It can actually be difficult to find obvious deficiency symptoms in humans. However, it is certain that the vitamin is highly important. All higher animals – including fish – produce the protein TTT with the single task of transporting vitamin E in the blood. Natures probably would not have gone to such trouble of making a transport protein for a substance that the body could easily do without.

“When nature has chosen exactly alpha-tocopherol from the thousands of antioxidants in our surroundings, there must be a reason”, declared Angelo Azzi of the University of Bern. Vitamin E slows down the blood platelets when they are about to clog and form blood clots.

This is significant to the tendency of other cells to stick to each other, divide, and to send signals to each other. Furthermore, it increases the production of nitric oxide (NO) which is an important signalling molecule that relaxes the blood vessels and thereby lowers the blood pressure. How can we translate these fundamental abilities into something we can see and feel, though?

The participants at the congress presented results showing that Vitamin E delays Alzheimer’s disease. According to a French study, the combination of vitamin C and vitamin E can prevent the disease from occuring in the first place. The same combination of vitamins also prevents pre-eclampsia. Finally, a randomized trial has shown that vitamin E reduces the frequency of colds in elderly people by 25%.

A constant controversial question is why only a single randomized trial have been able to show that vitamin E prevents coronary thrombosis when there are so many other indications of this effect. The explanation could be that synthetic Vitamin E has often been used instead of natural vitamin E. Synthetic Vitamin E consists of eight different substances of which only a single one is present in nature.

Another reason might be that the Vitamin E has not been supplemented with vitamin C; automatic supplementation with Vitamin C happens in animals because of their ability to produce Vitamin C themselves.

However, the reason might also be that the participants of almost all the studies had been severely atherosclerotic from the start. “Once calcification has damaged an artery, the damage will heal very poorly”, professor Meydani of Tufts University, USA. Vitamin E is probably better at preventing than curing diseases!

Professor Maret Traber from Oregon estimates that 70 – 80% of all adults get less than the recommended 30 mg. of Vitamin E weekly. Her advice is to live healthily and that there is no harm in taking an extra Vitamin E supplement.
The exact reason for its beneficial effect will perhaps not be elucidated for another 15 years.

By: Vitality Council

Reference:
Hopkin K. New York Academy of Sciences Magazine 2004; October: 4-6.

www.nyas.org/publications
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A Dangerous Cocktail

Claus Hancke

October 3, 2004

Politicizing researchers and lazy journalists are a dangerous cocktail.
It is very disgraceful that the Danish Radio’s TV news presented such a one-sided story about antioxidants, as happened at 6:30 p.m. yesterday, where it declared without any reservation that 9 people out of 1,000 taking antioxidants will die from them!

Just the day before, the Danish (state owned) Radio / Television received a press release from the Vitality Council, which was criticizing the story and emphasized that possible harmful effects can only be caused by taking beta-carotene in large (therapeutic) dosages.

This old news can in no way be used to generalize about other antioxidants. The postulated general overmortality refers to two studies, in which beta-carotene was used in such great amounts that the test persons became yellow.

The Vitality Council also emphasized in its press release that according to the Lancet study, selenium, a potent antioxidant, is able to halve the risk of several kinds of cancer. This result was not at all mentioned in the TV news.

Furthermore, even the official comment in The Lancet dissociated from that which was the only extract on TV from the study: The postulated overmortality. The Lancet comment is written by two statisticians, who are seriously criticizing the statistical preparation of the material, and they state that the conclusion about overmortality is not convincing.

Another critical point out of many is that the Cochrane group removed a study on selenium, which it had announced as being a ”high quality” study, before the calculation on average.

The reason given for removing the study was that it would be given more weight in the random-effects model than in the fixed-effect meta-analysis. The removed high-quality study showed that selenium clearly reduced mortality!

It is not very good science to ignore figures that you do not like.

The TV news journalists have been hunting for some sort of scandal and one-sidedly accepted the very dramatic statements of Christian Gluud, M.D., which went much further than what the study material could ever support.

The Lancet has saved its skin by its serious comment, but the writers have cast a bad shadow over the Cochrane institution.

By: Vitality Council

References:
1. TVA 2.nd October 2004, 6:30.
2. Press release from Vitality Council 1.st October 2004.
3. Goran Bjelakovic, Dimitrinka Nikolova, Rosa G Simonetti, Christian Gluud, Antioxidant supplements for prevention of gastrointestinal cancers: a systematic review and meta-analysis, Lancet 2004;364:1219-28.

www.lancet.com
www.cochrane.dk/index.htm
www.iom.dk

Not All Antioxidants Prevent Cancer

Claus Hancke

October 1, 2004

The Cochrane Institution is very well-respected for its objective consideration of medical issues. The last report from The Lancet today does not actually reveal anything truly new, despite a very useful summary of results from earlier prevention studies made with antioxidants. The results are listed after each antioxidant and after each type of cancer in the gastrointestinal tract.

The good news is that it looks as if selenium may very effectively prevent cancer diseases in the gastrointestinal region, as selenium both halves the frequency of cancer as well as the rate of death in the group of people taking selenium compared with the group taking placebo.

The disappointing news is that certain other antioxidants do not have any cancer-preventive effect in the studies mentioned and in some cases they even have harmful effects – mainly attributed to beta-carotene. This is a well-known fact.

The authors are inclined to think that the ones who might be harmed by antioxidants are people who are not very strained by the harmful free radicals in the first place. However, the authors will not warn against taking moderate doses of antioxidants or eating fruits and vegetables, and they thereby recognize the importance of getting moderate amounts of these antioxidants.

The study should be a memento for the authorities who prevent the public from being informed with fair and useful information on effects as well as side effects of dietary supplements. This censorship conceals positive as well as negative research results to the consumer who is left only to pure speculation about the use and dosage of the antioxidants which could be very beneficial if used correctly.

Antioxidants prevent atherosclerosis with great probability, but, naturally, this must happen before the atherosclerosis is far advanced. Based on his own research, the Californian Nobel Prize Winner Louis Ignarro, one of the world’s leading experts in vascular surgery, has recently in very clear terms encouraged anyone who want to avoid having blood clots to take supplements of vitamin C and -E.

In the last three months alone, the Vitality Council have posted at least six press releases about new scientific research regarding antioxidants; all involving important – in some cases essential – new knowledge from the leading research centres around the world.

By: Vitality Council

Reference:
Goran Bjelakovic, Dimitrinka Nikolova, Rosa G Simonetti, Christian Gluud Antioxidant supplements for prevention of gastrointestinal cancers: a systematic review and meta-analysis Lancet 2004; 364: 1219-28.

www.lancet.com
www.cochrane.dk/index.htm
www.iom.dk

Related articles:
Vitamin E or False Indication of Goods – 12-11-04 09:15
Biased Cochrane Study – 07-10-04 12:00
A Dangerous Cocktail – 03-10-04 12:00