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Thursday, March 12, 2009

Multiple Vitamins

There has been a series of excellent studies and articles recently published in the medical literature. Interestingly, two of the studies dealt specifically with food in regard to poor cardiovascular health.

In the first study1, U.S. researchers reported that people who live in neighborhoods packed with fast food restaurants are more likely to suffer from poor cardiovascular health. The study, presented at the American Stroke Association's International Stroke Conference, noted that residents of one Texas County who lived in neighborhoods with the highest number of fast food restaurants had a 13% higher risk of experiencing poor cardiovascular health compared to those neighborhoods with the fewest such restaurants.

Although the researchers indicated there was no absolute proof that living near a fast food restaurant raises your risk of this serious health concern, the study did suggest the two are linked in some way. Poor cardiovascular health happens to be the number three killer in the United States after poor heart health and abnormal cellular growth. It is estimated that approximately 780,000 Americans will suffer from poor heart health this year, with 150,000 people facing mortality and another 15% to 30% of survivors permanently disabled.

This reminds me of a study2 examining the effects that healthy young people experienced after consuming a high fat breakfast at McDonald's. It was found that for several hours after eating the breakfast, blood flow was significantly reduced in a certain artery but when the volunteers were given 1,000 mg of vitamin C and 800 IU of vitamin E prior to eating the high fat meal, they maintained normal healthy blood flow. There are also studies indicating that consumption of a high saturated fat meal doubles the risk of poor heart health for 24 hours. Clearly healthy fats such as fish oil, flax and olive oil promote health benefits versus the harm caused by a typical unhealthy high fat and high sodium fast food meal.

In a positive study3 regarding heart health, researchers from Spain reported in the latest edition of the journal Circulation that over the course of more than two decades, women who drank coffee on a regular basis had a somewhat lower risk of poor cardiovascular health compared to those who drank coffee less than once a month. Coffee drinking, however, did not seem to affect such risk for those women with high blood pressure, elevated cholesterol or elevated blood sugar. It was found that those women who drank several or more cups of coffee for a month had a 20% lower risk of poor cardiovascular health compared to those who drank the least amount of coffee. The protective effect of coffee appeared to be particularly strong in those women who have stopped smoking or who had never been smokers.

Of course the positive vitamin D articles just keep coming. In a study4 published in the February 2009 edition of the Journal of Clinical Endocrinology and Metabolism, it was found that teenage girls with low levels of vitamin D appeared to have less leg muscle strength. The researchers suggested that the lack of vitamin D hindered the ability of the muscles to contract in a normal fashion. Although none of the 99 girls, ages 12 to 14, who participated in the study had outright symptoms of vitamin D deficiency, such as muscle pain, the majority had insufficient blood levels of the vitamin which was, nevertheless, enough to affect muscle function. The American Academy of Pediatrics recently doubled the amount of vitamin D it recommends for infants, children and teenagers to 400 IU daily. This is still a joke compared to what the most recent evidence indicates is required. I recommend 2,000 to 4,000 IU per day of vitamin D3 based on the most recent science for teenagers and adults. For children above two years old, I recommend 1,000 IU per day of vitamin D3.

The February 23, 2009 edition of the Archives of Internal Medicine published a study5 in which researchers from the National Cancer Institute reviewed data concerning almost 500,000 men and women. During an average follow up period of seven years, almost 37,000 men and 16,000 women developed various forms of abnormal cellular growth. It was found that those men and women who consumed the highest amounts of calcium were 16% and 23% less likely, respectively, to develop abnormal cellular growth relative to their peers to consumed the lowest amounts. Researchers noted that calcium intake appears to be associated with a lower risk of total abnormal cellular growth in women and abnormal cellular growth of the digestive system, especially colon-rectal in both men and women.

Finally, there was another article6 published in the same edition of the Archives of Internal Medicine noting the benefits of B vitamins in regard to promoting healthy vision as we age. The study involved 5,200 women ages 40 and older. The group was randomly assigned to take a vitamin combo or placebo. Those women who took the vitamin combo of B vitamins (folic acid, B6 and B12) were 34% less likely to develop unhealthy vision and 41% less likely to develop visually significant poor vision compared to the placebo group. The researchers indicated that it was not clear whether the vitamins protected eyesight by lowering homocysteine levels, exerting antioxidant effects or improving blood vessel function.

Keep in mind your junk mass market once a day type vitamins will probably not work for this benefit. Why? The dosages of the B vitamins used in the study are many times what most multi-vitamins have. The dosages used in the study were folic acid at 2,500 mcg (2.5 mg), B6 at 50 mg and B12 at 1,000 mcg (1 mg). Most multi-vitamins only contain the RDA/DV levels of 400 mcg of folic acid, a few mg of B6 and 6 mcg of B12, grossly inadequate for providing any real benefits. The study is available for free by clicking here.

So what's the take home message this week? The answer is reduce dining and drive thru visits of fast food restaurants, no more than once per month, make sure that you have your morning cup of coffee and/or tea and don't forget to take your calcium, magnesium, vitamin D3 and B vitamins at optimal levels. Please don't be misled by your mass marketed alleged complete A to Zinc multis. They generally contain inferior forms and inadequate amounts of the nutrients that you need to optimize your health and well being not to mention they are full of chemicals like titanium dioxide, artificial colors and other things I refuse to consume.

1 Morgenstern LB, et al., BASIC, for Brain Attack Surveillance in Corpus Christi, American Stroke Association's International Stroke Conference 2009.

2 Plotnick GD, Corretti MC and Vogel RA, Effect of antioxidant vitamins on the transient impairment of endothelium-dependent brachial artery vasoactivity follow a single high-fat meal, Journal of the American Medical Association.

3 Lopez-Garcia E, Rodriguez-Artalejo F, Rexrode KM, et al., MD, Coffee Consumption and Risk of Stroke in Women, Circulation, Published online before print February 16, 2009.

4 Ward KA, Das G, Berry JL, et al., Vitamin D Status and Muscle Function in Post-Menarchal Adolescent Girls, Journal of Clinical Endocrinology & Metabolism, February 2009; Pages 559-563.

5 Park Y, Leitzmann MF, Subar AF, et al., Dairy Food, Calcium, and Risk of Cancer in the NIH-AARP Diet and Health Study, Archives of Internal Medicine, February 23, 2009, Pages 391-401.

6 Christen WG, Glynn RJ, Chew EY, Folic Acid, Pyridoxine, and Cyanocobalamin Combination Treatment and Age-Related Macular Degeneration in Women, Archives of Internal Medicine, February 23, 2009, Pages 335-341.

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