Vitamins: Controversial?

Dr. Edgar Miller is one of 5 authors of an editorial published in the Annals of Internal Medicine, December 17, 2013, that discussed three articles published in the same journal

Three articles published in the Annals of Internal Medicine, Dec 17, 2013, Vol 159, No. 12, looked at the results of 27 studies involving over 450,000 participants taking various types and doses of vitamins to prevent cardiovascular disease, mortality, cancer and cognitive decline. None of the trials found any benefit and some trials found that a particular supplement actually caused harm.

An editorial, with the provocative title, “Enough Is Enough: Stop Wasting Money on Vitamin and Mineral Supplements”, discussing the results of these three articles was also published. The authors quite rightly state that, in view of the evidence, vitamins and minerals should not be used for chronic disease prevention.

Does that mean nobody should take vitamins? No. It means that we must look closely at which vitamins we are taking and why we are taking them.

One reason to take vitamin supplements is dietary deficiency. If a person is unable to eat a healthy diet that includes plenty of dark green leafy vegetables, or if a person has digestive problems that impairs their ability to digest and extract nutrients from their food,  then taking a multivitamin may be appropriate.  he nutritional quality of the food available may be a concern in this age of commercial mass production, also making one consider a multivitamin. However, it is important to understand that taking daily multivitamins is never a substitute for healthy eating and will never by itself achieve optimal health in a person.

In circumstances of high stress, nutritional requirements can increase dramatically, making it impossible to eat enough food to meet these requirements. When the body perceives stress, it shifts into “fight or flight” in which the hormone cortisol  increases and changes the metabolism in different ways to ensure a successful fight with a tiger. It takes a lot of energy, requiring a lot of nutrients, to fight a tiger. The types of stress that affect us vary widely but the body always responds in the same way. Physical stressors include intense exercise , lack of adequate restorative sleep as well as ingestion of toxic substances such as alcohol, recreational drugs, pesticides, preservatives, etc. Work pressures and financial instability create emotional stress but  multi-tasking and anything that creates feelings of overwhelm or being trapped in unpleasant circumstances also shift us into a stress response. Our day to day stressors often feel normal or even enjoyable but that does not lessen the nutritional requirements and vitamin supplements to augment a nutritious diet may be needed to prevent the long term effects of chronic stress.

Some people have a genetic predisposition that can increase their requirement for certain nutrients. Single nucleotide polymorphism (SNP) is a name given to the many common but usually inconsequential genetic variations found  in people. Sometimes, though, SNPs can affect one’s health such as by impairing a person’s ability to metabolize a particular nutrient, resulting in a functional deficiency of that nutrient. In this case, supplementing with the nutrient can be beneficial. Sometimes a SNP will affect a broader area of metabolism and supplementing with several nutrients may be indicated.

Taking vitamins without considering one’s whole lifestyle is like putting gas in the car but not bothering with oil in the engine or air in the tires. Vitamins cannot do the job all by themselves. The 27 studies reviewed in the Annals of Internal Medicine showed that clearly. The body works like a symphony of interrelating vitamins, minerals, amino acids, essential fatty acids, neurotransmitters and hormones, all playing their part so others can play their parts. Balance in one’s life creates balance in one’s body, which is the real key to preventing chronic disease.

By Dr. Karla Dionne, MD
Balance Medical Center