Vitamin E and Dementia

The chorus of superficial and ill-informed anti-supplement articles continues to drown out better studies proving the benefits of supplements. Two studies published around the turn of the new year added support for using vitamin E to protect brain functioning against dementia, including Alzheimer’s. The first study was a small segment of a very big ongoing Finnish study called Cardiovascular Risk Factors, Aging and Dementia (CAIDE), researching connections between cardiovascular disease and memory disorders. The larger study, which began in 1998, led to other discoveries, such as the substantial cognitive benefits of 3-5 cups of coffee a day and, even more profoundly, the brain-enhancing impact of habitual exercise. In this study they measured the levels of several forms of vitamin E in 140 healthy seniors, and followed them over eight years with cognitive testing. They found a strong correlation between certain forms of vitamin E and reduced risk and severity of dementia. As I have written about several times in the past, there are many, many forms of vitamin E. The kind of E contained in most supplements, (dl alpha tocopherol) is synthetic. Our bodies can use the “d” form but not the “l” form. Even d alpha tocopherol is just one form of many naturally occurring forms, AND a great deal of research tells us that other forms (especially gamma tocopherol and probably delta tocopherol as well as the tocotrienols) are the ones our bodies really need. Furthermore, it is well-recognized that our measurement (i.u.) is really only a measure of activity in rats, not people. It was not surprising then, that in this study the researchers found that gamma tocopherol, beta tocotrienol and total tocotrienols were the effective forms of “vitamin E”. This should now be obvious, as the same has been seen in other studies. For example, findings that these “other” forms of vitamin E lower Alzheimer’s disease but NOT the plain old alpha tocopherol version, and this one as well. In 2012, the international consortium of experts empaneled to review research in their area of specialization, concluded that vitamin E was not helpful but, even then, they also felt the need to comment that the other forms of vitamin E might well be effective, calling for (as always) more research. Another new study published Jan 1 in the Journal of the American Medical Association provided additional encouragement. This study compared the response of Alzheimer’s patients to placebo, a conventional drug, the conventional drug plus 2,000 iu of the not so ideal form of vitamin E (alpha tocopherol)...

Breast Cancer Deaths Reduced By Multiple Vitamin Supplements?

Another study shows a powerful association between taking multiple vitamin supplements (MVM) and better health. The largest study ever conducted of multiple vitamin use in postmenopausal women with breast cancer found a strong linkage between MVM use and better prognosis. The Women’s Health Initiative is a massive study (over 161,000 American women) providing us insight into a broad range of lifestyle factors, health and diseases. Whenever you learn of some major discovery on women’s health, the odds are high that WHI data are the source of the groundbreaking research. Investigators studied the 7728 women in the WHI who were diagnosed with invasive breast cancer and followed them for over seven years. About 38% of the women diagnosed with invasive breast cancer were taking an MVM. Those women were 30% less likely to die of their invasive breast cancer than the women who were not taking an MVM. Studies like this are always open to question because association does not prove causation. What are the uncertainties in this study? Women who take an MVM often have other good health habits. Could those other habits explain their improved chances against their cancers? Investigators worked diligently to exclude these sources of confusion. They analyzed the data, digging out the protective effects of age at time of diagnosis, alcohol use, depression, diabetes, education level, hormone characteristics of the tumor, physical activity, race/ethnicity, self report of health status, smoking status and weight. Even after carving out all of these confounders, nearly every known risk factor for breast cancer, the beneficial association with MVM use held up. Women in this study had started taking MVM supplements before they developed breast cancer. Only postmenopausal women were studied. MVM supplements might not help women who start taking MVMs after they are diagnosed or premenopausal women. Of course, MVMs might help those women even more. We do not know yet. Even IF there is some unidentified protective factor more common among women using MVMs, the impact is so big (30% reduction in deaths), that it appears very unlikely to disappear. This is another excellent reason to take an MVM, especially a good...

Fishy Research

This seems to be the week of omega-3 oil publications. First there was a PATHETIC study whose authors claimed they had proved that O-3 supplements increase prostate cancer. http://jnci.oxfordjournals.org/content/early/2013/07/09/jnci.djt174.abstract. A boat load of scientists responded in the harshest terms, suggesting the author was trying to get attention (“the work of a junior professor”) and wondering how such a worthless study got published (“I have no idea how this study got accepted for publication”). The study contradicted previous research but only because of it’s bad design and the investigators’ truly horrible interpretation. It does seem that they were quite beyond their depth, purposefully hoping to grab attention or using ephemeral data to tout a predetermined conclusion. The nature of the study design could sometimes identify an association between factors but it can never prove causation. This study was far too poorly designed to even prove an association. One very simple and obvious point was that they did not determine where the omega-3 in the blood of their subjects came from (food or supplements). However, without that fundamental bit of information, the lead author was quoted “We’ve shown once again that the use of nutritional supplements might be harmful”. Sources of the oil could be crucial factor. Toxic contamination of fish and some supplements is a problem.Environmental toxins (especially dioxins and pesticides) have been linked to prostate cancer. This was just one of many overlooked confounders. Heavy tobacco and alcohol intakes appear to lead to more aggressive prostate cancer. In their data, smoking and alcohol both lowered the risk. Their research seems have been conducted in “opposite land”. The difference in blood levels between the highest and lowest groups was so small that the food the subject ate that day would change their grouping. The overall levels were so low that, if projected, the typical levels found among people living in countries where fish is most widely consumed (Scandinavia, Japan) would cause huge elevations in prostate cancer rates. That is not at all what we see. Other research has found 60-80% reduction in prostate cancer rates.The second study showed the importance of another fundamental issue overlooked by authors of the first. http://www.ncbi.nlm.nih.gov/pubmed?term=Garc%C3%ADa-Hernández%20VM%5BAuthor%5D&cauthor=true&cauthor_uid=23863036. This study, published in the International Journal of Food Science and Nutrition on July 18, compared the effects of different fish oil supplements on cholesterol and triglyceride levels. People think of omega-3 oils as “anti-inflammatory”. That is reasonable. The counterbalance to “anti-inflammatory” or “anti-oxidant”. Oxidization is sort of biochemical rust. Cancer and heart disease are among the health problems...

Vitamin D Is Too Good Not To Be True

Several years ago when I attended the first medical conference on vitamin D designed for clinicians, the limited data we had were very exciting. There was also many reasons to be skeptical and many were. It all sounded too good to be true they thought. Maybe higher vitamin D levels just told us who was already healthy. Instead of being sick and house-bound, they spent more time outside. The high vitamin D was not the cause of being well, it was the result. More complicated, time-consuming and expensive studies would have to be done to sort out the truth. Since then we have accumulated a great deal of research data. What does it show? Simply, the data shows that our high expectations about vitamin D were wrong. The highest expectations about vitamin D were actually too modest! At this point just about the only health outcomes that we can’t prove are influenced by vitamin D are the ones we have not measured yet. Study after study links diseases, syndromes, development and well-being to vitamin D. A few very recent discoveries follow: As we broaden our view to hunt down foreseen connections, more and more comes to light. For example, we have long been aware of a rising rate of premature onset of menses in little girls. There were many explanations including hormones in the food, rising rates of obesity and environmental hormone disrupting chemicals. Now we can add low vitamin D to the list of contributors. Vitamin D lowers the risk of ischemic stroke and diabetes. Low vitamin D is closely linked to vitiligo (patchy white skin) whether or not there is an autoimmune disease contributing to the vitiligo. Patients with hepatitis C are more likely to respond to drug treatment and get better if their D levels are higher. Black people with high blood pressure can lower it taking vitamin D but a dose of at least 2,000 iu is necessary and 4,000 iu/day (the highest they tested) is better. A paltry dose of 1,200 iu of D3 markedly reduced the symptoms of Parkinson’s Disease patients. Vitamin D appears to make prostate cancer cells less aggressive. Honestly, it is getting kind of boring. It is abundantly clear that optimizing everyone’s D level is a no-brainer, regardless of their health. Vitamin D is just plain GOOD. The end. I am interested in what we do not know and then, most importantly, what can be done about it. I want to help not just categorize. Diagnoses and labels...