Vitamin E in the News: Preliminary Interpretation

HEADLINE (CNN.com)

Study: Vitamin E may do more harm than good
Research finds those taking supplement died earlier
Wednesday, November 10, 2004 Posted: 11:48 AM EST (1648 GMT)

How true is this study? Who did it, and why? (Studies are expensive, so they're likely funded by some agency or group with a reason an agenda.) What should we now do about Vitamin E?

I have been sorting through the facts to see if I can answer these important questions for you. (Please see the next post for basic facts about Vitamin E.)

Dr. Edgar Miller, from Johns Hopkins Univerisity, led the study, which he presented at a meeting of the American Heart Association. Here's what he said about the need for Vitamin E:

"We don't think that people need to take vitamin E supplements, that they get enough from the diet," he said. Nuts, oils, whole grains and green leafy vegetables are all rich in vitamin E.

The average U.S. diet supplies six to 10 IU of E, Miller said. The Institute of Medicine, which sets recommended doses of vitamins and minerals, gives 1,500 IU of E as a daily upper limit.

"I would say it is too high," Miller said.

It is a common litany in medical circles to state that people get enough nutrients from their diets, so Dr. Miller's statement here is no surprise. It does suggest a prejudice to the study, however.

In an article elsewhere in the medical press* , the upper limit criticized by Dr. Miller, is explained:

The Institute of Medicine has set an upper tolerable intake level for vitamin E at 1,000 mg (1,500 IU) for any form of supplementary alpha-tocopherol per day because the nutrient can act as an anticoagulant and increase the risk of bleeding problems. Upper tolerable intake levels represent the maximum intake of a nutrient that is likely to pose no risk of adverse health effects in almost all individuals in the general population.

So Dr. Miller has taken a stance based on opinion ("I would say it's too high.") that is at odds with a guideline established within the medical community and based on observations in patients.

Coupled with his comment about getting all we need from foods, this study seems to be more about opinion than fact.

But what about the study itself? Dr. Miller re-analyzed 19 studies that had occurred between 1993 and 2004 in three countries, including the US. He found a slight INCREASE in deaths among those taking Vitamin E supplements.

One variable that may be key to understanding the study concerns who takes supplements. Not everyone takes supplements, and of those who do, not everyone takes Vitamin E. It is not unreasonable to consider that those who take Vitamin E may have an enhanced reason to do so.

For example, they may have heard the news over the years that Vitamin E helps prevent heart disease or cancer. Someone with heart disease or cancer in the family might be more likely to spend the money to take an E supplement, and it is exactly these people who are at increased risk of premature death from these causes.

If this is the case, the small increase in mortality noted by Dr. Miller's study may reflect this self-selection of Vitamin E consumers.

Another issue I have with the study is that I don't know -- yet -- if he took all the studies that occurred during those years, or a random sample of them, or just the ones that appeared to support beliefs he already held.

I will continue to look for more information about the nature of this study. Meanwhile, I would like to address two other details from this press release that have bearing on the warning about Vitamin E.

Getting Vitamin E from food:

Vitamin E is naturally occurring in a few classes of food. (See accompanying post on Vitamin E facts). These include nuts, some oils, and dark green leafy vegetables.

Any statement today that we can get all we need from foods is literally true, but not practical in application. Foods consumed today are hardly the direct-from-the-garden variety. Most are processed, few are fresh, and any component with anti-oxidant qualities (such as Vitamin E is known to have), when exposed to air for a time, has already experienced oxidation of those anti-oxidants: they're used up.

Plus, food choices -- our diets -- rarely consist of such wholesome foods as those that appear on this list of vitamin-E foods. One example is mustard greens. If we eat them at all, it would be rare to eat them every day.

So what is possible is not what is likely to happen, when it comes to using food as a source of nutrients!

The medical community already knows we need to supplement:

Almost everyone who is medically trained, including physicians and nurses, will state firmly that we can get all we need from food. But here are some supplements routinely 'prescribed' by doctors:

Calcium - to prevent osteoporosis, and now to help prevent colon cancer (see related article in an early posting)

Folic Acid - to prevent neural-tube defects in embryos, and sometimes to prevent heart disease

B-12 - for a variety of ills

Vitamin D - added to milk products for years because milk is consumed so widely (not naturally available in milk)

Iron - widely prescribed for women and supplemented in infant formulas

These are just 5 examples of the supplements doctors already recommend widely. So the sweeping generalization that we can get all we need from food is not correct, yet Dr. Miller of the Vitamin E study apparently went into the study with this point of view.

YOU may get all the E you need from your food, or you may need to supplement.

To find out if you need a supplement or to see what ills are associated with low amounts of vitamin E, read the list of symptoms at The World's Healthiest Foods: Feeling Great . You can find out about your own need by taking the Wellness Profile, or by clicking and following the links here for more information: Vitamin E Complex with Mixed Tocopherols.

Please Email This (click on the little envelope below to the right) if you know someone who would like to keep up with the news about Vitamin E. PL

*Medical College of Wisconsin Healthlink at http://healthlink.mcw.edu/article/983211401.html.

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