Posted on: Saturday, April 9, 2005

PRESCRIPTIONS
Get your vitamins the natural way

By Landis Lum

Q. Should I take vitamin E, beta carotene, vitamin C or other supplements to reduce cancers and heart disease?

A. In November 2004, the American Journal of Clinical Nutrition found that diabetics in the Iowa Women's Health Study who took more than 300 milligrams a day of vitamin C pills had increased deaths from strokes and heart attacks. And what about vitamin E?

In another randomized study of 29,000 male smokers, the April 14, 1994 New England Journal of Medicine found that taking 20 milligrams of beta-carotene (equal to 33,000 units of vitamin A) a day actually increased the risk of dying from lung cancer, strokes, and heart attacks. Other studies have also found increased lung cancers and heart disease with beta carotene.

Doctors B. Greg Brown and John Crowley from the University of Washington feel this study "effectively closes the door on the prospect of a major protective effect of long-term exposure to this supplement against complications of atherosclerosis (heart attacks and strokes) and overall cancer incidence."

Why? Because multiple previous studies involving 68,000 patients likewise found no benefit for vitamin E. Vitamin E may have pro- rather than antioxidant effects at higher doses — a meta-analysis of multiple studies in the Jan. 4 Annals of Internal Medicine found that vitamin E at doses of 400 IU a day or higher may actually increase your chance of dying.

In another randomized study of 14,000 smokers and 4,000 others exposed to asbestos, the May 1996 New England Journal of Medicine found that taking 30 milligrams of beta-carotene (a form of vitamin A) and 25,000 Units of retinol (vitamin A) a day actually increased the risk of dying from lung cancer by 46 percent.

Yet a diet high in fruits and vegetables, and high blood levels of beta-carotene, is associated with less cancers and heart disease.

So what's happening? In fruits and vegetables, there are hundreds of antioxidants and molecules that haven't even been discovered yet; it could be that one of these — or a combination of these, taken in the correct proportion — is the true "super antioxidant" protecting against cancers and heart disease. But if you take extra beta-carotene, it may throw off the balance of the substances you ingest in the natural, correct proportions in your diet, causing disease or premature death. So avoid large doses of any supplement. And there's no evidence that taking two, three or more vitamins or supplements in combination is beneficial — in fact, this may only add to their individual toxicities.

So get your antioxidants naturally through fruits and vegetables.

Dr. Landis Lum is a family-practice physician for Kaiser Permanente and an associate clinical professor at the University of Hawai'i's John A. Burns School of Medicine. Send your questions to Prescriptions, Island Life, The Advertiser, P.O. Box 3110, Hono-lulu, HI 96802; fax 535-8170; or write islandlife@honoluluadvertiser.com. This column is not intended to provide medical advice.