Throw away your supplements!

Today I am inspired to share with you an article which one one level, challenges us to rethink vitamins. On another level, it brings up many questions and deeper issues, which share as an invitation to re-claim or claim for the first time - our power and validity as decision-makers for our own health and wellness.
 
Let’s first read these excerpts from a controversial article by functional and integrative medicine, leader Chris Kessler, entitled, “Throw away your multivitamins and antioxidants!”

​I’m not a big fan of supplements. I’ve always believed that it’s preferable to get the nutrients we need from whole foods, as they’re found in nature, rather than from isolated, synthetic sources (i.e. supplements).
 
Unfortunately, modern medicine is obsessed with isolated, synthetic nutrients and has convinced itself that they have the same beneficial properties as nutrients found in whole foods.
 
A gigantic dietary supplement industry has arisen from this misguided belief. A 2006 National Institute of Health (NIH) conference (PDF) revealed that 20-30% of Americans use a multivitamin daily, forking over $23 billion a year to supplement manufacturers for the privilege. Many more Americans effectively take a multivitamin by eating fortified grain products, like Shredded Wheat cereal and Wonder Bread.
 
Most supplements don’t work
With these statistics in mind, you might be surprised (or even shocked) to learn that clinical trials have shown that most of these supplements not only don’t work as intended, they actually make things worse. The NIH conference examined the efficacy of 13 vitamins and 15 essential minerals as reported in long-term, randomized clinical trials.
 
First the positive results:

• A combo of calcium and vitamin D was shown to increase bone mineral density and reduce fracture risk in postmenopausal women.
• There was some evidence that selenium reduces risk of certain cancers.
• Vitamin E may decrease cardiovascular deaths in women and prostate cancer deaths in male smokers.
• Vitamin D showed some cardiovascular benefit.

Um, not too impressive considering the near universal faith considering how many people are popping these pills on a daily basis.
 
Now for the negative results:

• Trials of niacin (B3), folate, riboflavin (B2), and vitamins B6 and B12 showed no positive effect on chronic disease occurrence in the general population
• There was no evidence to recommend beta-carotene and some evidence that it may cause harm in smokers.
• High-dose vitamin E supplementation increased the risk of death from all causes.

 
Then there’s the now infamous JAMA meta-analysis on antioxidants. They looked at 68 trials with over 230,000 participants. Here’s what they found:
Treatment with beta carotene, vitamin A, and vitamin E may increase mortality. The potential roles of vitamin C and selenium on mortality need further study.
 
Oops!

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(Re)-introducing the concept of food synergy
 It’s crazy to me that so many health care practitioners – both conventional and alternative – tell their patients to take multivitamins and antioxidants when their is little support for that position in the medical literature.

That’s why I was so happy to come across a study in the American Journal of Clinical Nutrition addressing this issue. It’s called “Food synergy: an operational concept for understanding nutrition.” I’m relieved to learn that there are researchers working in the nutrition field that don’t buy into the synthetic nutrient hype, and understand the importance of whole food.
 
Here are some passages from that article:
A person or animal eating a diet consisting solely of purified nutrients in their Dietary Reference Intake amounts, without benefit of the coordination inherent in food, may not thrive and probably would not have optimal health. This review argues for the primacy of food over supplements in meeting nutritional requirements of the population.
 
Here the authors congratulate science on the discovery of fundamental nutrients such as vitamin C, and clarifying their role in health and disease. The realization that scurvy is caused by vitamin C deficiency has saved a lot of lives. But, the approach to nutrition that is fundamentally guided by nutrients has a dark side:

The aspect of science that reduces to fundamental principles, however, can lead to oversimplification and ultimately stifle understanding and progress.

Translation: reductionistic thinking can get us in trouble if we’re not careful.

The concept of food synergy is based on the proposition that the interrelations between constituents in foods are significant. This significance is dependent on the balance between constituents within the food, how well the constituents survive digestion, and the extent to which they appear biologically active at the cellular level.
 
It makes me so happy to see this in a major, peer-reviewed journal. The authors go on to define several aspects of food synergy:

• A buffer effect, i.e. the effect of a large intake of a particular nutrient may vary depending on if it is taken in concentrated form or as part of a whole food.
• Nutrients can affect each other’s absorption, such as copper-zinc and magnanese-iron. These interdependent nutrients tend to appear together in foods, but not necessarily in isolated supplements.
• It matters whether the nutrients have been produced by technologic or biological processes. Trans fat produced in ruminant animals (such as conjugated linoleic acids in dairy products) are beneficial to health, whereas trans fats produced in the processing of industrial seed oils are highly toxic.

 
Then they provide evidence that whole foods are more effective than supplements in meeting nutrient needs:

• Tomato consumption has a greater effect on human prostrate tissue than an equivalent amount of lycopene.
• Whole pomegranates and broccoli had greater antiproliferative and in vitro chemical effects than did some of their individual constituents.
• Free radicals were reduced by consumption of brassica vegetables, independent of micronutrient mix.

Note: In the supplement world, the idea is that “a nutrient is a nutrient, a molecule is a molecule” regardless of what source it comes from. These folks claim that it doesn’t matter whether a nutrient comes from a whole food complex or a laboratory. Did you know that most vitamin B1 supplements are made from derivatives of coal tar? That ascorbic acid (vitamin C) is made by reacting high-fructose corn syrup with sulfuric acid? That many iron supplements are made from rusty nails? I don’t know about you, but I’d rather eat some meat and vegetables to get those nutrients.

Should we all take a daily multivitamin as “insurance” against a nutrient deficiency? Here’s how the authors respond to that question:
In our view, the better “insurance” would be to eat food with a broad coverage of nutrients and take no supplements at all, unless they are deemed necessary to fix a specific medical problem.

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I love the challenge in this article. I don’t know about you, but I easily get caught up in:

1. The intellectualization of health as a purely scientific, one size fits all formula or worse, an impossibly complex combination of factors and changing theories that confound me and lead me into fear, which surely is not serving my health.
2. Giving power for what is good for me to people I don’t know and who don’t know me. I’m alone at my computer doing internet research on multiple sites by supposed experts who all have their own perspective and conclusions. How do I know what they say is good for me? How do I decide? What about relationship as part of our wellness path? Or perhaps we have a doctor we work with who tells us how many mg of calcium, for instance, to take twice a day. This is an interesting one and leads to the power of faith. In my documentary short, “The Curandera of Teotitlan del Valle”, the traditional healer emphasizes the essencial factor of faith in healing. Maybe our allopathic medical practitioner only had one semester of nutrition in medical school, but we give them power and they assert it. Not necessarily bad. If one is in line with what one chooses to have faith in, by feeling in harmony and resonance with it, this will help or allow for healing via the relationship and interaction with that practitioner, whether M.D., traditional healer or nutritionist. In a sense this is a placebo effect.
3. Believing there is a “right” actual answer for me that I need to find and figure out and do in order to be well.
4. Making financial commitments without thinking through my values. The expense of being dependent on so many supplements that I read about for my own health. Is it sustainable economically for me? Do I want to have to work to have enough money to support this habit? (Not that some medications and supplements aren’t and can’t be helpful and crucial. I am not talking about all or nothing thinking.) What about food? Why don’t I believe in the power of food, especially organically grown in nutrient rich soil?
5. The fear that if I don’t take all the supplements I read about that I won’t be well. If thought has power, then is thinking like this helpful to me?
6. Another aspect of external solutions, external authorities is, is it true that I have no natural knowing or inborn right to be considered an authority if not the best authority regarding what is good for me? What food, thoughts, beliefs and activities feel good to me? Why can’t what feels good be a valid cue to what is good? Of course one needs to be discerning around the sensation of feeling good: is it grounded and trustworthy or is it escapist, as in feeling good temporarily from eating half a box of oreo cookies in one sitting? But where is intuition and internal knowing as valid and real in making decisions for our health and healing?
 
These are the questions I have grappled with for my entire adult life, and it’s largely why I was drawn to be a Health and Wellness Coach: I want to help others with what is so important to me because these are important (and challenging) issues that illustrate deep and historic cultural, philosophic, gender and spiritual issues which have informed many of our lives without us even realizing it. The bottom line being: we have bought a story that says we have no power and we are not wise. We are dependent on others to define reality, goodness and rightness for us, and that’s how it is. My purpose in coaching these issues is to challenge this and to facilitate, guide and support clients find their way to their inner truth, power and the trust of that.
 
What do you think about these issues?
Could it be that supplements aren’t as good as we’re told and believe?
Does it not matter whether science now says they are not overall so effective because what matters is what we believe?
How do you feel about what you believe? Why do you believe in what you believe: does it come from acceptance of an external authority, or from a grounded sense, or a combination of these – and are you comfortable with that or does it invite reflection and re-consideration?

I'd love to hear your thoughts on these issues. I read every comment and will respond!

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