RSS Feeds
-
The role of multivitamins is life-long health.
Submit responseThe authors fail to find evidence for or against multivitamins- minerals [MVM] in chronic disease prevention yet issue a call for the FDA to control them. This despite another year going by without reported fatality from MVM. In the mean time, millions are injured or killed yearly by prescription drugs (1) while the top selling drug in cardiovascular prevention, atorvastatin (Lipitor[TM]), just reporting its 3rd placebo controlled trial, SPARCL, ending without mortality benefit [others are ASCOT and CARDS]. Clearly, the FDA role lies in such drug issues and not in the control of essential nutrients.
The chronic diseases considered include cardiovascular disease [CVD] that takes a lifetime to develop with pathology showing artery decline in the young. Not only are placebo controlled trials with essential nutrients largely unethical, trials tend happen at a late-stage of vascular decline when arterial "corrosion" is already extensive rather than when prevention starts, in childhood.
The authors miss the concept of life-long structural protein "corrosion" by homo-cysteine that opens cysteine based disulfide "bridges" and affects cysteine active cites in enzymes and any protein containing lysine or arginine. Such, often irreversible, protein thiolation is a phenomenon similar to protein "corrosion" by glycation, as by methyl- glyoxal in diabetes.
Considering the only therapy for reducing homo-cysteine is a MVM, and preferably a "high potency" one (2), such avenue of prevention has to start in childhood when randomized trials are not feasible. The absence of such trials over the 65 year existence of MVM explains the inability of the authors to conclude as to benefit of MVM, something the majority of Americans intuitively understand and where other researchers suggest health and cost benefits (3).
In age-related chronic diseases, prevention means dealing with root causes. The rationale for MVM in CVD is simple: it is a disease of which the incidence behaves like an epidemic and for which we have no free- living animal model while modern humans uniquely generate atherosclerosis naturally.
Only humans use heat, refining and processing proven to lower nutrient levels and MVM can reestablish pre-invent-of-fire levels of most micro-nutrients known to lower homo-cysteine. We know that homo-cysteine is controlled by at least 7 micro-nutrients and how it affects most proteins and in particular those of the arterial matrix, collagen, elastin, its fibers and proteoglycans (4, 5).
A high potency no-iron MVM costs $0.10 and comes without childproof cap attesting to safety. Long-latency diseases have old roots where most trials considered are meaningless and other avenues of science are available as vital guidance.
1. Lazarou J, Pomeranz BH, Corey PN. Incidence of adverse drug reactions in hospitalized patients: a meta-analysis of prospective studies. JAMA. 1998 Apr 15;279(15):1200-5. Medline 9555760
2. Vos E. Multivitamin supplements are effective and inexpensive agents to lower homocysteine levels. Arch Intern Med. 2001 Mar 12;161(5):774-5. Medline 11231722
3. Bendich A, Mallick R, Leader S. Potential health economic benefits of vitamin supplementation. West J Med. 1997 May;166(5):306-12. Medline 9217432
4. Takagi H, Umemoto T. Homocysteinemia is a risk factor for aortic dissection. Med Hypotheses. 2005;64(5):1007-10. Medline 15780501
5. Krumdieck CL, Prince CW. Mechanisms of homocysteine toxicity on connective tissues: implications for the morbidity of aging. J Nutr. 2000 Feb;130(2S Suppl):365S-368S. Medline 10721908
Conflict of Interest:
None declared
-
Another Viewpoint
Submit responseToday's articles on MVM supplementation demonstrate extensive labor by many individuals. Personally, I appreciate the great attention to detail, the immense work, and the thoughtfulness of the articles.
I would like to suggest that the basic issues can be viewed in other ways which have not been mentioned.
(1) The "disease oriented" approach of conventional medical thought is simply one way of addressing the issues of human health.
(2) A more fundamental approach might include an understanding of basic health principles, with efforts directed to help a person bring his life into line with principles which produce health, rather than constantly to analyze and struggle against the ever-growing complexity of disease-oriented thinking.
(3) American health care is very costly. Numerous sources demonstrate our success in producing a healthy population is not commensurate with the expenditures.
(4) It is possible that ever-increasing complexity and technology is not the full answer. Many answers to health may come in simple, tried and true, inexpensive packages.
(5) In my opinion, while the nutritional supplement industry definitely needs oversight, the FDA is in no way equipped to perform this function. The individuals involved do not seem to understand nutritional principles. The FDA overseeing the nutritional supplement industry would be comparable to a nutritionist overseeing a cardiac cath lab. There simply is not the knowledge base nor experience in either situation to do a competent job.
(6) It is my earnest, personal desire that the knowledge base, the practicality, and the marvels of nutritional medicine can be seen and understood by all of us in medical practice and institutions; that simple truths before our faces become obvious.
(7) I seriously doubt that we will solve the crisis in the cost of health care until changes of this nature occur.
Respectfully submitted,
Conflict of Interest:
None declared