The End of Dieting: How to Live for Life (37 page)

Just because almost all multivitamins contain some questionable and potentially cancer-promoting ingredients doesn’t mean that all supplements are harmful or worthless. Certainly, not all supplemental
ingredients are potentially harmful; many have significant benefits. A healthy diet might contain suboptimal levels of vitamins B
₁₂
and D, and for many people the levels of other critical elements may be similarly suboptimal. People aren’t carbon copies of one another. Scientific literature points to the potential health problems that may arise from deficiency and insufficiency, and my decades spent examining the blood of thousands of patients have made clear that some people need supplementation of certain nutrients to maximize their health potential.

Traditional multivitamins, however, aren’t the best answer. Some studies on multivitamins show benefits, and others don’t; but it’s not good science to look at studies on multivitamins as a whole because there are too many variables mixed together. Multivitamins are most often a combination of harmful substances and potentially helpful substances. My review of all the literature on the individual supplemental ingredients has led me to strongly advise against taking standard multivitamins that contain folic acid, beta-carotene, vitamin A (acetyl and retinyl palmitate), vitamin E, selenium, copper, and for men and postmenopausal women, iron.

Folic Acid

Stay away from folic acid, which is the synthetic form of folate, a member of the family of B vitamins. Synthetic folic acid found in supplements has a different chemical structure than natural folate, which is found abundantly in natural food, particularly green vegetables and beans. Your body processes folate and folic acid differently. Folic acid is about twice as absorbable as natural folate, and once absorbed it must be modified before it can act as folate.
¹
Your body can convert only so much folic acid into folate, so too much folic acid enters the blood and tissues as unmodified folic acid.
²
Exactly what unmodified folic acid does in the human body is unclear, but there is evidence that it can disrupt normal folate metabolism and promote cancer growth. Taking synthetic folic
acid has been linked to an increased risk of developing breast, prostate, and colorectal cancers.
³
For example, a ten-year study on women taking multivitamins concluded that those who took multivitamins containing folic acid increased their breast cancer risk by 20 to 30 percent.
⁴
A 2011 meta-analysis of six folic acid supplementation trials similarly found that the incidence of all cancers was 21 percent higher in the groups that received folic acid supplements.
⁵
In contrast, higher consumption of natural food folate helps to prevent breast, prostate, and colorectal cancers.
⁶
There is simply too much evidence to ignore. We must be cautious and avoid supplementing our diets with folic acid.

Fortunately, you don’t really need to take extra folic acid, because natural folate is abundant in green vegetables, beans, and other plant foods. A nutritarian diet supplies you with enough folate for your body to function properly. Folate is essential for several chemical reactions related to DNA production, including methylation and repair mechanisms, crucial steps in the division of cells. Folate is also important for normal fetal development and support of normal immune function to fight against cancer.
⁷
Folate has become widely known for protecting against neural tube defects in developing babies.

The U.S. government and health authorities insist that women who may become pregnant take supplemental folic acid, rather than recommending that they eat green vegetables, which contain folate in addition to hundreds of other cancer-protective micronutrients. This pill-for-every-ill mentality may create new problems, such as an increase in childhood cancers and breast cancer. Every woman should be aware that no supplement can substitute for healthful eating. Eating folate-rich foods during pregnancy may also offer protection against cardiac birth defects, childhood respiratory illnesses, and childhood cancers.
⁸

Since folate is most important very early on in pregnancy, the most important thing women can do to prevent neural tube defects and protect their unborn child from other health problems is to consistently eat plenty of greens and other folate-rich foods before becoming
pregnant and during pregnancy. Folic acid is a weak substitute for the real thing.

Beta-Carotene

Beta-carotene—along with alpha-carotene, lutein, and lycopene—is one of more than six hundred carotenoids, the yellow, orange, and red pigments that have antioxidant activity and are present in fruits and vegetables. Beta-carotene is a provitamin A carotenoid, which means that it is converted to vitamin A in the body. Carotenoids contribute to proper immune function and vision and defend the body’s tissues against oxidative damage. This helps to prevent chronic diseases and premature aging.
⁹

Early observational studies have found that individuals with higher beta-carotene blood levels had lower risks of cancer, and interventional studies using beta-carotene and vitamin A supplements followed. However, beta-carotene supplements were unable to produce the beneficial effects of carotenoid-rich plant foods. In fact, supplementation with beta-carotene was associated with an increased risk of cancer and premature death.
¹⁰
A meta-analysis of many studies of anti-oxidant vitamin supplementation found that vitamin A supplements were associated with a 16 percent increased risk of death, beta-carotene a 7 percent increase, and vitamin E a 4 percent increase.
¹¹
It is possible that beta-carotene from supplements could interfere with the absorption of other anticancer carotenoids, such as lutein and lycopene.
¹²

The precise reason for the increased risk is not clear. What is clear, however, is that beta-carotene supplementation is a poor substitute for the more than six hundred carotenoids found in nature. It’s possible for nutrients in isolation (in supplemental form) and at high doses to act differently in the body than when they are derived from foods and naturally balanced with other nutrients. A nutritarian diet style provides a more than adequate supply of carotenoids; therefore, supplemental beta-carotene and vitamin A simply are not needed—and they
may be risky. We should not be taking supplements that increase the risk of disease. Get your beta-carotene from food, not supplements.

Vitamin A

Vitamin A (acetyl or retinyl palmitate) is likely the most dangerous supplement of all. In addition to the 16 percent increased risk of death found in a meta-analysis of vitamin A supplementation trials,
¹³
high doses of supplemental vitamin A may also increase calcium loss. It has also been linked to an increased incidence of hip fractures.
¹⁴
And excess vitamin A can cause liver damage and birth defects.
¹⁵

Vitamin E

Vitamin E encompasses a number of similar fat-soluble compounds found primarily in nuts and seeds such as almonds, hazelnuts, and sunflower seeds. The multiple vitamin E fragments they contain, coupled with other healthful compounds, result in health benefits that you simply cannot obtain from a vitamin E supplement. When one fragment of vitamin E is isolated and supplemented, according to hundreds of studies, these benefits are lost. Similar to vitamin A and beta-carotene, vitamin E supplements were found to not be protective, and a small increase in the risk of death was reported in a recent meta-analysis.
¹⁶
Though hardly the most harmful of supplemental ingredients, vitamin E supplements do not give you the best benefit-to-risk ratio. Vitamin E is important, but it’s best to get vitamin E from nuts and seeds.

Selenium

Selenium deficiency is definitely harmful and usually the result of a steady diet of refined foods, or malnourishment. It is also sometimes
related to gastric bypass surgery. A nutritarian diet prevents selenium deficiency.

While selenium deficiency is harmful, too much selenium can be harmful too, which is why taking selenium in supplemental form is so risky. Recently, evidence has emerged that high selenium levels may be associated with diabetes, elevated cholesterol levels, prostate cancer, cardiovascular disease, and impaired immune and thyroid function. There is also a link between selenium excess and amyotrophic lateral sclerosis (ALS).
¹⁷
In light of these studies, I advise avoiding supplemental selenium. You will automatically get sufficient selenium from a healthy diet, so you won’t need this ingredient in a supplement.

Copper and Iron

Copper and iron are essential minerals. Iron is crucial for oxygen transport in the blood, and both iron and copper take part in many of the body’s vital chemical reactions. The human body stores excess iron and copper, and as we age these metals may build up and become toxic. Iron, in excess, also has pro-oxidant effects that may contribute to cardiovascular disease and cognitive decline in older adults.
¹⁸
Excess copper intake, especially when in conjunction with high saturated and
trans
fat intake, may also contribute to cardiovascular disease and accelerate cognitive decline in older adults.
¹⁹

The most common sources of excess iron and copper are red meat and multivitamins. One of the negative health effects of red meat is due to its heme iron, which is too readily absorbed. Adequate, but not excessive, amounts of iron and copper are found in plant foods.

Excess iron is somewhat less of a concern for menstruating women compared with men because women lose some iron as a result of menstruation. Some women who have a heavier menstrual flow each month and who absorb iron less efficiently may require more iron than natural plant foods can supply. However, keep in mind that the health benefits
of a nutritarian diet and lower body fat stores include reduced menstrual pain and menstrual bleeding over time, which would also reduce iron requirements. So the amount of iron menstruating women need can be relative to the amount of blood they lose each month, their dietary choices, and their differences in absorption of iron.

The primary issue for men and postmenopausal women is to not consume excess iron. Eating red meat can result in your getting too much iron, which can increase your risk of heart disease and dementia. The iron from supplements is not as well absorbed as the iron in meat, so a low-dose iron supplement may be helpful if an increased need exists from heavy menstrual flow. Low iron levels can cause fatigue, even when anemia is not present. Also, iron deficiency in infants and toddlers can retard brain development and intelligence, so it’s important that pregnant and nursing mothers aren’t deficient in iron. A blood test showing a ferritin level lower than 50ng/ml indicates a need for iron. Supplemental iron should be taken only when there is a deficiency or increased biological need, such as during pregnancy or in premenopausal women who are experiencing excessive bleeding.

Vitamin B
₁₂

Vitamin B
₁₂
is involved in red blood cell production and keeps the nervous system working properly. Vitamin B
₁₂
deficiency can elevate the amino acid homocysteine, a risk factor for cardiovascular disease, and cause a number of serious health problems, including anemia, depression, confusion, fatigue, digestive issues, and nerve damage.
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As we get older, our ability to absorb vitamin B
₁₂
from food begins to decline. In fact, about 20 percent of adults older than sixty have insufficient vitamin B
₁₂
levels, and insufficient B
₁₂
levels are associated with an increased risk of Alzheimer’s disease.
²¹
In addition, vitamin B
₁₂
is made exclusively by microorganisms, which means that animal products are the only dependable source of it. Soil contains vitamin B
₁₂
–producing
microorganisms, but since we wash produce before we eat it, most of us are unable to get sufficient vitamin B
₁₂
from plant foods alone. Therefore, vitamin B
₁₂
supplementation beyond what is found in a nutritarian diet is necessary.

Vitamin D

Vitamin D is produced by the skin in response to exposure to the sun’s ultraviolet rays. It regulates bone density by increasing the intestinal absorption of calcium and promoting the activity of bone-building cells. Although it is most known for its role in bone health, recent evidence has shown that vitamin D has important functions relevant to many other aspects of human health.
²²
Insufficient vitamin D levels are associated with several cancers, diabetes, cardiovascular disease, depression, and autoimmune diseases.
²³
And a number of studies have now found correlations between low vitamin D levels and increased risk of death from all causes.
²⁴
Higher blood levels of vitamin D, on the other hand, have been associated with reduced risk of several cancers.
²⁵
One newly published study found that a doubling of vitamin D level resulted in a 20 to 23 percent reduced likelihood of mortality over thirteen years of follow-up.
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