First comment is I really worry about anyone who says research is rubbish. The reality is that these days almost everything we eat and buy has been the result of specialist research. Without it we could never advance at all, Without it we would still be in caves without a wheel!
Basically if your diet is varied and balanced with your 5 a day, there is no place for vitamins as you cannot make use of them much beyond the RDA (recommended daily amount) which is now written on many foods.
Excess does not contribute to your health and will be either removed in the urine or will accumulate which is not good for you. Its a bit like calories, eat the right amount and you are fine, eat too many and they accumulate and you get fat!
2007-03-15 18:47:51
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answer #2
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answered by Dr Frank 7
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This is the best answer I've seen to this flawed study so far:
Today's review of trials on antioxidants in the Journal of the American
Medical Association fails the four key tests of 'publication bias'. For the
following reasons I suspect it's an attempt to demote vitamin therapy so we keep
taking the drugs.
The first way to investigate whether an analysis of studies is biased is to
read the summary, and see if it correlates with the actual result. The
conclusion of this study says 'treatment with beta carotene, vitamin A, and vitamin
E may increase mortality' creating the impression these antioxidants are no
good. What it fails to say, all of which are clearly shown in the results, is
that 'vitamin C given singly, or in combination with other antioxidants, and
selenium given singly or in combination with other antioxidant supplements
may reduce mortality'. It also fails to say that 'beta-carotene or vitamin A
did not show increase in mortality if given in combination with other
antioxidants' , or that 'vitamin E given singly or combined with 4 other antioxidants
did not significantly influence mortality'. If you can have one take home
message it is that antioxidants are team players and reduce mortality in
combination, and that vitamin C and selenium are m ore beneficial than beta-carotene
or vitamin A.
The next way to investigate whether an analysis is a stitch up is to see if
all trials are included, how trials are excluded, and what the trials actually
say. Two classic primary prevention studies, where vitamin E is given to
healthy people, are those of Stampfer et al, published in the New England
Journal of Medicine, the first of which gave 87,200 nurses were given 67mg of
vitamin E daily for more than two years. A 40 per cent drop in fatal and non-fatal
heart attacks was reported compared to those not taking vitamin E
supplements (1). In another study, 39,000 male health professionals were given 67mg of
vitamin E for the same length of time and achieved a 39 per cent reduction in
heart attacks (2). Guess what? They are not included.
Bjelakovic's analysis goes on to further degrade antioxidants by deciding
which trials (usually the positive ones) are high bias, then excluding them, and
which trials are low bias (usually the negative ones) and only adding these
together. I don't agree with how this is done. For example, it is well known
that taking statin drugs, that lower cholesterol and induce CoQ10 deficiency,
make vitamin E harmful by turning it into an oxidant. This is an obvious
bias but the authors don't even mention this. Once you exclude these trials
vitamin E has an overall positive effect.
The next test is to see if the most negative studies were actually negative.
These studies can skew results on an overall analysis. One the studies most
cited to show increase risk of gastrointestinal cancer is that of Correa et
al. So I read the actual paper and contacted the author, Dr Pelayo Correa from
the pathology department at the Louisiana State University Health Sciences
Centre in New Orleans, and asked about the increased risk he had supposedly
found. He was amazed, he said, because his research, far from being negative,
had shown clear benefit from taking vitamins.
His study, published in the Journal of the National Cancer Institute, had
involved giving people with gastric cancer either beta-carotene, vitamin C or
antibiotics to kill off the stomach bacterium Helicobacter pylori. All three
interventions produced highly significantly improvements, causing substantial
regression of gastric cancer. Correa and his colleagues had concluded:
'dietary supplementation with antioxidant micronutrients may interfere with the
precancerous process, mostly by increasing the rate of regression of cancer
precursor lesions, and may be an effective strategy to prevent gastric
carcinoma'. No evidence of increased mortality there.
In fact, as Correa told us, there was no way the study could show anything
about mortality. 'Our study was designed for evaluation of the progress of
precancerous lesions,' he said. 'It did not intend, and did not have the power,
to study mortality and has no value to examine mortality of cancer.' Without
this study the main conclusion, that antioxidants may increase
gastrointestinal cancer, becomes completely invalid.
So, I'm afraid this 'meta-analysis' fails all four tests of publication bias.
The summary at the front refers to negative results only, not the positive
results. Some key positive studies have not been included. Positive studies
have become negative studies by jiggling the statistics. Known dynamics that
would bias some studies towards a negative effect have been ignored. In
conclusion, I will keep doing what I've always been doing, because this study
confirms it - and that is to supplement a combination of antioxidants, including
selenium and high dose vitamin C, because, as this study says, it seems to make
you live longer and reduce your risk of premature death.
Patrick Holford is co-author of Food is Better Medicine Than Drugs. See
_www.foodismedicine .co.uk_ (http://www.foodisme dicine.co. uk/) for his in-depth
feature on the 'antioxidant myth'
Wishing you the best of health,
(http://www.patrickh olford.com/) References:
1. M. J. Stampfer, et al.., Vitamin E consumption and the risk of
coronary disease in women, New England Journal of Medicine, vol 328(20), 1993, pp.
1444-9
2. E. B. Rimm et al.., Vitamin E consumption and the risk of coronary
heart disease in men, New England Journal of Medicine, vol 328(20), 1993, pp.
1450-6
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2007-03-15 17:52:52
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answer #5
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answered by Graham W 3
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