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Vitamins No Help in Heart Disease?

Posted Dec 20 2008 5:47pm

If you'd like a perfect example of the way the media reports on vitamins-- and why it makes me crazy-- look no further than the recent headlines proclaiming "Vitamins No Help in Heart Disease".

First here's what happened, as reported in the Nov 12 issue of the Journal of the American Medical Association. Researchers enrolled 14,641 male physicians in the study, all of whom were at very low risk for cardiovascular disease. The men were divided into four groups.

  1. The first group took 400 IUs of vitamin E every other day and 500 mg of vitamin C every day.
  2. The second took vitamin E and a placebo vitamin C.
  3. The third, real vitamin C and a placebo vitamin E.
  4. The fourth group took 2 placebos.

After 8 years the researchers found no difference among the groups in the incidence of heart attack, stroke, or congestive heart failure.

"There are no compelling reasons to take either vitamin E or C for cardiovascular disease prevention" said the lead author, Howard D. Sesso.

OK read that over carefully and see if you can spot the problems.

Number one, we have no idea what kind of vitamin E was given. From past experience, doctors- who know absolutely nothing about this stuff- tend to give alpha-tocopherol, the least effective of the 8 components of vitamin E. Number two, look at the dose. Four hundred IUs taken every other day. And if previous experience is any guide, they probably used an synthetic source, which is about half as effective as a natural source. On what planet do you dismiss any possible benefit from vitamin E based on a low dose of an ineffective form of the vitamin given to a population that wasn't at risk in the first place?

And while vitamin C at 500mg is a nice basic dose, no one seriously thinks that's enough to make a therapeutic difference.

So the first thing that's wrong here is that it's a lousy study that seems almost pre-destined to show little effect. In fact the cards were so loaded against the vitamins that they would have to be miracle pills- literally preventing any cases of heart disease at these low doses- before the researchers would give them any credit.

The second thing is that the press unanimously reported this study as another case showing that vitamins are "ineffective".

Never mind that just last year multivitamin and vitamin E use was found to be associated with lower mortality from cerebrovascular disease (CVD) in the Japan Collaborative Cohort Study for Evaluation of Cancer. Never mind that vitamin E is the most potent fat-soluble anti-oxidant in the plasma and the tissues. And never mind that no less a source than the Physicians Desk Reference states that "The results of a very large number of studies, including in vitro and animal studies, epidemiological and intervention trails, support a role for vitamin E in the prevention of cardiovascular disease". And don't even get me started on the multiple benefits of vitamin C.

Look, I admit that some studies of single nutrients have been disappointing. And I'm certainly not saying that such studies shouldn't be reported. But is the message we really want to send here that vitamins are "ineffective"? Is that really what this study shows?

The moral of the story is this: Look a little deeper than the headlines. That's probably good advice in general, but it's certainly good advice in the field of health reporting.

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