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Dietary Supplements Under Attack

April 2009

By William Faloon

A Hidden Cause of Heart Attack and Stroke

Even when all conventional risk factors are controlled, the progressive decline of nitric oxide in the arterial wall (the endothelium) too often leads to coronary heart attack and stroke.68-75

A Hidden Cause of Heart Attack and Stroke

Seven years ago, Life Extension researchers identified a critical compound (tetrahydrobiopterin) that is an essential cofactor for the enzyme that synthesizes nitric oxide in the endothelium.76 We spent several hundred thousand dollars trying to develop an affordable way to manufacture this compound as it offered tremendous promise for eradicating atherosclerosis.

We failed to find an affordable way to make tetrahydrobiopterin. The good news is that nutrients that suppress peroxynitrite (like gamma tocopherol and pomegranate) increase endothelial nitric oxide by blocking the oxidation of tetrahydrobiopterin.77,78

Indeed, clinical studies show that supplemental gamma tocopherol enhances platelet endothelial nitric oxide synthase activity.52,53 Furthermore, a diet high in gamma tocopherol-rich walnuts improves endothelium-dependent vasodilation in those with high cholesterol.63

By administering only alpha tocopherol as was done in the flawed study, one would expect gamma tocopherol to be suppressed, peroxynitrite levels to increase, and precious tetrahydrobiopterin to be oxidized, thus depriving the endothelium of the nitric oxide it needs to protect against heart attack and stroke. Is it any wonder that this study failed to show vascular disease reduction in those given only alpha (but not gamma) tocopherol?

Failing to Account For All Vascular Risk Factors

Numerous independent risk factors are associated with the development of atherosclerosis and subsequent heart attack and stroke risk. A major flaw in this study was expecting low-dose vitamin C and/or E to somehow overcome all of these underlying causes of artery disease.

We know it is impossible for vitamins C and E to overcome these many risk factors, but this did not stop the media from recommending that Americans discard their supplements.

The following represents a succinct list of documented vascular disease risk factors:

  1. Low testosterone (in men)
  2. Excess fibrinogen
  3. Low HDL
  4. Excess LDL and total cholesterol
  5. Excess glucose
  6. Excess C-reactive protein
  7. Excess homocysteine
  8. Hypertension
  9. Low blood EPA/DHA
  10. Excess triglycerides
  11. Excess insulin
  12. Excess estrogen (in men)
  13. Oxidized LDL
  14. Excess platelet activity
  15. Nitric oxide deficit (endothelial dysfunction)
  16. Insufficient vitamin D
  17. Insufficient vitamin K2

The basis for doing this study, as outlined by the study’s authors, was to use vitamins C and/or E to:

  1. Trap organic free radicals… deactivate excited oxygen molecules… inhibit LDL oxidation
  2. Modify vascular reactivity… prevent tissue damage
  3. Modify platelet activity and thus reduce thrombotic potential.

As one can clearly see on the previous page, there are 17 documented cardiovascular risk factors. Yet only three of these risk factors are what formed the basis for conducting this low-dose vitamin C and/or E clinical trial. The three most important risk factors the authors of the flawed study expected to favorably influence with vitamins C and E were:

  1. LDL oxidation
  2. Platelet activity and thrombotic potential
  3. Vascular reactivity (another term for endothelial dysfunction).
Failing to Account For All Vascular Risk Factors

For every one mechanism the study’s authors proposed might enable low-dose vitamin C and/or synthetic vitamin E to work, there are five additional risk factors that would not be corrected. For instance, vitamins C and E in these low doses are not going to reduce C-reactive protein,86 homocysteine, fibrinogen, or glucose.87 Vitamins C and E in any dose are not going to increase testosterone, decrease estrogen, or provide cardioprotective EPA/DHA and vitamin D.

On the contrary, as we have already shown, by giving only alpha but not gamma tocopherol, one might expect increased LDL oxidation and impaired endothelial function. That’s because alpha tocopherol displaces gamma tocopherol in the body. Gamma tocopherol suppresses the peroxynitrite radical that oxidizes both LDL protein and the tetrahydrobiopterin that is needed to produce endothelial nitric oxide.

As far as platelet activity and thrombotic potential (abnormal clotting inside a blood vessel) are concerned, gamma tocopherol is significantly more potent than alpha tocopherol in inhibiting platelet aggregation that can lead to a heart attack or stroke.52,53 By displacing gamma tocopherol, the alpha tocopherol used alone in this study may have increased abnormal platelet aggregation risk.

From everything we know today, this study was designed to fail. Not only did it not correct for the major causes of vascular disease, but it may have exacerbated some of the more dangerous ones.

None of What I Wrote So Far May Really Matter

You have just learned why low-dose vitamin C and/or E supplementation would not be expected to reduce heart attack and stroke risk.

I have saved the biggest shocker for last. It turns out that a significant number of the study subjects (who were all medical doctors) who were supposed to take the vitamin C and/or E supplements did not take their pills. Yet when the calculations for heart attack or stroke incidence were made, those who took as little as 66% of their low-dose vitamin C and/or E supplements were counted as having taken the entire dose.

At the end of the study, 28% of the study subjects admitted they had not even taken 66% of their low-dose vitamin C and/or E supplements.

Even more troubling is the method used to track who was really taking their supplements. Participants were asked to remember and track supplement usage for over eight years’ time without any verification of actual pill counts, compliance by plasma antioxidant analysis, or in vivo surrogate markers of oxidative stress. Relying upon participants’ memory and recollection over a lengthy time period of many years is a rather pathetic way of ensuring adherence, and renders the authors’ so-called “sensitivity analysis” meaningless.

The lack of adherence, i.e., the fact that a significant percentage of the study participants were not even taking their vitamins, may be the most significant flaw to this study. No one in the mainstream media bothered to report this, or any of the other flaws that jumped out at us.

Instead, the media’s message was don’t waste your money on vitamin C or E pills. Many supplement users who are taking the right form and dose of their vitamin C and E nutrients may believe the media’s biased reporting.

Shocking Deficiencies of Vitamin E

The media used this horrific-ally flawed study as a basis to steer Americans away from vitamin C and E supplements. It’s as if all of the previous positive published studies disappeared overnight.

What was omitted is the fact that 92% of American men and 98% of American women do not consume the recommended dietary allowance of vitamin E in their diet. The federal government says Americans need 15 milligrams per day of vitamin E, yet even this minute amount is not found in the diets of the vast majority of people.88

This means that most Americans require a vitamin E supplement to avoid a chronic deficiency, but this important fact was conveniently left out of the news stories.

Conventional medicine says that severe vitamin E deficiency results mainly in neuro-logical symptoms such as impaired balance and coordination and muscle weakness. These neurological symptoms do not develop for 10-20 years, as it takes time for free radicals to inflict nerve damage in the absence of sufficient vitamin E. The reality is that chronic vitamin E deficiency adversely impacts virtually every cell of the body.89-94

Does Drug Money Influence How Medical Journals Report on Dietary Supplements?

A group of statistical researchers investigated the relationship between pharmaceutical advertising and articles regarding dietary supplements in medical journals.99 The analysis revealed that:

  1. Journals with the most pharmaceutical ads published significantly fewer major articles about dietary supplements per issue than journals with the fewest pharmaceutical ads (P < 0.001).
  2. The percentage of major articles concluding that dietary supplements were unsafe was 4% in journals with the fewest pharmaceutical ads and 67% among those with the most pharmaceutical ads (P < 0.005).
  3. The percentage of articles concluding that dietary supplements were ineffective was almost twice as high (50%) among journals with more pharmaceutical ads than among those with fewer pharmaceutical ads (27%).

The researchers concluded that increased pharmaceutical advertising is associated with the publication of fewer articles about dietary supplements and more articles with conclusions that dietary supplements are unsafe.99

A major reason why many conventional doctors are biased against dietary supplements is that the journals they read seldom publish the favorable studies. Dietary supplements compete directly against prescription drugs in many disease categories. When dietary supplements are properly used to prevent disease, demand for expensive pharmaceutical agents is diminished. It is thus in the financial interest of pharmaceutical companies to encourage negative studies to be published in influential medical journals.

It seems more than a coincidence that mainstream medical journals publish negative editorials against dietary supplements at times of the year that garner the most media coverage. Life Extension has long argued that the billions of advertising dollars spent by pharmaceutical companies influences media bias against dietary supplements. This latest study reveals that drug money may also be corrupting medical journals that have a significant impact on professional and public opinion.

A Media Coup for Pharmaceutical Companies

The optimal moment of the year to get your message to the masses is the second week of November. This is a time in between holidays, when winter is setting in, and few people are on vacation. The television networks consider this their most important “sweeps week” as it provides the most accurate measurement of their ratings.

Media Also Attacks Vitamin D

The timing of the release of this horrendously flawed vitamin C and E study could not have been more perfect for pharmaceutical interests. It came out less than one week after the November elections, when the media was primed to sensationalize any story that would attract viewers for their all important “sweeps week.”

On the very same day the media launched its attack on vitamins C and E, the same news sources reported that very high doses of the statin drug Crestor® reduced heart attack rates by 54% in healthy people who had high C-reactive protein levels.95 Just think, uneducated consumers read on the same day that vitamins C and E are worthless and an expensive statin drug performs miracles.

Financial analysts predict a windfall for the makers of Crestor® based on this widely distributed report. In retrospect, conducting a study only on people with high C-reactive protein (but not particularly high LDL) was a brilliant marketing strategy. It had a high probability of a successful outcome, and if the study failed, Crestor® was never approved to lower C-reactive protein or be used in this population group, so the pharmaceutical company had nothing to lose.

We at Life Extension have long warned about the vascular dangers of elevated C-reactive protein and even recommended statin drugs if natural approaches fail to reduce C-reactive protein. We don’t believe most people have to purchase expensive brand name drugs like Crestor®, as generic simvastatin (name brand Zocor®) or pravastatin (name brand Pravachol®) can provide similar benefit at a fraction of the price.

Media Also Attacks Vitamin D

Not content to bash only vitamins C and E, the media the very next day in November 2008 ran a headline story stating that “Supplements don’t reduce breast cancer risk.” This story was based on a study of women who received only 400 IU a day of supplemental vitamin D.96

Don’t Be a Victim of This Flawed Propaganda

As has been reported for years in this and other health publications, 400 IU a day of vitamin D is clearly inadequate.97 To reduce breast cancer risk by around 50%, a daily dose of 1,000 IU and higher is required. The major flaw in this study is that participants in the active and placebo group were allowed to take vitamin D outside the study, which rendered the findings meaningless even if the proper dose had been given.

The fact that the media made this study headline news is regrettable because only about 20% of the study population achieved a 25-hydroxyvitamin D blood result at the minimum level required to prevent breast cancer (approximately 30 ng/mL or higher). In other words, most participants in the active or placebo group failed to achieve even the minimal blood concentrations of vitamin D that other studies document are needed to protect against breast cancer.98 So all this study did was help confirm what vitamin D experts have been saying for over five years now, i.e., a minimum of 800 IU to 1,000 IU of vitamin D a day is required… not the 400 IU used in this study.

Don’t Be a Victim of This Flawed Propaganda

It is in the economic interests of drug companies to steer Americans away from healthier lifestyles and dietary supplements. As more Americans fall ill to degenerative disease, drug company profits increase exponentially.

Enormous amounts of pharmaceutical dollars are spent influencing Congress, the FDA, and other federal agencies. The result is the promulgation of policies that cause Americans to be deprived of effective, low-cost means of protecting themselves against age-related disease.

As a member of the Life Extension Foundation, you gain access to scientific information that is interpreted in the context of what health-conscious people are really doing to protect themselves against age-related diseases. You also learn how this information is distorted by the government, drug companies, and the media to discourage the public from following healthier lifestyles.


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