Life Extension Magazine®

Issue: Aug 2000

A Critical Analysis of The National Academy of Sciences' Attack on Dietary Supplements

Putting anti-supplement reports under the microscope.

By William Faloon

William Faloon
William Faloon

Consumers of vitamin supplements have been hit with a lot of negative press lately, and The Life Extension Foundation has been on the forefront in evaluating whether these anti-supplement reports have scientific merit.

Two months ago, we examined a presentation made at an American Heart Association meeting where a doctor stated that compared to non-supplement users, vitamin C takers had higher rates of carotid artery wall thickening. In response to this claim, The Foundation conducted an identical test on 30 members who had been taking very high doses of vitamin C (and many other nutrients) for many years. Results showed that these vitamin C supplement takers as a group had remarkably healthy carotid arteries compared to the average population. The group we tested were significantly older than the people evaluated by the American Heart Association. Our group should have had more evidence of carotid atherosclerosis and thickening. Instead, Foundation members as a group were found to have no indication of increased carotid wall thickening in response to their very high vitamin C intake. We also showed how this American Heart Association presentation, which looked at people taking relatively low potencies of vitamin C (500 mg a day and less), had no relationship to Life Extension Foundation members who are taking very high doses (2000 mg a day and higher) of vitamin C along with other nutrients that have been shown to reduce the risk of atherosclerosis.

On April 10, 2000, the National Academy of Sciences issued a press release that stated:

"Insufficient evidence exists to support claims that taking megadoses of dietary antioxidants, such as selenium and vitamins C and E, or carotenoids, including beta-carotene, can prevent chronic diseases."

This report received widespread media attention, and many news articles questioned the value of dietary supplements altogether. The National Academy of Sciences’ press release was based on the conclusions of a 512-page book that ostensibly looked at all the published scientific literature about the intake of certain nutrients and subsequent risk of developing disease.

Contradiction and Omission

The name of this 512-page book is Dietary Reference Intakes For Vitamin C, Vitamin E, Selenium and the Carotenoids. This book contains a startling contradiction. The negative conclusions drawn by the authors are opposite to the positive findings about the supplements that are described in the very same book. This contradiction is not surprising, considering that the book is authored by two “committees” comprised of 40 members.

The book omits published studies about antioxidants. It also fails to take into account that supplement takers usually consume a wide variety of nutrients to protect their health, not just vitamin C or E alone. The authors of the book did capably describe many of the positive studies indicating a disease risk reduction in response to a particular supplement. But it turns pessimistic when even one study fails to confirm the many positive ones. An example of the pessimistic tone can be seen in the following quotation that appeared on page 187:

"A large and growing body of experimental evidence suggests that high intakes of vitamin E may lower the risk of some chronic diseases, especially heart disease. However, the limited and discordant clinical trial evidence available precludes recommendations at this time of higher vitamin E intakes to reduce disease risk."

This statement is followed by numerous pages itemizing the studies showing that vitamin E prevents chronic diseases. For instance, the author’s analysis of observational human studies shows “risk reductions of 30% to 60%” in coronary heart disease risk in those consuming the highest amounts of vitamin E. Despite these reductions in heart attack risk, the authors stated, “As of this date, there are insufficient data on which to base a recommendation for vitamin E as a heart disease preventive to the general population.” The authors did, however, raise the “safe” upper dose limit of vitamin E to 1500 IU a day.

It should be emphasized that the book essentially supports dietary supplementation for the purpose of disease reduction. In fact, this book makes a strong case that these supplements (vitamin C, vitamin E, selenium and the carotenoids) produce significant health benefits. The negative twist, however, comes when the authors conclude that there is “insufficient evidence” to recommend that the general population supplement with these nutrients.

What are "Dietary Reference Intakes"?

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The primary purpose of this book is to establish new government recommended daily allowances for vitamin C, vitamin E, selenium and the carotenoids. The new term for RDA is “Dietary Reference Intakes,” which is defined as “reference values that are quantitative estimates of nutrient intakes to be used for planning and accessing diets for apparently healthy people.”

One problem with this definition of “Dietary Reference Intakes” is that it fails to take into account that as people age, they are no longer “apparently healthy.” While some aging people optimistically claim to be as healthy as ever, aging wreaks havoc in every cell of the body. The authors recognized their limits in setting new “Dietary Reference Intakes” by admitting that they were not able to estimate the amount of these nutrients “required by children, adolescents, lactating women and the elderly.”

Unfortunately, when the press reported on this book, it failed to mention the limitations that the authors themselves placed on their conclusions. In setting these new “Dietary Reference Intakes,” the authors emphasized their limitations by stating that “scientific judgement was required for evaluating the evidence and in setting the reference values.”

“Scientific judgement” is a fancy way of saying that these new recommendations are based on the arbitrary conclusions of two committees. This subjective approach should not be confused with bona fide science, as an evaluation by another group could yield completely different conclusions.

The vitamin E recommendations are a good example of what “scientific judgement” really means. Those concerned about protecting their health take vitamin E because of studies showing “risk reductions of 30% to 60%” in heart attack risk. Yet, in the “scientific judgement” of the committees, there is still “insufficient data” to recommend that people actually take vitamin E supplements.

What They Said About Vitamin C

While increasing the maximum safe daily intake of vitamin C to 2000 mg a day, the authors of the 512-page book set the recommended daily intake of vitamin C as follows:

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Males 90 mg
Females 75 mg
Smokers 35 mg additional
(to compensate for the increased “oxidative stress” smoking induces)

These doses of vitamin C, the authors noted, “should maintain near maximal neutrophil ascorbate concentrations with little urinary excretion.”

Supplement users, however, are taking vitamin C for reasons other than to maintain their “neutrophil ascorbate concentrations.” (Neutrophils are specialized immune cells that require vitamin C to kill pathogens and still maintain their cellular integrity.)

As was the case with vitamin E, the 512-page book contains numerous pages of summaries of published papers indicating significant health benefits in response to vitamin C supplementation. One study describes that when smokers were supplementing with 2000 mg a day of vitamin C, “the adhesion of their monocytes to endothelium decreased to that seen in non-smokers.” (Monocyte adhesion is an initial factor leading to the development of atherosclerosis). Instead of recommending that smokers take 2000 mg of vitamin C as the people did in the study, the authors suggest that smokers obtain only 110 to 125 mg per day of vitamin C.

This kind of illogical recommendation is pervasive through the vitamin C chapter. For instance, page 103 of the book states:

"Numerous investigators have reported a beneficial effect of high-dose vitamin C administration, either orally or intraarterially, on vasodilation. This beneficial effect of vitamin C is most likely related to its antioxidant effect. Vitamin C improves endothelial function and vasodilation, possibly by scavenging superoxide radicals, conserving intracellular glutathione, or potentiating intracellular nitric oxide synthesis."

Strangely, the authors interpret these kinds of positive findings as an indication to not take high doses of vitamin C. The 512-page book makes it clear that high doses provide the beneficial effect of vitamin C on the arterial system. The contradictory conclusion, however, is that people only need between 75 and 125 mg of vitamin C a day. These types of contradictions may be explained by the fact that many different people were involved in writing the 512-page book.

When it comes to vitamin C and cancer, the authors again provide substantial data from the published literature to show both potential risk reduction benefit, definitive risk reduction benefit or no risk reduction benefit. Since some studies show no risk reduction benefit, the authors advise against vitamin C supplementation for the purpose of cancer prevention.

A partial list of supplements typically consumed by the serious vitamin consumer

  • Coenzyme Q10
  • Alpha lipoic acid
  • Ginkgo
  • Grape-seed
  • Green tea
  • Vitamin A
  • Vitamin B1
  • Vitamin B2
  • Vitamin B3 (in the form of niacin and niacinamide)
  • Vitamin B5
  • Vitamin B6
  • Vitamin B12 (in the form of methyl and cyanocabolomin)
  • Folic Acid
  • Biotin
  • Vitamin C (and both water and fat soluble forms)
  • Vitamin D
  • Vitamin E (in the form of alpha and gamma tocopherol or tocotrienol)
  • Fatty acids (fish, flax or Perilla oils, gamma linolenic acid, etc)
  • Choline
  • Inositiol
  • Magnesium
  • Zinc
  • Selenium
  • Molybdenum
  • Manganese
  • Lutein
  • Alpha carotene
  • Beta carotene
  • Lycopene
  • Calcium
  • Trimethylglycine (TMG)
  • Acetyl-l-carnitine
  • Chromium
  • Bilberry
  • Low-dose aspirin
  • DHEA
  • Melatonin
  • Taurine
  • N-acetyl-cysteine
  • Lysine
  • Silymarin
  • Potassium

Each one of the above nutrients has been shown to provide specific health benefits, and many work together in a synergistic fashion to protect against the onset of degenerative disease.

The same hold true with immune function. Some studies show positive benefit, others show no benefit. Therefore, according to the authors, vitamin C supplementation is not recommended.

On page 125 of the 512-page book, the authors offer the following conclusion regarding vitamin C and cancer:

"Although many of the above studies suggest a protective effect of vitamin C against specific cancers by site, the data are not consistent, or specific enough to estimate a vitamin C requirement based on cancer."

When evaluating the potential benefit of vitamin C to prevent cataract, the authors describe the following studies:

  • 490 mg a day of vitamin C resulted in a 75% reduction in cataract compared to doses less than 125 mg a day.
  • 300 mg a day of vitamin C associated with a 70% reduction in cataract.
  • Higher intake of vitamin C is associated with a 20% reduction in cataract.
  • No association found in cataract risk in people taking 260 mg a day of vitamin C compared to those taking 115 mg a day. (This is considered a negative study.)
  • Cataract risk was 45% lower in nurses taking vitamin C supplements for ten years, but no effect was observed for those taking vitamin C for less than ten years.

(This, too, is considered a negative study by the authors.)

Based on the above studies, the authors of the 512-page book concluded:

"Although many of the above studies suggest a protective effect of vitamin C against cataracts, the data are not consistent or specific enough to estimate the vitamin C requirement based on cataract.."

When evaluating the effects of vitamin C on asthma and chronic obstructive pulmonary disease, again the authors cite studies showing a significant protective effect, but their conclusion is:

"Although many of the above studies suggest a protective effect of vitamin C against asthma and obstructive pulmonary disease, the data are not consistent or specific enough to estimate the vitamin C requirement based on asthma or pulmonary disease."

In the summary, the authors make an argument that optimal cardiovascular and cancer protection may occur with total daily vitamin C intake of 90 mg, but state it may be difficult to conduct large-scale clinical studies in the U.S. and Canada to prove this because it would be hard to isolate a group that consumes less than 90 mg a day of vitamin C. The authors go on to provide examples of vitamin C protecting against a wide range of other diseases, but discount all these studies as “insufficient” to warrant wide scale supplementation.

While the 512-page book cited many published studies documenting the beneficial effects of vitamin C, there were serious omissions. The most significant study that was omitted was published in the American Journal of Clinical Nutrition in August 1996. This study examined 11,178 elderly people over a 9-year period. The results of the study showed that those who took high potency supplements of vitamin C and E had an overall 42% mortality risk reduction. Said differently, there were 42% fewer people dead over a nine year period who took high potency vitamin C and E supplements compared to those taking low potency or no supplements.

In addition, we discovered numerous positive studies about vitamin C that met the criteria for inclusion in the 512-page book (as defined by the authors) which were ignored.(1-166) Had these positive studies been included, they would have erased the doubt the authors expressed about the disease prevention potential of vitamin C.

What Are Vitamin C's Side Effects?

The authors speculated about the potential toxic effects of vitamin C, but concluded that the extent of toxicity appears to be diarrhea in some people at high doses. Had the media read the 512-page book, instead of relying on the biased press release that implied a health risk to vitamin C supplements, the media would have reported that high doses of vitamin C are remarkable safe.

What They Said About Selenium

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Selenium is a mineral used to protect against a wide range of diseases, but the authors of the book only discussed the role of selenium as an antioxidant and cancer preventive agent.

The authors omitted from discussion studies showing selenium protects against heart disease,167-197 studies showing selenium protects against hepatitis viral damage,198-206 studies showing selenium slows progression of HIV,207-224 studies showing that selenium protects against cataract,225-234 and numerous other studies showing definitive health benefits in humans.235-273 These studies were omitted as if they did not exist.

Here is what the 512-page book did report about studies on selenium and cancer on pages 290-291:

"Subjects assigned a daily combination of selenium (50 mcg), beta-carotene (15 mg) and vitamin E (30 mg) achieved a significant (21 percent) decrease in gastric cancer mortality, resulting in a significant 9 percent decline in all-cause mortality. However, these results cannot be attributed to selenium alone, because the individuals consumed selenium in combination with beta-carotene and vitamin E."

"200 mcg a day of selenium administration in the form of yeast showed no effect on recurrence of non-melanoma skin cancer compared to placebo group but significantly lower rates of prostate, colon and total cancer were observed among those assigned to the selenium group." (This was considered a negative study by the authors)

"The risk of prostate cancer for men receiving 200 mcg a day of selenium was one-third that of men receiving placebo."

While numerous published studies exist to support the protective role of selenium against cancer, the authors choose only the above three studies to question the value of selenium supplementation. The three studies cited above, however, are quite positive, yet the authors twisted their meaning to imply the studies showed no definitive cancer risk reduction benefit.

As far as cancer and selenium are concerned, the 512-book concluded with the following information on page 291:

"Results of these three studies are compatible with the possibility that intakes of selenium above those needed to maximize selenoproteins have an anti-cancer effect in humans. These findings support the need for large-scale trials. They cannot, however, serve as a basis for determining dietary selenium requirements at this time."

The overriding error with the above “conclusion” is that it failed to incorporate the findings of a large-scale clinical study published in the December 25, 1996 issue of the Journal of the American Medical Association showing that compared to placebo, those people receiving a 200 mcg supplement of selenium had a 37% reduced risk of cancer incidence and a 50% reduction in cancer mortality. This 9-year study is exactly what the authors of the book said needed to be done to validate the anticancer benefits of selenium. The fact that this positive and well recognized study was omitted seriously questions the credibility of this 512-page book.

The authors omitted studies indicating that selenium may be effective as an adjunctive cancer therapy. One study274 showed that when rats with mammary tumors where given moderate doses of supplemental selenium, a significant inhibition of cancer-associated angiogenesis occurred. Tumors require new blood vessels to sustain their rapidly proliferating cancer cells. Substances that inhibit the formation of new blood vessels are called antiangiogenesis agents, and these substances are being extensively studied as potential cancer therapies. Selenium’s anti-angiogenesis property may be one reason why is has been shown to reduce cancer mortality rates in humans already diagnosed with cancer.

In Germany, selenium is being used as an adjunctive cancer therapy. In a study275 omitted from the 512-page book, German doctors evaluated the effects of selenium supplementation in women with breast and gynecological cancers. Here is a summary of their findings:

"In pilot studies with low-dose selenite (up to 300 micrograms a day) the patients reported a better quality of life. Side effects were not reported. Analysis of the immune system reveal a stimulation of B19 lymphocytes and natural killer cells. In Germany, a country with selenium deficiency, clinical studies are now carried out on the effects of selenium as a drug to reduce side effects of chemo- and radiotherapy, enhance quality of life by reducing toxic side effects and help to restore immune function."

Another study that was omitted from the 512-page book showed that rectal cancer patients treated with radiation and chemotherapy benefitted from high dose selenium supplementation. In this study, 2000 micrograms of selenium were given after every course of chemotherapy and 400 micrograms of selenium given daily during irradiation. The doctors were able to verify a protective effect and concluded that “oral selenium intake in rectal cancer patients is easily tolerated with no side effects.”276

Another study277 omitted from the 512-page book measured serum levels of selenium in those diagnosed with colon cancer. The results of this study showed that colon cancer patients with low serum levels of selenium had significantly shorter survival time compared to patients with higher selenium levels. In a related study278 also omitted from the 512-page book, patients with colorectal cancer or adenoma had very low serum selenium levels compared to age-matched healthy controls. The doctors conducting this study stated:

"These results indicate that low selenium status is strongly associated with colorectal neoplasia (including extension and severity of the disease) and that it may not only be a result but also one of tumorogenic factors. That means that selenium supplementation could be important in prevention or even adjuvant therapy of colorectal cancer."

Another significant study279 sponsored by the National Cancer Institute, (but omitted from the 512-page book) showed that the combination of selenium and vitamin E or the combination of n-acetyl-cysteine and vitamin A analogs may be effective in protecting against lung cancer.

Another omitted study280 reviewed the molecular mechanisms of selenium’s actions in the body and concluded that:

"Higher levels of selenium supplementation can be expected to affect other functions related to tumorigenesis: carcinogen metabolism, immune function, cell cycle regulation and apoptosis. Thus, according to this 2-stage model of the roles of selenium in cancer prevention, even individuals with nutritionally adequate selenium intakes may benefit from selenium supplementation."

Despite questioning the health benefits of selenium, the authors of the 512-page book increased the maximum safe daily amount of selenium intake to 400 mcg per day. Many vitamin takers, of course, have been consuming 400 mcg a day and higher of selenium for decades without evidence of toxicity (selenosis). Since published studies show 200 mcg a day of selenium results in significant (up to 50%) reductions in cancer mortality,281-288 one might think the recommended allowance would be increased to 200 mcg a day, but that was not the case. Instead, the authors concluded the following on page 319:

"Limited evidence has been presented that intakes of selenium greater than the amount needed (55 mcg) to allow full expression of selenoproteins may have chemopreventive effects against cancer. Controlled intervention studies are needed to fully evaluate selenium as a cancer chemopreventive agent."

The problem with the above conclusion is that only “limited evidence” was presented in the book about selenium’s health benefits, as the authors omitted most of the positive published studies showing that selenium prevents cancer and is effective in treating and preventing many other diseases.

Selenium may even reduce the incidence of heart attack. Another study180 omitted from the book involved 3387 men aged 53-74 followed over a three year time period. Men with the low serum levels of selenium had a 70% greater risk of coronary heart disease compared to those men with higher selenium levels, and this finding was independent of other risk factors. However, not all studies are consistent. A five-year study192 of 1,110 men aged 55 to 74 years showed that the risk of stroke was 3.7 times greater in the low selenium group compared to the high selenium group. However, in this same study, high selenium levels did not produce a statistically significant reduction in the rate of heart attacks. So selenium was shown to protect against heart attack in one study, and stroke (but not heart attack) in another study. Since these findings are inconsistent, the authors do not recommend people supplement with selenium.

One finding that shows up repeatedly is that adults living in selenium deficient geographic areas have severely reduced life spans. Heart muscle damage is common at autopsy in these selenium-deficient cases. In 25 cities in the United States, low selenium correlates with high rates of heart attack and cancer.177 In trying to understand the mechanisms by which selenium protects against heart disease, scientists have looked at the effects of selenium in protecting the enothelial lining of the arterial system against oxidative damage, protecting blood cells against abnormal aggregation, and by inhibiting LDL cholesterol oxidation. Moreover, selenium prevents toxic effects of cadmium and mercury, and helps to modulate the active transport of calcium out of the arterial system.183

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One study186 pointed out that human platelets need selenium to create an important antioxidant enzyme called glutathione peroxidase. Platelets of selenium-deficient subjects show increased aggregation, thromboxane B2 production and synthesis of the lipoxygenase-derived compounds. In these deficient subjects, selenium administration increases platelet glutathione peroxidase activity and inhibits platelet hyperaggregation and leukotriene synthesis. In addition to its potential effects in protecting against cardiovascular events, selenium appears to protect the body against damage caused by hepatitis B, hepatitis C and HIV. In one study on HIV patients191 selenium deficiency was associated with myopathy, cardiomyopathy and immune dysfunction including oral candidiasis, impaired phagocytic function and decreased CD4 T-cells.

The book omitted any information relating to the role of selenium in preventing cataract. One of these omitted studies226 showed that when supplemental selenium was given along with beta-carotene and vitamin E, there was a statistically significant 36% reduction in the prevalence of nuclear cataract. The book omitted any reference to the protective effect selenium confers against primary liver cancer and infection with the hepatitis B or C virus. One notable study that was omitted198 involved a staggering 130,471 people followed for eight years. The group who received supplemental selenium had a 35.1% reduction in the incidence of primary liver cancer compared to the placebo group which did not receive selenium. When selenium supplementation was discontinued, incidences of primary liver cancer began to increase, indicating that continuous intake of supplemental selenium is essential to sustain its protective effect against liver cancer. In a sub-group of this study that evaluated 113 patients infected with the hepatitis B virus, the daily intake of 200 mcg of selenium resulted in zero rates of liver cancer, compared to 7 liver cancers in the placebo group (not receiving selenium supplements). When the selenium group stopped taking the selenium supplement, primary liver cancer rates began to increase.

Another omitted study289 examined the association between plasma selenium levels and risk of hepatocellular carcinoma among chronic carriers of hepatitis B and/or C virus in a cohort of 7,342 men. This 5.3 year study showed that those with low blood selenium levels were 47% more likely to develop hepatocellular carcinoma (primary liver cancer) compared to those with higher levels of selenium.

Also omitted was a small case history report290 showing substantial benefit to treating advanced hepatitis C patients with a combination of alpha lipoic acid, silymarin and selenium. Here is what the physician reported regarding his clinical observations:

"The triple antioxidant combination of alpha-lipoic acid, silymarin and selenium was chosen for a conservative treatment of hepatitis C because these substances protect the liver from free radical damage, increase the levels of other fundamental antioxidants, and interfere with viral proliferation. The 3 patients presented in this paper followed the triple antioxidant program and recovered quickly and their laboratory values remarkably improved. Furthermore, liver transplantation was avoided and the patients are back at work, carrying out their normal activities, and feeling healthy."
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The physician noted that supplementation with these three nutrients is relatively inexpensive compared to more than $300,000 for liver transplant surgery. He also noted that other problems with liver transplant surgery include a shortage of available livers, reinfection of the new liver with residual virus, and high mortality rates associated with the procedure including greater risks of cancer from the immune-suppressing drugs given to suppress organ rejection.

In another omitted study,291 when selenium, n-acetyl-cysteine and interferon were used to treat hepatitis C, selenium and n-acetyl-cysteine showed no enhanced effect compared to interferon alone. When 544 IU a day of vitamin E was added to the selenium, n-acetyl-cysteine and interferon group, however, complete response occurred in six out of eight patients. Compared to the group receiving interferon alone, the group obtaining the vitamin E, selenium, n-acetyl-cysteine and interferon showed a 2.4 greater chance of obtaining a complete response and had a significant reduction in viral load. This study helps substantiate the need to use multiple antioxidant nutrients in treating disease. While selenium by itself has been shown to protect against hepatitis-induced liver cancer, this study showed the importance of adding other antioxidants (vitamin E and n-acetyl-cysteine) to put active hepatitis infection into remission when combined with interferon.300

Yet another omitted study206 involving 20,847 people showed that those supplementing with selenium showed a 70% reduction in becoming infected with the hepatitis B virus compared to surrounding populations not receiving supplemental selenium.

Numerous published studies demonstrate a molecular basis for how selenium may protect against hepatitis infection and subsequent development of liver cancer, yet the authors of the 512-page book chose to omit this plethora of research as if it did not exist.

Selenium has shown efficacy in slowing the progression of HIV infection. One study207 showed that low plasma level of selenium in children with AIDS is an independent predictor of mortality, and appears to be associated with faster disease progression. This study showed increased mortality greater than 5-fold in children with low selenium levels. Another study292 found that selenium deficiency is an independent predictor of survival in adults with HIV-1 infection. These two studies were omitted from the 512-page book.

Also omitted was a study210 indicating that supplementation with selenium may help to increase the enzymatic defense systems in HIV-infected patients and slow disease progression.

In a study213 funded by the FDA, supplemental selenium was shown to have a positive effect in boosting various immune parameters that are suppressed by the HIV virus. The doctors conducting this study stated:

"Taken together, these results suggest that selenium supplementation may prove beneficial as an adjuvant therapy for AIDS through reinforcement of endogenous antioxidative systems."

The sheer volume of studies showing selenium to be an effective adjunctive therapy against HIV infection is overwhelming, but none of these studies were reported on in the 512-page book. Its not just people infected with the HIV virus who are immune compromised. A pioneering study published in The Lancet293 found that seniors taking modest doses of a multivitamin/ multimineral supplement containing zinc and selenium showed a general reduction in infection and required antibiotics for significantly fewer days. A more recent study brings the effect of these two minerals into sharper relief. This well-designed study (randomized, placebo-controlled, double-blind) found that seniors taking zinc and selenium had significantly fewer infections over a two year period, but that vitamin supplementation alone did not have a major effect.294 The zinc and selenium supplement cut the number of infections by nearly two thirds compared to placebo. A follow-up study demonstrates that seniors supplementing with zinc and selenium show improved antibody response to the flu vaccine.268

Despite the enormous health benefits that selenium supplementation has been shown to confer in humans suffering from chronic disease or normal aging, the authors omitted these studies from the 512-page book, which would lead people suffering from these diseases to believe there is no value in taking supplemental selenium.

While the authors increased the safe total daily intake of selenium to 400 mcg and cited a few of the studies showing selenium may prevent cancer, the authors’ “conclusion” is that 55 mcg a day from diet is adequate. This “conclusion,” recommending only 55 mcg of selenium a day, contradicts the published studies showing that 200 mcg a day from supplemental selenium confers protection against the development of cancer and other diseases.

The authors stated that “insufficient evidence” existed to warrant selenium supplementation for the prevention of cancer, yet the authors omitted most of the positive evidence showing that selenium is effective in preventing cancer.

What They Said About Vitamin E?

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Compared to the paucity of data reported about selenium, the authors provide an extensive section of excerpts from the published literature about the benefits of vitamin E. Beginning on pages 211-212 of the book, the authors reveal the molecular basis by which vitamin E may protect against heart attack and stroke as follows:

"Vitamin E does inhibit LDL oxidation whether induced by cells in culture or by copper ion in vitro. In addition, vitamin E could affect atherogenesis at a number of steps, based on the following in vitro observations:
  • Vitamin E inhibits smooth muscle cell proliferation through inhibition of protein kinase C.
  • Vitamin E inhibits platelet adhesion, aggregation, and platelet release reactions.
  • Vitamin E inhibits plasma generation of thrombin, a potent endogenous hormone that binds to platelet receptors and induces aggregation.
  • Vitamin E decreases monocyte adhesion to the endothelium by down-regulating expression of adhesion molecules and decreasing monocyte superoxide production.
  • Vitamin E potentiates synthesis of prostacyclin, a potent vasodilator and inhibitor of platelet aggregation.
  • Vitamin E mediates upregulation of the expression of cytosolic phospholipase A2 and cyclooxygenase.
  • Vitamin E enrichment of endothelial cells in culture inhibits the expression of intracellular cell adhesion molecule and vascular cell adhesion molecule induced by exposure to oxidized LDL cholesterol."

In animal models, the authors conclude that the “antioxidant hypothesis of atherosclerosis is strongly supported.”

In a summary of human epidemiological studies, the authors cite “risk reductions of 30% to 60% in the highest, relative to the lowest, quintile of intake (of vitamin E) in these studies.” The authors then cite interventional human studies where vitamin E showed a risk reduction benefit or no risk reduction benefit. Since some studies showed no risk reduction, the conclusion was to not recommend vitamin E supplementation for the prevention of cardiovascular disease.

When looking at diabetes mellitus (Type I or Juvenile diabetes), the authors related the results of many studies indicating that vitamin E might protect against the complications associated with diabetes including excessive oxidative stress, platelet hyperactivity and neuropathy. They also reported that vitamin E may allow better control of blood glucose. The author’s conclusions about whether diabetics should actually use vitamin E were stated page 218 of the 512-page book as follows:

"The available data strongly suggests that individuals with diabetes are subject to increased oxidative stress. However, no clinical intervention trials have tested directly whether vitamin E can ameliorate the complications of diabetes mellitus. . . . Studies on humans show that lipid and lipoprotein oxidation proceed more rapidly in patients with diabetes than in nondiabetic people and that treatment with vitamin E can partially reverse this process. In theory then, intervention with vitamin E therapy to inhibit atherosclerosis might be more effective in individual diabetics than in nondiabetics. However, as of this date, there are insufficient data on which to base a recommendation of supplemental vitamin E in diabetics."

The book does not discuss the effects of vitamin E on the more prevalent Type II diabetes, but Life Extension’s review of the published literature reveals data that strongly suggests a protective effect.295-311

As far as vitamin E and cancer, the book states:

"Cancer is believed to develop as the result of an accumulation of mutations that are unrepaired. DNA is constantly undergoing damage due to interaction with free radicals, and therefore one mechanism by which vitamin E might inhibit cancer formation is by quenching these free radicals. An additional vitamin E preventive mechanism that has been proposed is an effect on the immune system. Many compounds, including vitamin E, have been proposed as anticarcinogens."
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The author’s conclusion about vitamin E supplementation, however, is that, “Overall, the epidemiological evidence for an effect of vitamin E on cancer risk is weaker than that for vitamin E and cardiovascular disease. Observational epidemiological studies provide only limited evidence for a protective association and only for some cancer sites.”

The Life Extension Foundation has identified published studies showing a protective effect for vitamin E that were omitted from this book.312-336 Inclusion of these omitted studies would have provided a more persuasive basis to argue that vitamin E may protect against certain cancers.337-352

When it comes to the effects of vitamin E on immune function, the authors relayed the results of studies showing that vitamin E enhances certain immune parameters in the elderly. Nevertheless, their conclusion was, “Whether or not increases in vitamin E intake have any effect on immune function in younger populations remains uncertain. However, the evidence is strong enough to warrant continued investigation.” The Life Extension Foundation cannot understand why the authors point to uncertain effects in younger people as a reason older people shouldn’t take vitamin E to enhance immune function, since it is the elderly who are so vulnerable to death (influenza, pneumonia, cancer, etc.) from immune impairment.

As it relates to cataracts, the authors pointed out five studies showing vitamin E protects against cataract and four studies showing no protective effect. One of the negative studies used only 50 IU a day of vitamin E, whereas most serious supplement takers consume 400-800 IU a day of vitamin E.

The authors pointed to studies showing that vitamin E does not slow the progression of Parkinson’s disease, but omitted studies showing people who take vitamin E have a reduced risk of developing Parkinson’s disease in the first place.

When it came to Alzheimer’s disease, the authors pointed to a controlled study in which 2000 IU a day of vitamin E slowed the progression of the disease. They also pointed to several other studies suggesting that vitamin E might be beneficial in slowing Alzheimer’s disease and Down’s syndrome progression. Omitted were studies showing that vitamin E may reduce the risk of developing Alzheimer’s disease. The conclusions of the authors were as follows:

"Although these results are promising, it is still too early to draw any conclusions about the usefulness of vitamin E in Alzheimer’s disease and Down’s syndrome."

Tardive dyskinesia is a neurologic disorder that has been shown to respond favorably to vitamin E therapy. The authors report one study showing that 1600 IU a day of vitamin E produced significant benefit in one test score of the disease.

Despite the findings presented in the 512-page book that higher doses of vitamin E provide disease risk reduction and treatment benefits, the authors conclude that only 22 to 33 IU a day of vitamin E from food is needed. The authors, however, raised the maximum safe daily dose of supplemental vitamin E to 1100 to 1500 IU a day, which is consistent with many published findings showing that higher doses are required to prevent chronic disease.

In a review of the toxicity studies on vitamin E, the authors concluded that:

"Humans show few side effects following supplemental doses below 2100 IU a day. However most studies of the possible effects of supplemental vitamin E on human health have been conducted over periods of a few weeks to a few months, so the possible chronic effects of lifetime exposures to such high supplemental levels of vitamin E remain uncertain."

In the press release promoting the 512-page book, however, the National Academy of Sciences twisted the above statement to say that, “extremely large doses may lead to health problems rather than confer benefits.”

The half-truths in the press release promoting the book (and in the 512-page book itself) relating to possible adverse reactions to vitamin E, are egregious. For instance, the authors point to one study in which 50 IU of vitamin E a day increased the risk of hemorrhagic stroke by 50%. The authors then cite numerous other studies showing that 400 to 2000 IU a day of vitamin E produced no increased risk of hemorrhagic stroke. Plus, the authors point to studies showing that supplemental vitamin K abolished any abnormal negative coagulation factors that could be attributed to vitamin E.

The 512-page book states that 1100 to 1500 IU a day of supplemental vitamin E is safe, but the National Academy of Sciences issued a press release indicating that high supplemental doses of vitamin E could be dangerous because of “greater risk of hemorrhagic damage because the nutrient can act as an anticoagulant.”

This distorted press release caused the media to blare warnings that vitamin supplements could be dangerous, when the underlying facts presented in the 512-page book show that in the doses most people take (400 to 800 IU of vitamin E, for instance), the supplement is safe and does not pose any health risk whatsoever.

Right after the National Academy of Sciences’ press release was issued, a new report about vitamin E was presented on April 19, 2000 at a conference entitled Experimental Biology 2000. At the conference, scientists reexamined and unveiled new vitamin E dependent pathways that prevent narrowing of the arteries, which is a major risk factor for cardiovascular disease. The scientists discussed how artery narrowing occurs when platelets, or red blood cells, adhere to and aggregate on artery walls.

“By shutting down a critical enzymatic pathway, vitamin E renders platelets less sticky,” says John F. Keaney, MD, Boston University School of Medicine, “The outcome is less adhesion, less narrowing of the arteries. The benefit is a potential drop in cardiac events.”

Results presented by Ishwarlal Jialal, MD, PhD, of the University of Texas Southwestern Medical Center, reveal that vitamin E also prevents white blood cells from forming arterial plaque. Vitamin E, Dr. Jialal stated, functions as an important antioxidant and anti-inflammatory agent, protecting artery walls from damage that could lead to heart disease.

According to Mohsen Meydani, DVM, PhD, Tufts University, “Vitamin E affects the way a variety of cells circulating in our blood interact with artery walls. As a result, they are less likely to damage and cause inflammation. When artery walls are not narrowed and inflamed, heart disease may be prevented.”

According to another presenter at the conference, Lester Packer, PhD, University of California, Berkeley, “Vitamin E acts like the ‘home-run batter’ on the team of antioxidants, outperforming the others, including vitamin C. While they all work synergistically to protect against cell damage, the others run out of steam much earlier. Because it works longer and harder than the rest, the research indicates vitamin E is the most potent antioxidant in the mix. . . . In fact, the other antioxidants help rejuvenate vitamin E so it works better.”

“The research presented at this conference clearly suggests that meeting daily needs throughout the life cycle can help prevent narrowing of the arteries—a major risk factor for heart disease,” says Maret Traber, PhD, Oregon State University. According to Dr. Traber, the nation may not be consuming enough vitamin E. The results from the 1994-1996 USDA’s Continuing Survey of Food Intake by Individuals indicate that 69% of Americans are not meeting daily dietary needs for vitamin E. Says Dr. Taber, “Because the evidence linking vitamin E to the prevention of heart disease is so strong, dietary supplementation is indicated for these individuals.”

To obtain enough vitamin E from food to attain a reduction in the risk of cardiovascular disease, the scientists stated, you would need to consume nine tablespoons of olive oil, 75 slices of whole wheat bread, 40 almonds or 200 peanuts each day, according to Dr. Taber.

The scientists at the Experimental Biology 2000 conference stated that doses between 50 to 1000 mg of vitamin E may be necessary to reap the potential beneficial effects, though many studies indicate 200 mg (about 300 IU) is sufficient. The scientists stated for those individuals who have difficulty meeting needs through diet alone, supplementation may be indicated. The scientists did acknowledge the National Academy of Sciences’ upper safety threshold of 1100 IU to 1500 IU a day of vitamin E, but indicated that people could obtain the beneficial effects of vitamin E in these dose ranges.

Another omission from the 512-page book is on the issue of gamma tocopherol supplementation.

A group of scientists published a study in the April 1997 issue of the Proceedings of the National Academy of Sciences showing that too much alpha tocopherol vitamin E could displace gamma tocopherol in the tissues and cause undesirable effects. Despite this article about the benefits of gamma tocopherol that appeared in the National Academy of Sciences’ own journal, there is no recommendation in the National Academy of Sciences’ 512-page book for anyone to take supplemental gamma tocopherol or tocotrienol because of “insufficient evidence”at this time. These types of omissions and contradictions are rampant throughout this 512-page book.

What They Said About Beta-Carotene

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The book devotes a considerable number of pages to describing the published studies showing that high blood levels of beta-carotene confer significant protection against the development of chronic disease.

First of all, the authors confirm that most studies show a significant antioxidant effect in the body in response to high levels of beta-carotene in the blood. The authors next describe several studies showing that in certain age groups, beta-carotene supplements enhance several parameters of immune function including increasing natural killer cell activity, lymphocyte response to mitogens, and T-helper cell response. The authors caution that the usefulness of these immune markers has yet to be established.

The authors refer to findings related to beta-carotene levels in blood and overall mortality showing that people with the lowest levels of beta-carotene in the blood had a significant increase in their risk of dying. Those with lowest levels of beta-carotene had a 43% increased risk of death from cardiovascular disease, a 51% increased risk of death from cancer, and a 38% increased risk of overall mortality. Other studies cited by the authors corroborated these findings.

As it related to cancer, the authors showed that over a 13-year time period, persons who went on to develop cancer had significantly lower pre-diagnostic carotene concentrations than persons who remained alive and free of cancer. The most consistent result reported by the authors was a lower risk of cancer at several tumor sites in those who consumed relatively large quantities of carotene-rich fruits and vegetables. The consistency of the results was borne out when the authors cited 26 out of 28 humans studies showing that low intakes of fruits and vegetables resulted in the highest rates of lung cancer.

A review of cancers of the oral cavity, pharynx and larynx, showed that fruit and vegetable consumption was associated with a reduced risk of cancer in 13 of 13 studies. Blood analysis in many of these studies consistently showed that beta-carotene levels were lowest in the people who went on to develop cancer.

In looking at cervical cancer risk, the authors reported that over a 15-year period, women with the lowest blood levels of beta-carotene were 2.7 times more likely to contract this form of cancer.

The authors then examined studies showing that diets high in beta-carotene result in reduced risk of cardiovascular disease. One study showed that men with the highest level of beta-carotene in their blood were 36% less likely to develop coronary artery disease. Another study showed that men with the lowest levels of beta-carotene had a 2.64 times greater risk of developing angina pectoris (chest pain caused by obstructed coronary arteries). Still another study of over 39,000 men showed a 29% reduction in coronary artery disease in the group having the highest levels of carotenes. The authors then looked at carotid artery thickness, and found that people with the highest levels of carotenes had the least evidence of carotid atherosclerosis.

When looking at cataract and macular degeneration risk, the authors identified some studies showing that high blood levels of beta-carotene are protective, while other studies showed no benefit. One study227 that was omitted from the 512-page book showed that those with the lowest serum levels of beta-carotene and vitamin E have a 2.6-fold greater risk of developing senile cataract compared to those with high blood levels of beta-carotene and vitamin E. The conclusions of the scientists who conducted this study were:

"Low serum concentrations of the antioxidant vitamins alpha tocopherol and beta-carotene are risk factors for end stage senile cataract. Controlled trials of the role of antioxidant vitamins in cataract prevention are therefore warranted."

The authors pointed out that most of the positive studies relate to beta-carotene obtained from food, rather than supplement sources. The authors then cited the following three negative trials showing that beta-carotene supplements fail to prevent cancer:

  • In long-term heavy smokers, 20 mg a day of synthetic beta-carotene (with or without 50 IU of synthetic vitamin E) led to a higher incidence of lung cancer and no reduction in other cancers compared to placebo.
  • In asbestos workers and smokers, 30 mg of synthetic beta-carotene and 25,000 IU of vitamin A led to a higher incidence of lung cancer.
  • In a 12-year trial on physicians, 50 mg every other day of synthetic beta-carotene produced no increased or decreased risk on cancer or total mortality. With regard to lung cancer, there was no increase in lung cancer even in smokers who took the beta-carotene supplement for 12 years.
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Based primarily on these three negative studies, the authors recommended against supplementation with beta-carotene and suggested instead that beta-carotene be obtained from five servings per day of fruits and vegetables. The authors speculated that there may be nutrients contained in fruits and vegetables other than or in addition to beta-carotene that are responsible the myriad of health benefits associated with high beta-carotene blood levels.

Despite the disease risk reduction benefits of other carotenoids (like lycopene and lutein), the press release the National Academy of Sciences sent to the media cautioned against supplementing with ANY carotenoid. This prompted the media to write articles that would frighten the typical consumer away from supplements containing alpha-carotene, lycopene or lutein. In the 512-page book, a few of the positive studies are revealed about the benefits of these other carotenoids, but most positive reports about lycopene, lutein and alpha-carotene were omitted.

There are a number of other inconsistencies regarding the authors’ evaluation about carotenoid supplementation.

First of all, few consumers take beta-carotene by itself. Beta-carotene is thought to synergistically work with other antioxidants to protect against the free radical damage that can lead to chronic disease. In fact, beta-carotene is one of 60 to 90 different nutrients that health conscious people take to protect against disease. In studies where beta-carotene supplements are combined with other nutrients, the findings are quite different than the three negative studies the authors pointed to.

For instance, in a trial involving 30,000 people, the combination of selenium, higher-dose vitamin E and beta-carotene produced a 13% reduction in overall cancer deaths. Among these receiving this combination of supplements, the risk of dying from lung cancer was reduced by 45%, but the number of people actually getting lung cancer was small and considered to be limited from a statistical standpoint. The significance, however, is that when combinations of higher dose antioxidants are used, better clinical results often manifest. A number of published studies, for instance, show that when beta-carotene is combined with other antioxidants, reductions in indicators of oxidative stress occur, whereas beta-carotene by itself sometimes fails to protect against free radical-induced oxidative stress. Some of these studies involve smokers as well as nonsmokers.

A significant study353 that was omitted from the book dealt with assessing the risks of heart attack in users of beta-carotene, vitamin C and vitamin E supplements. This study found that the risk of heart attack was reduced by 45% in the group with the highest intake of beta-carotene from supplements or diet compared to the lowest. This cardiovascular disease reduction in those supplementing with beta-carotene was independent of other known risk factors for coronary artery heart attack. Another study on diabetic men showed that a combination of vitamin E, vitamin C and beta-carotene significantly decreases susceptibility of LDL to oxidation. This study is consistent with epidemiological and intervention studies suggesting that antioxidant vitamin use significantly decreases risk for coronary heart disease.

The authors of the 512-page book point to studies showing that beta-carotene by itself does not reduce cardiovascular disease risk, but this does not reflect the fact that most supplement takers use beta-carotene as just one of many cardio-protective antioxidants. The idea of combining antioxidants is not novel. As one scientist stated in a published paper criticizing the negative beta-carotene studies:

"These studies support the hypothesis that the carcinogenic response to high-dose beta-carotene supplementation reported in the human intervention trials is related to the instability of the beta-carotene molecule in the free radical-rich environment in the lungs of cigarette smokers. This is especially possible because smoke also causes decreased tissue levels of other antioxidants, such as ascorbate and alpha-tocopherol, which normally have a stabilizing effect on the unoxidized form of beta-carotene. Nutritional intervention using a combination of antioxidants (beta-carotene, alpha-tocopherol and vitamin C) as anticarcinogenic agents could be an appropriate way to rationally and realistically reduce cancer risk."

Another study76 that was omitted from the beta-carotene section of the 512-page book involved the treatment of heart attack patients with daily supplements containing 1000 mg a day of vitamin C, 400 IU a day of vitamin E, 50,000 IU of vitamin A and 25 mg of beta-carotene and compared these patients to a placebo group receiving no supplements. The results showed that damaging lipid peroxide levels in serum were 5.5 times higher in the placebo group compared to the group receiving the combination of four antioxidants. Angina pectoris, total arrhythmias and poor left ventricular function occurred less often in the antioxidant group. Cardiac end points were significantly less in the antioxidant group. The conclusions of the doctors conducting the study were:

"These results suggest that combined treatment with antioxidant vitamins A, E, C and beta-carotene in patients with recent acute myocardial infarction may be protective against cardiac necrosis and oxidative stress, and could be beneficial in preventing complications and cardiac event rate in such patients."

A growing number of scientists are recognizing the potential value of combination antioxidant approaches to disease prevention, something that serious vitamin consumers recognized many decades ago. In a published study354 a review of the scientific literature relating to antioxidants and disease prevention revealed that in the prevention of heart disease, optimal health required “interacting co-nutrients,” and not just a single supplement by itself. The conclusion of the study was that:

"In cardiovascular disease, vitamin E acts as first risk discriminator, vitamin C as second one; optimal health requires synchronously optimized vitamins C + E, A, carotenoids and vegetable conutrients."

What About The Other Carotenoids?

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In recommending against taking beta-carotene supplements, the authors also recommended against supplementation with all other carotenoids (such as lycopene and lutein). Their basis was that “insufficient evidence” existing to establish an effective daily requirement for these other carotenoids.

The authors presented several positive studies showing high levels of lycopene in the diet or in serum resulted in reduced risks of cancer. One study showed that daily intake of 6.46 mg of lycopene resulted in a significant reduction in the risk of prostate cancer.

The authors then site in the 512-page book two additional positive overview studies showing a multitude of potential health benefits of lycopene and one no-response study conducted in Asia in which blood levels of lycopene did not affect prostate cancer risk. The authors attributed the lack of effect in this no-response study to the fact that tomato products are not widely consumed in Asia, and the test subjects as a group, therefore, had very low lycopene levels to begin with.

The authors related the results of many studies showing that women with low carotenoid status have about three times greater risk of cervical cancer.

Omitted were several hundred studies showing specific reductions in disease risk in those who consumed high amounts of lycopene, lutein, alpha- carotene and/or other carotenoids in food or supplement form.355-555 These omissions would lead the reader to believe there is only limited positive data about the health benefits of the “other carotenoids.”

The authors caution against taking carotenoid supplements, but fail to discuss studies indicating that when combined with other supplements, the carotenoids exhibit potent disease-prevention effects. One such study413 examined the effects of lycopene and vitamin E on the growth of two human prostate cancer cell lines. Lycopene by itself was not a potent inhibitor of prostate cancer cell growth, but when combined with vitamin E, “a strong inhibitory effect of prostate carcinoma cell proliferation, which reached values close to 90%, was observed.” The scientists noted the synergistic effect of lycopene and vitamin E.

Another omitted study380 showed that men with the highest blood levels of lycopene had a 25% reduced risk of any type of prostate cancer and a 44% reduction in their risk of aggressive prostate cancer. An interesting paradox to this study was that in men with low lycopene, beta-carotene supplements were associated with risk reductions comparable to those observed with high lycopene. The doctors concluded this study by stating:

"These data provide further evidence that increased consumption of tomato products and other lycopene-containing foods might reduce the occurrence or progression of prostate cancer."

The authors omitted a study370 that examined the effect of daily consumption of a tomato juice supplemented with vitamin C (600 mg), vitamin E (400 IU, or 400 mg) and beta-carotene (30 mg) on various indexes of lipid peroxidation in smokers. The findings showed that relative to the placebo juice (that contained no added vitamins), the vitamin-supplemented juice resulted in a significant decrease in measurements of lipid peroxidation such as breath-pentane excretion as well as a significant improvement in the resistance of LDL to oxidation. The scientists conducting this study concluded:

"This study thus indicates that an antioxidant-supplemented drink can reduce lipid peroxidation and susceptibility of LDL to oxidation in smokers and may ameliorate the oxidative stress of cigarette smoke."

Another omitted study discussed the synergistic benefits of carotenoids371 in protecting against free radicals. This study ranked the various carotenoids based on their antioxidant ability and found that lycopene was the most potent. The scientists noted that:

"Mixtures of carotenoids were more effective than the single compounds. This synergistic effect was most pronounced when lycopene or lutein was present. The superior protection of mixtures may be related to specific positioning of different carotenoids in membranes."

Also omitted were studies showing protection against immune cell oxidative stress when serum lycopene and other carotenoid levels were increased. 369,374 One study showed a 45% increase in cellular glutathione in response to lycopene supplementation.421

The authors stated virtually nothing about the benefits of lutein in protecting against certain cancers. The authors did relate studies showing that those who consumed high amounts of lutein and zeaxanthin had “a 60% lowered risk” of macular degeneration. Other studies related by the authors showed high intakes of lutein and zeaxanthin reduced cataract risk by about 20%. Despite these revelations, the authors concluded that:

"Insufficient Macular Pigment Optical Density studies have been conducted to date to make recommendations relative to dietary intakes of lutein and zeaxanthin."

As it relates to cardiovascular disease, the authors omitted a study505 showing that in elderly people, high serum levels of lycopene reduced the risk of aortic atherosclerosis by 45% in nonsmokers and by a staggering 65% in smokers. The scientists concluded that:

"Our findings suggest that lycopene may play a protective role in the development of atherosclerosis."

Other studies433,438 show that lycopene induces a specific artery-protecting effect by protecting LDL cholesterol against oxidation, thus decreasing the risk for coronary heart disease.

Lycopene was first made available in supplemental form because of a study showing that it might protect against the development of pancreatic cancer. Subsequent studies445,446 have confirmed that low lycopene (and selenium) levels are present in pancreatic cancer patients compared to controls. Inflammation of the pancreas greatly increases the risk of pancreatic cancer and one study showed that patients with chronic pancreatitis503 had significantly lower plasma concentrations of antioxidants including selenium, vitamin A, vitamin E, beta-carotene and lycopene. This study was also omitted from the 512-page book.

Doctors are now evaluating the effects of lycopene in the treatment of many cancers. One study430 showed that a combination of lycopene and vitamin D3 was effective in inhibiting a promyelocytic leukemia cell line. The scientists conducting this study concluded that:

"The combination of low concentrations of lycopene with vitamin D3 exhibited a synergistic effect on cell proliferation and differentiation and an additive effect on cell cycle progression. Such synergistic antiproliferative and differentiating effects of lycopene and other compounds found in the diet and in plasma may suggest the inclusion of the carotenoid in the diet as a cancer-preventive measure."

At the April 12, 1999 meeting of the American Association of Cancer Research, a presentation was made showing that the administration of 15 mg twice a day of a lycopene supplement to prostate cancer patients for 30 days resulted in a 20% reduction in PSA and a shrinkage of tumor volume.

While the authors were bashing beta-carotene because it failed to prevent lung cancer in long-term smokers, they ignored another study434 showing that high serum levels of lycopene conferred a 44% risk reduction in lung cancer, whereas high serum levels of beta-carotene and other nutrients had no effect on lung cancer risk.

The sheer number of positive published studies linking lycopene and other carotenoids to lowered disease risks makes a persuasive case for taking carotenoid supplements if adequate amounts are not obtained from dietary sources. At the same time, it has to be recognized that the preponderance of the evidence indicates that beneficial effects are most likely to occur when a wide range of carotenoids are consumed, along with sufficient amounts of other antioxidants like vitamin E, C and selenium to maintain the stability of these carotenoids in the body.

Conclusions

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As previously stated, the press release issued by the National Academy of Sciences used to promote the 512-page book said:

"Insufficient evidence exists to support claims that taking megadoses of dietary antioxidants, such as selenium and vitamins C and E, or carotenoids, including beta-carotene, can prevent chronic diseases."

This statement, however, is contradicted by published findings presented in the 512-page book itself showing disease risk reduction benefits to vitamin C, vitamin E, selenium and the carotenoids.

The 512-page book omitted many other positive published studies about these supplements. When these omissions are added to the favorable findings that were reported on in the book, it is difficult to ascertain how anyone concerned about protecting their health would not supplement with vitamin C, vitamin E, selenium and the carotenoids.

The media’s response to the press release promoting the book was to question the value of all dietary supplements. Yet the book did not review folic acid, coenzyme Q10, B-vitamins, zinc or a host of other dietary supplements commonly consumed. These nutrients have shown considerable disease risk reduction benefits in several thousand published studies.

The overriding question is, Does this 512-page book have any meaning to the vitamin consumer who takes many different nutrients? Our unequivocal answer is no!

The serious vitamin consumer takes high potencies of 50 to 90 nutrients every day. Many of these nutrients work synergistically together to protect against disease. For instance, coenzyme Q10 has been shown to protect LDL cholesterol against vitamin E by-product-induced peroxidation. This fact was first published in the National Academy of Sciences’ own journal (Proc Natl Acad Sci; 1991, USA 88:1646-1650), but omitted from the 512-page book published by the National Academy of Sciences. As reported in the April 2000 issue of Life Extension magazine (pages 21-22), the reason vitamin E appears to work so well in some studies, but fails in other studies, may relate to the amount of coenzyme Q10 naturally present in the bodies of test subjects. Coenzyme Q10 may act as a “silent partner” in amplifying the beneficial effects of vitamin E, whereas a CoQ10 deficit may enable vitamin E breakdown products to induce certain types of free radicals.

While the serious vitamin consumer long-ago recognized the importance of taking synergistic antioxidant therapies, mainstream scientists remain fixated in attempting to evaluate the effects of one nutrient at a time. While this research is helpful in identifying potential life extending supplements, it does not provide the information needed by those who consume multiple nutrients.

The fundamental problem with the National Academy of Sciences’ 512-page book is that it focused primarily on studies involving single nutrients, while the serious vitamin consumer is taking many nutrients concomitantly. The 512-page book failed to address the synergistic effects of taking multiple dietary supplements.

One of the more positive conclusions from the 512-page book was the recommendation for “full-scale intervention trials to test the preventive potential of vitamin C, vitamin E, selenium and the carotenoids for chronic disease.” While the authors allege there is “insufficient evidence” today, they acknowledge that the disease reducing potential of these nutrients should not be ignored.

This 512-page book was substantially funded by the U.S. Department of Health and Human Services, which oversees the Food and Drug Administration (FDA). The Canadian health ministry also provided funding. The FDA and Canadian health ministry have been historically biased against dietary supplements and may use this book to gain greater regulatory authority. As a propaganda tool, the book has been highly effective in persuading the media to generate anti-supplement reports worldwide.

The U.S. and Canadian governments spent considerable tax dollars funding this report that questions the value of vitamin C, vitamin E, selenium and the carotenoids. People who rely on the popular press and Federal government to inform them about health matters may be dissuaded from using dietary supplements based on the misleading press release used to promote the book.

For those who understand the premise behind using multiple supplements to statistically reduce the risk of degenerative disease, the book will serve as a reminder that the government is still committed to disseminating false and misleading information against dietary supplements. This misinformation campaign continues despite the existence of persuasive evidence that the proper use of these supplements could dramatically reduce the incidences of cardiovascular disease, cancer, dementia, cataract, immune dysfunction and a host of other diseases related to aging.

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