There’s been tons of media coverage on the latest Vitamin E & C study (called the Physicians’ Health Study II). Much of the media has reported that these vitamins have no benefits for cardiovascular health. Here’s what was really found:
Supplementation of 400 IU of Vitamin E every other day and 500 mg of Vitamin C every day had no significant effects on the reduction of nonfatal myocardial infarction, nonfatal stroke and cardiovascular disease death. The study lasted 10 years and utilized a group of 14,641 male physicians, average age of 64 years.
(Click here to read the study.)
Here’s why you shouldn’t throw away your vitamins (Specific to this study):
- The most striking concern for me was the age of these men. The average age was 64 at the beginning of this study. So, by the end of this 10-year study, 4,696 of these men were over the age of 70 and 4,054 were over the age of 80. At that age, of course they’re going to die of cardiovascular disease! At the least, these guys will have some heart attacks and strokes. Did the researchers actually think that some Vitamin E & C supplements could defeat the number one cause of death (cardiovascular disease) and send the male gender rocketing past their previously recorded life span?
- There are too many factors in cardiovascular disease. Vitamins E & C may play a beneficial role, but they will not play a total role.
- This is not a representative sample for Americans. This sample was made up of male physicians, likely 99% white of Northern European descent, highly educated and all of them were probably making some pretty nice paychecks. These guys could afford good food, vitamins, exercise, health insurance and other healthy lifestyle factors. Perhaps supplementation of Vitamin E & C could do no more for them on a cardiovascular level. But what about the rest of us?
- There has been no consistency with dosage in vitamin research. Conventional science has to get away from the more is better belief and begin to actually understand the small details of these vitamins. The most effective dose may not be the highest amount that can be absorbed by the body.
- Quality. This is huge! Where are these products being manufactured? What is the quality of these supplements? In the world of vitamins, you definitely get what you pay for. Supplements are essentially an unregulated industry with a lot of companies sacrificing quality for profits. I would never give up my vitamins for a cheaper brand that may be full of fillers and junk. This is a vital point to consider when research is being done on these products.
Final thoughts:
Research is clear that if you use a quality supplement, your risk of side effects from Vitamin E or Vitamin C is very rare. However, there is some valid evidence to suggest that high amounts of Vitamin E (more than 1,500 IU/day or 1,000 mg/day) may increase the likelihood of hemorrhage for some individuals. But, not to worry, common supplements won’t get near that amount; you’ll probably see around 350 IU on your bottle.
There is still valid evidence to support the use of these vitamins for prevention and treatment of a variety of chronic conditions. I haven’t been swayed by this study. I’ll continue to take quality vitamins (with a Vitamin E level of no more than 800 IU/day) and feel confident that I am receiving benefits.
When you say, “Did the researchers actually think that some Vitamin E & C supplements could defeat the number one cause of death (cardiovascular disease) and send the male gender rocketing past their previously recorded life span?” you are missing the value of statistical analysis. The question is not whether vitamins “defeat” heart attacks, it is whether it reduces the likelihood of heart attacks – which is exactly why you, me, and everyone else would take them. It doesn’t matter if there are other factors that contribute to heart disease because the study isn’t measuring whether disease was prevented, it is measuring whether the chance of heart disease was reduced.
If vitamin E helps eliminate certain problems that make heart attacks likely, it should have worked its magic for some small number of people in the research sample. The rest, who got heart attacks from things like – say – stress, would have gotten heart attacks anyway. But that wouldn’t have affected the study’s results, since the study would have captured the improvement in the subgroup of research subjects. Rather than 800 heart attacks, there would have been 750, which would have been a significant effect.
Similarly, if the vitamins had any effect at all in reducing the chance of heart attacks for a very small percentage of the people who were taking appropriate doses and who didn’t, as you mention, exercise regularly (say even just one in thirty participants in the study), then a study with this number of research subjects should have captured that effect.
Great points Alex.
My somewhat exaggerative comment of extending lifespan was mainly poking concern at the mean age of the participants. Many of these participants were nearing life expectancy by the middle of the study. And unfortunately, many of the news stories generalized these findings to the general population with headlines like, “Vits E and C Prove Worthless for Cardiovascular Health”. The sample used in this study (white, male, physicians, 65+) is simply not representative of the population. Is it then wise to extrapolate those findings to the general population?
Additionally, the lack of attention to vitamin quality is big in this study. For the multis, participants were given Centrum Silver. Can we be sure that Centrum disintegrates and is absorbed efficiently?
Maybe I’m being too critical, but I have a lot of concerns for the inductive reasonings of this entire study… I think there are quite a few fallacies that weren’t acknowledged by the authors. This makes the findings questionable in my opinion. More importantly, I feel the media and PR on this study overstated the results of this study. What’s new though right?!
You’re right though, the brand of Vits E and C used in this study did not reducie nonfatal myocardial infarction, nonfatal stroke or cardiovascular disease death for this population. And this does mean something.
I value your opinion… what do you think about the validity of the study (external, internal)? What might the general population take away from this study?
Interesting comments and discussion! As a physician myself, I like your comment about the fact that it is hard to assess the effect of additional Vitamin E and C in a population who already is likely getting enough. This is similar to why fish oil (omega-3) hasn’t been shown to have much benefit in the Japanese population because their background intake of fish is so high. It seems the current trend (at least among some nutrition researchers) is a tailored approach – an otherwise healthy individual who has an adequate diet may not need specific vitamin supplementation, but as soon as you have certain chronic diseases (such as chronic kidney disease) you may benefit from ensuring proper nutritional support, and vitamins tailored to those specific needs could help. Any thoughts on the tailored approach?
Great point about the fish oil Neil. I would also agree with the trend to the tailored approach. The Linus Pauling institute has some really interesting research in this area… http://lpi.oregonstate.edu/