Tuesday, 20 January 2015

The benefits of vitamin supplements

Some of the  evidence on the benefits of antioxidant vitamin supplements

Russell Setright


Many people take antioxidant and multivitamin supplements to help fill the gap caused by dietary deficiencies and poor lifestyle and to help improve general health and wellbeing. It is also thought that improving diet and lifestyle may help support the immune system, improve memory, delay the onset of Alzheimer’s disease, enhance wellbeing, reduce the risk of Autistic Spectrum disorders, reduce cancer risk and Macular Degeneration.
These are big asks, but is there any evidence? Yes there is, and following are just a few examples from clinical trials and studies that have reported the positive effects of vitamin supplementation.

Immune function,
The benefits of improved nutrition by the use of multivitamin and mineral supplementation on immune function and general wellbeing was demonstrated. This study found supplementation with a multivitamin containing the B group of vitamins, vitamins C and E + selenium slowed the progression of the HIV virus by half in the first two years(1)  Past studies have also found that HIV progression is slowed in those taking multivitamin mineral formula compared to placebo (2) However, this is the first trial to look at early intervention, that is before HIV infection has progressed to AIDS. The authors of the study explain that it is immune system support that the multivitamin + selenium combination gives that may explain the statistically significant benefit in the reduction of HIV progression to AIDS.

Other benefits of multivitamin supplementation have found an 8 per cent reduction in overall cancer incidence in older men who supplemented with a daily multivitamin (3) However, in a follow up study that looked at CVD and multivitamin use found only a small reduction in CVD and a small reduction in total deaths among multivitamin users but these were not statistically significant(4)
Multivitamin supplementation may also help protect women from certain cancers. A study of  7,728 women who developed invasive breast cancer was undertaken and a comparison of mortality rates revealed that women with invasive breast cancer who took multivitamin/mineral supplements were 30 percent less likely to die from their cancers than women with invasive breast cancer who hadn't taken the supplements(5)
Another study examined years of multivitamin use and risk of colorectal adenoma among 43,641 women enrolled in the Nurses’ Health Study between 1991 and 2007.
The use of multivitamins was assessed through biennial questionnaires since 1989 and the authors of the study reported that use of multivitamins is associated with lower risk of colorectal adenoma, even with relatively short duration of use(6)

Multivitamins supplementation may also improve memory, mood and general wellbeing.  a meta-analysis of 10 studies was undertaken and the results found that supplementation with multivitamins were found to enhance immediate free recall memory (7)

Alzheimer’s Disease (AD)
 Difficulty with activities of daily living often affect Alzheimer's patients, which is estimated to affect as many as 5.1 million Americans. These issues are among the most taxing burdens of the disease for caregivers, which total about 5.4 million family members and friends.
A Cross-sectional and prospective study of dementia among 65 years or older people  were assessed in 1995 to 1997 for prevalent dementia and AD, and again in 1998 to 2000 for incident illness and supplement use was ascertained at the first contact.
The authors concluded that the use of vitamin E and multivitamin containing vitamin C supplements in combination is associated with reduced prevalence and incidence of AD(8)
In another study, a double-blind, placebo-controlled, randomized, multicenter trial of 341 patients with Alzheimer’s of moderate severity found there were significant delays in the time to the primary outcome for the patients treated with selegiline median time, 655 days; vitamin E 670 days or combination therapy 585 days, as compared with the placebo group 440 days.
The authors of this study concluded that in patients with moderately severe impairment from Alzheimer's disease, treatment with selegiline or alpha-tocopherol (vitamin E) slows the progression of disease(9)
New research from the faculty of Icahn School of Medicine at Mount Sinai working with Veterans Administration Medical Centers suggests that alpha tocepherol, fat-soluble Vitamin E and antioxidant, may slow functional decline (problems with daily activities such as shopping, preparing meals, planning, and traveling) in patients with mild-to-moderate Alzheimer's disease and decrease caregiver burden. There was no added benefit for memory and cognitive testing with the vitamin.
The trial of Vitamin E and memantine in Alzheimer's Disease (TEAM-AD examined the effects of vitamin E 2,000 IU/d, 20 mg/d of memantine, the combination, or placebo on Alzheimer's Disease Cooperative Study/Activities of Daily Living (ADCS-ADL) Inventory Score. Cognitive, neuropsychiatric, functional, and caregiver measures were secondary outcomes. A group of 613 patients with mild to moderate Alzheimer's disease were in the study.
This trial showed that vitamin E delays progression of functional decline by 19% per year, which translates into 6.2 months benefit over placebo.
The author previously led a study on vitamin E in patients with moderately severe Alzheimer's disease(9). Which also found vitamin E supplements slowed disease progression in this group of patients as well.(10)

In a randomized, double-blind and placebo-controlled study, 215 men in full-time employment aged between 30 and 55 were given either a multivitamin or a placebo for a period of 33 days. The  group reported significantly improved ratings of general mental health, reduced subjective stress and increased ratings of 'vigour', with a strong trend towards an overall improvement in mood.(11)

Autism Spectrum Disorder
Women who reported not taking a daily prenatal vitamin immediately before and during the first month of pregnancy were nearly twice as likely to have a child with an autism spectrum disorder as women who did take the supplements -- and the associated risk rose to seven times as great when combined with a high-risk genetic make-up, a study by researchers at the UC Davis MIND Institute (12)

Macular Degeneration
There is clinical evidence for potential benefits from vitamin C, β-carotene, vitamin E and zinc, as well as emerging epidemiological and clinical data for the carotenoids lutein and zeaxanthin and for omega-3 fatty acids. A survey of the literature suggests that some specific micronutrients may be of value in treating or preventing AMD(13)(14)(15)

The information given by Naturopath Russell Setright in this article is for general educational purposes only and not for the treatment of any disease or condition. Always see your Healthcare Practitioner for any suspected disease accident or condition for diagnosis and treatment and follow there expert advice.

1.        Marianna K. Baum,  Adriana Campa,  et al.  Effect of Micronutrient Supplementation on Disease Progression in Asymptomatic, Antiretroviral-Naive, HIV-Infected Adults in BotswanaA Randomized Clinical Trial JAMA. 2013;310(20):2154-2163.
2.       Jiamton  S, Pepin  J, Suttent  R,  et al.  A randomized trial of the impact of multiple micronutrient supplementation on mortality among HIV-infected individuals living in Bangkok. AIDS. 2003;17(17):2461-2469
3.        Gaziano J, Sesso HD, Christen WG, et al. Multivitamins in the Prevention of Cancer in Men: The Physicians' Health Study II Randomized Controlled Trial. JAMA, 2012; DOI: 10.1001/jama.2012.14641
4.       Howard D. Sesso et al. Multivitamins in the Prevention of Cardiovascular Disease in MenThe Physicians' Health Study II Randomized Controlled Trial. JAMA, 2012 DOI: 10.1001/jama.2012.14805
5.       S. Wassertheil-Smoller, A. P. McGinn, N. et al. Multivitamin and mineral use and breast cancer mortality in older women with invasive breast cancer in the women’s health initiative. Breast Cancer Research and Treatment, 2013; DOI: 10.1007/s10549-013-2712-x
6.       J Massa, E Cho et al. Long-term use of multivitamins and risk of colorectal adenoma in women, British Journal of Cancer , (12 November 2013) | doi:10.1038/bjc.2013.664
7.       Grima NA, Pase MP, Macpherson H, et al. The effects of multivitamins on cognitive performance: a systematic review and meta-analysis. Alzheimers Dis. 2012;29(3):561-9. doi: 10.3233/JAD-2011-111751.
8.       Peter P. Zandi, PhD; James C. Anthony, PhD et al. Reduced Risk of Alzheimer Disease in Users of Antioxidant Vitamin Supplements. Arch Neurol. 2004;61:82-88.
9.       Sano M, Ernesto C, Thomas RG, et al. A controlled trial of selegiline, alpha-tocopherol, or both as treatment for Alzheimer’s disease. N Engl J Med 1997;336:1216-22.
10.    Vitamin E May Delay Decline in Mild-to-Moderate Alzheimer’s Disease . JAMA, JAN-1, 2014 
11.    Northumbria University (2010, May 20). Multivitamins can add sparkle for healthy young people News Release.
12.    Rebecca J. Schmidt, Robin L. Hansen, et al. Prenatal Vitamins, One-carbon Metabolism Gene Variants, and Risk for Autism. Epidemiology, 2011
13.    Aslam T, Delcourt C, et al. Micronutrients in age-related macular degeneration. Ophthalmologica. 2013;229(2):75-9. doi: 10.1159/000343708. Epub 2012 Nov 20.
14.    Age-Related Eye Disease Study Research Group. Control Clin Trials. 1999; 20 (6):573-600

15.    Chew, E. Presentation at Retina Subspecialty Day, American Academy of Ophthalmology Annual Meeting, Las Vegas USA, 10 Nov, 2006.

1 comment:

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