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Whoa!  Lay Off the Vitamins!
Posted: 10 June 2013 05:19 AM   [ Ignore ]   [ # 16 ]
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VYAZMA - 10 June 2013 04:41 AM
Coldheart Tucker - 09 June 2013 10:50 PM

I’m sorry, but I’m not going to go through the article and pull out the embedded links.  I will point you to this link from the story -> http://my.clevelandclinic.org/media_relations/library/2011/2011-10-11-national-study-finds-vitamin-e-supplement-may-increase-prostate-cancer-risk.aspx which has this to say about vitamin E doses. The paper, which will appear in the October 12 edition of the Journal of the American Medical Association, found that a group of men taking a daily dose of 400 IU of vitamin E from 2001 to 2008 had 17 percent more cases of prostate cancer than men who took a placebo.

Well the RDA for Vitamin E is 30 IUs.  Not 400.  It sounds like a cruel test they put those guys through.  It equates to poisoning.
So I reckon even with all the nuts I eat and my vitamin I get around 60-65 IUs of vitamin E.  That’s a far cry from 400 IUs.
Laboratories do that alot don’t they?  “Let’s see if this carpet cleaner is poisonous”-“Inject that rat with 100 times the actual exposure rate that a consumer will ever be exposed to”. “Oh, look, the rat died, the carpet cleaner must be poisonous.”
I feel sorry for those poor guinea pig guys in the test.  It looks like the tests gave them cancer…not vitamin E!

I also wonder if they had the genetic potential to get prostate cancer and could have gotten it anyway without the experiment.

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Posted: 10 June 2013 05:48 AM   [ Ignore ]   [ # 17 ]
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TimB - 09 June 2013 11:18 PM

Some of the studies referenced were simply correlational (and do not therefore support an assumption of direct causality). Even the totality of the studies referenced should not be used to make a blanket statement that everyone who takes any vitamin supplement should stop doing so.

This statement only holds if there was a good reason to take the vitamins in the first place and since the number of situations in which vitamin supplementation has been shown to be beneficial are relatively few most people should refrain from using them unless there is good reason since these studies raise concern

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Posted: 10 June 2013 05:50 AM   [ Ignore ]   [ # 18 ]
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Mriana - 10 June 2013 05:19 AM
VYAZMA - 10 June 2013 04:41 AM
Coldheart Tucker - 09 June 2013 10:50 PM

I’m sorry, but I’m not going to go through the article and pull out the embedded links.  I will point you to this link from the story -> http://my.clevelandclinic.org/media_relations/library/2011/2011-10-11-national-study-finds-vitamin-e-supplement-may-increase-prostate-cancer-risk.aspx which has this to say about vitamin E doses. The paper, which will appear in the October 12 edition of the Journal of the American Medical Association, found that a group of men taking a daily dose of 400 IU of vitamin E from 2001 to 2008 had 17 percent more cases of prostate cancer than men who took a placebo.

Well the RDA for Vitamin E is 30 IUs.  Not 400.  It sounds like a cruel test they put those guys through.  It equates to poisoning.
So I reckon even with all the nuts I eat and my vitamin I get around 60-65 IUs of vitamin E.  That’s a far cry from 400 IUs.
Laboratories do that alot don’t they?  “Let’s see if this carpet cleaner is poisonous”-“Inject that rat with 100 times the actual exposure rate that a consumer will ever be exposed to”. “Oh, look, the rat died, the carpet cleaner must be poisonous.”
I feel sorry for those poor guinea pig guys in the test.  It looks like the tests gave them cancer…not vitamin E!

I also wonder if they had the genetic potential to get prostate cancer and could have gotten it anyway without the experiment.

Miriana, there was a control group. There is no reason to suspect that the men in the treatment group were genetically more predisposed to get prostate cancer than those in the control group since subjects were randomly assigned to each group. The whole purpose of doing a controlled study is to cancel out confounding variables such as genetic differences.

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Posted: 10 June 2013 05:59 AM   [ Ignore ]   [ # 19 ]
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VYAZMA - 10 June 2013 04:41 AM
Coldheart Tucker - 09 June 2013 10:50 PM

I’m sorry, but I’m not going to go through the article and pull out the embedded links.  I will point you to this link from the story -> http://my.clevelandclinic.org/media_relations/library/2011/2011-10-11-national-study-finds-vitamin-e-supplement-may-increase-prostate-cancer-risk.aspx which has this to say about vitamin E doses. The paper, which will appear in the October 12 edition of the Journal of the American Medical Association, found that a group of men taking a daily dose of 400 IU of vitamin E from 2001 to 2008 had 17 percent more cases of prostate cancer than men who took a placebo.

Well the RDA for Vitamin E is 30 IUs.  Not 400.  It sounds like a cruel test they put those guys through.  It equates to poisoning.
So I reckon even with all the nuts I eat and my vitamin I get around 60-65 IUs of vitamin E.  That’s a far cry from 400 IUs.
Laboratories do that alot don’t they?  “Let’s see if this carpet cleaner is poisonous”-“Inject that rat with 100 times the actual exposure rate that a consumer will ever be exposed to”. “Oh, look, the rat died, the carpet cleaner must be poisonous.”
I feel sorry for those poor guinea pig guys in the test.  It looks like the tests gave them cancer…not vitamin E!

Vyazma the usual dose found in most OTC Vit E supplements is in fact 400iu. The reason the study was done was because earlier retrospective studies of men taking extra ( not the RDA) vitamin E seemed to show a correlation between supplemental Vit E intake and reduced rates of prostate cancer so that is what this study was designed to look at.

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Posted: 10 June 2013 06:19 AM   [ Ignore ]   [ # 20 ]
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Mriana - 09 June 2013 05:55 PM

I take D and calcium.  Sometimes I take Flaxseed (the vegetarian Omega-3 equivalent, since I am a vegetarian) and sometimes I take garlic and echinacea-golden seal.  I don’t do this every single day and in the summer, I don’t do vitamin D, esp since I’m out in the sun a whole lot more than in winter- at least 30 min every day, if not every other day.  However, I think a doctor with proven to work medicine is better when one is sick any day.

Miriana, this post points out the issues with vitamin and supplement use. Many people are taking these things because they think it sounds like a good idea or because they “heard” it was a good idea but most people haven’t really checked the facts. Keep in mind that if there is no proven benefit when using a supplement or vitamin then no amount of risk is acceptable even if it may be small. You wouldn’t take a drug from the doctor unless you there was proof the benefits outweighed the risks. The same rule should apply to supplements and vitamins. To summarize the things you are taking in brief.

Vit D - In amounts of 800-1000 iu a day this is considered safe. There is little data on the safety or benefit of taking amounts above that. There is also no data currently to support the notion that measuring vit D levels and supplementing people with low Vit D levels is safe or beneficial.

Calcium - Calcium supplements may have a marginal effect on bone loss but recent studies have linked calcium supplementation to an increased risk of cardiovascular disease. Most people probably should not take calcium supplements and instead try to get calcium through their food ( Broccolli, dairy etc).

Flax seed - despite the popular belief that Omega 3 fatty acids are useful in reducing the risk of heart disease there is insufficient evidence at this time to demonstrate any benefit in individuals who have not had a prior heart attack or stroke and as such the use of Omega 3’s for primary prevention of cardiovascular disease is not recommended.

Ecchinacea and Garlic - I am not really sure what your rationale is for using these. Ecchinacea has been largely marketed as a cold preventative or treatment although it has not been proven beneficial for either of these things.

Sounds a bit surprising doesn’t it? That’s because most of the information the public gets on a daily basis comes from the mass media and they are more concerned with sensational reports about the latest thing you can do to help you live to 100 even if the study they are quoting was done by a high school kid on 5 guys in a pool hall ( I have no idea what a high school kid is doing in a pool hall but you get the idea).

[ Edited: 10 June 2013 06:39 AM by macgyver ]
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Posted: 10 June 2013 08:40 AM   [ Ignore ]   [ # 21 ]
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Macgyver has made exactly the point I think gets overlooked in these discussions. The issue is not that vitamins are poisonous, and no one is trying to argue that taking a daily multivitamin is like smoking. The point is simply that almost everyone assumes there is some health benefit to taking vitamins and that, even if there isn’t, they can’t hurt. Unfortunately, in most cases there isn’t any real reason to think there is a health benefit. And we are now beginning to find evidence that they can do harm. So all we are saying is that the assumptions that vitamin supplements are good for you and are safe should be examined in light of the evidence, like any other assumption or health claim.

It always surprises me how deeply embedded the belief that these supplements enhance health is, even in a group of smart, informed, and otherwise quite skeptical folks. There is a lot we don’t know about vitamin supplementation, and a lot of uncertainty associated with epidemiologic studies, which make up most of the data. But while the absence of evidence isn’t necessarily evidence of absence (of a benefit), it is still absence of evidence. The default ought to be, it seems to me, not to put extra stuff into your body without a reasonable body of evidence to suggest you will get more benefit than harm from doing so. Yet there is a tendency to see foods and supplements as either “good” or “bad” for you and to forget that benefit and harm involve dose, as well as lots of other variables. Vitamin supplements are, in themselves, neither good nor bad, they simply have to be evaluated in the same way as any other medicine, in terms of dose and the particular needs and risk factors of the individual as far as we can determine them from the existing research evidence.

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Posted: 10 June 2013 09:00 AM   [ Ignore ]   [ # 22 ]
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macgyver - 10 June 2013 05:59 AM

Vyazma the usual dose found in most OTC Vit E supplements is in fact 400iu. The reason the study was done was because earlier retrospective studies of men taking extra ( not the RDA) vitamin E seemed to show a correlation between supplemental Vit E intake and reduced rates of prostate cancer so that is what this study was designed to look at.

Fair enough.  I had mentioned that my personal multi-vitamin contains only a maximum of 100% RDA for each of the minerals and vitamins it has, at most.
It contains 30 IUs of Vita-E.

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Posted: 10 June 2013 09:15 AM   [ Ignore ]   [ # 23 ]
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mckenzievmd - 10 June 2013 08:40 AM

Macgyver has made exactly the point I think gets overlooked in these discussions. The issue is not that vitamins are poisonous, and no one is trying to argue that taking a daily multivitamin is like smoking. The point is simply that almost everyone assumes there is some health benefit to taking vitamins and that, even if there isn’t, they can’t hurt. Unfortunately, in most cases there isn’t any real reason to think there is a health benefit. And we are now beginning to find evidence that they can do harm. So all we are saying is that the assumptions that vitamin supplements are good for you and are safe should be examined in light of the evidence, like any other assumption or health claim.

I think that’s too far.  I believe that over doses or mega-doses of vitamins are bad for you.
But to say that there isn’t a health benefit for taking another form of a nutrient your body needs is stretching it.
We need Vitamin C. Without it we’ll get sick. If a tablet contains 100% of my daily RDA of vitamin C- then it is beneficial.
Oranges don’t contain some magical form of vitamin C that is somehow better for me.  It’s a chemical. 
By taking my particular multi-vitamin, I’m doing just that, ensuring I get the vitamins I need.  And because it is a mild Multi without mega doses, I can be confident
I’m not taking too much.
Let’s not argue this:  When I take one of these vitamins, the K or the D or the C is going into my system and being used by my body for processes.
It’s no different than eating. And I eat good most of the time as well.
Those minerals and vitamins are going to work after I digest them.
If people are buying single chemical tablets of vitamins say,  Vitamin K and taking more than the RDA-that’s bad. I agree.  That’s believing some nutrient might cure you, or give a better sex like or more hair.  That’s not my case.
And I know you can justify it to say it is my case...but it’s not.
Like I said…I pop an orange flavored chewable Centrum, and those chemicals are going to work.  My body doesn’t reject them because it can tell
it came from a tablet.
And I’ll give you a little ammunition here…I get a mild(very mild) flu or cold maybe once every three years at most. I don’t get shots.

[ Edited: 10 June 2013 09:17 AM by VYAZMA ]
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Posted: 10 June 2013 09:54 AM   [ Ignore ]   [ # 24 ]
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Occam. - 08 June 2013 05:58 PM

Sorry, my motto is the old duPont one, “Better living thourgh chemistry.”  At eighty-two, one’s intestines are quite a bit less efficient at absorbing materials into the blood stream, and the rest of the body’s somewhat less efficient at using the materials so I feel I have to raise the amount ingested just so I get a reasonable amount for my metabolism.

One example is vitamin D.  For years the FDA set the maximum at 400 I.U.  Now it’s been raised significantly.  Since my Northern European skin is susceptible to cancer, I avoid the sun and take 3000 I. U. of it a day.

Occam

Perhaps your use of Vitamin D will prolong your life or shorten it.  I don’t claim to know which.  But eventually you will die of something, and if it is of “natural causes”, those of anti-supplement persuasion can blame the Vitamin D.

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Posted: 10 June 2013 11:37 AM   [ Ignore ]   [ # 25 ]
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VYAZMA - 10 June 2013 09:15 AM

I think that’s too far.  I believe that over doses or mega-doses of vitamins are bad for you.
But to say that there isn’t a health benefit for taking another form of a nutrient your body needs is stretching it.
We need Vitamin C. Without it we’ll get sick. If a tablet contains 100% of my daily RDA of vitamin C- then it is beneficial.
Oranges don’t contain some magical form of vitamin C that is somehow better for me.  It’s a chemical. 
By taking my particular multi-vitamin, I’m doing just that, ensuring I get the vitamins I need.  And because it is a mild Multi without mega doses, I can be confident
I’m not taking too much.
Let’s not argue this:  When I take one of these vitamins, the K or the D or the C is going into my system and being used by my body for processes.
It’s no different than eating. And I eat good most of the time as well.
Those minerals and vitamins are going to work after I digest them.
If people are buying single chemical tablets of vitamins say,  Vitamin K and taking more than the RDA-that’s bad. I agree.  That’s believing some nutrient might cure you, or give a better sex like or more hair.  That’s not my case.
And I know you can justify it to say it is my case...but it’s not.
Like I said…I pop an orange flavored chewable Centrum, and those chemicals are going to work.  My body doesn’t reject them because it can tell
it came from a tablet.
And I’ll give you a little ammunition here…I get a mild(very mild) flu or cold maybe once every three years at most. I don’t get shots.

Vyazma, the evidence for or against a standard multivitamin is muddy to say the least. There are as many studies showing harmful effects as there are showing benefit. Unfortunately the majority of those studies are not controlled trials. I suspect a grand meta analysis would most likely show no effect of any real significance one way or the other. To me that alone is reason enough not to bother but aside from that your reasoning is not consistent.

You say that you agree that someone taking a large dose of a single vitamin is wrong but smaller doses of many vitamins within the RDA is OK.  Consider the rationale. You are arbitrarily saying that dose X is safe but dose Y isn’t without any good evidence to back that up. Keep in mind that using the RDA has several pitfalls. First of all that RDA takes into account all sources including the foods you eat. Since the majority of us in the industrialized world are already getting the RDA of most vitamins in our foods, taking a MVI is then increasing your intake to twice the RDA. Additionally the RDA (now they use RDI - recommended daily intake) was originally developed in WW II as a rough guide for the amount of vitamins and nutrients put in rations for civilians and soldiers. There was a built in safety margin such that the actual amount listed is probably more than what is needed for good health. These guidelines have been amended every 5 years or so based on new data but the decisions are generally based on short term issues such as scurvy, child brain development, pregnancy requirements and so on. They don’t take into account illnesses that may take many years to develop like cancer since there is limited data on this.

As we have been saying here, there is little if any evidence that adults in industrialized countries will benefit in any way from vitamin supplementation except in special circumstances. Since the risks of supplementation are unknown it seems wise to avoid ingesting a substance with unproven benefits and unknown side effects

Another comment too in regards to a chemical being the same whether you get it from your food or from a plant. You are absolutely correct. There is difference between a molecule of ascorbic acid ( vit C) from a pill or an orange, but this assumes that we know everything we need to know about the biology and chemistry vitamin c and the diseases it can prevent. It may be possible that vitamin c is better absorbed when presented to the body in orange pulp. It may also be possible that sailors who ate orange got less scurvy because of vitamin c AND something else in the oranges. Vitamin C and scury may be bad example because we have the biology of scurvy and the chemistry of vitamin C pretty well worked out but with many other diseases and vitamins we are far less knowledgeable so to assume for example that Omega 3 fish oils are all we need to prevent heart disease instead of the whole fish is a bit presumptuous and in fact has turned out to be wrong. We obviously don;t know all we need to in order to come to that conclusion and this is the case with most nutrients.

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Posted: 10 June 2013 12:10 PM   [ Ignore ]   [ # 26 ]
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MacGyver-I suspect a grand meta analysis would most likely show no effect of any real significance one way or the other. To me that alone is reason enough not to bother but aside from that your reasoning is not consistent.

Have they done this grand meta analysis?

You say that you agree that someone taking a large dose of a single vitamin is wrong but smaller doses of many vitamins within the RDA is OK.

Yeah, isn’t that just like eating food? When I eat a large breakfast for example with eggs, potatoes, sausage, OJ and toast I’m getting lot’s of small doses of many vitamins. Isn’t that the same?
But if I ate that meal 20 times a day it would be bad for me.( I know it would be bad for different reasons..but it still makes my intended point.)
Or, If I eat 1 multi a day I get a small doses of many vitamins. But it would be bad for me to eat 10 of those multis a day.
At what point is vitamin E carcinogenic?  Does it really matter?  If vitamin E caused cancer by giving mega doses, or just the dose found in vitamin E supplements, whats the long term, small dose prognosis?  Maybe everyone has an increased risk of prostate cancer just from eating peanuts for 20 years? I don’t know Mac.
I’m just a consumer..trying to take care of my health. And don’t think I don’t appreciate you taking the time to type this stuff out.
Your concern is heartfelt. I believe it.

 

Consider the rationale. You are arbitrarily saying that dose X is safe but dose Y isn’t without any good evidence to back that up.

But isn’t that what the study is showing too? Or is the study saying that long term exposure to Vitamin E in regular doses could cause cancer?

As we have been saying here, there is little if any evidence that adults in industrialized countries will benefit in any way from vitamin supplementation except in special circumstances. Since the risks of supplementation are unknown it seems wise to avoid ingesting a substance with unproven benefits and unknown side effects

I can’t argue with this. Other than the fact that if I don’t take the multi, I will still be ingesting these compounds anyways through foods.
To say nothing of pesticides, hormones etc…
Maybe it’s time to invest in a juicer.  But that is expensive!  It really is.  Good quality fresh fruits and vegetables aren’t cheap anymore. Especially when buying enough to make juices with.
I’d rather do that than Vitamin tablets. You gotta also remember I was raised on Flintstones. It’s not something I see as dangerous. There it is.
Yes maybe irrational thinking, but there it is. It’s just vitamins.

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Posted: 10 June 2013 02:16 PM   [ Ignore ]   [ # 27 ]
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Yeah, isn’t that just like eating food? When I eat a large breakfast for example with eggs, potatoes, sausage, OJ and toast I’m getting lot’s of small doses of many vitamins. Isn’t that the same?

What I believe MacGyver and I are saying is that the difference between taking supplements and getting all your vitamins from your food is simply that since you are probably already getting all you need from your food, the supplements are almost certainly bringing your total intake up to more than you need. The amounts of these things we need to avoid deficiencies are tiny, and it is hard to eat a diet in the developed world that has any major vitamin deficiencies, even if it is an unhealthy diet in other ways. So any supplement is probably going to lead you to exceed the RDI for your total intake, even if the supplement alone is less than the RDI.

Also, there is some evidence that supplements are different in their health effects from the source of the same nutrients in food. While the “natural is good/artificial is bad” argument is bogus as a rigid general principle, in some cases the protective effect with respect to some disease of eating certain foods does not seem to happen when taking supplements containing the nutrients we originally believed was the factor in those foods that provided the benefit. In other words, if fresh vegetables as a high proportion of the diet are associated with lower cancer rates (as they frequently are), this doesn’t mean that we can extract specific nutrients/antioxidants/etc. from those vegetables, take them as supplements, and get the same protective effect. Vitamin C and scurvy represents a very simple case in which the supplement probably does work as well as the source in food, but that seems not to be the case for many other supplements on the market.

Fish oil capsules, for example, do not appear to have the same protective effects as eating fish in terms of cardiovascular disease risk (e.g.). So even when a nutrient is necessary, it may not always be as beneficial taken in supplement form as it is when eaten in food. So while specific vitamin supplements may be beneficial in people with particular risk factors, overall healthy adults seem to be better off just eating a reasonably balanced diet. The evidence doesn’t seem to support the idea of taking multivitamins as “insurance” against an incomplete diet, even though the idea seems quite reasonable.

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Posted: 10 June 2013 04:49 PM   [ Ignore ]   [ # 28 ]
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Just to elaborate a little further on what Mckenzie said, there are a number of reasons why supplements may not be the same as the original food item.

1) Absorption - Some molecules are absorbed better or worse in the presence of other substances. Doxycycline for example should never be taken with dairy products because calcium inhibits its absorption. The same may be true of nutrients. A food item may have the same amount of a particular vitamin as a supplement but you may see different effects on health because the other components of that food item may alter absorption.

2) Metabolism - Most substances that enter the body are chemically altered in the liver to one extent or another but how they are altered and how fast depends on what other molecules are around at the time. It is often said that statin drugs should not be taken along with grape fruit but few people understand why. It turns out that grape fruit juice inhibits an enzyme called CYP3A4 which is responsible for inactivating statins. As a result consuming grape fruit juice results in significantly higher serum levels of the statin which increases the risk of statin related side effects.

Some substances become more biologically active after processing in the liver while others become less. Still others are changed into substances with entirely different biological properties and all of these things can be altered by the presence of other molecules that may be circulating.

Even a simple apple or piece of meat is a very complex mixture of chemicals and its difficult to predict how all of those things are going to affect the metabolism of each other substance in the that food item.

3) Over simplifying - As Mckenzie already pointed out, just because people who eat fish have less heart disease and fish have a lot of Omega 3 fatty acids in them doesnt mean that Omega 3 fatty acids are the reason for the reduced heart disease. You can’t necessarily distill the benefits of a fish down to a single molecule and get the same effect. Sometimes you can but often its more complicated. There may be a number of items in fish that need to be consumed in concert to get the same effect and we may have only identified one.

The body isn’t a simple container of water.

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Posted: 10 June 2013 06:24 PM   [ Ignore ]   [ # 29 ]
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A number of comments:

1.  From the large amounts of “fast food” in the diets of many in the U.S. I’d guess that they aren’t getting the needed levels of quite a few vitamins and other components.  So, supplemental vitamins might actually help.

2.  I read the abstracts of scientific papers in the health section of Science Daily, and I’m fascinated by the huge number of research projects at various colleges and medical schools on various aspects of nutrition and how many of them reach the conclusion that increased amounts of some particular vitamin, amino acid, or mineral has a positive effect.

3.  I can’t get angry at the weakness of a great deal of medical research because it’s hard to justify using humans as controls who might die earlier if not given some particular item.  However, I believe the project on which this thread is based was purely observational.  As such, it’s extremely difficult to weed out other factors that may contribute to the results.  For example, are people who already recognize they have some health weakness more likely to take supplemental vitamins?  If so, the conclusion that the supplements cause earlier death would quite possibly be unjustified.

Occam

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Posted: 10 June 2013 06:40 PM   [ Ignore ]   [ # 30 ]
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macgyver - 10 June 2013 06:19 AM

Sounds a bit surprising doesn’t it?

No, not coming from someone who’s not a doctor and doesn’t have a medical degree to practice medicine.

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