Subject: FAQ: Vitamin Supplementation

From: [email-masked] (Lance Sanders)
Date: 10 Jun 1993 10:32:29 -0500

[Excerpts from Chemtao: Synergies In The Life Sciences (c) 1990 LKS]

   Dr. Jeffery Blumberg, chief of the antioxidants research laboratory at 
the USDA Human Nutrition Research Center on Aging at Tufts University:

   "We're undergoing a paradigm shift. Current medical thinking is based 
on treating disease, not promoting health. But chronic diseases don't 
just appear out of nowhere; they all actually begin in youth and progress 
at a subclinical level, until they reach a threshold...although no 
miracle drug, supplements can be a powerful new tool in the 
armamentarium, a proactive way to prolong your health span.
    We do need the kinds of clinical trials that prove the cause and 
effect before making public health recommendations...(but)...concern 
about safety (re: C, E and beta carotene) has been overstated.
    The difficulty has always been not in (introducing) new ideas, but in 
escaping from the old ones.
    We're at an admittedly frustrating stage, where I think one well-
informed, rational person could decide to take a supplement, and another 
could decide not to.
    Nobody is saying you don't need a healthy diet --- fluids, fiber 
(etc.), all those things are important and beneficial. But now there's 
something else you can do. It's but one of many things and it doesn't 
necessarily compensate for eating a high-fat diet, breathing polluted air 
or smoking...but unlike some of the other things, it's relatively easy to 
do."

Vitamin E
---------

   Results from Dr. Simin Meydani, D.V.M., Ph.D., Assistant Prof. of 
Nutrition at the USDA Human Nutrition Research Center at Tufts University 
(Medford, Mass.) and Robert P. Tengerdy, Ph.D., Professor of Microbiology 
at Colorado State U. (Fort Collins) indicate that vitamin E is a powerful 
immune system stimulator. 
   E appears to enhance the ability of white blood cells to destroy 
invading agents such as bacteria, and to modulate biosynthesis of the 
chemicals that control inflammation as well as to boost T-helper cell 
activity. 
   The mechanism of action involves modulation of phagocytic activity, an 
early shift from IgM to IgG type antibody production. 

   In the immune system, prostaglandins generally have an inhibitory 
effect. Vitamin E appears to inhibit the synthesis of prostaglandins. 

   Dr. Kursheed Jeejeebhoy, of the U. of Toronto determined in 1990 that 
smokers breathe out more pentane, a gas that is given off when cells are 
being attacked by free radicals.
   Next, for two weeks, Dr. Jeejeebhoy gave 800 IU of vitamin E daily to 
13 smokers who consumed an average of 24 cigarettes a day. He discovered 
that the pentane gas exhaled by them after they started vitamin E 
supplementation dropped by about 40%, indicating that E curbed a great 
deal of cellular damage. 

   A study presented on 9/22/92 to a Harvard School of Public Health 
cancer forum, by Columbia School of Public Health researcher Regina 
Santella, found that vitamin E protects against carcinogens in cigarette 
smoke.
   Using antibodies to DNA adducts (adducts result from carcinogen/DNA 
binding, which can block replication and lead to cancer), in a trial of 63 
heavy smokers and 27 non-smokers, the researchers found more than three 
times as many DNA adducts in the smoking group.
   Smokers with higher vitamin E levels had significantly lower levels of 
adducts.
   Vitamin E may curtail formation of DNA adducts, though larger studies 
are needed to confirm the result.

   [Johns Hopkins School of Public Health in Baltimore reports that low 
    physiological levels of vitamin E appear to increase the risk for
    all types of lung cancer by about 2.5 times.]

   A study in 1992, directed by the National Cancer Institute, involving 
1,100 oral cancer patients and 1,300 healthy controls, compared the use 
of vitamins (incl. A, C, E, minerals and multivitamins) with the risk of 
oral cancer. 
   Conclusion: people who take regular vitamin E supplements have half the 
chance of developing oral cancer as those who don't, when smoking, drinking 
and other risk factors are accounted for.
   [The amount of E in many multivitamins (~ 30 IU) didn't seem  
    to offer protection; individual supplements of 100 IU and higher did.]
   [American Journal of Epidemiology, 11/92]

   Preliminary results from Finland studies of 36,000 men and women 
indicate that those with high blood levels of vitamin E had less cancer 
and fewer deaths from cancer. Low levels of vitamin E in the people 
involved in the study indicated a greater risk of breast and stomach 
cancer. 

   Vitamin E can block the formation of nitrosamines (potent cancer-
causing chemicals formed in the saliva and gastrointestinal tract from 
the combinations of nitrates and amines in food), and protect lung tissue 
from the harmful effects of air-borne environmental pollutants. 

   Vitamin E prevents low-density lipoprotein from becoming modified LDL. 
In other words, the vitamin prevents the conversion of harmless low-
density lipoprotein into the oxidized compound that is recognized and 
ingested by macrophages (when they die, the fat-filled macrophages 
accumulate into deadly arterial plaque). 
  [Hermann Esterbauer, Prof. of Biochemistry, U. of Graz, Austria; J.C. 
   Fruchart, Pasteur Institute, Lille, France; Sai R. Ramasastry, M.D., 
   medical director, Dept. of Hyperbaric Medicine, Presbyterian-University 
   Hospital, Pittsburg, etc] 

   [Dr. Ramasastry also concluded from a study of 10 patients who either 
    received 400 I.U. of E or a placebo daily, that vitamin E as an 
    antioxident prevents skin ulceration in chronic vein insufficiency: 
    "Ninety percent of patients with deep vein thrombosis - that is,
     blood clots in the deep internal veins - will eventually develop
     chronic venous insufficiency which leads to skin ulceration fron
     reduced blood flow. It's believed that increased lipoperoxidation
     at the site of skin ulceration is one of the causes of breakdown
     of skin grafts; thus a means of reducing lipoperoxidation could aid
     in healing these patients."]

   Harvard University's School of Public Health and Brigham and Women's 
Hospital (Boston) researchers published a study in the 5/20/93 New 
England Journal of Medicine (one of several on-going) that found an 
association between as much as 14x the daily recommended allowance of 
vitamin E for at least two years, and a reduced risk of heart disease, by 
as much as 40 percent. 
   The studies, involving more than 87,000 female nurses in 11 states 
(and 45,000 male health care professionals in the Boston area), disclosed 
that a 40% decline in heart disease was found in the women only when they 
looked at those particpants who took an average of 100 - 400 
International Units (I.U.) of E per day, and compared them with those who 
took only 6.4 I.U. daily. 
   [RDA for adults = 30 I.U.] 

   Researcher Dr. Meir J. Stampfer, who reported at an annual meeting of 
the American Heart Association (11/17/92), said he had expected the 
studies to demonstrate a LACK of benefit to taking E: 

   "It didn't seem plausible that a simple maneuver like taking vitamin E 
would have such a profound effect."
   "The women who took vitamin E supplements were not different in terms 
of their life style and general health status when compared to nonusers 
of supplements. This leads us to believe that vitamin E has a very strong 
protective effect."

   In the study of men (directed by Dr. Eric B. Rimm of Harvard), those 
who consumed more than 60 units of E/day were 36% less likely to develop 
heart disease than were the men who consumed less than 7.5 units/day.
   Men taking supplememts of 100 units or more/day for at least two years 
had a 37% lower risk than those who took no supplements.
          [The longer the use of E, the greater the benefit.]
          [Frank Speizer, who led the women's study, said the
           level of E from foods had no effect.]

   Long-term, double-blind clinical trials to elucidate the findings 
(that will eliminate other beneficial factors such as aspirin use and 
exercise) are under way. 

   [Dr. William Castelli, director of the landmark Framingham Heart Study:
    "Americans are always looking for a magic bullet. They should be 
     watching their total diet and adding vitamin E to that. If you go 
     and pig out at the local greasery, vitamin E is not going to help 
     very much."]

   Vitamin C greatly enhances the ability of vitamin E to prevent damage to 
LDL, which, if damaged, is suspected of being the first step in the 
progression to heart disease.
   [Dr. Lester Packer, molecular biologist, U. of California/Berkeley 
    (Journal of Lipid Research)]

   A study of monkeys by Dr. Anthony J. Verlangieri at the U. of 
Mississippi, suggested that E may not only help prevent arteries from 
clogging, but may even help to unclog them.

   Verlangieri fed groups of monkey either (1) ordinary monkey chow, (2) a 
high-lard-and-cholesterol diet w/ a placebo pill or (3) a high-fat diet 
laced with a daily dose of 100 IU of vitamin E.
   After three years, the regular-chow monkeys had no artery blockage. The 
fat-chow, placebo-pill group showed 87% blockage. The fat-chow group who 
also got vitamin E had only 1/3 the blockage.
   Six monkeys given vitamin E for two years after their arteries had 
become partially blocked, showed dramatic de-clogging, decreasing from 33% 
to 8% blockage.

   Dr. Scott Grundy, director of the Center for Human Nutrition at the U. 
of Texas Southwestern Medical Center in Dallas fed volunteers 500 mg. of 
vitamin E/day (10x the amount found in the diet), and then tested the LDL 
cholesterol molecules in their blood. They found the cholesterol had been 
rendered resistant to oxidation.
   Vitamin C and beta-carotene hindered, but did not completely block 
oxidation.

   Dr. Donald Mickle, associate professor of clinical biochemistry at 
Toronto Hospital, reported that water-soluble vitamin E was able to 
mitigate some of the damage to heart cells during the "reperfusion" period 
of heart attack victims, when blood flow resumes after a clot has been 
removed from a blood vessel.

   Dr. Richard Weisel, of the U. of Toronto, reported in Nov. 1990 that 
vitamin E is washed away from the blood by heart-lung machines during 
coronary bypass surgery, and large doses of E adminstered two weeks before 
surgery helps to maintain aerobic metabolism in the heart.

   A study by Dr. Ishwarlal Jialal of the U. of Texas Southwestern Medical 
Center in Dallas, described at the 1/92 meeting of the American Heart 
Association in Galveston, demonstrated that men who were given 800 units of 
vitamin E a day for three months experienced cessations of bloodstream 
chemical changes that preceed arterial blockage. Dr. Jialal noted that at 
the levels used in the study, vitamin E "has no bad side effects." 

   Dr. Jean Luc Cadet of the Columbia U. College of Physicians and 
Surgeons has found that E reduces symptoms of tardive dyskinesia which 
appears in 20 to 30% of people taking antipsychotic medications. 13 of 15 
patients taking E supplements for four weeks had symptom severity reduced 
by half. Vitamin E appears to work by protecting the brain from free-
radical damage. 

  [ Dr. Stanley Fahn, director of Parkinsonism and movement disorder 
    research at Columbia notes that people in early stages of Parkinson's 
    disease who take vitamin E (3200 I.U.) and C (3,000 mg) supplements
    show much slower progression of the disease. ]

   Dr. Stewart Factor, of the Dept. of Neurology, Albany Medical 
College/NY, agrees that E may slow the progression of Parkinson's.
   Dr. Factor's study involved 14 patients who took between _400_ 
(emphasis mine) and 3200 I.U. of vitamin E daily for an average of seven 
years. When compared to matched controls, the vitamin E-supplememted 
group had significantly less damage. 

   Researchers at Central Middlesex Hospital in London reported in 1992 
that a lack of antioxidant chemicals such as vitamins E and beta-carotene 
might accelerate degenerative processes in the brain.
   Blood levels of E, A and other vegetable constituents were measured in 
20 demented and 20 healthy patients. The dementia sufferers had 
significantly lower blood levels of E and beta-carotene. Alzheimer's 
patients also had less vitamin A.

   Researcher Simin Meydani of Tufts University, Boston, believes that 
vitamin E may reverse effects of aging on the immune system by protecting 
against age-related oxidation. 

   Preliminary results from Dr. Paul Sternberg of Emory U. School of 
Medicine in Atlanta, suggest that vitamin E supplements may protect the 
eyes against age-related damage and the degenerative effects of everyday 
ultraviolet light exposure. 

   A study directed by Dr. M. Christina Leske of the State University of 
New York at Stony Brook, and published in the Feb. 91 issue of the Archives 
of Ophthalmology, concluded that older people who regularly use 
multivitamin supplements were 37 percent less likely to have cataracts.
   The study was based on 1,380 people between the ages of 40-79 who were 
treated at two Boston hospitals. The key nutrients were suspected to be 
vitamins A and E.

   Lester Packer of California's Lawrence Berkeley Laboratory notes that 
excessive exposure to the sun may lead to skin cancer by destroying 
vitamins C and E (and other antioxidants) which protect cells from damage 
from ultraviolet radiation. 

   Dr. Helen Gensler, of the U. of Arizona College of Medicine and Cancer 
Center/Tucson, at a 4/91 Atlanta meeting on nutrition and cancer (sponsored 
by the Centers for Disease Control and the National Cancer Institute), 
reported that vitamin E oil applied to the skin may drastically cut skin 
cancer risk.
   Her experiments were based on past research which found a key similarity 
between humans and mice: those whose immune systems are supressed by UVB 
light are at highest risk for skin cancer.
   Dr. Gensler exposed 70 mice to UVB light 30 minutes a day, five days a 
week for three months. Half had vitamin E oil applied for three weeks 
before exposure, then three times a week while exposed. The rest had no 
protection.

   The 35 vitamin E-protected mice were not immune-supressed; the 
unprotected ones were. Without E, 81% developed skin cancers, compared 
with 42% of those treated with vitamin E oil.
   [ DL-alpha-tocopherol vitamin E was used, not the version containing 
     acetate, often sold as a cosmetic cream. ]

   Researchers at the Dept. of Agriculture's Human Nutrition Research 
Center have shown that vitamin E taken before exercise can minimize 
muscle damage (caused by oxygen radicals) and reduce imflammation and 
soreness that can follow a demanding exercise routine. 
   Subjects took 800 I.U. of E/day for seven days before running downhill 
on a treadmill for 45 minutes (half took the vitamin, half a look-alike 
placebo).
   Those taking E produced far fewer fat oxidation by-products. A benefit 
was noted in men over 55 as well as those in their 20's.
   Vitamin E also reduced blood levels of two chemical messengers that 
promote inflammation.

   Dr. Robert S. London of North Charles Hospital in Baltimore reports that 
women suffering from pre-menstrual syndrome (PMS) report a 27 to 42% 
decrease in symptom severity after receiving 400 IU of vitamin E daily.
Dr. London suspects that E activates brain neurotransmitters (four to six 
weeks before results are discernable). 

[  A 1990 study at the Baylor College of Medicine in Houston, involving 10 
   women with, and 10 women without, PMS, found that 70% of the PMS women 
   had abnormally low zinc levels during the symptom phase. 
   Study director C. James Chuong believes that zinc spurs the secretion of 
   hormones such as progesterone, and that too little zinc causes a 
   plunge in progesterone, altering brain chemistry. ] 

[  A 1991 study by Dr. James Penland of the Human Nutrition Research 
   Center, a part of the Agricultural Research Service in Grand Forks, N.D., 
   concluded that women who doubled the calcium in their diets suffered 
   fewer physical and psychological discomforts associated with menstruation.
   10 women were followed for 5 1/2 months, and comsumed 1300 mg. of 
   calcium/day. They reported "significantly fewer problems" with mood 
   swings common to PMS, as well as fewer aches and pains. ]

   Vitamin E is also being looked at as a treatment for fibrocystic breast 
disease (benign but painful), retrolental fibroplasia (eye disorder causing 
blindness in infants), intermittent claudication (circulatory disorder of 
the legs resulting in painful cramps), as well as possibly alleviating some 
of the distressful symptoms of menopause. 

    [Patients on anticoagulant therapy with drugs such as Coumadin or 
     Heparin should consult their physician before beginning
     supplementation of vitamin E.]

Vitamin C
---------

   UCLA researcher Dr. James Enstrom, in a 10-year study of 11,348 U.S. 
adults, reported in the May 1992 issue of Epidemiology that after taking 
account of factors such as age, history of serious disease, cigarette and 
alcohol use, cholesterol level, and fat intake and exercise, viatmin C 
supplementation had an independent impact on life span. 

   Three groups were compared: those getting 50 mg or more per day in 
food, plus an average supplement of 500 mg of vitamin C; those getting 50 
mg. or more and no supplement, and those under 50 mg. with no supplement. 
   Men in the highest vitamin C group had a 35% lower mortality rate and a 
42% lower death rate from heart disease and stroke, representing a gain of 
up to five years in lifespan.
   Women getting the highest levels of C were 25% lees likely to die of 
heart disease or stroke, with 10% less mortality, suggesting a gain of a 
year. 
   
   The UCLA study concluded that: "Based on our analyses, the inverse 
relation of total mortality to vitamin C intake is stronger and more 
consistent in this population than the relation of total mortality to 
serum cholesterol and dietary fat intake." 

   The data also suggested that vitamin C protects against cancer, but 
current findings were inconclusive. Larger studies are underway to 
elucidate mechanisms and pathways (results in 3-4 years). 

   USDA researcher Robert A. Jacob reported in 8/92 that skimping on 
intake of vitamin C (less than 1/3 RDA for nine weeks) caused levels of 
glutathione, a potent antioxidant, to drop 50%. Glutathione can 
deactivate at least 30 carcinogens, and is very important in both immune 
system defense, and, perhaps, the aging process. 
   Sperm were particularly damamged by the lack of vitamin C and drop in 
glutathione. 
   An earlier, parallel study by Dr. Jacob, involved 10 men on a closely 
monitored diet. They received 250 mg. of vitamin C for two weeks, then 
were dropped to only 5 mg./day for a month, followed by another month at 
10 mg./day. Sperm samples from the men during the low vitamin period 
found that the genetic damage was twice as high as when the men were on 
250 mg. of the vitamin.
   [The damaged was measured by testing for levels of oxidized guanine.
    The level of vitamin C was determined by measuring the ascorbic
    acid in seminal fluid.]

   A related study by Bruce Ames, at the U. of California, Berkeley 
[published Dec. 15th, 1991, in the Proceedings of the National Academy of 
Sciences], reported that an analysis of sperm from 24 men showed that of 
15 with below-normal levels of vitamin C, eight had high levels of 
genetically damaged sperm (genetic damage increases the risk that natural 
repair mechanisms would fail, and the risk that a child conceived of that 
sperm will have a birth defect). 
   In the study, one group of men had a diet that was meticulously 
controlled. A second group ate unregulated diets. The relationship 
between low dietary ascorbic acid and high levels of oxidation damage to 
DNA was documented in both the groups.
   When the daily intake of dietray ascorbic acid was decreased from 250 
mg. to 5 mg., the amount of ascorbic acid in seminal fluid fell 50% while 
the product of oxidation of DNA, indicating damage, doubled. 
   When the C level was returned to 250 milligrams/day, it took one month 
for semen ascorbic acids levels to return to its original level and for 
DNA damage to decrease.

   Ames also said that the level of C set by the U.S. Agriculture Dept. 
(60 milligrams) is barely enough for most people, and for smokers, etc., 
may be FAR below what is needed to maintain health. 

   [ A global review of 61 studies including 14,947 men, directed by Dr. 
     Niels Skakkebaek of the U. of Copenhagen, and published in the
     9/12/92 issue of the British Medical Journal, found that average
     sperm count in healthy men has dropped by half in the past 50 years,
     supporting speculation that environmental pollutants may damage 
     production of sperm cells.
     Dr. Sherman Silber, an infertility specialist at St. Luke's Hospital
     in St. Louis, cautioned against jumping to conclusions but noted that:
     "If there is something in our environment having an effect that is 
      drastic enough to decrease sperm count by that much, we should know
      what this factor is."
      Dr. Skakkebaek's review was the first to collect world stats, and to
      limit the analysis to healthy men. ]

   In 1990, U. of Edinburgh/Scotland researchers compared 430 healthy men 
with 125 men who had angina. Regardless of other risk factors (such as 
cholesterol), those with the lowest blood levels of vitamin C (and E) 
were more than twice as likely to complain of chest pain as those with 
the highest levels of the vitamins. 
   [The fatty tissues of the angina-sufferers was also remarkably low in 
    linoleic acid --- a polyunsaturated fat found in foods also rich in 
    vitamin E.]

   Dr. Christopher J. Bulpitt, of the Hammersmith Hospital in London, 
noted in April 1991 that: 

   blood pressure is lower in individuals who consume higher levels of 
vitamin C
   blood pressure goes up in winter as consumption of fresh fruits and 
vegetables rich in C goes down
   older people are more likely to have both high blood pressure and 
vitamin C deficiencies
   vitamin C exhibits many well-known actions that help control blood 
pressure.

   A 1/92 study in the British Medical Journal reported that women taking 
vitamin C supplements (250-500 milligrams) for 10 years were about half 
as likely to have cataracts as non-vitamin takers.
   The study supported others showing that antioxidants are potent 
preventatives against cataracts.

   Vitamin C works as an alcohol detoxifying agent in many people.

   Dr. Marianne Chen, in a 1990 study at the U. of South Florida College 
of Medicine, gave 13 healthy men two or three alcoholic drinks on three 
separate occasions. 
   In one case, the men were given 2,000 mg. of vitamin C one hour before 
the alcohol. Case 2, they took 2,000 mg. of C every day for two weeks 
before the alcohol. Case 3: no vitamin C. 
   The vitamin C in both cases significantly speeded up clearance of 
alcohol from the blood in more than half the men. 
   Conclusions: a single megadose of vitamin C may help the "sobering-up" 
process. It must be taken before and not after drinking. It works on only 
about half of the population. In a few individuals, vitamin C prolongs 
alcohol's circulation in the blood. 

   Conditions in which dry mouth is a symptom (diabetes, high blood 
pressure, aging, smoking, radiation, etc.) are marked by a vitamin C 
deficiency, and sufferers may find relief by increasing their vitamin C 
intake. Lack of vitamin C may impede natural chemical production of 
saliva. 
   [Dr. Cyril O. Enwonwu, Meharry Medical College]

   An increased level of vitamin C is being associated with interference 
with "common cold" viral transmission, an increase in blood levels of 
high density lipoprotein (the "good" kind), prophylaxis against urinary 
tract infections in women (two 500mg. capsules daily), stimulation of 
antibodies and white blood cells, relief from exercise-induced asthma 
attacks, prevention of inflammation and bleeding of the gums, elimination 
of many environmental toxins from the body (in conjunction with a 
complete bioflavonoid profile), and the inhibition of build-up of 
cholesterol deposits on artery walls. 
   Vitamin C appears to enhance immune function in general, by helping 
the thymus release hormones to change immature, inactive T lymphocytes 
into "battle-ready" cells. 

Beta-carotene (A), Vitamins B, D, K / Trace Components
------------------------------------------------------

   Beta-carotene is a long-chain hydrocarbon, exactly twice the size of a 
vitamin A (retinol) molecule. When absorbed, it is broken down into 
vitamin A.
   Beta-carotene is only 1 of about 500 compounds known as carotenoids, 
and is stored in lung, liver, kidney and fat tissues. The tissues also 
convert carotene into retinoic acid (an anticarcinogen) as needed. 
 
   Dr. JoAnn Manson, an associate physician at Brigham and Women's 
Hospital in Boston, in a study of 87,245 nurses, found that women who had 
a daily intake of 15 to 20 milligrams of beta carotene/day were at a 40 
percent lower risk of stroke, and a 22 percent lower risk of heart attack 
than women who got less than 6 mg./day. 
   [ A vitamin E intake of 100 mg./day conferred a 36% reduction in risk 
     over those who got less than the RDA of 10 mg.] 

   Drs. Charles Hennekens and J. Michael Gaziano (same research 
institution), in a study of 1271 elderly Massachusettes residents, found 
that the more beta carotene they consumed, the lower their risk of heart 
disease, independent of other risk factors for heart disease. Beta 
carotene reduced the death rate by 40-50 percent. 

   A 1992 study from the University of Brussels (Belgium) analyzed the 
blood of 80 stroke patients for 21 days. Those with above-average vitamin 
A levels were more likely to survive, recover completely or have less 
disability.
   Ten patients with very high A levels showed no disabilities within 24 
hours after their strokes. Those with high A who did not recover 
completely had less neurological impairment than those with low levels of 
vitamin A. 

   Dr. Ronald R. Watson, of the U. of Arizona, demonstrated in a 1991 
study that 60 older men and women (average age 56) who took 30 to 60 
milligrams of beta-carotene daily for two months had more killer cells, 
T-helper cells and activated lymphocytes than those who did not take the 
supplement. Extra beta-carotene may booster a faltering, aging immune 
system. 

   At a February meeting in San Diego called Carotenoids in Human Health, 
a study was presented by doctors from the Oregon Health Sciences Center 
that indicated 180 milligrams of beta-carotene/day increased CD4 cells 
(white blood cell type) in some HIV-infected people.
   Improvement was seen in some patients after four weeks.

   Animal studies have suggested that the carotenoids can prevent 
radiation-induced skin tumors and chemically-induced mammary and bowel 
tumors from becoming carcinogenic, as well as impact positively on the 
prevention of lung, mouth, throat, esophagus, cervix and bladder cancers. 

   Dr. John Vena of the U. of Buffalo reported in the 1/93 Nutrition and 
Cancer journal that a study of 351 men with bladder cancer and 855 
cancer-free men showed that carotenoids appear to reduce the risk of 
developing bladder cancer.

   Dr. Xiang-Dong Wang of the USDA's Human Nutrition Research Center:

   "Beta-carotene may be converted to retinoic acid and prevent tumor 
growth. Retinoic acid has been shown to inhibit the growth of skin and 
and baldder tumors; it is a very strong preventative agent and treatment 
for cancer."

   [Popular foods with highest levels of beta-carotene (descending order):
    sweet potatoes, cooked spinach, raw carrots, fresh cantaloupe,
    acorn squash, Romaine lettuce, uncooked, dried apricots,
    watermelon, cooked asparagus, summer squash, fresh peaches, corn 
    (cooked on the cob).]

   A study in a 5/93 American Journal of Clinical Nutrition by U. of 
Michigan scientists, found that beta-carotene is absorbed much more 
readily when taken in pill or capsule form than when ingested as part of 
vegetables and fruits. 
   Natural food sources' fiber and pectin inhibit the absoprtion of beta-
carotene into the blood. 
   People who depended on raw fruits and vegetables for their carotene 
got only half as much as people who took beta-carotene supplements.

   [The researchers cautioned that larger studies are needed to confirm 
    their findings, and, of course, people still should consume fruits
    and vegetables for fiber and numerous other constituents that cannot
    (or are not yet) found in pill form.]

   [Natural Carotene Products Cooperative, Eustis, Fla., produces 
    concentrated beta-carotene crystals derived from carrots, that include
    both the cis- and trans- isomers of the molecule, which may be more
    effective than the trans- alone.]

   Dr. Thomas E. Edes, an associate professor of general internal 
medicine at the U. of Missouri School of Medicine, fed lab rats 
benzopyrene, charcoal-broiled meats and some industrial wastes in an 
attempt to ascertain whether these carcinogens were preventing vitamin A 
from getting to the lungs and other tissues (people who smoke have lower-
than-normal levels of vitamin A, but the general population is exposed to 
the same types of carcinogens through different avenues). 
   Rats fed benzopyrene had abnormally low levels of vitamin A in their 
intestines, liver and lungs. Rats fed high doses of beta-carotene (non-
toxic - converted to A) maintained normal levels of vitamin A in their 
tissue, despite exposure to benzopyrene. 

   Patients who have suffered strokes and have higher blood levels of 
vitamin A are less likely to die and more likely to achieve a full 
recovery. 
   In studies on 80 patients admitted to hospital following a stroke, a 
post-stroke, 21-day evaluation of neurological and functional status 
revealed that those with high blood vitamin A concentrations recovered 
fully within 24 hours. 10 of the 80 with high A levels experienced no 
disability after thier stroke, compared with five patients with low 
vitamin A concentrations. 
   Among the patients who continued to experience neurological problems, 
those with high vitamin A levels scored better on tests used to measure 
neurological impairment. 

   A study reported at the American Academy of Opthalmology meeting in 
Dallas in '92 showed that between 30-35% of people with macular 
degeneration showed some improvement after being given vitamin and 
mineral supplements.
   Researchers believe that free radicals contribute to the development 
of macular degeneration, and that vitamins A, C, E and beta-carotene may 
inhibit the harmful effects.

   Iowa state U. researchers have synthsized a less toxic form of vitamin 
A, useful in treating skin disorders and in preventing blindness. At a 
3/89 meeting of the Federation of American Societies for Experimental 
Biology, it was disclosed that the water-soluble form of A is made by 
attaching glucose and glucuronic acid to it. The synthetic does not 
produce any of the toxic side-effects of the regular vitamin. 

   Because the brain cannot properly utilize glucose without the B 
vitamins (causing a slackening of brain chemicals important to mental 
sharpness), low levels of the B vitamins are being associated with rage, 
instability, vague fears, nervousness, manic depression, heightened risk 
of cardiovascular disease, depressed immune function, mental fatigue and 
paranoia, especially in teenagers. 

   Combinations of the B vitamin folic acid and B12 can apparently offer 
protection against lung cancer. 
   Folic acid appears to counteract cancer by strengthening chromosomes, 
and perhaps preventing dangerous viruses from infiltrating deep into 
cells and touching off a tumor. 

 [Dr. Douglas Heimburger, U. of Alabama Medical Center, Birmingham; Dr. 
  Henk van den Berg of the Dept. of Clinical Biochemistry at the TNO-CLVO 
  Toxicology and Nutrition Institute in Zeist, Netherlands; Dr. Hemminge 
  Bhagavan, Hoffman-LaRoche Pharmaceuticals in New Jersey ]

   Dr. Charles Butterworth Jr., of the U. of Alabama/Birmingham, studied 
464 women infected with the HP virus, implicated in 80% of cervical 
cancer cases. He found that those with lower levels of folacin in red 
blood cells were 5x more likely to develop cell changes leading to 
cervical cancer than those with higher red blood levels of the B vitamin. 
   Dr. Butterworth: "It's a fascinating peek at how viruses and a lack of 
nutrients may work together to foster cancer; kind of a double 
whammy...when folacin is lacking, chromosomes are more apt to break at 
'fragile' points. This lets the virus slip into the healthy cell's 
genetic material, promoting the initial changes preceeding cancer. Once 
disease occurs, though, dosing with folacin supplements has no apparent 
benefit." 

   A finding in the 8/19/92 issue of the Journal of the American Medical 
Association suggests that folic acid alone, or in combination with 
vitamin B6, can reduce an important risk factor for heart attacks. 
   Dr. Meir Stampfer, of the Harvard School of Public Health: 
   "Men who had abnormally high levels of homocysteine (a product of 
protein metabolism) had 3.4 times the risk of heart attack. This was 
unrelated to other coronary risk factors. B6/folic acid can reduce levels 
of homocysteine into the normal range." 

   B5 taken in combination with choline has a dramatic effect on 
intelligence. Two-thirds of the subjects in an experiment conducted by 
the Optimum Nutrition Institute in London experienced an increase in IQ, 
one subject by as as much as 35 percent. 

   Dr. Vicken Sahakian, an endrocrinology fellow at the U. of North 
carolina/Chapel Hill, in a study at the U. of Iowa showed that expectant 
mothers may be able to alleviate nausea and vomiting associated with 
severe morning sickness with vitamin B6. 
   Thirty-one women, less than five months pregnant, took 25 milligrams 
of B6 every eight hours. Twenty-eight others with symptoms were given a 
placebo. All were asked to rate symptom severity 4x/day. 
   Vomiters in the B6 group dropped by half; the placebo number 
increased. Nausea was eased in severe sufferers, but not in mild to 
moderate cases. 
   It's thought that B6 interfers with elevated hormone levels in 
pregnancy that affect brain areas that trigger vomiting. 

   Researchers at the Scripps Clinic in California and the Cleveland 
Clinic have found that oral doses of vitamin B12 can block allergic 
reactions from sulfites as well as antiasthmatic drugs.  Allergic 
reactions were prevented in 60 to 70 percent of the patients who were 
first given the vitamin then exposed to the sulfites. 

   A recent study from the Tufts U. Medical School Center found that 
people over 60 with symptoms ranging from tingling sensations, weakened 
limbs, lack of balance, memory loss, mood changes and some psychiatric 
disorders may be suffering from a lack of vitamin B-12 (of course, many 
of the symptoms can be caused by other disorders). 
   Dr. Robert Russell: "Vitamin B-12 is probably the most important 
nutrient affected by aging." 

   A study of 1,500 women age 45-80 found that women who lost abnormally 
high levels of calcium through their urine could cut the loss by up to 
50% with tiny doses of vitamin K daily. When the supplement was stopped, 
calcium loss resumed at the rapid, old pace. 
   [Dr. Cees Vermeer, U. of Limburg, Maastricht, the Netherlands]

   People who have high blood levels of vitamin D are much less likely to 
have colorectal cancer than those with low levels. 
   [Dr. Cedric Garland, principal author; U. of California, San Diego; Johns 
    Hopkins School of Hygiene and Public Health] 

   Low levels of the trace mineral manganese can stunt growth, cause 
fatigue, birth defects and reproductive problems. 
   Levels of manganese in the blood were 33% lower in 23 women with 
osteoporosis than in 17 healthy controls. When given a supplement, women 
with osteoporosis absorbed twice as much manganese into the blood, 
suggesting a greater need for the mineral.
   [Dr. Jeanne Freeland-Graves; U. of Texas at Austin]

   Low levels of magnesium are linked to diabetes, high blood pressure, 
cardiovascular disease and pregnancy problems. 
   [Conference on Trace Substances in Environmental Health---St. Louis]

   Calcium supplements can reverse the effects of salt in hypertensive 
black adults. 
   [Drs. Zemel and Sowers; Wayne State University, Detroit]

   A study of 6634 men and women by the U. of Southern California, LA, 
showed that for each gram of dietary calcium consumed per day, the risk 
of high blood pressure was lowered by 12% overall; 16% for non-drinkers 
and light drinkers; 25% for people under 40; 18% for people with lean 
body mass.
   For those persons having all three chracteristics ---moderate 
drinkers, lean and under 40--- the risk is reduced by 40 percent.
   [James Dwyer, USC/LA]

   Dr. Lawerence M. Resnick. M.D., Assoc. Prof. of Medicine at New York 
Hospital-Cornell U. Medical Center, in a 1/22/92 Letter To The Editor
(New York Times):

   "As is so often true, we've really just rediscovered the wheel. A 
Toronto physician, W.L.T. Addison, in articles writetn between 1924 and 
1928, first documented the antihypertensive actions of both calcium and 
potassium supplementation in patients suffering from essential 
hypertension. He further suggested that these minerals worked by 
offsetting the effects of salt. His work was forgotten for more than 50 
years, but his insights deserve to be remembered.
   Our group at the Cardiovascular Center of New York Hospital-Cornell 
Medical Center was the first in the modern era to demonstrate what 
Addison suspected: that the ability of calcium to lower blood pressure 
depends on the underlying type of hypertension present. Specifically, we 
demonstrated as early as 1983 that low levels of the kidney hormone, 
renin, identify subjects in whom calcium supplementation lowers pressure 
most often. Interstingly, these are also the subjects in whom dietary 
salt usually elevates pressure. Hence we routinely utilize plasma renin 
activity measurements in screening hypertensive subjects prior to 
providing any dietary advice to limit salt and/or to increase calcium 
intake."

   Selenium deficiency may be a contributing factor in the high rates of 
hypertension in the chain of states from tidewater Virginia to Oklahoma 
known as the "Stroke Belt". 
   [Drs. Curtis Hames and Herbert Langford; U. of Mississippi]

Aspects of General Supplementation 
----------------------------------

   Multivitamin supplements in general appear to be associated with:

   (1) The prevention of birth defects in pregnant women

       [Dr. Joseph Mulinare; Centers for Disease Control--Atlanta; Dr. 
        Aubrey Milunsky, director of Boston U. Center for Human Genetics;
        Dr. Godfrey Oakley, director of the division of birth defects
        and developmental disabilities, Centers for Disease Control], 

   (2) Marked improvement in non-verbal intelligence levels

       [David Benton, U. of Swansea, Wales/Dr. Stephen J. Schoenthaler,
        California State University, Stanislaus]

   (3) General health maintenance in the elderly, despite lowered
       caloric intake

       [Food and Nutrition Research News Briefs, Oct.1-Dec.31, 1986;
        U.S. Dept. of Agriculture's Human Nutrition Research Center
        on Aging/Tufts University]

   A study by Dr. Ranjit Kumar Chandra, a research professor at Memorial 
University of Newfoundland/St. John's, Canada, that appeared in the 
11/7/92 issue of the Lancet, indicated that vitamin supplements taken by 
older people may increase their ability to fight infections and cut their 
number of sick days in half. 
   Ninety-six healthy, elderly Canadians took either vitamin pills or 
inactive placebos. Those taking vitamins had greater T-cell and natural 
killer cell activity resulting in lower infection rates.

   [The supplements contained 400 retinol equivalents of vitamin A, 16 
    mg. of beta-carotene, 2.2 mg of thiamin, 1.5 mg. of riboflavin,
    16 mg. of niacin, 3.0 mg. of vitamin B6, 400 micrograms of folate,
    4.0 micrograms of B12, 80 mg. of vitamin C, 4 micrograms of D,
    44 mg. of E, 16 mg. of iron, 14 mg. of zinc, 1.4 mg. of copper,
    20 micrograms of selenium, 0.2 micrograms iodine, 200 mg. of calcium,
    and 100 mg. of magnesium.]

   Dr. James Cooper, geriatrician, National Institute on Aging, Bethesda, 
Md.:
   "It's extremely interesting and needs to be duplicated in Americans. 
it it holds up, taking a multi-vitamin a day would be a reasonable 
recommendation." 

   Dr. Richard Berkowitz, chairman of the Dept. of Obstetrics, Gynecology 
and Reproductive Health at Mount Sinai Medical Center in New York:

   "We know of no downside to taking multivitamin supplements." 

   Dr. Ishwarial Jialal, of the U. of Texas Southwestern Medical Center, 
Dallas, reported at a 01/92 meeting of the American Heart Association and 
in the Physicians Health Study that preliminary evidence in favor of 
antioxidant supplementation is building:

   "It is still a bit early to recommend taking supplements, but a 
significant number of people have done so for years with no adverse 
effects."
 
[ In a 3/10/92 interview by the New York Times, "Vitamins Win Support as 
  Potent Agents of Health", Dr. Jialal admitted that "given his preliminary 
  results, and the relative harmlessness of effective levels of vitamin E,
  he himself planned to start a supplement of the nutrient daily." 

  Dr. Walter Willett of the Harvard School of Public Health, takes a
  multi-vitamin, and 1 vitamin E cap daily: "With E, you can't get high
  levels from diet."

  Dr. Joel Schwartz, researcher at the Harvard School of Dental Medicine:
  "The bottom line is that in general there is an anti-tumor effect with 
   agents like beta-carotene and E.
  In 1990 Dr. Schwartz stated that he had been taking daily beta-carotene
  and vitamin E supplements for four years.

  Dr. Jeffery Blumberg, chief of the antioxidants research laboratory at 
  the USDA Human Nutrition Research Center on Aging at Tufts University,
  takes a daily multivitamin/mineral supplement plus 400 IU of vitamin E
  but cautions that "what I take might not apply to anyone else".

  Rutgers University nutrition researcher Paul Lachance takes 250-500
  mg. of vitamin C/day, plus 5000-10000 IU of beta-carotene and
  200-400 IU of vitamin E. ]

   Dr. Claude Lenfant, director of the National Heart, Lung and Blood 
Institute in Bethesda, Md.:

   "The evidence is accumulating that people who are taking an 
antioxidant of some sort seem to have a high degree of protection from 
coronary disease." 

   Dr. Scott Grundy, director of the Center for Human Nutrition at the U. 
of Texas Southwestern Medical Center in Dallas:

   "It's an extremely important theory...this oxidation research pushes 
intervention right into the actual sites of plaque formation. 
    I think we can say at this point that vitamins C, E and beta-carotene 
have the ability to block the oxidation of LDL. If the oxidation theory 
is valid totally or in part, this represents another nutritional approach 
to preventing atherosclerosis." 

   Dr. Simin N. Meydani of the Human Nutrition Research Center on Aging at 
Tufts University in Boston:

   "We used to think about vitamins strictly in terms of what you needed 
to prevent short-term deficiencies. Now we're starting to think about 
what is the optimal level of vitamins for lifelong health and to prevent 
age-associated diseases." 

   Dr. Walter Willett, Harvard School of Public Health:

   "I think we need to keep our minds open. It was only a loony fringe 
that was even thinking of studying these things (supplements) 10 years 
ago --- now everybody's researching it. I think it's highly likely 
there's something important going on. Clearly, there's a need to pursue 
it rapidly and carefully."

   Dr. James Enstrom, author of the 10-year UCLA vitamin C study, and co-
authors Linda E. Kanim and Morton A. Klein:

   "The large drop in cardiovascular death rates since the late 1960's 
added validity to our findings. The decline in deaths from heart disease 
and heart attacks, a trend that has been particularly pronounced among 
men, coincided with large population-wide increases in the consumption of 
vitamin supplements containing vitamin C." 

   Dr. Kenneth J. Rothman, an epidemiologist at Boston University, in an 
editorial accompanying Dr. Enstrom's article in "Epidemiology":

   "While earlier studies were inconclusive about the value of 
supplements, the new data indicate those who take supplements containing 
vitamin C do better than those who simply have a reasonable dietary 
intake of the nutrient. 
    It is unlikely that only vitamin C is protective, but rather, it is 
probably that a variety of antioxidants and other nutrients act in 
concert against a variety of different insults." 

   Dr. Irwin Rosenberg, director of the U.S. Department of Agriculture's
Human Nutrition Research Center on Aging at Tufts University:

   "What is exciting is that we are starting to get observations that say 
we should be able to delay or reverse many problems and symptoms 
associated with the aging process by increasing our intake of nutrients 
that are protective."
   "In the past we didn't have good studies showing that improving the 
diet plus adding vitamin supplememts would have a clear health benefit.
These studies are now coming along."

   [Broad ranges of optimal antioxident levels based on current research:
    
    Vitamin C:     250 - 1,000 milligrams
    Vitamin E:     100 - 400 I.U. (International Units)
    Beta Carotene: 15  - 30 milligrams (25,000 - 50,000 I.U.) ]

   The United States Pharmacopeia has established voluntary criteria for 
the dissolution and disintegration of supplements in light of the 
discovery several years ago that many supplements never dissolved in the 
intestines and were therefore not absorbed by the body. 
  [Supplement dissolution studies performed by Dr. Ralph Shangraw,
   chairman of the department of pharmeceuticals of the University
   of Maryland/Baltimore]

   The first wave of standards are now in effect, and cover water-soluble 
vitamins (B vitamins and C). Those for the fat-soluble vitamins (A, D, E 
and K), and multi-vitamins and minerals may be ready by next year.
[Time-release and chewable supplements are not covered by these standards.]

   [Stay clear of supplements with more than the recommended daily 
    allowance of copper (an oxident) and iron, and more than 200
    micrograms of selenium or chromium.

    Do not buy supplements within nine months of their expiration dates;
    they may have been in-bottle for several years by that time.]

   The dangers associated with possible abuse of vitamin supplements must 
be weighed against their pronounced, documented positive effects, and the 
insidious dangers from the effects of environmental toxins.
   Supplements are capable of blunting the effects of some toxins, and 
there are more than 23 clinical trials now underway focusing on retinoids 
and beta carotene, compounds in the vitamin A family, along with 
selenium, and vitamins B6, B12, C and E for use as chemopreventives. 
   There are commercially available, safe, effective supplement dosages, 
such as those found in the TwinSport Endurance Mutivitamin Fitness Paks 
(as well as other TwinLabs formulations), which would appear to have 
presaged many chemopreventive and prophylactic strategies. 

---------
Lance Sanders                 "Science consists in grouping facts so 
[email-masked]        that general laws or conclusions may
GE Mail: L.Sanders6            be drawn from them."
Vox: (312) 667-5958                                 --- Darwin