False Propaganda Against Vitamins

November 30, 2005

A frightening warning in an article in the Danish newspaper, Ekstra Bladet, claims that people will get sick from taking Vitamin B and injure their hearts by consuming Vitamin E. These claims are twisted and false.

Condescending evaluations of vitamin supplements are quite common. They rarely come from experts, but often from people who know something about something else and therefore think they know something about everything.

As a rule, it is stated that the vitamins only provide expensive urine and do not help against anything at all. Sometimes this message is spread rather too thickly.
The vitamins are poisonous! As the other day in a large published article in the newspaper Ekstra Bladet: You get sick from nutritional supplements, the headline stated. Further down, it became clear that you would not only get sick. You would die!

Whenever these kinds of statements appear, people get scared. They cannot imagine that anyone will write anything in Ekstra Bladet if it is not true. But unfortunately there are writers who don’t bother with that. This is evident from the mentioned article, which is mainly based on two gross, false claims. Here we comment on them in reverse order.

“The last new thing was the B vitamin folic acid, which should also be able to protect against heart disease. Recently, a large Norwegian study showed that folic acid did not make users less prone to heart disease. On the contrary, they got sick from the pills”.

Is that right? No. It is wrong. In the Norwegian randomised trial (it was called NORVIT), approx. 900 people who had had blood clots in the heart were supplemented with 0.8 mg of folic acid per day for 3-4 years. The table shows the relative mortality and incidence of heart clots in those who received folic acid and those who received inactive pills (placebo.)

……………………..………..……Folic acid……Placebo
Blood clot in the heart…….57,9…………….59,2
Total mortality………………….28,7…………….31,7

As seen, the overall mortality was 9% lower if folic acid was given instead of placebo. The risk of blood clots was also reduced. How does that agree with the fact that people “got sick (meaning heart disease) from the pills”? The answer is that it is not true. Admittedly, none of the differences were statistically significant. It was a trend. But that is not the same as the study showing the opposite of the trend.

And now to the first claim. It is about vitamin E. It was claimed that vitamin E should protect against heart disease, it says, but “when the major scientific studies came, it turned out that it… gave… heart failure, bleeding and an increased risk of dropping dead”.

Heart failure. That claim must come from the HOPE-TOO study, the only one of the many studies with a total of well over 100,000 participants in which heart failure has been found to be caused by vitamin E treatment.

4,000 people with severe atherosclerosis participated in HOPE-TOO. Those who received vitamin E (400 IU/day) had slightly more often weakened heart. The difference was statistically uncertain, i.e. that it could be accidental. The absence of heart failure in all the other studies suggests the same.

On the other hand, a slightly reduced risk of lung cancer was found in HOPE-TOO, and it was reliable. But since this has not been found in other studies either, it is unreasonable to mention it. It could be random anyway.

Another peculiarity of HOPE-TOO was that even though the participants were given 25 times the recommended amount of vitamin E, it could not be seen in the blood tests. On average, the participants had very little vitamin E in their blood, despite the large supplements. The concentration in the blood (17.6 mmol/l) was even at the lower end of the normal range (12-42 mol/l). Either the participants have not taken the vitamins, or they have e.g. taken them on an empty stomach so that they were not absorbed from the intestine. So where does the vitamin E study end up?

In other words: Here a single, guaranteed misleading, result from one small experiment is misused – as “fact”. It is cheating and distortion. And for the record: That you should start bleeding, let alone die from vitamin E in the mentioned doses, is out of thin air. In contrast, the vitamin prevents, in animal experiments, gastric bleeding caused by aspirin.

Professor Maret Traber, Oregon State University, is considered one of the world’s leading vitamin E researchers. She recommends vitamin E for a number of chronic health problems, including heart disease. Louis Ignarro, who received the Nobel Prize in 1998 for his research on blood vessels, unequivocally recommends vitamin E and C for the prevention of atherosclerosis. It works, he says.

Of course, what even such big celebrities think is no argument in itself. It is the substance that counts. Yet. If you are free to choose your advisers, you are likely to prefer the most knowledgeable – and the most reliable.

By: Niels Hertz  MD

References:
1. A. Astrup. Du bliver syg af kosttilskud. Sund og Slank. Ekstra Bladet. 26.11.05.
2. The HOPE and HOPE-TOO Trial Investigators. Effects of long-term vitamin E supplementation on cardiovascular events and cancer. JAMA 2005;293:1338-47.
3. Bonaa KH. NORVIT: Randomized trial of homocysteine-lowering with B-vitamins for secondary prevention of cardiovascular disease after acute myocardial infarction. Program and Abstracts from the European Society of Cardiology Congress 2005; September 3-7, 2005; Stockholm, Sweden. Hot Line II. Iflg. Linda Brooks. NORVIT: The norwegian vitamin trial. Medscape Sept. 2005. (Not published in printed media.)

You Must Plug The Hole Before The Boat Sinks

October 11, 2005

A Norwegian study has shown that if you have already experienced an acute myocardial infarction, the risk of another such infarction will not be reduced by taking folic acid, Vitamin B6, and Vitamin B12, even if homocysteine levels are lowered thereby.
If you get a great deal of folic acid, the blood content of the amino acid homocysteine will be relatively low. So much is certain. When the content is low, the risk of blood clots in the heart or brain hemorrrhage – other things being equal – is also low. It is also safe, but both are statistics only.

With these facts in the bag, one is tempted to think that supplementation with folic acid must be a good idea. As you know, folic acid is the B vitamin that young women should take to avoid having children with spina bifida. One can agree with the American Heart Association, which advises everyone to get 0.4 mg of folic acid a day, the same dose that women should take as a supplement.

In Tromsø in Norway, the so-called NORVIT trial (Norwegian Vitamin Trial) was the first to test whether supplements also help heart patients who have already had a blood clot in the heart. If the media is to be believed, it ended with a scare.

The results, which were presented in September at this year’s congress of the European Society of Cardiology (ESC), led directly to warnings against folic acid in the press: B vitamins could be dangerous for heart patients, it said, and our own Danish heart association was quick to announce, that folic acid is “still” not recommended for heart patients – even though the month before was said something close to the opposite.

But, as is so often the case, the reports were misleading. Strictly speaking, the Norwegian trial did not show that folic acid is dangerous. If you want to argue that it showed anything at all, it was that the risk of heart attack, stroke, or death decreased—albeit by only a few percent—in those who took 0.8 milligrams of folic acid a day for 3.5 years . However, this was not statistically certain.

The fact is that there were in fact not one, but three trials, with a total of 3,750 people, all of whom had had blood clots in the heart. One showed that a combination of folic acid, vitamin B6 and B12 led to approx. 20% more cases of blood clots in the heart than placebo (cheat pills). The second – the only one where only folic acid was used – showed no difference in reality. There was also no difference in the third trial, where the participants only received vitamin B6.

In one area, the experiments turned out to be successful: those who received folic acid achieved a drop in the blood homocysteine content of approx. 30%. Enough so that one could hope for a nice drop in the number of new blood clots. Which did not appear.

But the questions arise: Is it appropriate for heart patients to be careful about taking folic acid, vitamin B6 and vitamin B12 at the same time?
Or are we talking about completely different anatomical conditions with secondary prophylaxis than there are with primary prophylaxis? After all, you have had a blood clot.

Also at the congress, the ESC’s designated commentator, Ian Graham, doubted the result. He believed that the experiment might have been too small and too complicated to be credible.

One can go a step further and think that the result is purely due to chance. In any case, it is not supported by any theory.
It is more likely that folic acid is simply not suitable for preventing blood clots in severely arteriosclerotic patients. – In other words secondary prophylaxis.

There is a lot of evidence that folic acid – and low homocysteine – slows the development of atherosclerosis in healthy people – i.e. primary prophylaxis. But the usefulness of this function diminishes when the calcification is already very advanced. The bottom plug must be inserted before the boat is sunk.

If folic acid is to prevent blood clots, you probably have to start in good time. On the other hand, the vitamin has other benefits. Among other things. experiments convincingly indicate that it helps to keep the brain young, even in the elderly.

By: Vitality Council

Reference:
Bonaa KH. NORVIT: Randomized trial of homocysteine-lowering with B-vitamins for secondary prevention of cardiovascular disease after acute myocardial infarction. Program and Abstracts from the European Society of Cardiology Congress 2005; September 3-7, 2005; Stockholm, Sweden. Hot Line II. Iflg. Linda Brooks. NORVIT: The Norwegian vitamin trial. Medscape Sept. 2005. (Not published in a printed media).

www.medscape.com/viewprogram/4494_pnt
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