VITAMINS AND MINERALS, TOO MUCH OR TOO LITTLE?

Vitamins and minerals, and trace minerals for that matter, are micronutrients that the human body requires in specific concentrations to function optimally.  They are substances which, if we are deficient in any of them, may potentially disrupt normal physiological processes, including bioenergetics.  However, when consumed in excess dosages at supraphysiologic levels, micronutrients do not further improve health nor enhance mental or physical performance.  In some instances, repeated mega-dosing of certain fat-soluble vitamins such as Vitamin A can in fact be toxic to the human body, and even some water-soluble vitamins such as Vitamin C can put a strain on the kidneys as the body has to metabolize and excrete the excess dosage, with potential consequences such as kidney stones or mild disruptions in the body’s acid/alkaline base that can compromise health.

I have chosen to highlight this topic of dosing in my blog today specifically because, as a nutritionist, I have observed for decades an alarming obsession by a health conscious segment of the public to megadose micronutrients, as though large doses of vitamins were a panacea of health, a trend that has been driven aggressively by the mass marketing strategies of nutraceutical companies selling products that indirectly claim to resolve the etiology of virtually every chronic and acute malady, even aging.  Everyone reads the large print on a supplement label, but few people read the fine print, especially the ubiquitous FDA warning: “THESE STATEMENTS HAVE NOT BEEN EVALUATED BY THE FOOD AND DRUG ADMINISTRATION.  THIS PRODUCT IS NOT INTENDED TO DIAGNOSE, TREAT, CURE OR PREVENT ANY DISEASE”.  Caveat emptor indeed!

That said, the role of vitamins and minerals in bioenergetic processes can hardly be understated.  You can top off a car’s gas tank, but if it is low on oil and poorly maintained, it will surely break down sooner or later.  Further hampering a proper scientific literature review of the role of vitamins and minerals in bioenergetics are numerous confounding variables and multivariates that are rarely factored into studies looking at micronutrients.  One noteworthy problem common to nearly all such studies is the lack of testing of subjects’ baseline levels of vitamins at the start of the study.  It presents as extremely difficult to know for certain whether a study participant benefited from the supplementation of a specific vitamin because they were initially deficient in that micronutrient on a cellular level, as determined by tests such as Spectracell’s intracellular functional micronutrient analyses and mitogenic stimulation and measurement of DNA synthesis, as opposed to the overly simplistic measurement of circulating levels of micronutrients in plasma sometimes ordered up by family physicians in a standard blood panel, which is nowhere near as accurate as Spectracell’s testing methods.

An excellent illustration of the abovementioned point may be found in a clinical trial from 2007 which involved a period of supplementation of vitamins C and E that lasted 3 weeks.  The subjects from one group consumed a daily dose of 400 mg of vitamin E, subjects from the second group ingested 1000 mg of vitamin C, subjects from the third group ingested 400 mg of vitamin E along with 1000 mg of vitamin C, and subjects from group 4 (the control group) consumed a placebo.  Exercise testing was administered in the form of an anaerobic sprint test (RAST) and the Cooper 12-min run test.  The results indicated that there were no significant differences between groups during the study in anaerobic power assessed by RAST.  The study did however find a significant difference between groups in terms of aerobic power (p < 0.05), indicating an association with aerobic glycolysis and oxygenation of the blood.  The study concluded that daily consumption of vitamin E, vitamin C, and a combination of vitamins E and vitamin C for a period of 3 weeks significantly improved aerobic power.  However, this is yet another study that did not look at the baseline or post-study intracellular concentrations of micronutrients in study participants, hence making it impossible to determine if the subjects benefited as observed because of pre-existing deficiencies in vitamins E and C or from the ingestion of unnatural supraphysiologic doses of the vitamins, thus placing in doubt the validity of conclusions drawn from the study.  As with all matters relating to science, especially in the murky depths of nutrition science, the proverbial “devil is in the details”!

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Getting to the heart of the matter

Sorry that I’ve been away for so long folks.  The past few weeks have been a trying time for me, as I recently lost a close family member to the ravages of heart disease, and so it is in his honor that my thoughts logically turn to the subject of atherosclerosis and it’s etiology.

Of course, we have all heard ad nauseum the standard condescending diet and lifestyle recommendations for preventing heart disease peddled by our esteemed FDA and AMA, both of whom are promoting an archaic outdated paradigm to the general public, in fact increasing instead of decreasing the pandemic of heart disease, which is now the number one killer of both men and women in America.  Conventional wisdom on how to address the underlying cause of atherosclerosis and heart disease in general is propagated as a plea to “avoid cholesterol, eat more fruit and so-called healthy whole grains”, “exercise and watch your saturated fat intake”, “replace butter with margarine” (worst advice ever), etc.  I wish to posit an alternate, albeit less discussed, hypothesis of heart disease, one that does not benefit the coffers of the pharmaceutical giants but does address this chronic disease state illuminated by cutting-edge scientific data.  I propose that, at its heart (pun intended), atherosclerosis is not so much about how much fat, or even saturated fat, that an individual consumes, unless they are one of the unlucky few born with a genetic predisposition toward heart disease, such as my aforementioned family member, a condition referred to in medical nomenclature as familial hypercholesterolemia.

Heart disease is essentially a by-product of systemic inflammation triggered by excess blood glucose and triglycerides driven by the over-consumption of refined sugars and atherogenic fats such as trans fat and an excess of Omega 6 oils, in the absence of sufficient Omega 3, especially highly-inflammatory atherogenic hydrogenated oils such as palm oil and vegetable oil, which are now ubiquitous in most modern processed foods, instead of using healthier oils such as olive and avocado oil that are more expensive to produce, but healthier nonetheless.  Which leads us back to the corporate mantra in America: profits first, people second.

Did you happen to notice that almost every food that is labeled “low fat” has had the fat calories replaced by sugar calories?  I maintain that sugar is the true enemy of the heart, not healthy fats!  We have known this academically since the 1980s and yet our government continues to demonize fat instead of sugar as the progenitor of heart disease, which only benefits the sugar and corn lobbies, not the health of the general public.  Special mention goes to corn lobbyists in particular, the most prevalent and profitable crop in the United States.  And why is this, I wonder.  Is it because folks are eating a record amount of corn on the cob these days?  I think not!  In four words, the single most common toxic ingredient found in processed foods and sodas: High Fructose Corn Syrup.  Decades of low-fat dieting have done absolutely nothing to reduce the incidence of obesity, heart disease and Type II diabetes.  In fact, they have only gotten worse, and now even many children have diabetes and heart disease, which are basically just two sides of the same coin.

We have all read the alarming statistics, e.g. 1 in 3 Americans is now either obese or overweight.  I think that the time has come to arrest the true “criminal” at the scene of this crime, sugar, instead of the innocent bystanders, healthy fats and cholesterol.  The demonization of cholesterol is especially tragic, in light of the fact that there is not a single cell in the human body that does not require cholesterol to survive.  If we don’t get enough cholesterol in our diet (howdy Vegans!), the liver will actually manufacture its own cholesterol and circulate it throughout the body, bathing every cell in this critically important hormonal precursor.

Bottom line?  If you’d like to learn more about this controversial topic, I recommend a specific book that is an easy read (also available as an audiobook) and gets right to the heart of the matter!  See link below:

http://www.cholesterolclarity.com/

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Vitamin supplements useless?

A few years ago, the news media reveled in erroneously reporting the contentious notion that multivitamin supplements are useless and ineffective, based upon the dubious findings of one single study that was contaminated by egregious study design and wildly broad conclusions.  Where do I even begin?  Here’s a short list of bullet points that serve to highlight the utter stupidity and lack of science in this so-called “breaking news”:

 

  • Pre-existing health and nutritional status was not screened for the study participants, e.g. existence of or absence of micronutrient deficiencies, their overall health, genomic influences, medications, lifestyle, stress, sleep, endocrine health, or inflammatory markers.

 

  • The study was ripe with numerous confounding variables that were not taken into consideration, such as supplement efficacy and absorption, intracellular uptake, participants’ varied absorptive capacities, the biochemical properties of the supplement’s ingredients (i.e. natural versus synthetic forms of the vitamins), possible sub-clinical dosages of the individual micronutrients contained in the supplement, the wrong ratios of specific vitamins and co-factors that interact positively or negatively with each other, depending on timing and dosing, individual differences in bile-related lipid absorption of the fat soluble vitamins in the supplement, the hydration status of study participants, which can affect water-soluble vitamin absorption. I could go on and on, but I won’t.

 

  • The duration of the study is also relevant, presenting as yet another potentially confounding variable, in terms of assessing long-term chronic disease risk, e.g. cancer and heart disease.

 

  • Most important of all, it is notable that the supplement evaluated in the study was Centrum, which is just about the most garbage synthetic multivitamin available to consumers. It is the multivitamin equivalent of a Big Mac compared with grass-fed filet mignon.  Centrum is manufactured by Pfizer, one of the corporations making 70% of the pharmaceuticals that Americans are taking daily.  In 2015, Pfizer published profits coming in at $48 billion.  I would never go so far as to suggest that they make shoddy supplements to keep consumers needing their medications, but they are making shoddy supplements.  All supplements are simply not created equal!

 

I’m going to cease and desist now, because my blood pressure is going through the roof just thinking about this stuff.  I was employed in a doctor’s office when this “news story” hit the media outlets and it is noteworthy that even most of our patients believed that the story was utter nonsense.  It took quite a lot of nerve for these so-called “researchers” to conclude that decades of scientific data pertaining to multivitamin supplementation had all been invalidated by them based on a study of a single questionable product, especially when taken in the context of a Standard American Diet (SAD) that is woefully deficient in fruits, vegetables, and nutritionally dense foods.  I guess they expect people to get their daily RDA of vitamins from Big Macs, Doritos, and sugar-laden breakfast cereals.  Good luck with that, folks.  In the meantime, I would respectfully suggest that you invest in a high-quality multivitamin/mineral supplement as a kind of “health insurance policy”, unless of course you happen to consume a diet that is so exceptional that Michael Pollan himself would genuflect in your presence!

 

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The most important vitamin is not a vitamin!

Winter is here.  Brrrrrrr!  The days are getting shorter and sunlight is growing scarcer, thus our thoughts naturally turn to Vitamin D (if we happen to be nutritionists).  There are basically two key areas to focus on in any useful discussion of Vitamin D, which to start with is not actually a vitamin per say, but a pro-hormone that is required by the cells of your body for virtually every process of cellular metabolism.  The fact that 1 out of 3 Americans is woefully deficient in this critical micronutrient is nothing short of a criminal offense against Nature.  There are many popular myths about Vitamin D, so I shall seek to debunk a few of them in my blog post today.

First off, it is not true that you can get all of your required Vitamin D from the orange dwarf star around which our tiny planet revolves every 365 days.  It is true that you can synthesize about half your requirement of this Vitamin via sunlight, which of course is even more challenging at this time of year, when UV is low, unless you’re a guy who happens to work outdoors every day for 8-10 hours without a shirt on, in which case you will have also increased your skin cancer risk, a topic that now brings me to a screeching halt in this discussion, as we take a slight detour to explore the dangers of Vitamin D deficiency versus skin cancer.  Let me put it bluntly.  You are about 20 times more likely to suffer the adverse effects of Vitamin D deficiency than develop a malignant melanoma as a result of moderate exposure to direct sunlight, i.e. 1-2 hours a day (at any time of year).  So do yourself a favor and redirect your sunscreen lotion budget toward the purchase of a good quality Vitamin D supplement, because no matter who you are (even if you do work outdoors all day), you will only be able to get about half your daily serving of Vitamin D from the sun.  The other half has to come from your diet or supplements.  Also, one particular observation that you won’t hear from the mouths of most conventionally-trained dietitians and nutritionists is that if Vitamin D is ‘Batman’, then ‘Robin’ is Vitamin K (the last vitamin to be discovered), a mostly overlooked but critical biochemical sidekick to Vitamin D, so make sure that your Vitamin D supplement also contains a small amount of Vitamin K.

OK, so now I’m going to bring up some biohacking geeky stuff, for those of my readers proudly wearing a propeller hat!  In other words, let’s take a look at how to evaluate your lab work, on the outside chance that your primary care physician is actually astute enough to check your serum levels of Vitamin D at your annual physical (if he or she doesn’t, fire them!).  It is vital to differentiate between minimal blood levels of Vitamin D required to prevent Vitamin D deficiency-related pathologies such as bone loss and rickets, as opposed to optimal blood levels necessary for the optimization of health.  The conventionally accepted “cutoff” for minimal Vitamin D is 32 ng/ml, but numerous recent studies have established that the most desirable range is actually somewhere between 60-80 ng/ml, widely considered as the “sweet spot” for Vitamin D by enlightened Functional Medicine physicians.  It is also very important to keep in mind that Vitamin D is one of the few micronutrients that you also do not want to get too much of due to dangers of toxicity (especially in the absence of Vitamin A supplementation), hence the upper cutoff is 100 ng/ml.  To keep one’s level of Vitamin D within that “sweet spot” range, one must supplement a bit more aggressively in the wintertime, as we cannot absorb sufficient Vitamin D from sunlight in the winter, and this also depends on one’s skin tone and where one resides in terms of latitude.

The critical role of Vitamin D as a pro-hormone cannot be overstated!  Speaking anecdotally, when I worked as a Clinical Nutritionist, my physician-employer and I uncovered ubiquitous hormonal deficiencies and imbalances in our patients that all turned out to be a direct result of severe Vitamin D deficiency, requiring an aggressive prescription of high-dose Vitamin D and K supplementation, sublingual DHEA and pregnenelone, and increasing dietary cholesterol (yes, cholesterol!).  The body is unable to adequately manufacture almost all of its hormones in the absence of sufficient Vitamin D and cholesterol serving as hormonal precursors, an often-overlooked consideration in endocrinology.  We found that many of our new patients came to us after years on a so-called “healthy” low-fat low-cholesterol diet, and who had avoided sun exposure like the plague, brainwashed into thinking that they would surely get skin cancer from any amount of sun exposure.  Some had Vitamin D levels below 10 nanograms per milliliter, which was about the same level as prisoners of war that had spent years in solitary confinement.

So if you want to get sick and wreck your hormonal health, feel free to do the same as the person in the picture below, while consuming a Standard American Diet (SAD) that is low in Vitamin D!

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Omega 3 supplements are not created equal

I have fish on my mind this morning, as I had leftover salmon for breakfast.  So here are a few tips and thoughts on Omega 3 supplements, in bullet point format:

  • There are seven important factors to consider when choosing a fish oil: purity, freshness, potency, nutrients, bioavailability, sustainability, and cost.
  • Not all fish oils are created equal.  It is important to do our homework and make an informed choice.  Many fish oils are oxidized or made with poor quality ingredients, and may therefore actually cause health problems, instead of solving them.
  • The potency of fish oil products depends not only on the levels of EPA and DHA, but also upon the molecular structure of the fats in the oil, which in turn affects absorption.
  • We need to screen for purification processes involving the mercury content of fish oils, even if obtained from wild-caught fish such as Alaskan salmon.
  • Natural fish oils are better absorbed than farmed fish oils.  Preliminary evidence suggests that krill oil may be better absorbed than ordinary fish oil, and some studies suggest that krill oil, though pricey, may be more effective for reducing inflammation.
  • Many fish oils are made from fish that are endangered, so if this is an ethical consideration for you, you may want to choose products made from fish that are certified by organizations such as the Marine Stewardship Council (MSC).
  • Try to avoid Omega 3 supplements from non-marine sources, e.g. yeast; they are poorly absorbed and not as effective.
  • I don’t usually endorse a specific product or manufacturer, but my personal recommendation for the best available Omega 3 supplement is krill oil.  Although it is more expensive than ordinary fish oil, it is better absorbed and can therefore be taken in smaller doses.  The fish oil supplement that I personally take is actually from Costco: “Schiff Mega Red” Krill Oil, which has the added benefit of containing high-content phospholipids and astaxanthin that protect the health of our cell membranes, as well as specific organs such as our eyes.
  • In the final analysis, the best Omega 3 supplement of all is manufactured by Mother Nature, i.e. consume more wild sustainably-caught fish such as salmon and sardines (at least 3 times a week), just like centenarians in the Mediterranean, instead of sustaining the profitability of supplement manufacturers.

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