Positive Health Online

Antagonism to Supplements

It struck me recently that as a fully qualified doctor who has chosen to specialise in Ecological and Environmental causes of disease I should, perhaps, review the current trend of antagonism towards the use of natural supplements when fighting disease. As the Medical Director of The Diagnostic Clinic and the Secretary to the largest group of doctors and scientists involved in Ecological Medicine in the UK, the British Society of Ecological Medicine (www.ecomed.org.uk) I have been aware of levels of deficiencies in a variety of vitamins and minerals within those who are ill, as well as those attending for screening.  Studies showing deficiencies in magnesium running at about 61% of the population in the USA[1] and Vitamin D deficiency at around 59%[2] are simple and typical examples. 

There is clear evidence of deficiencies from a clinical view point if you know what you are looking for and the causes are manifold. Why, therefore, is it that there is so much apparent effort being put into place to keep the General Public away from nutrients? 

As our ever ageing population find themselves on a myriad of medications we are also seeing growing efforts to medicate the healthy. Putting aside the possible benefits of mass vaccinations (most UK children now receive over 20 vaccines before the age of 12) we are also lowering the age at which we would all benefit from cholesterol lowering agents such as statins, blood pressure controlling tablets, anti-clotting agents such as Aspirin – and that does not account for the easy availability of antacids to counteract poor diet nor the use of pain killers for the slightest twinge. 

Some research, I felt, was needed to try and establish the best advice to offer with regard to supplemental approaches.

On 12th July 2007 the European Court of Justice upheld a ban of vitamins and supplements as ordered by a directive in 2002[3] which in effect will lead to over 5000 products disappearing, loss of access to over 300 vitamins and mineral ingredients out of a current total of around 420 and which would include the loss of many forms of Vitamin C, Vitamin E and trace minerals such as silicon, boron and vanadium[4].  Furthermore, it is estimated that 21 million people in Britain will have their choice to obtain nutrients restricted and unless suppliers and manufacturers come up with between £80,000 and £250,000 to test each nutrient it is unlikely that any of the banned substances will reappear.[5]

An individual's freedom of choice will be markedly hampered and, argues the Alliance for Natural Health, products are to be banned with little if any scientific justification.  This is all despite our current Government's statement on 3rd July 2008 "Patient Choice: Policy and Guidance on Improving Patient Choice, including how, when and where patients receive treatment, and giving the public a bigger hand in shaping local care systems".[6]

A report by the Cochrane Database of Systemic Reviews 2008 Issue 3 pretty much mirrored that of the Journal of the American Medical Association from March 2007.[7] This is in stark contrast to the British Medical Association's Vegetarian Statement:

"Research has demonstrated that a vegetarian diet reduces cancer fatalities by up to 40% according to many studies including the British Medical Journal".[8]  Furthermore, a 1992 US Department of Agriculture report estimated the following potential health benefits if everyone in the US could be convinced to eat a diet containing the recommended daily amounts of primary nutrients:

• 20% reduction in cancer;
• 25% reduction in heart and vascular conditions;
• 50% reduction in arthritis;
• 20% reduction in respiratory and infectious diseases;
• 50% reduction in infant and maternal deaths.[9]

So, it would appear that if you eat enough of the right stuff you reduce the big killers in developed society such as heart disease, arterial disease, strokes, cancer, osteoporosis and neurodegenerative diseases. We better come up with some answer since evidence-based medicine is now generally agreed to be the third or forth leading cause of death in Western societies[10]  Furthermore, the BMJ published in its journal "Clinical Evidence" that out of 2500 treatments offered in conventional medicine:* 13% are beneficial to the patient;

• 23% are likely to be beneficial;
• 8% is a trade-off between benefits and harm;
• 6% are unlikely to be beneficial;
• 4% are likely to be ineffective or harmful;
• 46% have unknown effectiveness.[11]

As there is apparently a 64% chance that any treatment given in conventional medicine will either be harmful, ineffective or be prescribed with uncertainty of what might happen I would argue that there is no more scientific proof of the safety and effectiveness of drugs than there is for natural treatment methods.  But I think I am veering from the point of this article.

Deficiencies Abound

We know that the modern diet and lifestyle creates nutritional deficiencies.  15 out of 21 deaths in the US were related to nutrition according to Dr Everett Koop, US Surgeon General, in a statement in 1998.  Furthermore there is a proliferation of nutrition-based research highlighting diseases that are linked to nutritional status.[12]

The Earth Summit in 1992 highlighted that fewer minerals were returned to the soil than were taken out and pesticides and insecticides upset the natural pro-biotic eco-balance in the soil.[13]

We have declining mineral values in farm and range soils over the last 100 years as follows:

• North America 85%;
• South America 76%;
• Europe 72%;
• Asia 76%;
• Africa 74%;
• Australia 55%.[14]

And what's more, we have known about this for quite some time.  The US Senate's 74th Congress, Second Session in 1936 stated "The alarming fact is that food (fruits, vegetables and grains) now being raised on millions of acres of land no longer contain enough of certain minerals [and are therefore] starving us – no matter how much of them we eat".  Furthermore, the same Session stated;
"No man of today can eat enough fruits and vegetables to supply his system with the minerals he requires for perfect health because his stomach is not big enough to hold them". 

How worried should we therefore be if two-times Nobel Prize winner Dr Linus Pauling's statement is correct "You can trace every sickness, every disease and every ailment to a mineral deficiency". 

Well, perhaps not every problem but we can certainly cite deficiencies in calcium, magnesium, manganese, silicon and born as associated with osteoporosis. Also selenium, zinc, copper  and sulphur with arthritis; heart attacks and strokes with deficiencies in selenium, magnesium and Vitamin C; cancer with antioxidants particularly selenium and even arguably hypertension with Vitamin B3, magnesium and calcium imbalance.  The list, of course, goes on.

We are faced with mineral and vitamin deficiencies due to inadequate levels in food, poor nutritional intake, poor digestion and absorption, increased excretion – which is further enhanced by certain medications and drugs. Mineral deficiencies occur through competitive toxic metal accumulation and additives and pesticides may well be influencing our bowel flora which interferes with our digestive capabilities and absorption. 

Alcohol and cigarettes lead to deficiencies in Vitamin B Complex, Vitamin A and magnesium; antihistamines create a Vitamin C deficiency; Aspirin is associated with deficiencies in Vitamin A, B Complex and C as well as the minerals calcium, potassium and iron and caffeine is associated with a lack of inositol, biotin and zinc and can inhibit calcium and iron assimilation.  Toxic element accumulation is antagonistic to the uptake and retention of a variety of supplements.  Examples are aluminium interfering with iron, calcium and Vitamin C; cadmium with zinc, calcium, magnesium and copper; mercury with selenium and nickel with manganese, zinc and copper again.  These are all heavy metals found persistently in those patients who undergo toxic metal assessment. 

So What Can We Do?

Those who have the financial capacity might be interested in tests such as NutrEval by the laboratory Genova (formerly Great Smokies Laboratories, USA) that now have a branch in the UK serving Europe.  This gives a broad indication of nutritional deficiencies and this extensive test can also indicate the presence of heavy metals and one's ability to detoxify.  Those who prefer to save their money and are willing to trust in some of the facts and statistics mentioned above might simply choose to supplement their diet with non-pharmaceutical grade vitamins and minerals.  It appears that around 98% of the nutrients we buy off-the-shelf are pharmaceutical "isolates" provided either as byproducts of industrial manufacturing or specifically manufactured. As an example the main producers of Vitamin C, providing approximately 110,000 tonnes annually, include BASF, Hoffman la Roche, DSM, Merck and the China Pharmaceutical Group Ltd. 

I was introduced in the mid-90s to Natural Food State. Other than by juicing and trusting on the level of nutrients within the fruits and vegetables I used or by going for the 'supergreen foods' I could find no source of reliable nutrient supplementation other than from the US Company Grow Co Inc. 

The process of manufacturing a Natural Food State nutrient places isolate vitamins and minerals into organic and pesticide-free frit or vegetable pulp. A microorganism in the form of a yeast is introduced and this complexes the nutrient with the many different components within the plant pulp acting similarly to soil bacteria in an adequately mineralised soil. The process continues with the yeast being broken down to avoid any antigenic or allergic property and the outcome is a nutrient-enriched pulp.

The principles discovered by Dr. Blobel, Nobel Prize winner for Physiology 1999, have significance when we consider the ability of plants, such as Saccharomyces cerevisiae (nutritional baker's yeast), to transform inorganic substances into forms that are readily utilised in the human physiology. NFS follows the exact same principles. This transformation fixes the carriers to the nutrient and provides them with addresses and post codes which allow them to be delivered to the appropriate cell receptor sites.

When this is concentrated down the supplement is delivered in:

• A form recognised by the body as food in a complex that does not require high dosage;
• Is complexed with co-factors necessary for nutrient assimilation;
• Provides higher absorption rates than pharmaceutical grade supplements;
• Has proven success in preventative and treatment applications;
• Subjectively and objectively improves the wellbeing of patients and also avoids the development of deficiency diseases in the healthy;
• Are proven to be an effective method of treating disease.[15,16,17,18,19]

The pharmaceutical industry is not best pleased with Natural Food State. In fact, in 1993 Grow had to defend themselves and successfully won a court ruling from the US District Court who stated:

1. Studies indicate that Grow material may be different from vitamins mixed with foods;
2. Grow materials are better than isolated USP materials;
3. Grow materials may be better absorbed, retained and utilised than USP nutrients;
4. Grow materials are manufactured under proprietary process.[20]

This last statement is very relevant as, apparently, a lot of other companies are now labelling their products "Food State".  Be wary as what little evidence I have seen of other product studies do not convince me that the proprietary process as developed by Grow over the last 40 years or more is necessarily being followed. 

In conclusion, therefore, I think we have a vitamin, mineral and nutrient deficient food chain. I think we have disease directly aligned to deficiencies. I do not think we can eat our way to health without supplementation. I do not think there is a big pharmaceutical conspiracy that is bullying the intelligent scientists advising the EU or publishing in the JAMA or conning the Cochrane database. I do not think there are any grounds to suggest that supplementation is not both needed and advisable for those of us who are well and those who are ill. However, if we do not encourage knowledge about Natural Food State we will find ourselves commercially unable to obtain necessary nutrients either due to the failings within the food industry or governmental embargo upon off-the-shelf nutrients. We need supplements and we need them in Natural Food State.

Nutrient and Supplement Research

A breakthrough in nutritional science was the awarding of The 1999 Noble Prize in Physiology to Dr. Gunter Blobel for discovering that proteins have intrinsic signals that govern their transport and localisation in the cell.

Dr. Blobel, a cell and molecular biologist at Rockefeller University in New York, has been researching the molecular mechanisms underlying the processes by which proteins are directed or transported into the cell.
Dr. Blobel discovered that proteins have an inherent signal that is essential for governing them to and across the cellular membranes. He also showed that similar, "address tags", or "post codes", direct proteins to other intracellular locations.

Selenium

Selenium is the only mineral that qualifies for an FDA-approved qualified health claim for general cancer reduction incidence. The claim reads:
"Selenium may reduce the risk of certain cancers. Some scientific evidence suggests that consumption of selenium may reduce the risk of certain forms of cancer."

Selenium – Governments Reports

The UK 1: A UK Government Report

A government report has revealed that most people in the UK are not getting sufficient amounts of the trace element selenium in their diet. According to the MAFF report Food Surveillance Information Sheet No.51, the average consumption of selenium is currently only 34 mcg per day which falls well short of the RNI (Reference Nutrient Intake , formerly recommended daily allowance) set by the Government's COMA report in 1991 which stated that the desired level for men is 75 mcg and 60 mcg for women.

UK 2: Select Committee on Environment, Food and Rural Affairs Written Evidence

Memorandum submitted by Dr Helen Fullerton
"Selenium is desperately low in virtually all UK soils, and as admitted by MAFF, its intake is half what it should be in the human population, due both to removal by cropping and to leaching by the sulphate in acid rain and ammonium sulphate fertilisers."

UK 3: Selenium intake

Estimated selenium intakes in the UK
Year Intake (_g/day)
1974 60
1985 63
1991 60
1994 43
1995 39
Taken from Total Diet Study

This document has been prepared for consideration by the Scientific Advisory Committee on Nutrition. It does not necessarily represent the final views of the Group or the policy of Health Departments and the Food Standards Agency.

UK 4:  Lancet

Thyroid Disease Selenium Critical to General Health and Thyroid Function
by Mary J Shomon
Researchers writing in the July 15, 2000 issue of the British-based international medical journal, The Lancet, called attention to the importance of selenium to health, citing the trace mineral's potential to reduce the risk of thyroid problems, pregnancy and fertility problems, heart disease, and progression of HIV to AIDS, among other important findings.

According to the review study, diet and geographic location can impact the amount of selenium you are getting. Selenium is an essential trace mineral found in the soil. Typically, crops will convert selenium into organic forms that can be absorbed nutritionally by humans. Getting sufficient quantities of selenium may increase thyroid hormone metabolism, improve fertility, help fight cancer, and reduce risk of cardiovascular disease and arthritis.

The author of the study – The importance of selenium to human health The Lancet, Volume 356, Number 9225, 15 July 2000 – Margaret Rayman, a professor of nutritional medicine at the University of Surrey in Guildford, England, began focusing on selenium several years ago, after her research into the condition known as pre-eclampsia showed that low selenium levels were a common denominator in all the women in the study. Her research went on to discover that in the UK, and in Europe as well, selenium levels were abnormally low overall. Rayman found that dietary consumption of selenium had dropped 50% in the past two decades, a time period during which the UK had reduced it imports of selenium rich North American wheat in favour of selenium poor European wheat.[21]

Research carried out across the USA 1
Research carried out across the USA found that those states with low levels of selenium in the soil had the highest incidents of cancer, whereas those States with high levels of selenium in the soil had the lowest rates of cancer. [22]

USA 2

An American study, published in the Journal of the American Medical Association (JAMA) showed that selenium supplementation led to a 50% reduction in cancer mortality. This was the first double-blind, placebo-controlled study to show such a drastic effect of selenium supplementation to the diet.

The study was carried out on 1,312 patients aged between 18 – 80 years and diagnosed with skin carcinoma from seven dermatological clinics in the USA. The aim of the study was to determine whether daily selenium supplementation could prevent skin cancer from recurring, and although the results did not support this contention, the researchers did discover that cancer rates (including colorectal, prostate and lung) were significantly lower in the patients taking selenium supplements than in the placebo group.

The results revealed that there were 63% fewer cases of colon cancer, 58% fewer cases of colorectal cancer and 46% fewer cases. The total reduction in cancer mortality was found to be 50%, and there was a 37% decrease in cancer in general (all types).[23]

Research from Finland

A study undertaken at the University of Tampere, Finland provided further evidence. Blood samples taken from over 20,000 men were frozen and compared 11 years later with the mens' medical records.

The researchers found that the men who developed lung cancer had had low levels of selenium in their blood and overall, it was found that men with the lowest levels of selenium were more than three times likely to develop lung cancer than those with high levels of selenium. The researchers concluded that "poor selenium nutrition is a highly significant factor for lung cancer".[24]

West Germany: Skin Cancer and Selenium

In West Germany, researchers found a link with skin cancer and low levels of selenium. 101 patients with skin cancer were examined at the University of Bonn and blood selenium levels were compared with a control group of healthy people. The researchers found that skin cancer patients had significantly lower levels of selenium and concluded that low levels of selenium preceded the onset of skin cancer and may even have contributed to its cause.

Taiwan: Low Dietary Selenium Levels linked to Increase in Cancer

The College and School of Public health and the National Taiwan University have been conducting experimental research which has linked a low dietary selenium intake with increased cancer. They studied the association between plasma selenium levels and risk of liver cancer in chronic carriers of hepatitis B and/or C virus.

Blood was drawn from 7,342 men in Taiwan between 1988- 92. Cases were followed-up for an average of 5.3 years, the results showed that average selenium levels were significantly lower in the liver cancer cases than in the hepatitis-positive patients. The research found a significant positive correlation between plasma selenium levels and liver cancer.[25]
 

References

1. United States Department of Agriculture, Agricultural Research Services – www.ars.usda.gov  
2. Journal of Clinical Endocrinology and Metabolism March 2010.
3.  Directive 2002/46/EC of the European Parliament.
4. Alliance for Natural Health January 26th 2005.
5. The Sunday Telegraph 17.7.05.
6. www.dh.gov.uk.en.healthcare/patientchoice/index.htm
7. JAMA 2007; 298: 400-401 – Antioxidant Supplements and Mortality, Huang et al
8. BMJ 28.6.94, 6945 Volume 308.
9 The China Study – T. Colin Campbell PhD and Thomas M Campbell II
10. JAMA 1998 April 15; 279 (15): 1200-5.
11. ISSN 1752-8526 (c) BMJ Publishing Group Ltd 2008.  All rights reserved.
12. www.vitasearch.com  
13. Journal of Applied Microbiology 1998, Volume 84, No 4, pp.551-558
14. US Senate Document No 264 and 1992 Earth Summit Report, Depletion Levels (%)
15. www.growco.us  
16. American Journal of Clinical Nutrition, 48, 3.601-604. 1988.
17. Vinson et al, Nutrition Reports International, 36, 3. 497-505. 1987.
18. Hsaio et al, Nutritional Reports International, 32, 1. 1985.
19. Comparative Human Bioavailability of Zinc, Royal Society of Chemistry. 1989.
20. US District Court Submissions in Respect of Re-Natured Foods (Food State) Vitamins 1993.
21. Margaret Rayman. The importance of selenium to human health. The Lancet, 356 (9225). 15 July 2000.
22. Archives of Environmental Health September/October 1988.
23. Clark LC, Combs G.F.Jr, Turnbull BW et Al. Effects of Selenium supplementation for cancer prevention in patients with carcinoma of the skin. JAMA 276: 1957-63. 1996.
24. Kneckt P et al. Selenium Deficiency and Increased Risk of Lung Cancer. Abstract of paper read at the Fourth International Symposium on Selenium in Biology and Medicine, Tubingen. West Germany. July 1988.
25. YU and colleagues, School of Public Health, College of Public Health, National Taiwan University, Taipei Taiwan Yu MW et al. Plasma selenium levels and risk of hepatocellular carcinoma among men with chronic hepatitis virus infection. American Journal of Epidemiology 150(4): 367-74. 15 Aug 1999.

Supplemental Reference

Letters to the Editor Positive Health PH Online Issue 148: Critiques of Cochrane Review reported in JAMA [7] www.positivehealth.com/article-view.php?articleid=2445  

Declaration of Interests
Dr Rajendra Sharma has no direct financial interest or financial association with any of the above-mentioned companies (other than The Diagnostic Clinic – see below).  He is, on occasions, paid an honorarium to lecture on cardiovascular disease by Genova.  He is a shareholder in The Diagnostic Clinic who obtain supplements for their own label from Animus Health (www.animushealth.com) distributors in the UK of Grow Co Inc products.