Vitamins 'may shorten your life'

20 april 2008--Research has suggested certain vitamin supplements do not extend life and could even lead to a premature death.
A review of 67 studies found "no convincing evidence" that antioxidant supplements cut the risk of dying.
Scientists at Copenhagen University said vitamins A and E could interfere with the body's natural defences.
"Even more, beta-carotene, vitamin A, and vitamin E seem to increase mortality," according to the review by the respected Cochrane Collaboration.
The research involved selecting various studies from 817 on beta-carotene, vitamin A, vitamin C, vitamin E, and selenium which the team felt were the most likely to fairly reflect the impact of the supplements on reducing mortality.
It has been thought that these supplements may be able to prevent damage to the body's tissues called "oxidative stress" by eliminating the molecules called "free radicals" which are said to cause it.
This damage has been implicated in several major diseases including cancer and heart disease.
'Just eat well'
The trials involved 233,000 people who were either sick or were healthy and taking supplements for disease prevention.
VITAL VITAMIN FACTS
Vitamin A: Found in: Oily fish, eggs and liver; Good for: Thought to boost immune system, and help skin, sight and sperm formation
Vitamin C: Found in: Many fruit and vegetables; Good for: Helps heal wounds and assists the body in absorbing iron, may boost the immune system
Vitamin E: Found in: Vegetable oils, seeds and nuts; Good for: May help boost circulation and keep elderly people active
Beta-carotene: Found in: Vegetables that are reddish-orange in colour; Good for: May boost vision and keep the mind sharp
Selenium: Found in: Butter, nuts, liver and fish; Good for: May boost the immune system
How many take vitamins? Between 10-20% of people in the West
How much is the global market worth? About $2.5bn (£1.3bn)
After various factors were taken into account and a further 20 studies excluded, the researchers linked vitamin A supplements to a 16% increased risk of dying, beta-carotene to a 7% increased risk and vitamin E to a 4% increased risk.
Vitamin C did not appear to have any effect one way or the other, and the team said more work was needed into this supplement - as well as into selenium.
In conclusion, "we found no evidence to support antioxidant supplements for primary or secondary prevention," they said.
It was unclear exactly why the supplements could have this effect, but the team speculated that they could interfere with how the body works: beta-carotene, for instance, is thought to change the way a body uses fats.
The Department of Health said people should try to get the vitamins they need from their diet, and avoid taking large doses of supplements - a market which is worth over £330m in the UK.
Vitamin supplements help and are not a substitute Joel Kosminsky, London
"There is a need to exercise caution in the use of high doses of purified supplements of vitamins, including antioxidant vitamins, and minerals," a spokesperson said.
"Their impact on long-term health may not have been fully established and they cannot be assumed to be without risk."
A 'stitch-up'

ESC: Homocysteine Lowering Flops Again in Heart Outcomes

VIENNA, Sept. 5 -- Once again a major clinical trial using vitamins to lower homocysteine levels has failed to change clinical outcomes for patients with heart disease.
Norwegian researchers said that B vitamins were successful in lowering homocysteine levels in coronary patients, but the reduction had no apparent impact.
"Vitamin B supplementation is not justified as secondary prevention for coronary artery disease," said Marta Ebbing, M.D., of Haukeland University Hospital in Bergen, Norway, during the European Society of Cardiology meeting. "We saw no significant effect of B vitamins on death or cardiovascular events."
Dr. Ebbing and colleagues enrolled 3,090 heart patients who were undergoing coronary angiography into the Western Norway B-vitamin Intervention Trial (WENBIT).
In the study, 771 patients were assigned to homocysteine-lowering therapy with 0.8 mg daily doses of folic acid, 0.4 mg daily of Vitamin B12 and 40 mg of Vitamin B6. There were 771 patients who received B6 alone. There were 769 patients randomized to receive folic acid plus B12 and 779 patients to placebo.
The patients were compliant in taking their medication, illustrated by significantly-lowered homocysteine levels in the groups receiving folic acid and vitamin B12, Dr. Ebbing said. The levels were checked at one month, 12 months and at the end of the trial after median follow-up time of 38 months. There was about a 30% reduction in homocysteine.
The endpoint was a composite of mortality, non-fatal acute myocardial infarctions, unstable angina, and non-fatal stroke. Dr. Ebbing said there were 422 primary endpoint events.
There were 31 deaths among the patients on folic acid, B12, and B6. There were 33 deaths among those on folic acid and B12. There were 28 deaths among those on B6. And there were 25 deaths among those on placebo.
The design of the study compared those on folic acid -- the homocysteine lowering regimen -- against those not on folic acid and found a 10% greater relative risk of experiencing an event -- a difference that failed to reach statistical significance (P=0.35).
"WENBIT confirms and adds additional evidence to findings in similar trials that have shown no impact of lowering homocysteine," Dr. Ebbing said, but she refused to say that her study had finally put a stake into the concept that homocysteine has some impact on heart disease.
"For example," she said, "we still are not certain about a possible role in stroke." She said in her study there were only 56 strokes -- with no significant difference among groups.
"The study appears to confirm what we know about homocysteine," said Freek Verheught, M.D., of the University Medical Center in Nijmegen, The Netherlands, who moderated the press briefing at which Dr. Ebbing's study was presented. "It may be a marker that there is some cardiovascular problem."
"The idea that one could cure our ailments by taking vitamins is appealing," said Daniel Jones, M.D., president of the American Heart Association, and dean of the School of Medicine at the University of Mississippi in Jackson, "but it hasn't worked out. We aren't any closer to understanding the role of homocysteine in cardiovascular disease today than we were 15 years ago when it was first suggested that levels of homocysteine were in some way related to the disease process."
He said it might be possible that starting children on increased doses of vitamins might have an impact later in life, but he said that study is unlikely to be done.
"Outside of a clinical trial, I have never ordered a test for homocysteine levels in a clinical setting and I don't plan to do so," Dr. Jones said.
Drs. Ebbing, Jones and Verheught disclosed no conflicts. No funding source was disclosed for WENBIT. Additional source: Final Programme ESC Congress 2007Source reference: Marta Ebbing, et al "WENBIT: Western Norway B-vitamin Intervention Trial" Final Programme ESC Congress 2007, p 317.

F.D.A. Approves Vitamin Rules

WASHINGTON, June 22 (Reuters) — Makers of vitamins, herbs and other dietary supplements taken by millions of Americans must meet new government standards to show the products are free of contamination and contain exactly what the label says, United States health officials said Friday.
Under the Food and Drug Administration rules, companies in the $18-billion-a-year industry must test the purity, strength and composition of all of their supplements.
“This rule helps to ensure the quality of dietary supplements so that consumers can be confident that the products they purchase contain what is on the label,” Andrew von Eschenbach, the commissioner of food and drugs, said in a statement.
Congress gave the agency power to set manufacturing standards for dietary supplements in a 1994 law. The final requirements announced on Friday will not apply to all makers until 2010.
In addition to product testing, the new standards address design and construction of manufacturing plants, record-keeping and handling of consumer complaints.
Inspectors will check manufacturing plants for compliance, F.D.A. officials said. For less serious violations, the agency may ask a company to fix a problem. Bigger problems could lead to product seizures or other action, said Robert Brackett, head of the Center for Food Safety and Applied Nutrition at the agency.
Some supplements have been recalled in the past because they were contaminated with microbes, pesticides or metal, or because they did not contain the ingredients listed.
The drug agency has also warned companies that sold supplements with undeclared drug ingredients for impotence, and others with less-than-advertised levels of vitamins A and C and folic acid.
Senator Richard J. Durbin, Democrat of Illinois, said the manufacturing rule was “better late than never,” but he added that “the requirements do not appear to go as far as they could have.”
Supplements do not have to be proven safe and effective before they can be sold, as medicines do, and the new rules will not change that.

FDA issues new safety rules for vitamins

By KEVIN FREKING, Associated Press WriterFri Jun 22, 7:06 PM ET
For the first time, manufacturers of vitamins, herbal pills and other dietary supplements will have to test all of their products' ingredients. The Food and Drug Administration said Friday it is phasing in a new rule that is designed to address concerns that existing regulations allowed supplements onto the market that were contaminated or didn't contain ingredients claimed on the label.
Last year, the agency found that some supplements contained undeclared active ingredients used in prescription drugs for erectile dysfunction. In the past, regulators found supplements that didn't contain the levels of Vitamin C or Vitamin A that were claimed.
If, upon inspection, the FDA finds that supplements do not contain the ingredients they claim, the agency would consider the products adulterated or misbranded. In minor cases, the agency could ask the manufacturer to remove an ingredient or revise its label. In more serious cases, it could seize the product, file a lawsuit or even seek criminal charges.
Dietary supplements — pills, liquids or other products — are a $22 billion industry.
Most companies already test their raw ingredients, said Steve Mister, president and CEO for the Council for Responsible Nutrition, a trade association representing about 65 manufacturers.
"This raises the bar so that all have to comply," Mister said.
The new rule goes into effect Aug. 24 and will have a three-year phase-in that gives smaller manufacturers more time to comply. Even the largest of the manufactures won't have to comply until June 2008.
The rule applies to all domestic and foreign companies that manufacture, package and label supplements for sale in the U.S. It requires them to analyze the identity, purity and strength of all the ingredients that go into their products before they are distributed.
It also includes requirements for record keeping and handling consumer complaints.
Dr. Sidney Wolfe, who has testified before Congress on problems with dietary supplements, said the new rule does not ease his concern that unsafe supplements are too easy to bring to market.
"You still don't have to show the product is safe. You don't have to prove it works," said Wolfe, director of Public Citizen's Health Research Group.
Consumers Union, publisher of Consumer Reports, called the rule a good step toward improving consistency in the ingredients that go into supplements.
"However, consumers still have no idea if a given product works, or whether it is dangerous," said Janell Mayo Duncan, senior counsel for Consumers Union, publisher of Consumer Reports.
Congress limited the Food and Drug Administration's oversight of vitamins and other dietary supplements in 1994. The new rule is a product of that law, meaning that the rule took nearly 13 years to develop.
Under the old regulations, supplements were governed by the same rules that applied to producing foods, such as cans of soup.
"The final rule will help ensure that dietary supplements are manufactured with controls that result in a consistent product free of contamination, with accurate labeling," said Dr. Robert E. Brackett, director of FDA's Center for Food Safety and Applied Nutrition.
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On the Net:
FDA: http://www.fda.gov/

Vitamins and Good Sense

Vitamin studies always seem to stir controversy, but certainly not visions of death. On that score, last week's report on antioxidant vitamins, published in the Journal of the American Medical Association, was a doozy. The researchers concluded that people taking the antioxidants vitamins A, its precursor beta carotene, and vitamin E, for whatever reason, at whatever dose, and for however long, may be putting their lives in jeopardy. But before you toss out your vitamin pills, let's examine this alarmist study a little bit closer.
Researchers from Copenhagen University Hospital set out to determine whether the antioxidant supplements lengthen one's life. That's difficult to answer, since most people taking vitamins are healthy. So the researchers identified antioxidant clinical trials large and small, as long as they reported at least one death. Any death counted, whether from heart disease or cancer, kidney failure or hip fractures, murders or suicides. Out of 747 antioxidant trials reviewed, 68 met the bill. Then, in what is called a meta-analysis, the 68 trials were combined into what is effectively one study.
http://www.usnews.com/usnews/health/articles/070304/12healy.htm