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Harvard Health Publications -- Harvard Medical School HEALTHbeat
December 6, 2006

Dear HEALTHbeat subscriber,

If you’re like me, you’re always looking for the little things you can do to improve your health. Whether it’s taking the stairs at work or flossing, these small efforts make me feel like I’m doing something good for myself. But what about taking that multivitamin? With conflicting news reports about their benefits, you may find yourself wondering whether you should even bother. In this issue, we explain why a daily multivitamin may well be worth it. Also, a Q&A from the Harvard Heart Letter helps clarify how you can get antioxidants from foods, rather than supplements.

Wishing you good health,


Nancy Ferrari
Managing Editor
Harvard Health Publications
HEALTHbeat@hms.harvard.edu

In This Issue
1 Multivitamins: Worth the trouble?
[READ]
2 Notable from Harvard Medical School:
* Healthy Eating: A guide to
   the new nutrition
* Buyer’s Guide to Herbs and
   Supplements
[READ]
3 What foods are rich in antioxidants?
[READ]

From Harvard Medical School
The Benefits and Risks of Vitamins and Minerals

About two out of five Americans take a vitamin or mineral supplement regularly. But is this money well spent? Are you already getting enough of the vitamins and minerals you need from your food? Is it sufficient to take a multivitamin a day, or should you consider adding more of certain vitamins or minerals? Could you be courting health troubles by consistently getting too much or too little of certain nutrients? This special report delves into what’s proven, what’s promising, and what may be a waste of money.
[READ MORE]
 
FREE SHIPPING
Order any Special Health Report today and you’ll receive free shipping on your purchase.
Click here to view reports for sale.
 

1\ Multivitamins: Should you buy this insurance?

Studies have raised doubts about vitamins, but the multivitamin pill is still a good idea.

The daily multivitamin pill is no substitute for a good diet. But none of us is perfect when it comes to healthful eating. We may know all about the virtues of leafy green vegetables and whole grains, but convenience and cravings lead us astray. The multivitamin is partial protection from our lapses.

It’s also an easy way to add surplus vitamins and minerals to our diets. By definition, vitamins are organic (carbon-based) compounds needed in only small amounts. Minerals serve a similar purpose, but are inorganic. Historically, nutrition focused on vitamin deficiencies that cause disease. But with fortification — the addition of nutrients, chiefly vitamins, to the food supply — and no shortage of food, the focus changed to whether vitamins and minerals in amounts beyond our basic needs might protect us against conditions like heart disease and cancer.

Some people scarf down megadoses, an approach most experts disagree with. The daily multivitamin is the cautious wager that some extra vitamins and minerals will pay off in better health even if deficiencies aren’t a problem.

Lately, though, it’s been looking like they might not, as high-profile studies have come to negative conclusions.

It’s well established that a trio of B vitamins — B6, B12, and folate — lowers homocysteine, an amino acid that’s a risk factor for heart attack, stroke, and dementia. The logical supposition: Having an ample supply of those Bs coursing through your veins (and arteries) could improve your chances of avoiding cardiovascular disease and cognitive decline.

But results from a large randomized controlled trial published in the New England Journal of Medicine (NEJM) in April 2006 showed that while the B vitamins lowered homocysteine levels, that didn’t result in fewer heart attacks or other major cardiovascular events. A second disappointing study was published in NEJM in June 2006. Despite their homocysteine-lowering prowess, B vitamins were no better than placebo at protecting people from cognitive decline.

Vitamin E hasn’t been faring too well, either. Johns Hopkins researchers dubbed 2005 the annus horribilis for vitamin E because of all the disappointing studies, chief among them their meta-analysis that found that large daily doses (400 IU and up) increased mortality risk.

The National Institutes of Health convened a meeting on multivitamin and mineral supplements in May 2006. The resulting statement was extremely cautious. Present evidence is “insufficient to recommend either for or against the use of multivitamin/multimineral supplements by the American public to prevent chronic disease,” was the inconclusive conclusion. The experts noted that the heaviest users of vitamin and mineral supplements are Americans who probably need them the least: People who are well-educated, have higher incomes, exercise, and already have healthy diets.

Yes to a multivitamin

Dr. Walter Willett, chair of the Harvard School of Public Health’s nutrition department, has suggested that taking a multivitamin daily is a form of nutritional insurance. He still says it’s a good policy, despite the spate of negative study results.

Those results have come from randomized controlled trials, which are usually regarded as the gold standard. But there are problems with clinical trials, too. They’re often fairly short, so a nutrient’s long-term consequences may be missed. For example, Dr. Willett says that beta carotene didn’t look like it was having any effect on cognition at the 12-year mark in Harvard’s Physicians’ Health Study, but at 18 years, benefits were detected.

There are also often questions about how applicable the results of clinical trials are. Some of the negative findings have come from studies that enrolled people who had vascular disease or diabetes. But how relevant are the findings to healthier folks? With the B vitamin research, it’s the reverse: The patients in those studies had homocysteine levels that were normal or just slightly elevated, so the results may not apply to people with higher levels.

Multivitamins are already part of some official recommendations. The federal government’s 2005 Dietary Guidelines suggest that people older than 50 take them as a way to ensure adequate vitamin B12 intake. And the Centers for Disease Control and Prevention advises all women of child-bearing age to take folic acid — and a multivitamin is also a good way to do that — because doing so lowers the risk of birth defects. That leaves men age 50 and under as the only adult group not covered.

If you take a multivitamin, be sure to buy a major brand-name or store-brand product. When Consumers Union tested cut-rate products, it found that almost half didn’t contain the listed amount of at least one nutrient.

For more information on vitamins and minerals in your diet, order our special health report Vitamins and Minerals: What you need to know, available at www.health.harvard.edu/VM.

 
FOR FURTHER READING
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    [Back to top]

2\ Notable from Harvard Medical School
** Healthy Eating: A guide to the new nutrition

Your diet is your first defense in preventing a host of diseases. This updated and expanded report from Harvard Medical School explains how a healthy diet will help you prevent heart disease, hypertension, diabetes, gastrointestinal disorders, and even some forms of cancer and blindness. Understand the new nutrition guidelines and put your family on the path to healthy and delicious eating.
 
[CLICK TO READ MORE or BUY]
** Buyer’s Guide to Herbs and Supplements

How do herbs and supplements work? Are they safe and effective? Do they do what the label promises? The Buyer’s Guide to Herbs and Supplements takes an expert look at many popular herbal remedies and other supplements and provides the answers to your questions.
 
[CLICK TO READ MORE or BUY]
[Back to top]

3\ What foods are rich in antioxidants?

Q: Given all the mixed reviews for antioxidant supplements, I’d like to incorporate more antioxidant-rich foods into my diet. What foods are the best sources?

A: Single antioxidants, like vitamin E or beta carotene, have never lived up to the hype that they halt heart disease, cure cancer, eradicate eye disease, or prevent Alzheimer’s. But the notion that antioxidants are good for you comes from studies showing that people who eat foods rich in antioxidants have better long-term health.

Antioxidants stabilize harmful by-products of the body’s energy-making machinery. These by-products, known as free radicals, can damage DNA, make LDL (bad) cholesterol even worse, and wreak havoc elsewhere in the body.

It’s possible that single antioxidants haven’t panned out because it takes a network of antioxidants — like those that exist in foods — to neutralize free radicals. If that’s the case, then it would be helpful to determine the antioxidant content of various foods. An international team of researchers has done just that. See below for the foods that top the list.

Antioxidant-rich foods

Here are the 15 foods with the highest per-serving content of antioxidants.
Product Antioxidants mmol/serving
Blackberries 5.746
Walnuts 3.721
Strawberries 3.584
Artichokes, prepared 3.559
Cranberries 3.125
Coffee 2.959
Raspberries 2.870
Pecans 2.741
Blueberries 2.680
Cloves, ground 2.637
Grape juice 2.557
Chocolate, baking, unsweetened 2.516
Cranberry juice 2.474
Cherries, sour 2.205
Wine, red 2.199
Source: American Journal of Clinical Nutrition, July 2006

Cooking appears to increase the antioxidant potential of most foods, with the exception of grains such as rice, pasta, and corn grits, which show lower levels after cooking.

The researchers were careful not to claim that eating foods at the top of the list will keep you healthy. Instead, they believe that rating the antioxidant potential of different foods could help test whether antioxidants really do prevent disease. In the meantime, the list toppers are healthy foods, so don’t hesitate to dig in.

This Q&A first appeared in the December 2006 Harvard Heart Letter, available at www.health.harvard.edu/heart.

 
FOR FURTHER READING
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Harvard Medical School publishes authoritative special health reports on a wide range of topics. Each report delivers practical information on diagnosis, treatment, and prevention of major health concerns in clear, easy-to-understand language. For more information on a specific topic, click the appropriate link below:

Alzheimer’s, Arthritis, Bladder, Cholesterol, Depression, Diabetes, Digestion, Energy, Exercise, Eye Disease, Headache, Heart Disease, High Blood Pressure, Memory, Menopause, Prostate, Sexuality, Sleep, Stroke, Vitamins

 
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Harvard Medical School offers special reports on over 50 health topics. Visit our Web site at http://www.health.harvard.edu to find reports of interest to you and your family.

Copyright 2006 by the President and Fellows of Harvard College.
To view our archive of past HEALTHbeat e-newsletters click here.
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