DEATH IN SMALL DOSES: BOOKS 1 & 2
Antioxidant Vitamins A, C & E in the 21st Century: Book One Also contains: ANTIOXIDANT VITAMINS ARE MAKING A KILLING: Invalidation Of The Free Radical Theory BOOK TWO: A HEALTH IMPACT STATEMENT FOR MEDICAL SCIENTISTSBy Randolph M. HowesTrafford Publishing
Copyright © 2010 Randolph M. Howes
All right reserved.ISBN: 978-1-4269-3798-9 Contents
About The Author.....................................................................vFundamental Value Of Creative Ideas..................................................xviChapter One: Inform Yourself.........................................................1Chapter Two: The Facts.... Just The Facts............................................10Chapter Three: An Epic Chronology Of Antioxidant Vitamin Studies.....................15Chapter Four: The Gigantic Antioxidant Vitamin Experiment............................42Chapter Five: Science Is Getting A Little Crazy......................................45Chapter Six: False Profits.... Er, Propherts.........................................52Chapter Seven: Where Are The Bodies?.................................................58Chapter Eight: A, C & E And Multivitamin Summaries...................................67Chapter Nine: Free Radical Theory Fails The Scientific Method........................76Chapter Ten:.........................................................................83Chapter Eleven: Improved, New Alternate Theories:....................................86Chapter Twelve: Now You Have The Facts, You Decide...................................96
Chapter One
Inform Yourself
If you are taking an antioxidant or an antioxidant vitamin or are thinking of going on antioxidants, this fully referenced book, Antioxidant Vitamin A, C & E in the 21st Century, is a "must read" for you. The undeniable legacy of antioxidant vitamin use at today's high doses is an assemblage of confusing and conflicting studies and reports of bad side effects in hordes of unsuspecting victims. Only by knowing this information, and in consultation with your healthcare professional, can you make an informed decision about your health care. If you are a user of antioxidant vitamins A, C or E, or multivitamins, you must read this book. Most of the antioxidant side effects I discuss are likely unknown to your busy doctor. Although knowledgeable about routine medical problems, few have heard of increased risks for cancer, heart disease and strokes and fewer still associate increased mortality as being antioxidant-related. As a surgeon, medical research scientist, biochemist and practicing doctor, I was appalled by the lack of information in the medical community on the full range of side effects of the antioxidant vitamins. This book is a selective reference source and summary demonstrating the ineffectiveness and adverse side effects of the antioxidant vitamins A, C and E.
Americans are the biggest pill poppers on the planet. Unrestrained marketing of healthcare supplements permeate all forms of media on a constant and daily basis. The old adage is that "It probably won't hurt me and it might help me. So, why not take it?" Unfortunately, when it comes to the antioxidant vitamins A, C and E, it is becoming manifestly clear that these are agents with unknown or questionable benefits and with known harmful side effects. Thus, the sensible, safe and prudent questions are, "So, why take them at all in the absence of a deficiency state?" "Why waste your money for pills that are only marginally effective, if effective at all or even harmful?" "Is it possible that this entire antioxidant sector of the health industry is driven by market forces and not by medical science?" "Are they just trying to con an unsuspecting public?"
The accumulated evidence on antioxidants and EMODs can be maddeningly contradictory. Antioxidant vitamins are no longer about science, they are about marketing.
Why take pills that are potentially harmful?
Aggressive marketing, testimonials and unrestricted advertising have led to wild claims and to the erroneous belief that antioxidant vitamins, such as A, C and E, are protective from common diseases and that they can effectively help reverse or cure a veritable laundry list of diseases, such as breast cancer, prostate cancer, skin cancer, colon cancer, head and neck cancer (including oral premalignant lesions), bladder cancer, colorectal adenomas, polyps of the colon, cardiovascular disease (including ischemic heart disease, hypertension, atherosclerosis, hyperhomocysteinemia, intimal thickening, lowering of cholesterol and triglycerides), strokes, diabetes (including endothelial dysfunction and insulin resistance), macular degeneration, cataracts, pre-eclampsia, Alzheimer's disease, mild cognitive impairment, Parkinson's disease, tardive dyskinesis, blood platelet disorders, renal insufficiency, and adverse effects of radiation therapy.... and yada, yada, yada.
However, in this far-reaching selective review, I report on 181 scientific reports (including prospective, cohort and randomized controlled trials, utilizing analysis and/or meta-analysis) that have shown that antioxidant vitamins produce either marginal effects, negligible effects, no effects at all or harmful effects with many of the disease conditions that I just listed in the above paragraph. And, that is not all. I provide alternative possibilities for safe disease prevention and cure, based on prooxidants.
The scale of the antioxidant vitamin use problem is worldwide. In all honesty, I should not be writing a book, which points out the dangers of antioxidant supplements and you should not have to be reading such a book, which describes your increased risk for disease and premature death from these vitamins. Had the investigators, manufacturers and profiteers been honest, these studies would have been stopped long ago and the truth would have been common knowledge. Thus, this book would have been unnecessary.
In a nut shell, the antioxidant vitamin supplements have failed to live up to their exalted, overstated expectations or to the rosy speculative predictions of the free radical theory.
Predictions of disease prevention and reversal by common antioxidants, such as vitamins A, C and E, have been based on the free radical theory, which was introduced in the mid 1950s by Dr. Denham Harman. It basically stated that harmful metabolic products of oxygen randomly accumulate over time and serve as the cause for most diseases and aging. It was founded on the following three ideas:
1) oxygen free radicals are harmful and deleterious, causing disease and aging
2) antioxidants will negate or scavenge free radicals and therefore,
3) diseases and aging can be prevented, cured and/or reversed by the use of antioxidants, including the common vitamins A, C and E
ANTIOXIDANT HOGWASH Today's marketing concepts with the antioxidant vitamins have an inadequate scientific basis and meager biochemical plausibility.
A Global Public Health Issue
However, studies on antioxidant vitamins have been rife with inconsistencies, confusing results and unpredictability. These studies were based on Harman's free radical theory, which is a testable theory. Surprisingly, the free radical theory has repeatedly and blatantly failed many of these tests. But, instead of acknowledging the failure of the antioxidant vitamins, the failed results were said to be merely "disappointing." The inability to reliably repeat studies or to predict their outcomes, for more than fifty years, means that the free radical theory has flat-out failed to meet the requirements of the scientific method and it is thus invalidated, which should be the end of the story. But, marketers of these antioxidant supplements have gone to great lengths to discredit or ignore report after report of these failed studies. Admittedly, study results have to be scrutinized, but eventually a pattern begins to develop, which will reveal underlying truths. Certainly, there are studies extolling the great benefits of the antioxidant vitamins. Yet, proponents of the use of antioxidant vitamins tend to ignore or deny nearly all of the negative studies and continue to push sales of their questionable products.
THE LAMENTABLE FREE RADICAL THEORY If the free radical theory had been a horse, it would now be glue. R. M. Howes, M.D., Ph.D. 1/13/07
For instance, on January 16, 2010, the Orthomolecular News Service issued, in part, the following statement, "Over half of the U.S. population takes daily nutritional supplements. Even if each of those people took only one single tablet daily, that makes 154,000,000 individual doses per day, for a total of over 56 billion doses annually. Since many persons take more than just one vitamin or mineral tablet, actual consumption is considerably higher, and the safety of nutritional supplements is all the more remarkable." Thus, by their own statements, this is a major public health and safety issue.
Many people, including doctors, gulp down handfuls of these supplements on a daily basis because of the perception that they promote good health. Such widespread use of antioxidant vitamin supplements and the accumulation of failed studies forces us to evaluate their safety and their impact on overall public health.
In this selective review, I directly address user safety and endeavor to answer the question, "Are antioxidant vitamins making a killing?" Are these agents actually "death in small doses?" There can be no doubt that the number of studies showing adverse effects of the antioxidant vitamins has increased to an impressive body of evidence (60 separate studies).
Of considerable concern is the fact that sixty studies have shown that the antioxidant vitamins can cause serious harmful side effects, including increased risk of cancer, heart disease, strokes and over all mortality. Ironically, these were the very same diseases that they were supposed to cure or prevent. Further, due the prevalent use of the antioxidant vitamins by the general population and especially in those diagnosed with cancer, this has become a global public healthcare issue.
Americans are unshakeably mesmerized by the alleged health benefits of nutritional supplements, especially the antioxidant vitamins A, C and E (Blendon et al, 2001).
In fact, a third of all adults, and half of those older than 55 years of age, reportly take at least 1 supplement daily (Millen et al, 2004). It seems to be a quick fix but as we all know, there are no safe quick fixes.
Let's Get More Specific
Everywhere we turn, someone is hawking the supposed benefits of antioxidants. Rack after rack of supplements flank the aisles of nutrition stores, pharmacies, grocery stores, supermarkets, sporting good stores, discount stores and now, pet stores, feed stores and on and on. Even though studies continually show their lack of effectiveness, the money just keeps rolling in. People seem to feel that they can neglect their health and make up for it by just popping a few pills.... magic pills.... magical antioxidants.
Even though they are proving to be harmful, many physicians prescribe and use these antioxidant vitamins themselves on a daily basis. Both beta carotene and vitamin E were thought to be free of toxicity but that view is changing rapidly as studies indicate that they can increase mortality rates and risk of common diseases. Tens of millions of Americans and world wide citizens may be hastening their demise, when they do not have to. Yet, many people state that they would continue to take these agents even though scientific evidence points out their harmful potential (Blendon et al, 2001). That fact alone illustrates the power of unrestrained advertising.
Actually, it appears that the antioxidant vitamins are more popular than ever, even in light of the poorly publicized studies showing their ineffectiveness. And, there are loads of critics of the scientific studies showing the lack of benefits of antioxidants and their harmful potential. They will ferociously defend their territory. They just can not bring themselves to believe the negative data and to toss out the flawed free radical theory from their thinking. Every time a study fails, they state that the results are "disappointing." If antioxidant vitamin users are increasing their risk of disease and an early death, these results are more than disappointing, they are disasterous and an abomination.
As E. Robert Greenberg said in 2005, in referring to many of the included antioxidant vitamin studies, "These research projects have all passed a rigorous peer review, and I do not question the scientific merit of any one of them. But isn't it past the time for the scientific and public health communities to loosen their ties to a theory (i.e., the free radical theory) that lacks predictive ability for human disease?" (Greenberg, 2005).
Deep interest in the relationship that specific foods, supplements, vitamins, antioxidants, or lifestyle factors have to our overall health has resulted in scientific research on the validity of widely publicized claims in disease prevention and cure. No single study provides the last word on any subject and one news report may dramatically overemphasize what appears to be a contradictory or conflicting result, when taken out of proper context. The scientific gold standard, randomized controlled trials (RCTs), are replacing testimonials, observational, epidemiologic or biased reports as being the most reliable source of valid information regarding the effectiveness of antioxidant vitamins A, C and E. Yet, even RCTs can arrive at erroneous conclusions and serve as the center of heated debate.
The Best Advice: Take them only if you have a vitamin deficiency
The best advice about antioxidant vitamins is to take them only if you have a proven vitamin deficiency. Otherwise, the second best advice about antioxidant vitamins is that it is rarely, if ever, advisable to obtain them from synthetic sources, as opposed to a balanced, nutritious diet of fresh fruits and vegetables. Unless one has a known vitamin deficiency, antioxidant vitamin supplements appear to be unnecessary, costly and potentially dangerous.
The overuse of many readily available antioxidant vitamin supplements appears to be a serious breach of human rights, as many of them are only sold to "protect and promote health." They make no claims about "curing" anything. Antioxidant vitamin supplements should be taken with considerable thought and subject to drug regulations and follow-up. People can not continue to ignore antioxidant vitamin supplement warnings. The data has stacked up against them. People, open your eyes and your minds to the preponderance of the data.
Experts are now recommending that, "Vitamins A, E, D, folic acid, and niacin should be categorized as over-the-counter medications..... Vitamin A should be excluded from multivitamin supplements and food fortificants." Further, they state that, "Vitamins have documented adverse effects and toxicities, and most have documented interactions with drugs. Vitamins, such as fat-soluble vitamins (A, E, D), can cause serious adverse events (Rogovik, Vohra and Goldman, 2010).
Clinical trials have basically failed to demonstrate a beneficial effect of antioxidant supplements on cancer and cardiovascular disease (CVD) morbidity and mortality. With regard to the meta-analysis, the lack of efficacy has been demonstrated consistently for different doses of various antioxidants in diverse population groups. Still, free radical theory sycophants try to hold their increasingly shaky ground and continue to "peddle for profit" their questionable products.
Over and over, the antioxidant vitamins have produced negative results and over and over, they have been and are being ignored or denied. It is my hope that this selective review will force readers to face the fact that the data showing a lack of effect or a harmful effect is substantial and can no longer be disregarded or passed over. We should also scrutinize the use of multivitamins, since many of these contain antioxidants.
In fact, no consistent data suggests that consuming micronutrients at levels exceeding those provided by a dietary pattern consistent with AHA Dietary Guidelines will confer additional benefits with regard to cancer or CVD risk reduction.
More recently acquired scientific data, i.e., over the last 25-30 years, provides the true picture of the relative ineffectiveness or null effect of antioxidant vitamin supplementation, their lack of predictive validity and of their untoward effects. Do not be misled by exaggerations, statistically generated "benefits," half truths or outright lies, regarding these antioxidant vitamin supplements.
On advertising, the 1930s performer, Will Rogers, famously referred to it as "the art of convincing people to spend money they don't have for something they don't need."
This current book is primarily a selective systematic overview of 181 interventional initial or follow up studies/reports, published peer reviewed papers and the analysis thereof, showing either marginal effects, negligible effects, no effects or harmful effects of the antioxidant vitamins A (beta carotene), C (ascorbic acid) or E (alpha tocopherol) or combinations thereof. The total number of participants for all of the above studies is well over 8,000,000 subjects or participants, some of which may have been repeats in follow up or parallel studies.
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Excerpted from DEATH IN SMALL DOSES: BOOKS 1 & 2by Randolph M. Howes Copyright © 2010 by Randolph M. Howes. Excerpted by permission.
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