139 replies to this topic

[wolfeye]

Total mortality risk in relation to use of less-common dietary supplements



Background: Dietary supplement use is common in older US adults; however, data on health risks and benefits are lacking for a number of supplements.

Objective: We evaluated whether 10-y average intakes of 13 vitamin and mineral supplements and glucosamine, chondroitin, saw palmetto, Ginko biloba, garlic, fish-oil, and fiber supplements were associated with total mortality.

Design: We conducted a prospective cohort study of Washington State residents aged 50–76 y during 2000–2002. Participants (n = 77,719) were followed for mortality for an average of 5 y.

Results: A total of 3577 deaths occurred during 387,801 person-years of follow-up. None of the vitamin or mineral 10-y average intakes were associated with total mortality. Among the nonvitamin-nonmineral supplements, only glucosamine and chondroitin were associated with total mortality. The hazard ratio (HR) when persons with a high intake of supplements (≥4 d/wk for ≥3 y) were compared with nonusers was 0.83 (95% CI: 0.72, 0.97; P for trend = 0.009) for glucosamine and 0.83 (95% CI: 0.69, 1.00; P for trend = 0.011) for chondroitin. There was also a suggestion of a decreased risk of total mortality associated with a high intake of fish-oil supplements (HR: 0.83; 95% CI: 0.70, 1.00), but the test for trend was not statistically significant.

Conclusions: For most of the supplements we examined, there was no association with total mortality. Use of glucosamine and use of chondroitin were each associated with decreased total mortality.

PMID: 20410091

[nowayout]

I thought longer telomeres were associated with longer life, but whatever.

Longer telomeres from multivitamin use don't seem to have helped the women in the study posted by the OP.

Edited by viveutvivas, 17 October 2011 - 04:48 PM.

[hivemind]

http://www.nutrition.../content/7/1/55

[niner]

I thought longer telomeres were associated with longer life, but whatever.

Longer telomeres from multivitamin use don't seem to have helped the women in the study posted by the OP.

This is a pretty flawed study. A bunch of post-menopausal elderly women megadosing on iron and taking synthetic folate...

[nameless]

Agree with Niner... not exactly the perfect study. I expect iron to be the biggest culprit, although did they break down the groups into those who took a multi w/iron, and those without? Seems logical to do so, but just glanced at the abstract and not the full study.

The thing I originally found curious was the magnesium link to mortality, until I realized it was elderly women. Increased mag = less calcum = more hip fractures.

And the study Trip posted above is sort of interesting, albeit it's a small study group. I wonder if CoQ10 alone could provide most of those benefits though.

Edited by nameless, 18 October 2011 - 03:38 AM.

[nowayout]

This is a pretty flawed study. A bunch of post-menopausal elderly women megadosing on iron and taking synthetic folate...

Still, their presumably girlish telomeres from all the vitamins didn't help them, did they?

As for the studies, one thing I have learned from these and other forums is that they're all flawed when they clash with our preconceptions, aren't they? The ones that seem to support our preconceptions are somehow never flawed and never challenged.

[Steve_86]

It's not multivitamins per say, it's the mega doses of individual vitamins/minerals that people have been taking for long periods, especially metals like zinc, iron, and copper.

I take 30mg of Zinc daily, could this be a dangerous dose? :O

I wouldn't take a metal like that at that amount everyday for the rest of my life. Why do you take zinc?

30mg Zinc along with 400mg Magnesium and 2grams Taurine daily has helped my Tic disorder a little (forceful eye squinting). I also take Zinc as it is supposed to support Testosterone levels. I always thought 30mg was a safe dose for chronic dosing but maybe I should reconsider?

[hippocampus]

you should check you blood (zinc, copper, iron levels) from time to time and be sure to stay at 10:1 zinc: copper ratio (cron-o-meter can help you with that). I supplement max. 15 mg to fix this ratio and only if needed (which is practically every day - at least till I fix my nutrition).

[QuantumTubule]

Anyone who has studied the component 'vitamins' in multivites shouldnt be suprised in the slightest, some of the vitamins must be doing some good as others definitly cause harm.
Here I will lisit components of standard multivitamins were vitamin molecule is unsatisfactory.Denoted -
Thiamine -
Riboflavin, dosage to low, phosphate prefferable.
Nicotanimide --,
No b4-adensine,
B5, dosage should be moderate
B6, - most of you know about this
B7, little research
little insitol
B9, folate -, unsatisfactory conversion to methlyfolate, methylfolate prescription drug
B12 cynocolobanbin -

Vitamin E trocopherol,- tocotrienol far supiour.
Vitamin C synthetic -
Vitamin A synthetic - many diverse isomers, preffer natural source.
Sorry about spelling

[smithx]

http://onlinelibrary...ial+maintenance

The present systematic review included 78 randomised clinical trials. In total, 296,707 participants were randomised to antioxidant supplements (beta-carotene, vitamin A, vitamin C, vitamin E, and selenium) versus placebo or no intervention. Twenty-six trials included 215,900 healthy participants. Fifty-two trials included 80,807 participants with various diseases in a stable phase (including gastrointestinal, cardiovascular, neurological, ocular, dermatological, rheumatoid, renal, endocrinological, or unspecified diseases). A total of 21,484 of 183,749 participants (11.7%) randomised to antioxidant supplements and 11,479 of 112,958 participants (10.2%) randomised to placebo or no intervention died. The trials appeared to have enough statistical similarity that they could be combined. When all of the trials were combined, antioxidants may or may not have increased mortality depending on which statistical combination method was employed; the analysis that is typically used when similarity is present demonstrated that antioxidant use did slightly increase mortality (that is, the patients consuming the antioxidants were 1.03 times as likely to die as were the controls). When analyses were done to identify factors that were associated with this finding, the two factors identified were better methodology to prevent bias from being a factor in the trial (trials with ‘low risk of bias’) and the use of vitamin A. In fact, when the trials with low risks of bias were considered separately, the increased mortality was even more pronounced (1.04 times as likely to die as were the controls). The potential damage from vitamin A disappeared when only the low risks of bias trials were considered. The increased risk of mortality was associated with beta-carotene and possibly vitamin E and vitamin A, but was not associated with the use of vitamin C or selenium. The current evidence does not support the use of antioxidant supplements in the general population or in patients with various diseases.

Edited by brokenportal, 22 March 2012 - 11:48 PM.

[Logan]

I love when the doses are left out. I bet the doses of antioxidants given far and above exceded healthy amounts recomended. It's ridiculous when findings suggest that antioxidants may contribute to mortality in cancer patients, without specifying doses and possible impact.

[hav]

Sounds to me like they pretty convincingly disproved their own conclusion. And invalidated their attempt to combine data from 78 unrelated studies with varying dosages and conflicting results. Their own analysis indicates an opposite conclusion for vitamin C and A. But they attribute the vitamin A results to antioxidants generally with no supporting basis.

Howard

[niner]

Sounds to me like they pretty convincingly disproved their own conclusion. And invalidated their attempt to combine data from 78 unrelated studies with varying dosages and conflicting results. Their own analysis indicates an opposite conclusion for vitamin C and A. But they attribute the vitamin A results to antioxidants generally with no supporting basis.

I don't see the problem. Meta analysis is valid if the studies meet appropriate criteria, so it's not like it's impossible for it to work. I haven't read the full paper, so I can't promise it was done right, but I don't see an obvious reason to think it wasn't. C and A having different results isn't surprising; is this just more of the usual problem of considering only the antioxidant nature of a compound while ignoring the rest of its biochemistry? It seems like the takehome message is that compounds aren't automatically beneficial just because they're antioxidants, which won't surprise anyone around here, but is probably news to the general public.

[mikeinnaples]

Personally, I have a huge problem when they use 'Vitamin E' in a study without saying what 'vitamin E' was used. It is probably wrong and silly of me, but I have a hard time rationalizing the legitimacy of any study if the researchers don't know the difference between, say a synthetic alpha-tocopherol and a gamma, or even a tocotreinol ...or how the interact with eeach other and have different effects.

[niner]

Personally, I have a huge problem when they use 'Vitamin E' in a study without saying what 'vitamin E' was used. It is probably wrong and silly of me, but I have a hard time rationalizing the legitimacy of any study if the researchers don't know the difference between, say a synthetic alpha-tocopherol and a gamma, or even a tocotreinol ...or how the interact with eeach other and have different effects.

Good point, Mike. The abstract that was posted here was the 'simple English' version, though the full abstract was linked. I haven't seen the full paper, but I'd hope they address this point there. Since it was a meta analysis, there were probably a variety of protocols. I think the really big studies have all used alpha tocopherol, so that most likely dominates the results.

[hav]

I don't see the problem. Meta analysis is valid if the studies meet appropriate criteria, so it's not like it's impossible for it to work. I haven't read the full paper, so I can't promise it was done right, but I don't see an obvious reason to think it wasn't. C and A having different results isn't surprising; is this just more of the usual problem of considering only the antioxidant nature of a compound while ignoring the rest of its biochemistry? It seems like the takehome message is that compounds aren't automatically beneficial just because they're antioxidants, which won't surprise anyone around here, but is probably news to the general public.

Maybe I'm a little simple but I can't get past the fact that they only considered studies of 4 antioxidants of which only 2 showed an increase in mortality while the other 2 showed a decrease. No matter how they twist the numbers, I don't see how they get off saying anything significant about antioxidants generally. And I'm not clear on what they concluded about vitamin E. Sounded like they might have only seen increase in mortality when it was taken in combination with A but I'm not sure I understood that part. I only was able to access the abstract.

Howard

[Mind]

This has been a recurring theme for many years now so I merged some of the threads. I think the take-away is that more is not always better. I am comfortable taking "low-dose" multi-vitamin or multi-nutrient formula while maintaining a reasonably good diet (on CR periodically as well).

[smithx]

I love when the doses are left out. I bet the doses of antioxidants given far and above exceded healthy amounts recomended. It's ridiculous when findings suggest that antioxidants may contribute to mortality in cancer patients, without specifying doses and possible impact.

Very unlikely with such a large sample size of the general public.

Most were probably taking standard multivitamins or other supplements which are commonly sold at drugstores.

[Logan]

I love when the doses are left out. I bet the doses of antioxidants given far and above exceded healthy amounts recomended. It's ridiculous when findings suggest that antioxidants may contribute to mortality in cancer patients, without specifying doses and possible impact.

Very unlikely with such a large sample size of the general public.

Most were probably taking standard multivitamins or other supplements which are commonly sold at drugstores.

You do realize, the doses of supplements commonly sold at healthfood and drug stores far and above exede healthy recomended amounts. I hope you do.

[gamesguru]

I take a high potency multi-vit, multi-mineral that is iron and copper free. I also take a green drink with a lot of vegetables in it, that makes sure I am getting a lot of unidentified phytonutrients in case I am over-consuming something like beta carotene (actually my multi contains "mixed-carotenoids"). I also do a hair analysis 1x a year to make sure I don't have any minerals too high. Recently it revealed too much Arsenic!!! It isn't from my multi as I have been taking it for years, but I am guessing it might be one of the bulk powdered supplements I have been taking...

Sorry to chime in late, but I have to respond to this since no one else has. Lots of cheap suppliers slip consumers contaminated powders and get verified by "dry labs". If you have any information concerning dry labs, you are advised to tell your friends and to avoid that supplier. Dry labs are a serious threat to consumer health as well as to the rule of law.

See: http://www.nutraingr...lly-incompetent.

I would also consider blood tests (if it's economical) to check your other nutrient levels, especially copper, zinc, and iron...since heavy metals can greatly disrupt homeostasis. I wonder if these buildups occur in spite of ALA+apple pectin+other heavy metal chelators, or if you haven't tried chelation yet?

[smithx]

You do realize, the doses of supplements commonly sold at healthfood and drug stores far and above exede healthy recomended amounts. I hope you do.

Take a look at this:

http://sciencenordic...se-sudden-death

“Our new study shows that these three antioxidants increase mortality by about four percent,” says Christian Gluud MD, a medical consultant and the head of the clinical research-based Copenhagen Trial Unit at the Copenhagen University Hospital, who led the study.
...
Gluud emphasises that the findings do not apply only to dietary supplements containing vitamin A, E or beta-carotene in high doses that exceed the recommended daily intake.

“For the great majority of the people in the trials, the doses covered were within the recommended daily intake level,” he says. “In other words, it is quite ordinary doses that give the increased mortality.”

Edited by smithx, 25 March 2012 - 01:33 PM.

[hav]

Been digging a little further into Vitamin A and apparently there's some debate about it's anti-oxidant status. http://www.exrx.net/...s/VitaminA.html

The role of vitamin A as an antioxidant is debatable. Vitamin A has been shown to possibly have some antioxidant characteristics. However, the carotenoids such as beta-carotene have in recent years received more attention from the scientific community because of the harmful role they may play as pro-oxidants (14). A great deal more research is needed that addresses the role of vitamin A as an antioxidant to determine the exact role the vitamin and precursors play.

If they wanted to get more shock value with this anti- anti-oxidant meta-analysis maybe they should have also cherry-picked colchicine as an anti-oxidant and racked up some really eye-popping mortality numbers.

Howard

[brunposta]

Hi guys,

I love this thread, is very interesting and have inspiring points from both point of view.
There's something else that might still missing in the debate: complex iterations. MY point is, given the complexity of human metabolism and external factors, even say that XYZ supplement have decreases mortality by XYS% is a perfectly designed study might not be enough to consider it safe. What about that same substance damage other structures that usually don't get warned during a sub-70 years lifetime, but can become the "weakest chain" in our 80es? What about if coffee protect us from type II diabetes, but raise of chances of getting Alzheimer when we are 80?
What about smoke increases your overall chances of death, but at the same time, oddly, it has a protective effect after you pass you 90ties still in good shape?
It's happens already with a lot of medicines in the 70es and the 80es, then retired from the market due to long term side effects.
I understand it's a complexity problem, so we can just study one of many aspect of the effect a specific substance generate in our bodies. And we will always have doubts, at least until we will have reliable computer models of human metabolism to simulate.
So, my strategy is to not consider only what studies says before to add a new supplement to my regimen. First of all I believe 80% of my life extension benefits come from good genetics and life style (diet, movement, mental health, good shape, etc...). Then, to have an extra edge, I take some specific supplements that I studied carefully, and of whom I understand how they work and what the do (roughly) in my body. I'm currently taking Metformin, fish oil, aspirin, LEF multivitamin, l-lipoic acid, carnosine, q10. I keep my eyes open, and my mind open as well, since I don't really know if this is the best I can take at the moment, but I consider it a low risk, potentially high rewarding regimen.
And maybe is true, the best strategy would be stay one the "second line" and not so much on the edge on supplements research. But I think for most folks on this forum we can't really help waiting.

Edited by brunposta, 25 March 2012 - 05:23 PM.

[Mynona]

I see a lot of flaws with this, or studies like this in general.

- What forms of vitamins was they taking? Synthethic? Exactly what form then? Whole food supplements?
- Where they REALLY healthy people? Or subclinical tested (in whatever health problem) with a lot of diffuse symptoms that health care does not care about? If so, they should be expected to have a shorter life.
- Wasn't there a study where they studied other studies, and just put aside a LOT of studies that did not show what they wanted?
- And: who is paying for the study (I haven't checked it/them).

Sorry if I should have read the whole thread, and now missed something. My English makes me not able to take as much at a time ^_^

I am sceptical about synthetic supplements of some kinds. There are some that I can take though. When I have the money, I buy whole food supplements. I always check what form and blend the synthetic vitamins and minerals has, before buying anything. I do my best to eat correct instead, and do NEVER eat anything unhealthy AT ALL. Thinking about phytic acid and whatever, to get as much vitamins, minerals and others as possible from my CR diet.

Taking supplements without thinking, I think is NOT GOOD. Cheap chromium oxide in too small or too high dose "because I want to loose weight" and similar like "I heard selenium is good and trendy to take now".

[Mind]

Highly regarded mouse study does not find lifespan extension from some other supplements (other than the typical vitamins, but are popular with life-extensionists, resv, curcumin, GTE, MCTs)

[DAMABO]

Increased mortality in people who started using vitamins during the study is probably an example of the sick user effect. People's health falls apart, and suddenly they decide they should do something, so they start taking vitamins. That's a flaw in this kind of study. I thought longer telomeres were associated with longer life, but whatever. I think you've convinced yourself that supplements are useless, and that's ok if you don't want to take anything.

Good point. this is why I prefer research on animals with controlled life conditions, where indeed many products have been shown to increase life span.

[DAMABO]

This is a pretty flawed study. A bunch of post-menopausal elderly women megadosing on iron and taking synthetic folate...

Still, their presumably girlish telomeres from all the vitamins didn't help them, did they?

As for the studies, one thing I have learned from these and other forums is that they're all flawed when they clash with our preconceptions, aren't they? The ones that seem to support our preconceptions are somehow never flawed and never challenged.

while I generally have agreed with most of what you say (such as: there needs to be some different approach to life extension than just some vitamin supplements, which are not that effective), I don't think that niner necessarily had a preconception, but rather that he was referring to the fact that the design didn't allow for controlling for factors. The study - haven't read it really but it's the classical fact with human studies that they cannot control all these factors (why use them, how consistently use them, how willfully use them, social climate, daily routine, etc.) that are not present in controlled studies on animals - this study cannot prove anything, that is probably the lesson to be learned. To prove some causal relation, one must control all variables, and manipulate one variable of interest, and then observe its effect.

[Kevnzworld]

I take the LEF 2 adays. I think that it's difficult to obtain an adequate amount of all nutrients on a daily basis from modern diets. Produce and meats commercially farmed don't contain the minerals, vitamins , enzymes and other nutrients as they once did. I think it was Bruce Ames that originated the triage theory of aging. It's based on the idea of constant, multiple nutrient deficiencies which the body must adapt to, causing stress resulting in aging. Certainly a properly formulated multi helps. None are perfect, and some use such bad forms of vitamins like E, that they might do some harm for those with a poor diet.
Most studies of multi vitamins are meta analysis, or observational based on questionnaires. Their value is close to useless.

Edited by Kevnzworld, 08 July 2012 - 04:32 AM.

[Mind]

I still take low doses of a multi-vitmamin, and supposedly therapeutic doses of D3 and fish oil, but I am not on the bandwagon of stuffing my face full of "anti-oxidants".

Scientific American questions the free-radical theory of aging.

Seems many LongeCity members are waaaay ahead of the curve on this issue, as usual. These forums are a treasure trove of cutting edge lifestyle, diet, and supplement trends.

[niner]

I still take low doses of a multi-vitmamin, and supposedly therapeutic doses of D3 and fish oil, but I am not on the bandwagon of stuffing my face full of "anti-oxidants".

Scientific American questions the free-radical theory of aging.

Seems many LongeCity members are waaaay ahead of the curve on this issue, as usual. These forums are a treasure trove of cutting edge lifestyle, diet, and supplement trends.

Anti-oxidant face-stuffing probably isn't going to do much good. Does that mean the free-radical theory of aging is broken? No, it means those so-called "antioxidants", many of which (e.g. resveratrol) aren't very good antioxidants and have completely different modes of action, are not getting to where they are needed. And where are they needed? In the mitochondria, where the problem ROS are constantly being created. The following is from FightAging:

"Rabinovitch's group genetically engineered mice to produce a natural antioxidant enzyme called catalase. The mice lived 20 percent longer than normal mice - on average they lived five and a half months longer than the control animals, whose average life span was about two years
...
We had differing hypotheses about where putting catalase might do the best in terms of the advantage to life and health of the mice," Rabinovitch explains. So they targeted the gene in three different places in the mouse cells - the cytoplasm, the nucleus - where they thought it might protect the all-important DNA of the cell - and the powerhouses of the cells, the mitochondria - where cells "burn" glucose for energy and churn out high levels of these oxidizing free-radicals. The mice that lived longest had the gene in their mitochondria.
"What we learned was that increasing the levels of catalase specifically in mitochondria was the way in which we could most effectively increase the 'healthspan,' as we call it, the increased time of healthy life for the mice," Rabinovitch says. Mice with high catalase levels in the other cell structures showed only modest life extension.

I think Scientific American is kinda missing the point. That article was originally published under a different title. I don't know when it was written, but it might be pretty old.

C60-olive oil is a mitochondrially directed antioxidant with extremely good pharmacokinetics. It has led to surprising levels of life extension in a small rat experiment.

Edited by niner, 19 January 2013 - 12:25 AM.