Tuesday, December 20, 2011
Vitamin studies need more work
Dr. Michael Camardi
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About Dr. Michael Camardi
Dr. Michael Camardi is a geriatrician at Carilion's Center for Healthy Aging. Age Matters is his new Roanoke Times column, appearing the third Tuesday of every month.
Camardi has been with Carilion for about three years and was one of the experts who reporter Beth Macy spoke to for her series, “Age of Uncertainty.” He wanted to start this column to help answer questions he’s often heard as part of his job.
Camardi was founder and past medical director of the geriatric liaison program for Jacobi Medical Center (Albert Einstein College of Medicine) in Bronx, N .Y.
Camardi trained at Winthrop University Hospital (Stony Brook University Medical School), where he was chief medical resident. He has received numerous commendations for his contributions to education, patient advocacy, community relations and hospital administration.
If you have questions for Camardi, please mail them to him at Center for Healthy Aging, 2118 Rosalind Ave., Roanoke, VA 24014, or e-mail them to firstname.lastname@example.org with “Age Matters” in the subject line.
Dear Dr. Camardi:
Any doctor I have ever been to has told me to take vitamins every day. Now I see on the Internet a story that they said came from a well-respected medical journal that vitamins can cut down on women's life span?
It seems as if every few weeks some crackpot says something and the world gets turned upside down. What kind of foolishness is this?
You are not the only one to have voiced some concerns, as I have received numerous notes from people upset about this story.
Many advances in medical science do turn our concepts of truth upside down.
And so we have an article in the Archives of Internal Medicine on Oct. 18 titled "Dietary Supplements and Mortality Rate in Older Women," which offers that in women, taking multivitamins may somehow shorten one's life span.
The authors looked at results over 20 years in about 40,000 women and in essence found that those taking a multivitamin had about a 2 percent increase in mortality while those who took a supplement with increased amounts of copper approach an almost 20 percent increase in mortality.
Stunning statistics and shocking to be sure, as we take vitamins to assure we have good health, not to lose it.
But let's apply the procedures I have presented in previous articles on how to understand medical data and analyze the presented work.
First and foremost there was no control group, and so this was only an observational study, which weakens its credibility. Next the study followed a select group of women with an average age of 62. One cannot make sweeping recommendations based upon a narrow and selected sample.
However this thought-provoking study does bring up an issue: The amounts of these vitamins and minerals as well as the sources they are taken from may possibly be toxic.
When one looks at where these supplements are extracted from and the overabundance of everything from vitamin D to zinc and consider that we as a nation are blessed to eat very well - in some cases, too well - one questions whether a normal person has to take any vitamins at all.
The amounts of vitamins and minerals we need to avoid deficiency are relatively small. So it begs the questions: How much is enough and is too much toxic? A balanced multi-sourced diet precludes the very reason why vitamins were invented.
And then there is the question of where the foods for these vitamin preparations are procured from and then what is done to them, which is the topic of another discussion.
This study may well serve as a call to re-examine what we are doing in this country as we spend billions of dollars annually in possibly, slowly, poisoning ourselves as we medicate for something we don't have.
What we need is more work in the incremental supplementation of selected nutrients for specific disease states, such as omega-3 and heart disease.
Without doubt the current study has its flaws and more work needs to be done. The purpose of a vitamin is to treat a deficiency; without a deficiency to treat, does taking too much of a good thing from sources that are poorly regulated do us harm? Until we know more let the Greek philosopher Aristotle be our guide, and "seek moderation in all things."