Disease Proof

The importance of vitamin D is often overlooked. So much so, that many in the United States are teetering towards vitamin D deficiency—not good! I’ll let Dr. Fuhrman explain:

Vitamin D is a fat-soluble vitamin that your body makes after exposure to ultraviolet (UV) rays from the sun. Vitamin D functions as a hormone because it sends a message to the intestines to increase the absorption of calcium and phosphorus. By promoting calcium absorption, vitamin D helps to form and maintain strong bones…

…Because vitamin D increases the absorption of calcium in the gastrointestinal tract and stimulates osteoblastic (bone-building cells) activity, vitamin D has been generating lots of interest lately in the medical literature. Borderline low levels of vitamin D have been found to be very common in the United States and Canada…

…It is estimated that over 25 million adults in the United States have, or are at risk of developing, osteoporosis. Adequate storage levels of vitamin D help keep bones strong and help prevent osteoporosis in older adults. Vitamin D deficiency results in diminished calcium absorption, and has been linked to a higher incidence of osteoporosis-related bone fractures seen in post menopausal women and older Americans…

…It is extremely important for individuals with limited sun exposure to ingest supplemental vitamin D.

So, what kind of supplement should you choose? How about one like this? Check out this study in JAMA, “Fracture Prevention With Vitamin D Supplementation.” Here’s a bit:

Objective: To estimate the effectiveness of vitamin D supplementation in preventing hip and nonvertebral fractures in older persons.

Data Synthesis: All pooled analyses were based on random-effects models. Five RCTs for hip fracture (n = 9294) and 7 RCTs for nonvertebral fracture risk (n = 9820) met our inclusion criteria. All trials used cholecalciferol. Heterogeneity among studies for both hip and nonvertebral fracture prevention was observed, which disappeared after pooling RCTs with low-dose (400 IU/d) and higher-dose vitamin D (700-800 IU/d), separately. A vitamin D dose of 700 to 800 IU/d reduced the relative risk (RR) of hip fracture by 26% (3 RCTs with 5572 persons; pooled RR, 0.74; 95% confidence interval [CI], 0.61-0.88) and any nonvertebral fracture by 23% (5 RCTs with 6098 persons; pooled RR, 0.77; 95% CI, 0.68-0.87) vs calcium or placebo. No significant benefit was observed for RCTs with 400 IU/d vitamin D (2 RCTs with 3722 persons; pooled RR for hip fracture, 1.15; 95% CI, 0.88-1.50; and pooled RR for any nonvertebral fracture, 1.03; 95% CI, 0.86-1.24).

Conclusions: Oral vitamin D supplementation between 700 to 800 IU/d appears to reduce the risk of hip and any nonvertebral fractures in ambulatory or institutionalized elderly persons. An oral vitamin D dose of 400 IU/d is not sufficient for fracture prevention.

Now, where can you find a gentle oral vitamin D supplement that’ll deliver this dosage? What about these? Take a look:

From Dr. Fuhrman's book Eat to Live:

We are on the verge of a revolution. Substances newly discovered in broccoli cabbage sprouts sweep toxins out of cells. Substances found in nuts and beans prevent damage to our cells' DNA. Other compounds in beets, peppers, and tomatoes fight cancerous changes in cells. Oranges and apples protect our blood vessels from damage that could lead to heart disease. Nature's chemoprotective army is alert and ready to remove our enemies and shield us from harm.

Hardly a day goes by when some new study doesn't proclaim the health-giving properties of fruits, vegetables, and beans. Unprocessed plant foods contain thousands of compounds, most of which have not yet been discovered, that are essential for maintaining health and maximizing genetic potential. Welcome to the phytochemical revolution.

Phytochemicals, or plant-derived chemicals, occur naturally in plants (phyto means "plant"). These nutrients, which scientists are just starting to discover and name, have tremendously beneficial effects on human physiology. The effects of our not consuming sufficient amounts of them are even more astounding--premature death from cancer and atherosclerosis.

Eating a wide variety of raw and conservatively cooked plant foods (such as steamed vegetables) is the only way we can ensure that we get sufficient amount of these essential health-supporting elements. Taking vitamin and mineral supplements or adding some vitamins to processed foods will no prevent the diseases associated with eating a diet containing a low percentage of calories from whole natural foods.

Scientists cannot formulate into pills nutrients that have not yet been discovered! If the pills did contain sufficient amounts of all the phytonutrients and other essential substances, we would have to swallow a soup bowl full of pills and powders. To date, researchers have discovered more than ten thousand phytochemicals. No supplement can contain a sufficient amount. Thankfully, you can get all these nutrients today by eating a wide variety of plant-based foods.

Please bear in mind that I am not against nutritional supplements. In fact, I recommend various supplements to many of my patients with various health problems, and a high-quality multivitamin/multi-mineral to almost everyone.

I do not recommend that most people consume supplements containing vitamin A, isolated beta-carotene, or iron, as there are risks associated with excess consumption of these nutrients. The point to be emphasized is that supplements alone cannot offer optimal protection against disease and that you cannot make an unhealthy diet into a healthy one by consuming supplements.

Dr. Fuhrman created his children's vitamin's, Pixie-Vites, because he couldn't find any good vitamins for his children to take. They all either had harmful ingredients (like refined sugar, artificial sweeteners, or isolated vitamin A), a poor balance of nutrients, or terrible taste his kids didn't like.

More than two painstaking years, and several formulations later, the Pixie-Vites are on the market with an ingredient list straight from the produce aisle, including:

raspberry juice powder, cherry juice powder, bioflavonoid complex, grape skin extract, hesperidin, rutin, quercetin, pineapple, broccoli, carrots, apple, orange, tomato, brussels sprouts, cauliflower, beet, blueberry, celery, grape, grapefruit, kale, plum, raspberry, spinach, strawberry, watermelon, radish, lemon, lime, cantaloupe, cherry, onion, papaya, peach, pear, leek and yellow pepper

Pixie-Vites are designed to compliment a healthy diet--and so they don't superdose children with things like folate that are readily supplied from fresh fruits and vegetables. And with all those fresh, natural plant-based ingredients, Pixie-Vites are favored by health conscious parents and children.

In the last few days, however, an unfortuate thing happened. A vegan website, the estimable Vegan Lunchbox, discussed Pixie-Vites with the impression that (like Dr. Fuhrman's Gentle Care vitamins) Pixie-Vites are vegan.

As became clear in the comments, in fact they are not, owing to one ingredient that comes from sheep's wool, called cholecalciferol--which is a potent source of Vitamin D.

Jennifer, who runs the blog Vegan Lunchbox, e-mailed Dr. Fuhrman for an explanation. As Dr. Fuhrman explains, the decision came down to nutrition:

The reason why the Vitamin D in Pixie Vites is not vegan and made from wool (please note it is not made by killing animals) is because that form of D is twice as absorbable as the vegan type and many kids do not eat a whole Pixie Vite and only take a small portion of one. I did not want to short change some kid by not supplying them with adequate D, so I let that one non-vegan ingredient slip by (since it is made from a by product of wool manufacturing).

Here is the complete list of ingredients. You can learn a lot more about how these vitamins came to be by listening to the second episode of the DiseaseProof podcast.

A recent study published in the British Medical Journal doubts the benefits of consuming omega-3 fatty acids. Despite vast research showing a reduced number of deaths from cardiovascular disease due to consumption of omega-3. Dr Mike Knapton of the British Heart Foundation isn't convinced. Reuters reports:

"People should not stop consuming omega-3 fats or eating oily fish as a result of this study," he said in a statement issued by the foundation.

"Until now, medical research has demonstrated a benefit from omega-3 fats in protecting people from heart and circulatory disease. This systematic review of numerous studies concludes that there is no clear evidence either way," he added.

Dr. Fuhrman says this does little to alter his conviction that for those who are deficient in omega-3 fatty acids, getting more from diet or supplementation is beneficial:

Interesting study, it shows that higher fish intake or use of fish oil did not significantly affect mortality one-way or the other. I guess we would expect to find that. Fish and fish oil are over-hyped as being such wonder foods that will make everyone live longer.

But now let's put this in perspective. Giving B12 to the entire population will not have a significant effect on lifespan either, but give B12 to those B12 deficient people and it will be very significant for them.

This study specifically excluded those studies that checked and monitored blood levels of omega-3 fats. Those studies that do monitor such levels definitely show a strong relationship between fatal heart attacks and omega-3 fatty acid levels in the blood.1

Since most people are not deficient in these fatty acids, taking more is not protective, but in a vegan population who does not eat any fish, a certain percent will be deficient in DHA. DHA deficiency is an important thing to avoid; it can lead to depression, dementia and later life neurological deterioration. And this study did not show fish or fish oil would not increase lifespan in a vegan population or a group documented to be low in omega-3 fatty acids, which has already been demonstrated in other studies.

So this finding takes the edge off all the high intake of fish and fish oil hype, but it does not make it less important to make sure that a deficiency does not exist in anything (including long chain omega-3's) and it is still important to take a supplement or to have ones blood drawn to make sure your level is adequate.

So even if this study is correct and that eating fish or taking fish oil or (vegan) DHA supplement does not have a significant effect on longevity for most people, there are still other good reasons to assure nutritional adequacy with supplementation. Epidemiological data indicate decreased plasma DHA interacts with genetic and other environmental influences to predispose people to dementia. Approximately 40% of fatty acid phospholipids in the brain are DHA. Individuals with dementia have lower plasma phospholipid DHA levels in the brain compared to controls. Prospective studies have reported consumption of at least 1 fish serving per week decreases risk of Alzheimer's disease by 60%. Preliminary data suggest that after adjustment for age, gender, apoE genotype, and homocystine levels, the top quartile of plasma DHA of approximately 2.7 or more servings of fish/week or 180 mg or more DHA/day is associated with 50% decreased risk of dementia.

This post is part of an on-going review of the recommendations of celebrity doctor Joseph Mercola, D.O. For an overview, see Monday's post.

As I have explained over the last few days, see The Meat and Butter Diet. I believe Dr. Mercola is aggressive beyond reason in recommending meat as a health food.

There is, however, some reasonable evidence in the scientific literature to support the idea that people should include some animal products in their diet. There are primarily three weaknesses of a vegan diet, they are:

• Plant foods do not contain B12 (all vegans should take B12).
• Some people have a need for more taurine, and may not get optimal amounts with a vegan diet. (Some vegans need to take a taurine supplement, or they could get a blood test to assure adequacy).
• Some vegans may not produce ideal levels of DHA fat (from the conversion of short-chain omega-3 fats) found in such foods as flax and walnuts, if they don't eat fish. I advocate that vegans and people who do not eat fish should supplement with DHA or get a blood test to assure adequacy.

Obviously, these three areas of potential deficiency on a vegan diet are easily remedied by taking a few supplements. There are loads of advantages of a vegetarian diet however that also should be considered, but that is not the topic of this article. And clearly a poorly designed vegetarian diet or one that is not supplemented properly with B12, Vitamin D (the sunshine vitamin), can be dangerous for one's health, but that still cannot be used as an argument to justify dietary recommendations with lots of high saturated fat animal products.

Meat in a Vegetable-Based Diet
Ignoring the ethical and environmental benefits to a vegan diet, which undoubtedly are substantial; claiming that a vegan diet-style is healthier and will make one live longer than a diet-style that contains even a small amount of animal products is not an argument that can be made with good scientific integrity.

We have substantial evidence from not only the China Study, but thousands of other studies to conclude that animal products when consumed in even moderate amounts such as 20 ounces a week can contribute to the development of chronic disease and are not health promoting. Many of these studies are referenced in my book Eat To Live and some can be reviewed elsewhere on this blog. However, these studies and the China Study cannot be used to validate the necessity of a strict vegan diet for optimal health as vegan populations were not studied in this enormous project. The lowest ranges of animal products consumed in the China Study were in the range of 1.7 servings per week or about 10 ounces per week.

Below that level of animal product consumption supplementation with B12 become critical for populations. If there were studies with large populations on vegan diets, a J-shaped* curve would likely be experienced, showing that as diets get lower than one serving of animal products per week, later life morbidity and mortality would start to be increased. The reason for this is that strict vegans who don't take supplements will likely develop B12 deficiencies (rural villagers do not take supplements) leading to life shortening events, lessening the reduction in heart attack or cancer deaths achieved by the reduction of animal foods.

Besides B12, there are also nutritional advantages to a small amount of animal products for some individuals, as there are individual differences in the production of non-essential amino acids, and reduction in the absorption and metabolism of essential amino acids that makes the ingestion of additional amino acids beneficial for some individuals, such as those with digestive impairments. For others, the addition of pre-formed DHA from fish or fish oil may be beneficial because the enzymes converting short-chain omega 3 fatty acids (obtained from plant) to these longer chain fats (what is already present in fish) may not be as efficient in some individuals. It also may be possible that some people have heightened needs for DHA, taurine or other protein components as they age and digestion and conversion is decreased. I have counseled thousands of individuals on vegan and near vegan diets over the last 15 years and have found these recurring issues when investigating patients with health problems and health concerns after doing extensive evaluations to discern a cause of their complaints.

A Research-Based Approach
It is too frequent that writers on both sides, the vegan proponents and those advocating inclusion of substantial amounts of animal products as health supporting, have pre-formed biases and try to defend their views, rather than evaluating all the evidence with logic and clarity. Nevertheless, the reality is that for the majority of individuals, allowing under 10 - 12 ounces of animal products per week does not appear to have disease risks as long as the animal products are low in saturated fat and not contaminated with parasites or toxic pollutants. Certainly, I have no desire to promote the consumption of animal products, and I am always willing to modify my recommendations if more science suggests that this guideline is not accurate in any way. However, we have to go with whatever data we have available today, and I suggest that for those who want to include animal products in their diet, we cannot with good science insist that this small amount is cancer or heart disease promoting.

I argue that either way of eating (vegan or non-vegan) can be made health-supporting (and should be supplemented appropriately to assure nutritional adequacy) and that debating which is better is not a valuable exercise. Therefore, I advocate a plant-based (vegetable-based) diet that is either vegan or one that is near vegan with a small amount of animal products, and my food pyramid designed for public guidance contains two to three servings of animal products permitted per week, assuming that the total ounces per week is under the 10 - 12 ounces range. Beef and cheese are too high in saturated fat and should not be considered health-supporting foods to be utilized on a regular basis in one's diet. Plus those animal foods rich in fat are much higher in environmental pollutants.

FISH: Not the Easy Answer
Even though some fish in the diet has been shown to be beneficial at reducing heart disease risk, presumably because of those beneficial fish oils, and there are studies that indicate some fish in the diet is longevity promoting.1 I still do not recommend people eat much fish. We do not need to eat fish to get those benefits from fish oil, we can take a supplement for that and there is too much good evidence linking fish consumption with higher rates of breast cancer, plus the pollutants in fish are of a major concern. Whether it is the pollution in fish or the cancer promoting effect from the high level of animal protein, eating fish is linked to a higher rate of breast cancer. When 23,963 women were followed as part of the Diet, Cancer and Health study, what stood out most was the link between fish consumption and breast cancer. The conclusion of the researchers was, "this study showed that higher intake of fish was significantly associated with higher incidence rates of breast cancer."2 Surprisingly, women consuming little or no fish were found to have approximately half the incidence of breast cancer compared to high consumers of fish. This study should not be ignored. It received scant media attention. Frequent fish consumption has also been linked to increased occurrence of thyroid cancer.3

If fish are consumed on a regular basis it should be a maximum of once per week and it should be of the cleanest variety, not those in the highest range of mercury or other pollutant contamination. That limits the choice in most cities in the continental US to ocean perch, shrimp, haddock, scallops, talapia, hake and trout, eliminating swordfish, pike, mackerel, shark, lobster, tilefish, grouper, sea bass, marlin, snapper and halibut as simply too high in mercury and bluefish, herring, clams, crab and oysters as simply too polluted. Most other fish are in-between these two categories.

EGGS, WHITE MEAT FOWL, FAT FREE DAIRY: Guidelines
Therefore, I do not recommend the eating of fish more than a few times a month, and I would much rather people who eat some animal products utilize eggs, (especially those high omega-3 eggs) and white meat fowl, such as turkey, chicken or fat-free dairy.

To conclude, if you want to eat animal products on a regular basis, limit the consumption to one or two servings of two eggs or egg whites, or one serving of eggs and one serving of white meat turkey a week, or one serving of eggs and one serving of low-fat dairy and one serving of white meat or an occasional fish. Do not eat fish for the supposed health benefits of fish. It is not advisable to consume enough fish to get enough omega-3 fats for your heart health. (It is much more reasonable to just take a daily amount of DHA to assure nutritional excellence and adequacy, such as my DHA Purity, which is algae-derived DHA and refrigerated to maintain freshness.)

Docosahexaenoic acid (DHA) is a long-chain omega-3 fatty acid. About half of the brain and eyes are made up of fat, much of which is DHA, which is an essential nutrient for optimal brain and eye function.1 Children's diets today are notoriously low in the beneficial omega-3 fats found in foods such as walnuts, flax seeds, soybeans, leafy greens, and certain fish. I do not recommend fish as a preferred source of these beneficial fats for children because of contamination with pollutants and mercury.

The most commonly used supplement to add DHA to the diet is fish oils, but what is not widely known is that most of us can produce sufficient DHA from short-chain omega-3 fatty acids received from walnuts, flax seeds, and green vegetables. Many fish make their DHA from eating greens, too, from algae.

New products are available that contain DHA from algae, the fish's original source. Unlike fish oil, the algae-derived DHA, grown in the laboratory, is free of chemical pollutants and toxins that may be present in some fish oil-based brands. I recommend favorable DHA products that are designed for purity and are suitable for children. Neuromins is a common (non-fish-derived) brand of DHA sold in most health food stores, and I also have designed and manufactured an all-plant-derived DHA supplement, DHA Purity, available on my Web site and in my office.

DHA is also a normal component of breast milk, and infants fed breast milk score higher on intellectual and visual measurements than those fed baby formulas lacking DHA. Children who were breast-fed, as a group, have higher IQ scores than those who were formula fed.2 Pregnant women should pay close attention to their DHA status to ensure proper DHA supply for prenatal development. Maternal supplementation with DHA during pregnancy, and lactation has been demonstrated to augment children's IQ.3

DHA is present in breast milk, but up until 2002, the United States was the only country in the world where infant formulas were not fortified with DHA, despite a 1995 recommendation by the World Health Organization to do so. In addition, the average DHA content of breast milk in the United States has been tested to be low compared to other countries that consume more fish. In fact, postpartum depression, lower IQ, dyslexia, and Attention Deficit Hyperactivity Disorder (ADHD) have been linked by many scientific studies to the low DHA intake common in the United States.4

Deficiency in DHA fatty acids has been linked to:

• Impulsiveness
• Aggressiveness
• Dyslexia
• Depression
• Reduced intelligence
• Sleep problems
• Temper tantrums
• Alcoholism
• Schizophrenia
• Manic depression 5

The first year of life is a crucial year that sets the stage for your child's healthy body and mind. Exposure to DHA-rich breast milk while the brain is rapidly growing assures that your child will develop his full intelligence potential. To supplement her healthy diet, Mom should be taking a multivitamin plus a daily DHA supplement containing approximately 200 mg of DHA, to assure adequate DHA content in her breast milk. Even after food is introduced, continued breast-feeding is important and necessary past the first birthday for maximum disease resistance, immune function, and brain development.

Once your child is off breast milk, I recommend that parents add a small amount of DHA (50 to 100mg) to their child's orange juice, oatmeal, or other food. Even if you don't do it every day, it still ensures that no child will suffer the consequences of DHA deficiency during these crucial years of brain development. When our children don't consume the right mix of brain boosting nutrients, they have a reduced ability to learn and a lower IQ, and later in life they can develop dementia and Alzheimer's disease. On the other hand, the right mixture of brain-supporting foods will afford our children the ability to reach their maximum potential in life, not just for health, but for emotional stability, happiness, and success in their chosen careers.

Plenty of parents give their children vitamins. But there is so much conflicting information. Which ones should you give? Why do so many of them have so much sugar in them? Why do the other ones taste so foul? What about studies show supplementing vitamin A or beta carotene can encourage certain diseases? Should children get iron? What about DHA?

In this DiseaseProof podcast, Dr. Fuhrman talks about the troubles he had finding supplements for his own children. The ones with the best ingredients tasted so bad his children wouldn't take them. The ones they were willing to take were full of sugar, or were missing important nutrients. Others had too much of things he didn't want his children to have.

Out of frustration, Dr. Fuhrman went to work with a vitamin manufacturer, spending two years developing his own children's vitamins. They're called Pixie-Vites, and the first shipment of them arrives this week.

This podcast is under fifteen minutes, and describes a parent's search for a better child's vitamin.

Listen to an mp3 of Supplements for Children.

Osteoporosis affects 8 million American women, and 2 million men, causing 1 1/2 million fractures each year. As many as 18 million more Americans may have low bone density (osteopenia), a precursor to osteoporosis. As women age, many develop collapse of their lumbar vertebrae resulting in pain and disability. Even after screening and diagnosis most women are offered drugs and calcium, without addressing all the additional causes of osteoporosis, which are discussed below.

Tomorrow evening PBS will launch a major television series about global health.

They have already launched a comprensive "Rx for Survival" website, which has lots of interesting information, essays, maps, statistics, and other fodder for discussion.

The site emphasizes infectious diseases in developing nations. One of the non-infectious diseases that is shown to be leading killer the world over, including in the world's most modern countries, is malnutrition.

As the site explains, that is not the same as starvation, and in some cases it's quite the opposite:

Malnutrition (from the French mal, meaning "bad") doesn't just mean lack of food. It might surprise some to learn that it refers to obesity, too. In addition, malnutrition describes a lack of micronutrients, including a range of vitamins and minerals.

One of the most powerful micronutrients for child survival is vitamin A. Found naturally in carrots and green and yellow vegetables, or supplied in vitamin capsules or liquid drops taken orally, vitamin A can improve children's health by preventing deaths caused by diarrheal dehydration and measles, dry eye, and nightblindness. Severe deficiencies of vitamin A can ultimately result in total blindness. Vitamin A supplement pills or drops administered twice a year in Africa were able to avert approximately 400,000 cases of childhood blindness per year. Worldwide, it's estimated that the supplements are boosting children's immune systems and saving up to a million lives a year among children at risk of infectious disease.

Pregnant women also benefit from vitamin A supplements, which help reduce maternal mortality dramatically. In a study done in Nepal, maternal mortality rates dropped by more than one-third when women took vitamin A supplements during their pregnancies. It was famously said by nutritionist EV McCollum, who identified vitamin A in 1913, that "Green leafy vegetables are unbottled medicine."

Ingesting vitamin A or beta-carotene in isolation—from supplements, instead of from food—may interfere with the absorption of other crucially important carotenoids, such as lutein and lycopene, thus potentially increasing cancer risk.

The precursor to vitamin A, beta-carotene once was regarded as a safe and beneficial antioxidant and even recommended as an anti-cancer vitamin, but it has recently been shown to increase the risk of certain cancers when administered as an isolated supplement. Scientists now suspect that problems may result when beta-carotene is ingested without other carotenoids that would have been present had it been ingested from real food. Beta-carotene is only one of about 500 carotenoids that exist. Beta-carotene supplements are poor substitutes for the broad assortment of carotenoid compounds found in plants.

• The CDC has released new diabetes numbers, and they're shocking. About 7% of the US is now thought to have the disease. Here's one story about the effect diet can have on diabetes.
• "To promote vaccine use, many in the public health community have overstated the risk of flu-related death and the effectiveness of the vaccine in preventing it." A Washington Post editorial by these people.
• A discussion of how much exercise children should get every day.
• Study: 20mg/day of iron supplements for pregnant women can have a statistically significant negative impact on the behavior of children.
• A Canadian couple is attempting to live on food from sources within 100 miles of their British Columbia home. The first step was some unplanned weight loss.

The New Scientist has word of a study suggesting mothers can reduce their daughters likelihood of developing breast cancer by getting lots of omega-3s during pregnancy and breast-feeding:

Elaine Hardman at the Pennington Biomedical Research Center in Louisiana looked at the effects of mothers' diets on mice predisposed to develop breast cancer. Female mice whose mothers ate a diet rich in omega-6 fatty acids and which ate the same diet themselves after weaning all developed tumours by six months. The diets of most people in western countries are much richer in omega-6 oils than omega-3s.

In mice whose mothers ate a diet richer in omega-3s, or mice fed this diet only after weaning, tumour rates fell to 60 per cent. In female mice fed the omega-3-rich diet and whose mothers ate it as well, the rate fell to just 13 per cent, Hardman told a meeting of the American Association for Cancer Research this week.

Dr. Fuhrman advocates a diet that is rich in vitamins and minerals from natural food sources. So why does he also recommend supplements?

I asked him that recently as part of an upcoming podcast, and he said there are many reasons. One, for instance, is that the vast majority of us do not get nearly enough sunshine to create the vitamin D we need. He also talked about the importance of NOT supplementing vitamin A or beta carotene, while praising caratenoids and phytochemicals (things about which I know very little).

When the podcast goes live in the next week or so, you can listen to Dr. Fuhrman's entire answer yourself. In the meantime, NBC has put the same question to Dr. Andrew Weil, who responds, in part, like this:

The main reason I take supplements is for insurance against gaps in my diet. Also, researchers are finding that some important vitamins (D and E particularly) and minerals are protective against disease in amounts that may be difficult to obtain through diet alone, no matter how conscientious you are. This is another reason I take supplements faithfully and encourage my patients to do so as well.

I recommend a comprehensive antioxidant and multivitamin for women and men as the basic foundation for nutritional insurance. My recommended daily antioxidant regimen includes 200 mg of vitamin C, 400 to 800 IU of natural vitamin E (or 80 mg of mixed tocopherols and tocotrienols), 200 mcg of selenium, 15,000 to 20,000 IU of mixed carotenoids, and 30 to 100 mg of coenzyme Q10.

In his books and in his practice, Joel Fuhrman, M.D. advocates eating foods that deliver optimal health. Yet he also recommends taking certain vitamins and supplements, like his Gentle Care Formula multiple. Here he discusses that recommendation.

Why Take Vitamins and Supplements?
Since most people's diets are not ideal and individual absorption and utilization varies from person to person, it makes sense to recommend that all people take a high-quality multiple to assure most favorable vitamin D, B12, zinc, iodine, and selenium status, to name a few.

Even if your diet is ideal, some people require more of certain nutrients than others. For example, it is not uncommon for some people to need extra vitamin D, or extra B12, even when their diets contain typical amounts of these vitamins. This is especially true regarding vitamin D because of the depletion of the atmosphere's ozone layer and subsequent increase in skin damage from the sun. Because of this, many people practice sun avoidance and wear sunscreen, which decreases their vitamin D production.

I also took into consideration my recommendation to avoid all salt added to food. Salt is iodinated, making it the primary source of iodine in most people's diets. Therefore, a multiple will assure adequate iodine intake in those who avoid adding salt to their diet.

Are there any problems with taking supplements?
The main problem with taking a typical multivitamin is that it may expose you to extra nutrients that you do not need. Sometimes too much of certain nutrients can have toxic or harmful effects. For example, I do not recommend taking supplements that contain vitamin A, isolated beta-carotene, or iron, because there are risks associated with consumption of these nutrients above what we receive in our diet.

Ingesting vitamin A or beta-carotene in isolation--from supplements, instead of from food--may interfere with the absorption of other crucially important carotenoids, such as lutein and lycopene, thus potentially increasing cancer risk. 1

The precursor to vitamin A, beta-carotene once was regarded as a safe and beneficial antioxidant and even recommended as an anti-cancer vitamin, but it has recently been shown to increase the risk of certain cancers when administered as an isolated supplement. Scientists now suspect that problems may result when beta-carotene is ingested without other carotenoids that would have been present had it been ingested from real food. Beta-carotene is only one of about 500 carotenoids that exist. Beta-carotene supplements are poor substitutes for the broad assortment of carotenoid compounds found in plants.