Vitamin and Mineral Therapy

The keys to a longer and healthier life, we’re told, are simple enough: Just eat right, exercise regularly, manage stress and get enough sleep. The tough part is practicing what’s preached.

Take food, for instance. The National Cancer Institute in Rockville, Maryland, recommends eating five servings of fruits and vegetables a day to reduce your risk of certain cancers, but fewer than 10 percent of us follow that advice. And by not making the right food choices, we might be eating our way toward cancer rather than away from it. Meanwhile, most of us don’t get enough exercise to stay healthy. And stress management? It’s hard enough to manage the kids, the job and the checkbook. And let’s not even begin to discuss coping with a lack of sleep.

Sigh! It can be hard to swallow all of this advice for better health. But there’s something that can make it go down a little easier: vitamin and mineral supplements.

Cheap, Safe and Proven

Nearly half of all Americans—about 100 million people—use supplements at least occasionally. About half of them pop vitamin pills daily, spending nearly $4 billion a year in the process. It seems like money well-spent: Growing evidence suggests that high doses of certain nutrients can help slow the natural aging process and stave off heart disease, stroke, certain types of cancer and other diseases.

In foods, there are hundreds of nutrient compounds called phytochemicals, many of which have beneficial effects on health. For example, some of the phytochemicals in vegetables are thought by researchers to ward off cancer but are not available in supplements. That makes eating a healthy diet important.

But many nutrients are found only in very low amounts in the foods we eat every day. And some nutrients, such as folic acid, are better absorbed in the form that is used in supplements.

“There is overwhelming evidence that supplements have beneficial effects on a person’s health, because they offer much higher doses of key nutrients than you find in food—sometimes amounts that you could never get from diet alone,” says Richard Anderson, Ph.D., lead scientist for the nutrient requirements and functions laboratory at the U.S. Department of Agriculture Human Nutrition Research Center in Beltsville, Maryland.

“Unless you’re consuming 4,000 to 5,000 calories of healthy foods a day—about twice the amount of the typical American—you’re not even getting the Recommended Dietary Allowances (RDAs) for several trace minerals, let alone amounts that can help prevent and treat disease.”

Supplements can also be fairly inexpensive. If you shop carefully, for as little as nine cents a day you can gulp down a brand-name multivitamin/mineral supplement that provides all of the essential nutrients you’d get from a whole day of healthy eating. Add another nine cents, and you can take enough of vitamins C and E in supplements to possibly protect you from cancer and heart disease. For a little more, you can take a calcium supplement to prevent osteoporosis. That’s less than the cost of a single apple in some places. Of course, some supplements cost more, but generally, for less than a dollar a day you can get more essential vitamins and minerals than you’d get from an entire day of healthy eating. Look for a natural supplement that’s free of food colorings, sweeteners and other additives.

And supplements are generally safe, especially if they are not grossly abused. “It’s true that a few supplements, most notably vitamins A and D, can cause some problems if taken in extremely large doses for extended periods of time,” says Michael Janson, M.D., director of the Center for Preventive Medicine in Barnstable, Massachusetts, and an officer of the American College for Advancement in Medicine. “But we’re talking about extremely large doses taken daily for a year or two.” These are amounts that may be as much as 50 times above the RDAs and even 10 or more times higher than the megadoses suggested on a short-term therapeutic basis to relieve a specific medical problem. (For more information about possible side effects of supplements, see “Watch What You’re Taking.”)

From Humble Beginnings

Vitamins and minerals—or rather, the foods containing these nutrients—have been used as therapy for thousands of years. The ancient Egyptians ate the livers of roosters and oxen to cure night blindness due to vitamin A deficiency and sea sponge, a natural source of iodine, to treat goiters.

It wasn’t until around 1906 that vitamins were first discovered. What triggered the search for vitamins was the fact that fat, protein and carbohydrates were found to be insufficient to support life. “It became clear that there was something else in food that was needed for survival, and the search was on. The ‘something else’ turned out to be vitamins,” says Annette Dickinson, Ph.D., director of scientific and regulatory affairs for the Council for Responsible Nutrition in Washington, D.C., a research and lobbying group for the supplement industry.

Scientists went to work isolating the nutrient compounds from foods through complex chemical procedures. In 1912, the term vitamine was coined (for “vital amine,” amine being a kind of chemical structure; a few years later, the e was dropped when it was learned that some vitamins had different chemical structures and were not amines). By 1925, vitamin supplements were on the market to a sufficient-enough degree that national magazines were tracking their sales, just like those of the automobile industry.

From 1906 through the 1940s, there was a lot of research going on with vitamins and supplements, and the actual vitamins were named alphabetically in the order they were discovered: The first vitamin isolated was called A, the next was called B, then C and so on, says Dr. Dickinson. “It took about 20 or 30 years to separate the compounds that were really vitamins from those that were something else.” And by that time, some letters were discarded, and others were filled in—one reason why there are eight B vitamins.

Vitamins versus Minerals

There are at least 13 vitamins and 15 minerals considered essential for good health. (To find out which nutrients these are, see “Getting What You Need” on page 142.) Vitamins are organic compounds, meaning that they contain carbon, which is found only in living things. Minerals are simpler, nonorganic compounds and are usually found in smaller amounts in foods. Along with essential fatty aids and amino acids, vitamins and minerals are among the almost 50 known essential nutrients we need for a healthy life, says Dr. Janson.

Four of those vitamins—A, D, E and K—are fat-soluble, meaning that excess amounts may be stored in the body. The others—C and the eight B vitamins—are water-soluble, so excess amounts are simply urinated away.

Minerals, most of which were identified years after the initial research into vitamins, are also classified in two categories: major minerals, or macronutrients, such as calcium, magnesium and potassium, which are found in relatively high concentrations in food; and trace minerals, or micronutrients, such chromium, copper, iron and zinc, which are usually found in only minute amounts.

All of these nutrients are crucial to the preservation of life. Whether from food or supplements, vitamins and minerals play a role in cell building and in the health of every organ in your body as well as of your bones, immunity and nervous system. And while they don’t supply energy—you get that from carbohydrates, protein and fat—they do release energy from food so that your body can use it.

“Every cell in your body needs every vitamin, but not every cell utilizes them in the same way or needs the same amounts,” says Dr. Janson. “Because of that, it’s hard to say which vitamins or minerals are most important.”

A Radical Solution

On the front line, at least when it comes to fending off today’s most common health concerns, are the so-called antioxidants: vitamins C and E and beta-carotene (a form of vitamin A). When taken in large-enough doses, these vitamins are believed to offer protection against 60 age-related afflictions, from cancer and cataracts to heart disease and high cholesterol.

How? By stopping toxic molecules called free radicals. Caused by radiation, cigarette smoke, car exhaust and other pollutants, free radicals eat away at healthy cells and turn them defective, similar to the way cancer cells run amok. Over time, the damage done by free radicals can cause the development of cancer, turn innocuous cholesterol into sticky plaque that clogs arteries and accelerate the natural aging process and the disease that it brings.

But researchers say that the best defense against free radicals is to get plenty of antioxidant vitamins, which stop free radicals from overtaking healthy cells. “Because of this, it’s hard to think of anyone in our society who couldn’t benefit from taking vitamin supplements, especially those containing plenty of antioxidants,” says Michael A. Klaper, M.D., a nutritional medicine specialist in Pompano Beach, Florida, and director of the Institute of Nutritional Education and Research, an organization based in Manhattan Beach, California, that teaches doctors about nutrition and its relationship to disease.

“We live in a far different world than our parents did. The sunshine is more oxidizing because of the thinning ozone layer. We add more chlorine to the water, so it is more oxidizing. Frying, barbecuing and adding preservatives and coloring make our foods more oxidizing. And the sad fact is, unless you’re lucky enough to run the local organic food co-op and live in a really clean area, you may not be getting the protection you need from diet alone.”

Who Benefits Most?

Your vitamin and mineral needs vary at different stages of your life, often because of the changing way your body absorbs nutrients. Infants, for instance, absorb about 70 percent of the calcium they consume; adults take in only about 30 percent. That’s why supplements become even more important as you age.

“The elderly could definitely benefit from supplementation, because once you’re in your sixties, food intake typically drops, and you’re not as active as you used to be,” says Judith S. Stern, R.D., Sc.D., professor of nutrition and internal medicine at the University of California, Davis.

Even if you manage to stay active, you can benefit from supplements. “Moderate exercise enhances immunity, but if you’re running more than 30 miles a week or doing a lot of other types of exercise, you can actually hurt immunity and be more prone to viruses,” says Kenneth H. Cooper, M.D., founder and president of the Cooper Aerobics Center in Dallas. “So if you exercise a lot, you should definitely take vitamin supplements rich in antioxidants.” His recommendation: 1,000 milligrams of vitamin C, 400 international units (IU) of vitamin E in the natural alpha-tocopherol form and 15 milligrams (25,000 IU) of beta-carotene each day.

Others who may be in special need of vitamin and mineral supplements, according to Dr. Stern: women of childbearing age; women who are pregnant or nursing; dieters, especially when they consume fewer than 1,200 calories a day; people preparing for or recovering from surgery; those who drink alcoholic beverages frequently; smokers; people who travel a lot and may not be able to eat a variety of foods; people who live in smoggy climates; and, possibly, strict vegetarians.

Beyond the RDA

Why do so many of us need nutritional boosts from a pill or tablet—or from a few of them? Because so many of us base our nutritional needs on the RDAs, first established by the Food and Nutrition Board in 1941 and updated periodically ever since.

RDAs are across-the-board guidelines for everyone from infants to adults and do not take into account special nutritional needs. The general nature of RDAs may leave us shy of the nutrients we need, which is why, some experts say, we’re a society nagged by so many health problems, from immune disorders such as colds and slow-healing cuts to more serious conditions such as arthritis and heart disease.

“The RDA is really a useless guideline for today, because it was designed to prevent deficiency diseases such as scurvy and beriberi—problems we don’t see in this country,” says Dr. Janson. “The RDA is not a useful guideline for achieving optimal health and treating disease, especially in today’s society.”

Changes in food labeling have added another number: the Daily Value, or DV. Like the RDA, the DV is a recommendation for how much of a specific nutrient you need in your daily diet to maintain adequate nutrition. On food labels, the percent DV tells you the percentage of your daily nutrient needs provided by one serving of that food, based on a diet of 2,000 calories per day. Multivitamin/mineral supplements are also labeled with the percent DV. Neither DVs nor RDAs are necessarily a true measure of what you may need to treat or to protect yourself from disease.

For that, experts say, you need to go beyond RDAs—often way beyond. “Generally, I’d say that vitamins in amounts well above the RDAs are safe for most people,” says Gladys Block, Ph.D., professor of public health and nutrition and epidemiology at the University of California, Berkeley, and an authority on vitamin therapy. In fact, experts say, the biggest benefits of some nutrients seem to occur when taken in large doses.

“Take vitamin C, for example,” says Alan Gaby, M.D., a physician specializing in preventive and nutritional medicine in Baltimore and president of the American Holistic Medical Association. Vitamin C’s RDA is 60 milligrams a day, approximately the amount you’d get in a glass of citrus fruit juice or a 1¼2-cup of broccoli.

“You could get as much as 500 milligrams if you eat a diet really high in fruits and vegetables, but that would be pushing it,” he says. “Yet most of the studies show that vitamin C does the most good—functioning as an antihistamine, killing viruses, boosting immunity and protecting against cancer, diabetes and other diseases—in dosages that range anywhere from 500 to 10,000 milligrams, which you could never achieve with food.”

Dr. Block has reviewed more than 100 studies examining the relationship between vitamin C and cancer. In virtually every study, the nutrient had a protective effect. In most studies, people with high intakes of fruits and vegetables containing vitamin C had a lower risk of cancer.

Same goes for beta-carotene, which converts into vitamin A in the body when needed. It’s safer to take in supplement form than vitamin A because it derives from plant sources and excess amounts are excreted (whereas fat-soluble vitamin A comes from animal sources, and excess amounts are stored in your body). Studies show that people who take this antioxidant vitamin in supplement form—it’s also found in carrots, squash, melons and other yellow-orange fruits and vegetables—cut their risk of heart attack and stroke in half compared with those who don’t.

And when taken in doses five to ten times what’s typically recommended, which is about six milligrams (10,000 IU), beta-carotene has been shown to greatly reduce precancerous lesions of the mouth, says cancer researcher Harinder Garewal, M.D., Ph.D., of the University of Arizona Cancer Center in Tucson.

Meanwhile, vitamin E has been found to help protect against heart disease, but only when taken in amounts at least seven times above the RDA of ten milligrams alpha-tocopherol equivalents (15 IU) for men and eight milligrams alpha-tocopherol equivalents (12 IU) for women—amounts hard to achieve through diet. (You’d have to eat four large mangoes or 12 apples just to get the RDA.) “Studies show it takes even more, between 400 and 800 IU, to relieve fibrocystic breast disease,” adds Dr. Gaby. “It would be impossible to get that much vitamin E from foods alone.”

The Mighty Minerals

While antioxidants get most of the headlines, they’re not the only super supplements. “There is a lot of exciting research being done with minerals right now,” says Dr. Anderson. And as with antioxidants, it seems that big benefits come in dosages you can’t normally get through foods alone.

“One thing I’ve been working on is chromium, a trace mineral that has been shown to reduce risk factors for diabetes and cardiovascular disease in some people,” he says. “It improves glucose and insulin and lowers cholesterol and triglycerides, a form of blood fat that has been linked to an increased risk of heart disease. Give someone the recommended 50 micro grams, and he’ll get along fine. But if you want protection against diabetes, you need about 400 micrograms; if you want to protect against heart disease, you need 400 micrograms. And research also shows that copper and magnesium can protect against heart disease—but only in amounts that you rarely get from food.”

Other experts say that zinc, an often overlooked and underappreciated mineral best known for healing wounds and building tissue, may be even more important than antioxidants for warding off invading infections and keeping the immune system strong. In fact, one of the hottest remedies for fighting colds is zinc gluconate lozenges; they kill many of the germs that cause sore throat and other symptoms associated with the common cold.

Zinc’s RDA is 15 milligrams for men and 12 milligrams for women, but most people get only between 8 and 10 milligrams—“and even less if they’re vegetarian,” says Ananda Prasad, M.D., Ph.D., professor of medicine at Wayne State University in Detroit and a leading expert on zinc. What should they get? “I’d say about 30 milligrams a day—more if they’re having a specific skin problem or another condition,” adds Dr. Janson. “As long as it is properly balanced with 2 to 3 milligrams of copper.” This is because zinc and copper interfere with each other’s absorption, says Dr. Janson. Too much of one can cause a deficiency of the other, so they should always be supplemented together.

Selenium is a mineral with antioxidant qualities that may also strengthen immunity. Research shows it protects against heart disease and cancer, alleviates arthritis symptoms and can even improve mood. The RDA is 70 micrograms for men and 55 micrograms for women; Dr. Janson recommends taking up to six times that amount each day to reap these rewards.

The Vital Vitamins

On the vitamin side, B₆ is another nutrient that is essential to strong immunity. It also offers relief from carpal tunnel syndrome, prevents kidney stones and relieves premenstrual syndrome.

And vitamin B₆ becomes even more important as you age. Elderly people seem to metabolize it less effectively than younger people, says Simin Meydani, Ph.D., chief of the nutritional immunology laboratory at the U.S. Department of Agriculture Human Nutrition Research Center on Aging at Tufts University in Boston. This could lead to a B₆ deficiency, and such a deficiency can hurt immunity.

Dr. Janson recommends taking 50 to 100 milligrams of vitamin B₆ daily, well above the RDA of 2 milligrams for men and 1.6 milligrams for women.

The bottom line: No matter what your age, gender, lifestyle or exercise habits, most people can benefit from supplementing their diets with vitamins and minerals, experts say.

“You can’t replace a healthy diet with vitamin and mineral supplements; you still need to eat as well as possible,” says Dr. Janson. “But you can make up for some of the fault of a poor diet with them—and most of us have fault with our diets.”

Like diet, exercise and stress management, supplements are only part of a total health plan—not magic pills that can make up for all of your other bad habits. “No matter how much I tell my patients to eat a better diet, a lot would rather take the pills, because it’s easier,” says Dr. Janson. “Sorry, but supplements are only a part.”

But they can make a big difference, he adds. “If you are healthy now and feel good, your energy levels are high, you have no problems with physical stamina when doing exercise and your mental processes are clear, then I don’t think you should expect immediately obvious effects from taking supplements—other than to maintain that state for many more years than if you didn’t take them.”