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Vitamin E --- How Much Is Enough
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How Vitamin E Prevents
Heart Attacks
and Why We Should Take It
By Saul Kent
On May 20, 1993, two papers showing
that
vitamin E reduces the risk of coronary heart disease
were published in the New England Journal Of Medicine
by scientists at the Harvard School of Public Health
.
The results of these studies, which were publicized
widely throughout the United States, convinced many
people who had been skeptical of the ability of vitamins
to prevent
heart disease and other lethal diseases, to start
taking dietary supplements. For
members of The Life Extension Foundation, however,
the Harvard studies merely confirmed what they had been
reading about for years. They also validated the work of
Canadian doctors Evan and Wilfred Shute, whose pioneering
clinical research with
vitamin E in the 1940s, 50s and 60s provided a solid
scientific foundation for future studies.
The reasons for all the hoopla over the Harvard studies
was the fact that the scientists studied (prospectively)
a vast number of subjects (39,910 male health
professionals and 87,245 female nurses) for a lengthy
period of time (4 years for the men and up to 8 years for
the women), and that they found a major reduction in the
risk of heart disease (40%-to-50%) in subjects who took
vitamin E supplements (at least 100 IUs a day) for at
least two years. The fact that the scientists were at an
eminent university (Harvard) and had published in a
prestigious journal (The New England Journal Of Medicine)
added to the public impact of the studies.
A commentary on these studies in the same issue of the
New England Journal by Daniel Steinberg, M.D., Ph.D. of
the University of California at San Diego offered the
typically cautious advice of alleged "authorities" about
what public health policy should be regarding
supplemental vitamin E (and other nutrients).
Why Not Advise People To Take Antioxidant Vitamins?
Dr. Steinberg raises the question of
whether "we" (the "authorities") should advise people to
take supplemental antioxidant vitamins. He concedes that
natural antioxidants such as
vitamin E,
vitamin C, and
beta-carotene are "generally considered not to be
toxic': which he says raises the question "Why not?" He
then proceeds to give what he considers to be "good
reasons why not. " Here are his reasons:
"First, I think we must not make exceptions to the rule
that recommendations to our patients must be backed by
proof of a clear benefit to be conferred . . . My own
conviction is that proof must include at least some valid
clinical intervention trials demonstrating the magnitude
of the benefit to be obtained in humans.
"A second reason for rejecting the 'Why not?' argument is
that we do not have data showing the long-term (and
presumably lifetime) intake of very large doses of
natural antioxidants will not be toxic . . . . Having
inadequate data on the benefit to be expected, we should
hesitate to accept any potential risk.
"Finally, before we lend our imprimatur to the widespread
use of a still unproved treatment, one that requires the
patient only to pop a few pills, we should ask how many
patients will slack off on their adherence to better
established, but somewhat more onerous, preventive
measures such as a
cholesterol-lowering diet, regular exercise, and
smoking cessation.
"Meanwhile, I think we must play by the rules and insist
on large, long-term, double-blind clinical trials. Until
they are done, let's hold the vitamin E."
The "Head In The Sand" Approach
Dr. Steinberg's third reason for not
recommending supplemental vitamin E is the typical "head
in the sand" approach, which has been parroted by the
"authorities" for decades. His statement that "we" should
not endorse "the widespread use of a still unproved
treatment" ignores the fact that millions of people are
already taking
vitamin E (and many other vitamins) on their own and
have been for decades! His "concern" that people will
"slack off on other more onerous preventive measures " if
they are advised to take vitamins ignores the fact that
most people who take high-dose vitamins do so as part of
a healthful lifestyle, while those who do not take
vitamins usually have other unhealthy habits as well! Dr.
Steinberg's remark that we should not recommend a
potentially lifesaving therapy because people might kill
themselves in other ways is the most absurd argument
proposed by the "authorities"!
Dr. Steinberg's second concern about the possible
"toxicity" of long-term intake of supplemental vitamin E
also ignores decades of high dosage
vitamin E usage by millions of people without any
significant indication of toxicity. The notion that
supplemental vitamins may be "dangerous" is one of the
greatest hoaxes ever perpetrated by the "authorities". In
fact, vitamins are extraordinarily safe. THE TRUTH IS
THAT NO ONE DIES FROM TAKING VITAMINS, WHILE HUNDREDS OF
THOUSANDS OF AMERICANS DIE EVERY YEAR FROM
FDA-APPROVED DRUGS!
The Folly Of Relying On The "Authorities"
It's a shame that so many "authorities" feel they must wait for the positive results of large scale clinical trials before they can recommend vitamin supplements. These scientists and physicians mislead people by insisting that it's appropriate to wait for "definitive proof" that supplemental vitamins can prevent diseases. Such advice is not only wrong, it's potentially life threatening for the following reasons:
The Value Of Biochemical Studies
Biochemical studies of the effects
of vitamins on disease processes are rarely reported on
by the media and aren't usually cited as evidence in
favor of taking vitamins. Yet such evidence can be better
and more compelling than the almost invariably flawed
results of controlled clinical studies. Biochemical
studies provide highly persuasive evidence of the
mechanisms of actions involved in taking vitamins.
When you know how vitamins help to keep you healthy and
alive, it will be very hard for the "authorities" to
convince you to wait for "more evidence" before taking
these vitamins!
In this edition of Life Extension Update, we've provided
you with solid evidence that supplementation with vitamin
B-6, vitamin B-12 and folic acid helps to prevent heart
attacks by reducing your body's levels of
homocysteine, a toxic substance that promotes the
development of the
atherosclerotic plaques in arteries that are the
major underlying cause of heart attacks and
strokes. What follows is evidence of how
vitamin E helps to prevent the formation of these
life-threatening plaques.
How Dietary Cholesterol Contributes To Heart Disease
It's been known for decades that the
regular consumption of foods high in fat and cholesterol
is associated with an increased risk of atherosclerosis,
and that higher-than-normal blood levels of cholesterol
increases your risk of coronary heart disease.
About 25 years ago, it became clear that there are
several types of cholesterol in our bloodstream (in the
form of lipoproteins), and that one form of cholesterol
(high-density lipoproteins [HDL]) is good for your heart
and your entire cardiovascular system. It is now accepted
by cardiologists that your HDL/LDL (low-density
lipoprotein) ratio is a better predictor of your risk of
heart disease than simply measuring your total
cholesterol.
The Oxidation Of LDL Cholesterol
The first sentence of the abstract
of the Harvard vitamin E study (in men) reads as follows:
"The oxidative modification of low-density lipoproteins
increases their introduction into the arterial intima, an
essential step in atherogenesis."
There have been many studies demonstrating that oxidized
LDL cholesterol plays a critical role in the formation of
arterial atherosclerotic plaques. Oxidized LDL can be
found in atherosclerotic lesions. It accelerates the
progression of these lesions by enhancing monocyte
adhesion and macrophage foam cell generation, which
induces the migration (to the lesion) of smooth muscle
cells. Oxidized LDL also contributes to plaque formation
by triggering thrombosis (blood clots that lodge in the
lesions); and by impairing vasodilation of arteries to
increase the shear stress of bloodlfow within your
arteries. All these factors contribute to
atherosclerosis, which, in turn, significantly increases
your risk of a fatal heart attack or stroke.
It is believed that the oxidation of LDL cholesterol
generally occurs within the arterial cell wall, where it
is sequestered from circulating antioxidants and comes
into contact with iron and copper ions, which help to
generate lipid oxidizing hydroperoxides and other free
radical species.
Inhibiting The Oxidation of LDL
Recent studies have shown that
antioxidant vitamins such as vitamin C and
vitamin E can inhibit the oxidation of LDL
cholesterol and, as a result, increasing numbers of
scientists are becoming convinced that this is the
primary mechanism by which these vitamins protect us
against heart attacks and strokes.
In one study, dietary vitamin E was found to decrease the
susceptibility of LDL isolated from hypercholesterolemic
men to oxidative modification. In another study, LDL
taken from a single subject after dietary vitamin E
supplementation was protected against oxidation when
compared to LDL taken from subjects who had not received
vitamin E. In a third study, supplementation with
vitamin C and vitamin E reduced the enhanced
oxidation of LDL caused by heavy cigarette smoking.
These findings are supported by in vitro studies, which show that both vitamin C and vitamin E inhibit oxidation in LDL taken from a wide variety of subjects. The antiatherogenic value of these antioxidant vitamins is further demonstrated by the inverse relationship between plasma levels of these vitamins and risk of death from heart disease.
A recent in vitro study by Vincent
A. Rifici, Ph.D and A.K. Khachadurian, M.D. in the
Journal of the American College of Nutrition, produced
strong evidence that vitamin E is a highly potent
inhibitor of LDL oxidation. Twelve healthy female and
male subjects, age 22-49, who were non-smokers and were
not taking any drugs or vitamin supplements, had samples
of LDL cholesterol removed for testing after being given
vitamin C alone followed by a period without any
supplementation, which was then followed by
supplementation with vitamin E. The subjects were given
250 mg of vitamin C 4 times a day, and then 800 IU of
vitamin E once a day.
The amount of lipid peroxides formed in the samples (a
measure of LDL oxidation) was determined by measuring
Thiobarbituric Acid Reactive Substances (TBARS)
immediately after incubation of the LDL in the culture
medium. Two additional measures of LDL oxidation used in
one subject were the appearance of conjugated dienes and
the loss of reactive amino groups in the apolipoproteins
found in the LDLs.
Strong Inhibitory Effect Of LDL Oxidation By Vitamin E
The results of the study showed that
supplementation with both vitamin C and vitamin E
inhibited the oxidation of LDL cholesterol, but that
vitamin E was especially effective in doing so. The
inhibitory effect of vitamin C was 15%, while vitamin E
inhibited LDL oxidation by 52% (the combined inhibitory
effect of both vitamins was 63%). The scientists
concluded that:
"Dietary supplementation with antioxidant vitamins C and
E increases the resistance of lipoproteins to in vitro
oxidation.... The onset of the propagation phase of lipid
peroxidation was delayed up to 6 hours in the vitamin
supplemented lipoprotein... as documented by decreased
TEARS production. We have also shown that vitamin
supplementation inhibits LDL oxidation according to other
measures of the process....Our results indicate that
dietary supplementation with antioxidant vitamins may be
effective in retarding oxidation of LDL in vivo as well.
"
