Nutrition Update

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JAMA article recommends vitamin supplements for all adults.

 

The June 19 2002 issue of the Journal of the American Medical

Association (http://jama.ama-assn.org/) published Scientific

Review and Clinical Applications articles sharing the title, "Vitamins

for Chronic Disease Prevention in Adults". The objective

of the Scientific Review is to review the clinically important

vitamins' effects, sources, deficiency syndromes, toxicity, and

relationship to chronic disease. The review of studies published from

1966 through 2001 on nine nutrients revealed a

population consisting of the elderly, alcohol-dependent individuals,

vegans, and those with malabsorption who are at

risk of inadequate intake or absorption of several of these nutrients.

The Clinical Applications article notes that

although deficiency diseases such as scurvy and pellagra are rare,

insufficient vitamin intake is a cause of chronic

diseases, and that suboptimal levels of vitamins, even though these

levels might be well above those classified as

deficient, are risk factors for osteoporosis, cardiovascular disease

and cancer.

 

The authors examined studies concerning the following nutrients:

vitamins A, B6, B12, C, D, E and K, folate, and the

carotenoids including alpha and beta-carotene, beta-cryptoxanthin,

lycopene, lutein and zeaxanthin. They noted the association

 

of low intakes of the B vitamins with elevated homocysteine levels and

the corresponding increased risk of coronary heart

disease disease; of low folate with neural tube defect, coronary heart

disease and breast and colorectal cancer; of vitamin B6

deficiency with cheilosis, stomatitis, central nervous system effects

and neuropathy; of low B12 with macrocytic anemia and

neurologic abnormalities; of suboptimal vitamin E with prostate

cancer; of low levels of various carotenoids with breast,

prostate and lung cancer; of vitamin D with secondary

hyperparathyroidism, bone loss, osteoporosis and increased fracture

risk; of vitamin C with cancer in some studies, of vitamin A with

vision disorders and decreased immune function, and of

vitamin K with blood clotting disorders and possibly with increased

fracture risk.

 

In the "Clinical Applications" article, Drs Fletcher and Fairfield

conclude that a large proportion of the general population

is at increased risk of cardiovascular disease, cancer, osteoporosis

and other chronic diseases because of

suboptimal vitamin levels.

 

The high prevalence of these diseases indicates the standard diet in

the U.S. fails to provide sufficient amounts of the

vitamins studied. They write, "Pending strong evidence of

effectiveness from randomized trials, it appears prudent for all

adults to take vitamin supplements." This is a significant move

forward from the notion that all of one's nutritional

needs can be met by diet alone that the medical establishment has been

advising for decades.