Multivitamin Multivitamin MisconceptionsMisconceptions

Gary E. Foresman, M.D.Gary E. Foresman, M.D.Middle Path MedicineMiddle Path Medicine

January 2011January 2011

““MVI Use…In the Women’s Health Initiative”MVI Use…In the Women’s Health Initiative”

►161,808 participants, postmenopausal 161,808 participants, postmenopausal womenwomen

►41.5% of participants used MVIs, primarily 41.5% of participants used MVIs, primarily Centrum-type MVIsCentrum-type MVIs

►After a median follow up of eight years, After a median follow up of eight years, MVIs had no influence on the risk of MVIs had no influence on the risk of common cancers, cardiovascular disease, common cancers, cardiovascular disease, or total mortality in postmenopausal or total mortality in postmenopausal womenwomen

Arch Int. MedArch Int. Med. Feb 9, 2009. 294-304. Feb 9, 2009. 294-304

““MVI Use and Risk of Prostate Cancer”MVI Use and Risk of Prostate Cancer”

►295,344 men, part of NIH-AARP Diet and 295,344 men, part of NIH-AARP Diet and Health StudyHealth Study

►Self-reported use of MVI was ascertained Self-reported use of MVI was ascertained and patients were followed prospectively and patients were followed prospectively for five years for five years

►32% increased risk of advanced prostate 32% increased risk of advanced prostate cancercancer

►98% increased risk of fatal prostate cancer98% increased risk of fatal prostate cancer

J Natl Cancer InstJ Natl Cancer Inst. May 2007. 754-64. May 2007. 754-64

““MVI Use and Breast Cancer Incidence”MVI Use and Breast Cancer Incidence”

►Prospective examination of the Prospective examination of the association between MVI use and the association between MVI use and the incidence of invasive breast cancerincidence of invasive breast cancer

►35,329 cancer free women followed 35,329 cancer free women followed for 9.5 yearsfor 9.5 years

►MVI users had a 19% increased risk of MVI users had a 19% increased risk of invasive breast cancerinvasive breast cancer

Am J Clin NutrAm J Clin Nutr. May 2010. 1268-72. May 2010. 1268-72

““Use of MVIs, Vitamin C, and Vitamin E in Use of MVIs, Vitamin C, and Vitamin E in Relation to Mortality”Relation to Mortality”

► 77,719 Washington State residents (both men and 77,719 Washington State residents (both men and women) aged 50-76women) aged 50-76

► Men and women without pre-existing heart disease Men and women without pre-existing heart disease had a 22% reduction in cardiovascular mortalityhad a 22% reduction in cardiovascular mortality

► People who took MVIs had much higher education People who took MVIs had much higher education status and healthy behaviors which “confounded” a status and healthy behaviors which “confounded” a statistically significant 13% reduction in overall statistically significant 13% reduction in overall mortalitymortality

► Addition of C and E led to further significant Addition of C and E led to further significant improvements in overall mortality, the higher the improvements in overall mortality, the higher the dose the betterdose the better

Am J EpidemiologyAm J Epidemiology. July 2009. 472-83. July 2009. 472-83

““MVI Use and the Risk of Myocardial Infarction…”MVI Use and the Risk of Myocardial Infarction…”

► 31,671 women with no history of CVD, age 31,671 women with no history of CVD, age 49-83, followed for 10.2 years49-83, followed for 10.2 years

►MVI users had a 30% reduction in risk of MI MVI users had a 30% reduction in risk of MI ► Those who used an MVI for greater than five Those who used an MVI for greater than five

years in this trial had an overall 41% years in this trial had an overall 41% decreased risk of MIdecreased risk of MI

► In a parallel trial of 2,262 women In a parallel trial of 2,262 women withwith a a history of CVD, MVIs had no benefithistory of CVD, MVIs had no benefit

Am J Clin NutrAm J Clin Nutr. Nov 2010. 1251-56. Nov 2010. 1251-56

Iatrogenic IllnessIatrogenic Illness

► 12,000 deaths per year from unnecessary surgery12,000 deaths per year from unnecessary surgery► 7,000 deaths per year from medication errors in 7,000 deaths per year from medication errors in

hospitalshospitals► 20,000 deaths per year from other hospital errors20,000 deaths per year from other hospital errors► 80,000 deaths per year from nosocomial infections80,000 deaths per year from nosocomial infections► 106,000 deaths per year from adverse effects of 106,000 deaths per year from adverse effects of

prescription medicationsprescription medications► 225,000 deaths per year from iatrogenic causes225,000 deaths per year from iatrogenic causes► Untold suffering from misinformation campaigns Untold suffering from misinformation campaigns

intended to make you into one of the above intended to make you into one of the above statistics while claiming to protect you from things statistics while claiming to protect you from things not part of the U.S. Medical Systemnot part of the U.S. Medical System

ReviewReview►100% of trials looking at our diets show 100% of trials looking at our diets show

every American has nutrition deficiencies every American has nutrition deficiencies and innumerable insufficiencies. and innumerable insufficiencies.

►Even Even JAMAJAMA recommends multivitamin recommends multivitamin supplementation (circa June 19, 2002). supplementation (circa June 19, 2002).

►The question isn’t whether to supplement The question isn’t whether to supplement with a multivitamin, the question is which with a multivitamin, the question is which multivitamin best promotes the prevention multivitamin best promotes the prevention of chronic disease.of chronic disease.

►Multiple trials prove that a poor Multiple trials prove that a poor multivitamin can lead to very grave multivitamin can lead to very grave results.results.

Review continuedReview continued

►The complexity of nutrient interactions The complexity of nutrient interactions makes the selection of a multivitamin for makes the selection of a multivitamin for the lay person impossible. the lay person impossible.

►Nutrisearch Comparative Guide to Nutrisearch Comparative Guide to Nutritional SupplementsNutritional Supplements

►Source Naturals: Life Force MultipleSource Naturals: Life Force Multiple►Douglas Laboratories: Ultra-Preventive Douglas Laboratories: Ultra-Preventive

XX►Middle Path Medicine’s Basic Middle Path Medicine’s Basic

Nutritional Protocol, the synergy of Nutritional Protocol, the synergy of nutritional support nutritional support