![[Multivitamin Episode 2] Finnish Shock? Copenhagen shock? Errors in multivitamin research | Dr. Esther Yeo](http://esther-mall.com/cdn/shop/articles/53_2c125c19-6a93-4bf8-9cda-4f23002b26c6.jpg?v=1734117875&width=480)
Multivitamins, like other nutritional supplements, have been criticized for their necessity. In a study of Los Angeles and Hawaii residents, 3 out of 4 people studied were more than enough with food, and 1 in 4 were helped by a multivitamin (Am J of Clin Nutr, 2007). Multivitamins contributed to an average increase of 8 percentage points in the percentage of nutrients that were lacking. In the United States, multivitamins can help with vitamin E, potassium, and calcium that are lacking in food, but vitamin A and iron are already consumed in large quantities from food, and there are reports that there is a risk of excessive intake in 10~15% of people when taking multivitamins.
However, there are two most critical and shocking findings about multivitamins: It is also a paper that is often cited by nutritional supplement useless advocates. First, it is a study conducted by a multinational research institute led by the Finnish National Institutes of Health on 29,000 male smokers over the age of 50 for 5~8 years. Surprisingly, taking 20 mg of beta-carotene daily from a multivitamin actually increased the risk of lung cancer by 18% compared to the placebo group. The results of the study made headlines in the media under the name of the Finnish Shock. Until then, beta-carotene was known to help prevent lung cancer and other cancers.
However, the results of this study were criticized for the unrealistically high doses of beta-carotene used in the trials.I was given 20 mg daily, which is 10 times more than what is usually found in a commercially available multivitamin. Another problem is that the beta-carotene used in the experiments at the time was synthetic. Depending on whether beta-carotene is synthetic or natural, it has the same chemical structure formula, but the isomer, which means a three-dimensional shape, is different. Synthetic beta-carotene is trans-form, but 20~50% of natural beta-carotene is cis-form. If it had been a natural beta-carotene product from carrots or dunariella, the results would have been different.
The results of the second study came from Copenhagen, Denmark in 2007. Researchers at the University of Copenhagen conducted a meta-analysis of 68 multivitamin papers published up to that time, and found that vitamin C and selenium neither increased nor decreased mortality, but increased mortality by 7% for beta-carotene, 16% for vitamin A, and 4% for vitamin E. The media dubbed the news the Copenhagen shock and reported that multivitamins were associated with higher mortality rates.
However, these results highlight the shortcomings of meta-analyses, which do not conduct new studies but rather collect and statistically re-analyze the results of other studies that have already been published.
First of all, the qualitative difference in products was not taken into account at all. It is obvious that a low-quality product containing an excess of synthetic vitamin A or synthetic beta-carotene will produce bad results. In addition, many of the participants in the study were elderly people with serious illnesses such as cancer or heart disease. Although it was clear that the treatment they received at the hospital, such as medication and surgery, was much more important in their mortality than the multivitamin, they compared the increase in mortality with the addition of multivitamins alone. In addition, deaths caused by homicide or suicide during the study period were calculated to include deaths that were not related to the results of supplementation. The age difference between the study subjects was also too large, ranging from 18 to 103 years. The health status of 18-year-olds and 103-year-olds is so different that they tried to interpret mortality as the same result. In addition, the duration of administration and the dosage also varied too much. There are papers that were administered once and observed for 3 months, and there are also papers that were administered for 6 years and observed for 14 years.
Even with the researchers reversing the statistics, the initial analysis showed that vitamin C and selenium reduced mortality by more than 10 percent. The researchers then arbitrarily subtracted 21 papers and ran the statistics again with only 47 papers. The result is the Copenhagen shock that many people know.
Just as important as the prejudice of some medical communities is the fact that many doctors don't know much about nutrition. In medical school education, the nutrition curriculum is very poor, and medical students do not learn nutrition properly. Even when I was in medical school, I learned proper nutrition for about a week, and it was only one credit. Many medical students don't take nutrition seriously. A person's health cannot be achieved only by medications or surgery prescribed by a doctor. Ignoring the most basic nutrition without studying it properly is not the right attitude for a doctor.
Multivitamins are foods that are not drugs by nature, so the mortality and cancer rates associated with them will continue to fluctuate in the future. Therefore, there is no reason to be complacent about each of these results. I'm not looking at disease or death, but rather on improving function. It's the idea of making healthy people healthier. If you think about it this way, it's easy to understand. After eating fresh vegetables and fruits, you will feel your physical condition improve. On the other hand, if you eat poorly, you will feel tired and sluggish. In this way, there is a correct answer to an experience that everyone can relate to with common sense.
Observing tens of thousands of people for years or more to determine what diseases they develop and what doesn't is an afterthought. This is where the loopholes in obsessive evidence-driven medicine come in. This is because it is not necessary to verify every paper to find out the truth. How are you going to prove it? Why else do you need to prove it? There are axioms in mathematics that don't need to be proved. For example, "parallel lines never meet each other in space."
I think it's the same with nutritional supplements. Supplementing the lack of nutrients is more beneficial to your health than starving yourself in any form or eating a poor diet.It is not necessary to determine all the molecular biological mechanisms of these nutrients. You don't have to do it with a blood test. The change in function is not something that comes out of a blood test, but something that I feel on my own. There's no reason to prove right now that mortality rates are declining decades from now. The answer lies in the feeling of refreshment you feel after a good meal. That's why hundreds of millions of people take a daily multivitamin.
![[Multivitamin Episode 3] Beta-carotene and Vitamin E are Synthetic and Natural | Dr. Esther Yeo](http://esther-mall.com/cdn/shop/articles/52_37760c4e-6a2a-41f9-8ffa-7baf0b35459c.jpg?v=1734117670&width=480)
Comments (0)
There are no comments for this article. Be the first one to leave a message!