Please Pass the Vitamins - Balancing Food & Supplements

For some reason, most nutrition professionals one encounters in medical offices or as spokespeople for organizations like the American Dietetic Association shrink from prescribing vitamin supplements. "You can get all the nutrients you need from a balanced diet" is the common mantra. Conversely, almost every book or article one reads in the popular media always advocates the use of supplements on the "take a pill for whatever ails you" theory.

Where does the truth lie?

Balanced diet proponents do have a valid point. Nutrients are most effective in their natural state. Important nutrients are far more numerous than A through E. For instance, vegetables contain hundreds of antioxidant compounds, most of which have yet to be distilled into a pill. When a study indicates that tomatoes prevent cancer, they're talking about that complex entity, the tomato, not a couple chemicals that could be extracted from it. These nutrients operate in concert, at a delicate balance. When we take the nutrients in pill form, we run the risk of throwing off that balance. For instance, too much copper can cause a zinc deficiency. Relying on supplements to meet your nutritional needs can give you the false illusion that you are eating an optimal diet, when in reality we don't know enough about what an optimal diet is to precisely define it.

On the other hand, the hard truth is that most Americans don't eat a balanced diet. Their diets tend to be lowest in fresh fruits and vegetables and whole grains, the very foods that are such a complex treasure trove of nutrients. Modern phenomena such as environmental pollution and substance abuse (tobacco, alcohol, and yes, prescription medicines) create stresses that the human body was not engineered to face. Our need for some nutrients spurts up during certain periods of life, such as adolescence, pregnancy, and old age. Many diseases increase the need for nutrients.

This month I will concentrate on the two nutrients where I feel supplementation is the most important - vitamin C (ascorbic acid) and vitamin E.

Vitamin C is essential for life, with numerous functions throughout the body. Vitamin C helps form and maintain collagen, the connective tissue found in skin, ligaments, cartilage, vertebral discs, joint linings, capillary walls, the bones and teeth. It also aids the metabolism of tyrosine, folic acid, and tryptophan, all of which play an important role in nervous system and adrenal gland function, affecting our moods and our reaction to stress. Ascorbic acid aids in thyroid hormone production and the body's elimination of cholesterol. One of vitamin C's most critical functions is that of an antioxidant: it helps prevent oxidation of molecules into free radicals, which can cause cellular injury and disease. This antioxidant function protects other vitamins, reduces the side effects of drugs such as cortisone and aspirin, and may reduce the toxicity of the heavy metals, lead, mercury, and arsenic. Vitamin C appears to strengthen the immune system, aiding in the prevention and treatment of infectious diseases, (such as colds and flu) cancer, and autoimmune disorders such as lupus and arthritis.

Vitamin C is found naturally in citrus fruits, potatoes, peppers, tomatoes and dark leafy greens. The RDA for vitamin C is 60 mg, and it's easy to meet and exceed this minimal requirement through food alone. However, keep in mind that the RDA is defined as a minimal level that prevents deficiency. Optimal levels for vitamin C are probably far higher. Toxicity for supplemental vitamin C is very low. Since vitamin C is a water-soluble compound, the body is incapable of storing it and excretes any excess in the urine. Extremely high doses (over 10 grams) sometimes cause diarrhea.

With potential benefit so high and potential negatives so low, why not hedge your bets and take a supplement? I recommend 1000mg/day. Smokers, people taking birth control pills, estrogen, cortisone, or aspirin, and anybody under unusual mental or environmental stress should take more, at least 2000 mg/day. Ideally, since vitamin C is excreted so rapidly, it's best to spread out this amount over the course of the day or take it in time-release form.

Vitamin E's most significant role is as a powerful antioxidant. Research indicates that vitamin E may help prevent heart disease in a very basic way, by preventing the cellular changes in blood vessels that encourage cholesterol to adhere to them. Logic also indicates that vitamin E's antioxidant function would help prevent cancer. So far studies in this regard have been promising, but inconclusive. Some of the most exciting research points to vitamin E's role in preventing or delaying cataracts, growths on the lens of the eye that cloud vision. Vitamin E has been shown to slow eye and kidney damage in childhood diabetics.

Like vitamin C, the need for vitamin E increases in the presence of environmental stressors like pollution and cigarette smoke. And like vitamin C, many people's diets in this less than ideal world are sub-optimal. Since vegetable oils are a primary source of vitamin E, people on low fat diets may not get enough to meet their needs. Vitamin E is a fat-soluble vitamin and therefore stored in the body. Nevertheless, toxicity is nonexistent at levels up to 800 IU/day (35 times the RDA). Since vitamin E has an anticoagulant function, intake levels above 1500 IU/day may cause bleeding problems.

Again, with potential benefits so high and potential risk so low, wouldn't you rather be safe than sorry? I recommend a supplement of 200 IU/day for most people, up to 800 IU for those with special needs, like childhood diabetes or cataracts.