Archive

Health Bits and Pieces
By Michael Janson, M.D.
September 15, 2005

An article in the British Medical Journal suggested that multivitamin-mineral supplements were useless for the elderly in terms of preventing infections, use of health services, or quality of life.  The authors of this study admitted that the supplements they used might be valuable in other ways not evaluated in their study, and they cited some studies on higher doses (Avenell A, et al., “Effect of multivitamin and multimineral supplements on morbidity from infections in older people” (MAVIS trial): pragmatic, randomised, double-blind, placebo-controlled trial.  BMJ. 2005 Aug 6;331(7512):324-9).

The doses of the most common multivitamin preparations are very low, and usually not in therapeutic ranges.  For example, the multi in this research contained only 2666 IU of vitamin A, 60 mg vitamin C, 5 µg vitamin D3, 10 mg of synthetic vitamin E, 1.4 mg of B1 (thiamine), 1.6 mg of B2 (riboflavin), 18 mg of B3 (nicotinamide), 6 mg of B5 (pantothenic acid), 2 mg of B6 (pyridoxine), 1 mcg of vitamin B12, 200 mcg of folic acid, 15 mg zinc, and a few other nutrients.  Such low doses are not adequate to see the full benefits of potent vitamins on the health of elderly people.

Obesity in the United States has increased again to 25 percent of the population (15 percent of children), and the figure is higher in 10 states.  About 2/3rds of Americans are overweight or obese, and the increase is related to the rise of diabetes and hypertension, as well as increased mortality and disability.  Trust for America’s Health documents this trend and makes recommendations (“F as in Fat: How Obesity Policies are Failing in America 2005.” http://healthyamericans.org/reports/obesity2005).

One reason for the rise in obesity in children is related to the fact that fast food (read junk) restaurants are clustered around schools.  School neighborhoods have 3-4 times as many fast-food outlets as other metropolitan areas.  (Austin SB, et al., “Clustering of fast-food restaurants around schools: a novel application of spatial statistics to the study of food environments.” Am J Pub Health, 2005 September; 95(9):1575-1581).  Overall, 78% of schools have a fast-food outlet within a half mile.

Anti-inflammatory drugs (NSAIDS) and low-dose aspirin can cause serious gastrointestinal bleeding and death  (Lanas A, et al., “A nationwide study of mortality associated with hospital admission due to severe gastrointestinal events and those associated with non-steroidal anti-inflammatory drug use.” Am J Gastroenterol. 2005 Aug;100(8):1685-93).  Mortality in this study was 15 per 100,000 users, with one-third of all deaths attributed to low-dose aspirin use.

While aspirin is commonly recommended for heart-disease prevention, the risks are never adequately explained to patients.  Earlier studies also documented kidney damage and gastrointestinal bleeding resulting even from very low-dose aspirin (Cryer B, Feldman M, “Effects of very low dose...aspirin therapy on...mucosal injury....” Gastroenterology 1999 Jul;117(1):17-25, and Caspi D, et al., “The effect of mini-dose aspirin on renal function...in elderly patients.” Arthritis Rheum 2000 Jan;43(1):103-8).  Aspirin does inhibit platelet aggregation, but dietary supplements offer safer alternatives.  These include grape flavonoids, ginkgo biloba, vitamins C and E, garlic, curcumin, ginger, fish oil, and many others.

Chromium is essential for fat and carbohydrate metabolism and has been associated with improved diabetic sugar control and better management of hypoglycemia.  New research in a nine-country case-control study of 1408 men shows that those subjects with the highest levels of chromium had a 40 percent reduction in the risk of a heart attack compared to men with the lowest levels (Guallar E, et al., “Low toenail chromium concentration and increased risk of nonfatal myocardial infarction.” Am J Epidemiol. 2005 Jul 15;162(2):157-64.)

A Japanese study evaluated 42,000 adults on a Western-style diet, with high amounts of red meat, poultry, cheese, white flour, and butter, a Japanese diet, high in some traditional foods, such as pickled vegetables and salted fish, and a healthy diet, high in fruits, vegetables, soy, and beans.  Colon cancer was double in both the Western diet and the Japanese traditional diet compared with the healthy diet. (Kim MK, et al., “Dietary patterns and subsequent colorectal cancer risk by subsite: a prospective cohort study.” Int J Cancer. 2005 Jul 10;115(5):790-8.)  Meat and saturated fats have often been linked to increased colon cancer risk.

Michael Janson, MD, is Past President of the American College for Advancement in Medicine. He is the author of four books, including Dr. Janson’s New Vitamin Revolution and the User’s Guide to Heart Healthy Supplements. He has a free monthly newsletter, Dr. Janson’s Healthy Living, available at his website, www.drjanson.com.  He practices in New England and Florida.