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5 lessons from the JAMA multivitamins and cancer study

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Multivitamins cut cancer risk, according to a new study in JAMA. Here are five takeaways that the mainstream press didn't tell you. 

The big news this week was a study published in the Journal of the American Medical Association (JAMA) showing that multivitamin use cut men’s cancer risk by 8 percent. Good news, right? Here’s what you may not have heard about it.

1. JAMA is not wholly biased against supplements

Surprised? Funded entirely by pharma ads, and read by mainstream allopathic physicians who have received less nutritional education than you or I, the Journal of the American Medical Association is not known for embracing natural medicines like vitamins. In fact, back in 1998 editor-in-chief George Lundberg devoted an entire issue to the subject of natural medicine— everything from botanicals to acupuncture. Soon thereafter, he was shown the door. The impact of this study on Americans’ health cannot be overstated—if only 1 percent of U.S. doctors read the study and now recommend supplements to their patients, imagine the health-care savings. And multivitamins are merely the gateway vitamin. Patients will likely follow with fish oil and vitamin D.

2. What's in the pill?

This was a low-quality supplement at work here. It was the Centrum Silver brand. Now, on the one hand, Centrum Silver is good quality because what’s on the label is what’s in the pill. “Centrum Silver has been tested many times by ConsumerLab.com and passed each time,” said ConsumerLab.com president Todd Cooperman. “The formula in Centrum Silver has been recommended by ConsumerLab.com due to its conservative levels of vitamins and minerals—intended to help seniors meet daily nutrient requirements but not exceed tolerable intake levels which raise toxicity risks.”

Cooperman pointed out that their testing firm has assayed four other vitamins—all with the identical vitamin/mineral formula as Centrum Silver—and all passed. “This is impressive, considering that 34 percent of the multivitamins selected for testing in this review failed to meet quality criteria for their contents, labeling, and/or ability to properly break apart in solution. However, the other Centrum Silver-like products all cost significantly less than Centrum Silver—only 3 or 4 cents per day compared to 11 cents for Centrum Silver.”

The other, less-expensive products include the Kirkland brand available at Costco, the DG Health brand at Dollar General, the Sam’s Club brand, and the Equate brand at Walmart.

Here’s the thing, which I’m guessing I don’t even have to tell you. These supplements may well be rated high quality, but it’s only by virtue of passing basic testing protocols—again, what they list on the label is what is found in the pills. This is pretty fundamental stuff, and any supplements company that fails this low bar really ought to be shamed out of business, or at least have their QA/QC director replaced.

But the real story is what type and amount of individual nutrients are on offer in these multivitamins. In Centrum Silver, for example, it uses 50 IU vitamin E, which is about 15 percent the 400 IU recommended to show cardio benefits. Worse, the form of vitamin E used is the synthetic dl-alpha-tocopherol. Synthetic alpha-tocopherol works only about half as well as natural d-alpha-tocopherol. What would happen if you formulated with the full spectrum of all four tocopherols as well as all four tocotrienols?

In addition, Centrum Silver uses 60 mg vitamin C, which is 100 percent the Daily Value. If Linus Pauling were still alive today, he’d tell you to take 500 mg vitamin C every three or four hours. Pop ‘em like candy! That way you get a steady state of vitamin C circulating in your blood. And the range of health conditions you might be able to prevent go far beyond cancer.

Centrum Silver also contains 200 mg calcium, which is 20 percent the Daily Value; this is mostly due to calcium being a bulky nutrient.

It also uses 55 mcg selenium, which is about one-quarter the amount shown to prevent prostate cancer, so it’s no wonder there was “no effect of a multivitamin on prostate cancer,” according to the JAMA study. In addition, as with vitamin E, form matters. High-selenium yeast trumps selenomethionine—studies with the latter routinely find no results, which is why selenium is not universally recognized as a prostate cancer preventive.

To Centrum’s credit, their formulation over the years has changed with the state of nutrition science. When this study began, lutein and lycopene—important carotenoids that may be beneficial for vision health and prostate cancer—were not part of the Centrum formulation. This study used the same formulation throughout, so who’s to say the evolved Centrum formula wouldn’t have some effect on prostate cancer that the old formula did not?

3. Cancer history matters

Digging deeper into the study, researchers found that subjects who had no parental history of cancer had a more significantly beneficial effect of taking the multivitamin, whereas those with a family history of cancer experienced no benefit at all. Interestingly, men with a history of cancer in themselves and not their parents had a significantly greater effect with the multivitamin than those without. Conclusion: If your parents did not have cancer, but you did, you will benefit most from a multivitamin. Go figure.

4. Duration matters

Multivitamin use is more beneficial the longer you take them.  As the researchers noted, “increasing duration of multivitamin use was strongly associated with a reduced risk of colon cancer in 88,756 participants in the Nurses’ Health Study followed up for 15 years.”

5. Study results are better than meets the eye

The effect of multivitamins are probably greater than these study results suggest. That’s because the subjects in this study—male physicians—are likely experiencing a better overall diet than the population at large. As the researchers noted, “Participants … represent on average a well-nourished population for whom the effect of a daily multivitamin on cancer outcomes may be less applicable to those of poorer nutritional status.” (Read: rest of the population.)

What is your favorite brand of multivitamin and why? Is it better than a Centrum Silver? Your comments below, please.

Discuss this Blog Entry 5

Jen Kellin (not verified)
on Oct 18, 2012

Very interesting Todd, thank you for sharing! I find it interesting and, quite frankly, frustrating that JAMA published this study using methods that aren't really transparent. However, as a product developer in nutraceuticals, I am at least glad to see the overall message that multivitamins are good for your health. Not only for the obvious business purposes but really because Americans are so overfed and malnourished. 99% of our population very likely should be taking a complete multivitamin. Has anyone looked into the bioavailability of multivitamins on the market today? Honestly, look into effervescent forms of vitamins. The absorption is proven to far exceed pill forms. I think that is a component of vitamins and minerasl that is overlooked. If you are taking vitamins daily or even on occasion, it seems that consumers would be very interested to know really how much their body's can even absorb.

Anonymous (not verified)
on Oct 19, 2012

Almost any brand is better than Centrum. It has too little in the way of nutrients and worse yet, there are too many "other ingredients" to get in the way of absorbing those ingredients. Go to your local health food store for many choices that are far superior to Centrum, which could very well be the worst supplement in America.

Rebecca Goodyear (not verified)
on Oct 20, 2012

I love the Terranova Synergistic Nutrition Living Multinutrient. The whole concept behind the range is amazing!

Anonymous (not verified)
on Oct 21, 2012

I like a whole foods organic multi. I believe it's more bioavailable. The one I take is New Chapter's Every Woman's One Dialy. . . assuming women will benefit as well from a mulit-vitamin!

Chris Turner (not verified)
on Oct 31, 2012

This particular research appears to be mainly an endorsement (advertisement) for Pfizer's Centrum. After all, Pfizer supplied all the vitamins for free, a large chemical firm co-sponsored the study, and at least one study author received funding from numerous pharmaceutical companies.

The overall insinuation is for the public to stick to "safe", RDA-level types of supplements, such as Centrum's, to get a minor but significant benefit. Allegedly, any supplement providing nutrients above RDAs is presumed to be unsafe and ineffective. However, it is those much higher doses than the RDAs that confer the most benefits. Yet high-dose supplements compete with Pfizer's and all other drug companies' main aim: to make money from chronic diseases with pharmaceutical medications.

The majority of accounts discrediting the safety and effectiveness of vitamins at high doses are nothing more than propaganda and scaremongering over vitamins (see supplements-and-health.com/vitamin-side-effects.html ), for political reasons.

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