Even Low-Dose Supplementation Would Save 48,000 Lives Annually
by Robert G. Smith, PhD
(OMNS Oct 26, 2012) A major new health study published online last week found that everyday multivitamin supplements lower your risk of cancer by 8%. This important result confirms what nutritionists and medical researchers have known over the past 50 years, that supplements of essential nutrients are beneficial for health and preventing disease. This is terrific news for everyone! Cancer deaths in the US in recent years have hovered near 600,000 per year (190 per 100,000) and are increasing. If taking a daily multivitamin will prevent 8% of these deaths, then the lives of 48,000 people in the US could be saved each year, just by taking an inexpensive daily vitamin pill.
Details of the study
The study was performed on approximately 15,000 older men, half assigned randomly to take a multivitamin tablet and the other half to take a placebo. The men included in the study were medical doctors older than 50, including some older than 70, averaging about 64, and the most common cancer found was prostate cancer. Overall the risk of cancer was low, about 2% per person per year. After about 11 years, the cases of cancer in the 15,000 participants were tabulated. Those who took the multivitamin tablet were diagnosed with 89 fewer (1379 vs. 1290) cases of cancer, which represents a reduction of 8%. This result, although modest, is significant because the reduction in risk was greater than would be expected by chance. However, when tabulated according to the specific type of cancer, for example, prostate cancer, no significant reduction in risk was found, probably because the incidence of each specific type of cancer was too low for statistical significance in the experimental methods employed. But when all the cases were considered together, this allowed the study to show a reduction in the cancer risk overall.
For many decades, it has been known that an excellent diet, along with adequate doses of supplements of essential nutrients can reduce the risk of chronic age-related diseases such as cancer. This knowledge was derived by doctors studying their patients and by observational health trials.[3,4] Other life-style changes, for example, quitting smoking, reducing obesity, and getting adequate exercise, are also known to reduce the risk for cancer and other chronic diseases. Thus, the new study doesn't add much to our existing knowledge. The participants in this study, being doctors, were in good health and most of them exercised regularly, ate generous amounts of fruits and vegetables, and did not smoke. So the results of the study, strictly speaking, are only applicable to a healthy population. However, it is likely that daily supplements of essential nutrients such as vitamins and minerals will help reduce the risk of age-related diseases such as cancer for everyone regardless of their health status and lifestyle. One confirmation of this was that the study showed a daily multivitamin tablet also reduced the risk of cancer for participants who previously had cancer.
Flaws in previous trials
To put this new result in perspective, it is important to note that, over the last two decades, dozens of random-controlled health trials of individual supplements have been performed in which no positive health benefit was reported. In many cases, this likely occurred because the doses were inadequate, the wrong forms of vitamins and minerals were used, the duration of the trials was not long enough, or the disease under diagnosis was inappropriate for the specific nutrient being tested. These problems are known to nutritionists, which suggests that these trials were designed to fail. Moreover, it is known that supplementing with just one individual nutrient is less effective for many health conditions than a multivitamin. For example, a B-complex vitamin tablet is often more effective in promoting health than a tablet containing only one of the B vitamins because their effect is synergistic, that is, the body's biochemical pathways require all the B vitamins to function normally. Further, antioxidants such as vitamins C and E are synergistic and are more effective taken together in adequate doses (C: 3,000 - 6,000 mg/day in divided doses; E: mixed tocopherols and tocotrienols, 400-1200 IU/day ). Although one must laud the study for choosing to test a daily multivitamin tablet, it has missed a golden opportunity, because the doses of essential nutrients were far too low.
The multivitamin is the most popular dietary supplement. 56% of American adult women and 48% of American adult men take multivitamins.  72% of physicians personally use dietary supplements. The multivitamin is the most popular dietary supplement taken by doctors. 
The multivitamin tablet used in the study contained doses of low-quality vitamins and minerals, some in an inaccessible form, such as magnesium oxide. The doses were similar to the recommended daily amounts published by the Institute of Medicine.  Such low doses, because they represent only an average minimum dose for health, should not be taken as the most appropriate dose for anyone. The study didn't test higher doses, and could not determine optimal doses for anyone's particular needs. The participants in the study were arguably one of the most healthy segments of the population because they were medical doctors. But most of us don't have such healthy lifestyles. Many, perhaps most, of us require much higher levels of essential nutrients because of poor diet, stressful lifestyle, and differences in their genetic background.[6-8] So for many people, the much higher doses of supplements recommended by orthomolecular medicine are an inexpensive and very effective way to reduce the risk of cancer and other age-related conditions such as diabetes, eye disease, and heart disease. [3,4,8]
Most vitamin and mineral supplements when taken at appropriate doses are extremely safe. Many nutritionists recommend doses of vitamins B1, B2, B5, and B6 in the range of 50 to 100 mg/day, vitamin B3 (niacin) in the range 200-1000 mg/day in divided doses, vitamin C in the range of 3,000-6,000 mg/day in divided doses, vitamin D in the range of 1500-2000 IU/day or up to 5000-10,000 IU/day for large or obese adults, and vitamin E in the range of 400-1200 IU.[3,10,11] Most of us have a deficiency in magnesium, which has been implicated in an elevated risk for cancer, and a dose of 200-500 mg/day of magnesium or more, taken in the proper form to recover from deficiency, will help to prevent cancer. You may benefit by discussing these very safe but much higher doses with your doctor. Higher supplemental doses of vitamins and minerals, along with an excellent diet, do the best job helping the body to fight cancer and other chronic diseases. [3,4,11-14]
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2. National Cancer Institute. http://www.cancer.gov/newscenter/newsfromnci/2012/ReportNationRelease2012
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14. McCann JC, Ames BN. (2011) Adaptive dysfunction of selenoproteins from the perspective of the triage theory: why modest selenium deficiency may increase risk of diseases of aging. FASEB J. 25:1793-814.
15. Council for Responsible Nutrition. (2012). CRN Consumer Survey on Dietary Supplements. Retrieved October 4, 2012, from http://crnusa.org/CRNPR12-ConsumerSurvey100412.html
16 Dickinson A, Boyon N, Shao A. Physicians and nurses use and recommend dietary supplements: report of a survey. Nutrition Journal 2009, 8:29 doi:10.1186/1475-2891-8-29