Wednesday, January 3, 2018

Why We use Whole Food Nutritional Supplements

The vast majority of nutritional supplements available are synthetically made.  Only a small number of companies offer supplements made primarily from whole foods in spite of several advantages associated with them.  I thought it would be appropriate to discuss the differences and particularly how these differences translate into different health outcomes.

First, it may be surprising to many that most supplements are synthetic.  This practice actually originated several decades ago from concerns about whole food sourced nutrients, concerns that we now know were unfounded.  These concerns centered around the idea that plant nutrient content can vary according to the conditions the plants are grown in.  With reasonable varying growth conditions, plant nutrient levels remain within a reasonable range.

To eliminate this varying but reasonable nutrient range, the idea of making nutrients synthetically emerged.  Unfortunately, it generates far greater variability in nutrient content and health impact than what it was supposedly trying to avoid.  The variations from whole food nutrient content that synthetic supplements create include:
  •  They are incomplete micronutrients.
  • They are devoid of the phytonutrients that always appear with micronutrients in whole food.

Incomplete micronutrients

There are 28 essential micronutrients such as vitamins and minerals.  This means that humans cannot make them from other food substances and that they must be obtained directly from food.  However, different micronutrients are “complexes” containing multiple parts.  Vitamin E is an example containing 8 tocopherols.

Unfortunately the FDA decided since the biggest piece of this 8 piece complex was alpha tocopherol that for the purpose of making a supplement, only alpha tocopherol could be included and yet it could be called “vitamin E”.  A tipoff that a supplement is a synthetic is that there will be a second term in the name which describes the synthetic form such as “d-alpha tocopherol succinate”.  This is 1 piece of the 8-piece complex made synthetically.

The collective group of tocopherols generate the health effects.  For example, different tocopherols in the group have different antioxidant properties and different abilities to suppress HMG CoA reductase, the enzyme that increases cholesterol production in the liver.  The best balance of these effects appears to come from the whole complex of tocopherols.

Devoid of phytonutrients

Vitamins and minerals do not appear in nature by themselves but rather they always appear in complexes with several phytonutrients.  For example, ascorbic acid which is part of vitamin C complex always appears with the phytonutrients called phenolic compounds such as flavonoids.  Much of the benefit attributed to vitamin C is now thought to come from these phenolics.

The FDA has allowed synthetic ascorbic acid to now be called “vitamin C” even though it is devoid of this group of phenolics that always appear with it in whole food.  While there are 28 essential micronutrients in whole food, there are about 16,000 known phytonutrients all which impart health benefits.

Several of the large studies on the impact of nutritional supplements have suggested that they provide no significant health benefits.  Most notable were 2 different arms of the Physicians Health Study which look at many health outcomes related to several lifestyle factors.  The studies used 400 IUs of synthetic alpha-tocopherol and 500 mgs synthetic ascorbic acid over a 10-year period. The conclusions of these two studies were:

“In this large, long-term trial of male physicians, neither vitamin E nor vitamin C supplementation reduced the risk of major cardiovascular events.”

“In this large, long-term trial of male physicians, neither vitamin E nor C supplementation reduced the risk of prostate or total cancer.”

These results are in contrast to many studies that look at obtaining these nutrients in greater amounts from whole food diets which have shown consistent improved health outcomes, outcomes which have been attributed to their nutrient content.

So, what generated the stark difference in the clinical trials that have looked at the benefits of nutrients in disease prevention and treatment?  It appears to be the difference in the effects between whole food complexes and isolated synthetic nutrients.  Whole food supplements are natural, complete nutrient complexes with superior health benefits. 

Sesso et al.  Vitamins E and C in the prevention of cardiovascular disease in men: the Physicians' Health Study II randomized controlled trial.  JAMA, 2008;300(18):2123-33.

Gaziano et al.  Vitamins E and C in the prevention of prostate and total cancer in men: the Physicians' Health Study II randomized controlled trial.  JAMA, 2009;301(1):52-62

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