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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