Confused about multivitamins

Here's the link

 http://www.mskcc.org/mskcc/html/77115.cfm

Here's an article posted by BlindedByScience on the alternative board about folic acid.

Who knows what to think anymore!?

<call me DISGUSTED!>

http://www.sciencedaily.com/releases/2007/07/070710064813.htm

Risks And Benefits Of Folic Acid Fortification Considered

Science Daily - Since the institution of nationwide folic acid fortification of enriched grains in the mid 1990s, the number of infants born in the United States and Canada with neural tube defects has declined by 20 percent to 50 percent. Concurrent with the institution of fortification, however, the rate at which new cases of colorectal cancer were diagnosed in men and women increased, report researchers at the Jean Mayer USDA Human Nutrition Research Center on Aging (USDA HNRCA) at Tufts University.<!-- Originally posted on ScienceDaily 2007-07-13 -->

  

Joel Mason, MD, director of the USDA HNRCA's Vitamins and Carcinogenesis Laboratory, and colleagues analyze the temporal association between folic acid fortification and the rise in colorectal cancer rates, and present their resulting hypothesis in an article in the July issue of Cancer Epidemiology Biomarkers & Prevention.

"Nationwide fortification of enriched grains is generally considered one of the greatest advances in public health policy," says Mason, who is also an associate professor at the Friedman School of Nutrition Science and Policy at Tufts. "But since the time that the food supply in North America was fortified with folic acid, we have been experiencing four to six additional cases of colorectal cancer for every 100,000 individuals each year compared to the trends that existed before fortification.

"Our analysis suggests that this increase is not explained by chance or by increased cancer screening. Therefore, it is important to analyze risks and benefits of fortification, and encourage scientific debate in countries that are considering instituting or enhancing folic acid fortification."

Mason and colleagues analyzed data from national cancer registries, one in the United States and another in Canada. The US data were derived from the nationwide Surveillance Epidemiology and End Results (SEER) registry that publishes cancer occurrence rates and survival data, covering approximately 26 percent of the population. The Canadian data were obtained from Canadian Cancer Statistics, an annual publication by the Canadian Cancer Society and the National Cancer Institute of Canada.

In 1996 and 1998, there were abrupt reversals in the 15-year downward trends in colorectal cancer rates in the United States and Canada, respectively. Since peaking in 1998 in the United States and in 2000 in Canada, the rates have not returned to their earlier levels. Although folic acid fortification of enriched grains -- including bread, cereal, flour, rice, and pasta -- did not become mandatory until 1998, large food companies began voluntary fortification in 1996, first in the United States and later in Canada.

Folic acid is the synthetic form of folate, a B vitamin that is essential for cell growth. After intestinal absorption, folic acid is converted to methyltetrahydrofolate, found naturally in foods such as leafy green vegetables, legumes and citrus fruits. "The body's response to folic acid appears to be complex," says Mason. "While fortification of the food supply is clearly beneficial for women of child-bearing age and their offspring, it is possible that it may, coincidentally, be linked to the increase in colorectal cancer rates. Our report is intended to create a foundation upon which to further explore that possibility."

As Mason and colleagues note, there is a compelling body of scientific evidence suggesting that habitually high intakes of dietary folate are protective against colorectal cancer. Mason explains, however, that "There are several reasons why we may have inadvertently created the opposite effect with folic acid fortification. First, folate's pivotal role in DNA synthesis also makes it a potential growth factor for cancerous or pre-cancerous cells, and when administered in large quantities to individuals who unknowingly harbor cancer cells, it could paradoxically enhance cancer development.

The addition of substantial quantities of folic acid into the foodstream may have facilitated the transformation of benign growths into cancers, or small cancers into larger ones," he says. "Second, the fact that a synthetic form of folate is used for fortification may be important," suggests Mason. "As the total amount of folic acid ingested increases, the mechanism that converts folic acid to methyltetrahydrofolate can become saturated. The leftover folic acid in the circulation might have detrimental effects, as it is not a natural form of the vitamin."

At a time when many countries are debating whether or not to institute or enhance folic acid fortification, Mason and colleagues urge caution and debate. "We must examine the effects of folic acid fortification on the population as a whole, which includes better defining the nature of the relationship between folic acid fortification and colorectal cancer," says Mason. "Improved monitoring and further research in this field is important to our understanding of the long-term public health effects of fortification."

Reference: Mason JB, Dickstein A, Jacques PF, Haggarty P, Selhub J, Dallal G, Rosenberg IH. Cancer Epidemiology Biomarkers & Prevention. 2007 (July); 16(7):1-5. "A Temporal Association between Folic Acid Fortification and a Rise in Colorectal Cancer Rates May be Illuminating Important Biological Principles: a Hypothesis."

MOTC--I was ready to start adding Folate based on what you've said.  I've had gastrointestinal problems all along and already had a pre-cancerous polyp removed during a colonoscopy,  but after reading that I'm leary.  Maybe someone will have more info in December (is it December) at the San Antonio Conference. 

Shirley---I'm with you about the cooking.  My world now is all about adapting to new realities.  No, I don't brush off every mushroom and if they are not cleaned and sliced I don't buy them.  And I'll use the convenience of organic frozen veggies.  I don't have the stamina to cook like I used to or even juice which which entailed alot of prep and clean up.  So, I know I'm going to be deficient in some areas.  So, till now popping a vitamin seemed a viable alternative.

The realization is that we are not normal.  Our bodies have proved that they know how to make Cancer so, the question of potentially fueling it becomes a very real one.  That's what makes Dr. Nortons statement so very scary. 

If I'd had a colonoscopy recently I probably would take it too.  But my last one was over a year and a half ago.  What dosage are you taking of Folic Acid?

I think the further we get out from our initial diagnosis & treatment, the more we consider & re-consider what is worthwhile to take as a supplement.....When first diagnosed, maybe we drank the green tea, gave up meat & alcohol, had green salads twice a day, cooked with whole grains, shunned sugar, and spent huge amounts of time cooking from scratch. Or maybe we took big doses of supplements because we were too tired for all of that. Some did both.

I keep reading and reconsidering what I take & why. Vitamin D continues to be one I consider extremely important. I also take CoQ10, alpha lipoic acid and/or milk thistle, fish oil, CLA, curcumin, quercetin, mushroom extracts, magnesium, resveratrol, and a few others. Still lots of pills.

For those who are worried about colon polyps, you might want to hang on to curcumin. A dose of 1440 mg a day (with quercetin) was shown to have a significant impact on the number and size of colon polyps in people who have a genetic predisposition to grow hundreds of them. No way to remove them all--these people have their colons removed to save them from colon cancer. An interview with one of the researchers is here:

Curry And Onions May Prevent Colon Cancer

Curcumin has been discussed in terms of bc in that it can help prevent metastases to the lungs (MD Anderson study in mice), but I also found that about 3 g a day keeps my blood pressure low. It acts as a blood-thinner, which is important for preventing strokes, and has strong anti-inflammatory actions without the side effects of aspirin or ibuprofen. So I continue to include this supplement in my daily pile-o-pills.

Shirley--Here is the deal about Selenium
The Nutritional Prevention of Cancer Study (NPC) was a trial designed to see if 200mcg of selenium could lower the risk of squamous and basal cell carcinoma in 1,312 people.  It did not work in fact, there was a "slight increase in squamouse cell skin cancers with selenium" said James Marshall from the Roswell Park Cancer Center.
The original study found Selenium protected against prostate, colon and lung.

So, the researchers went back to see if the selenium takers in the NPC study had a lower risk of other illnesses.

"There was a belief that as an antioxident, selenium could protect against heart disease, but the data was absulutely flat. We found no protection"  there was also a theory that oxidive stress could increase the risk of diabetes.  But, they found something completely different. 
After eight years, more selenium takers (10%) than the placebo takers (6.5%) had been diagnosed with Diabetes.
 "I wouldn't say that the findings raise alarms said Marshall. "But they're another cautionary tale that it's not a good idea to take high doses of nutrients."

In addition to that there was another study of 9000 people that showed that Diabetes was more common among those with higher blood selenium levels.

In 2012 the results of the Select trial will be in which is testing whether selenium 200mcg and/or vit E 400 IU
can lower the incidence of prostate cancer in 35,000 men.  Its incouraging that it is still underway because studies are halted if they are doing harm.

 It will take more evidence to know if Selenium promotes diabetes.  Marshall says "it could be a fluke."

Calico, I take curcumin from various sources but currently it's the NOW brand at 665 mg per capsule. It doesn't have quercetin in it--I take that separately. The quercetin also comes from NOW and contains some bromelain.

I skip the curcumin with bioperine (some suppliers are Life Extension & Doctor's Best) because it's easy to get too much bioperine at the dose I take and it can cause stomach upset. Bioperine is derived from black pepper and enhances the bioavailability of some of these supplements so more gets in the blood. The claim is that one can take smaller doses if bioperine increases the absorption. 

I had read in different sources about multivitamins feeding cancer cells, so I have not taken a multi since. I take vitamin d, and vitamin c. I was taking other pills but stopped when my kidneys started hurting. I do think that multivitamins might have extra vitamins that we don't need. Also, which vitamins we take might make a difference. Many of those studies are done in a way, that we don't know which vitamin does what. Confusing....

This was posted by Susie today.  I found it interesting.  

http://community.breastcancer.org/topic/79/conversation/694623?page=1#idx_1  

7 hours ago Edited 7 hours ago by saluki

After becoming thoroughly confuse by Dr. Norton's comment about not taking a multivitamin--what should arrive in my mailbox?

I just recieved my copy of Nutrition Action from the Center for Science in the Public Interest.

You know--the people that called Fettucini Alfredo---A Heart Attack on a Plate.----
Well Guess what their new issue is about---You guessed it----Cover story is Confused about Vitamins-Too Little or Too Much- focusing on  Folic , Selenium, and Vitamin D

From what I've gleaned it says if you take a multi with 400 mcg of folic acid---don't eat any cereal,
energy bar or other food that contains 400mcg in the serving you eat.

Joel Mason, director of vitamins and Carcinogenisis Laboratory at the Jean Mayer USDA Human Nutrition Research Center of Aging at Tufts University in Boston says--Colorectal Cancers rose soon after companies started adding folic acid to foods but that still has yet to be proved.

Seems that they have compelling data that getting adequatefolic acid protects against certain cancers but an abundant quantity may accelerate carcinogenisis.

Here is the deal--The Ovarian Cancer Screening trial found a 19% higher risk of BC in postmenopausal women
who were taking at least 400mcg from supplements.

But, in Sweden another study showed a lower risk of BC in women who took the most Folic Acid 380 to 400mcg a day.
But here is the big difference why this is misleading.
Flour is not fortified in Sweden where they are getting much less folic acid. 
So getting more is still much less than we get from our diets!

The thought is that "maybe folic acid only enhances the groth of tumors when you exceed the threshold."

This has left experts unsure of the wisdom of adding folic acid to flour, "especially when some advocates of reducing birth defects want it raised" when colorectal, prostate and breast cancer increase as we age.
We could be harboring precancerous lesions and folic acid may fuel their growth.

And since we are getting all this additional involuntary folic acid we may be benefiting some and harming others.

Also, the article talked about the follow-up of a three year trial that had given a placebo or 1000mcg of folic acid to 1000 people who already had a precancerous polyp (adenoma) removed from their colon or rectum.
"we saw an increased risk of advanced adenomas in people who got folic acid," says co-author John Baron,
a professor of medicine at Dartmouth School of medicine.  And more Folic Acid Takers (10%)than placebo (4%) had at least 3 new adenomas and more folic acid takers (11%) than placebo (6%) were diagnosed with cancer outside the colon or rectum.

This whole thing is making me crazy.

I have read Dr. Andrew Weil's book and he states that a multi vitamin with beta-carotene in the form of Vitamin A can actually INCREASE cancer risks in some people.

Who should we believe?

Valerie