A Historical Comparison of Natural versus Synthetic Supplements
Leon Isaac Drucker PhD
How nutrients affect the body is increasingly gaining attention, even with mainstream medical researchers. The use of vitamin supplements by the U.S. population has been a growing trend since the 1970s. In 1994, accumulated national surveys had indicated that 40 to 46 percent of Americans reported taking at least one vitamin or mineral supplement at some time within the month surveyed (National Center for Complementary and Alternative Medicine, 2004). This trend has been steadily increasing, and should continue to climb due to continued research and consumer demand. Vitamins have also gained popularity, since the growth of processed foods.
There are several forms of vitamins. This paper will divide them into two segments, synthetic vitamins and whole food vitamins. In an attempt to understand the differences between natural and synthetic vitamins, this paper summarizes numerous peer-reviewed articles describing the physiochemical differences. In addition, man references on nutrition were similarly studied in order to distinguish between isolated or manufactured chemical nutrients, versus whole-natural-biochemical food complexes. Furthermore, numerous published studies were similarly scanned for reference of proven clinical advantages, if any, of natural vitamins.
This paper demonstrates that synthetic vitamins many times fail in scientific trials that look at reducing the risk of chronic disease, while it is consistently found that people consuming high levels of fresh fruits, vegetables, whole grains and nuts have lowered risks for cardiovascular disease, cancer, respiratory disorders, and other chronic health problems. Taking massive amounts of synthetic vitamins not only fail to prevent chronic diseases, but may also be harmful. In addition, this paper concludes that rather than rely on isolated vitamins, individuals should use nutrient-dense, whole-food supplements, which supply a plethora of factors including vitamins, minerals, phytochemicals, and phospholipids. This paper further demonstrates that modern science supports the view that natural vitamins are nutritionally superior to synthetic ones.
TABLE OF CONTENTS
Chapter 1 Introduction 1
Statement of the Issue 1
Research Questions 8
Significance of the Study 11
Definition of Terms 15
Chapter 2 review of Related Literature and Research 22
Natural Supplements Have More Advantages Than
Synthetic Counterparts 22
Comparative Bioavailability to Humans of Ascorbic Acid Alone
or in a Citrus Extract 22
Fruit and Vegetable Intake and Risk of Major Chronic Disease 24
The Effect of Fruit and Vegetable Intake on Risk for Coronary
Heart Disease 25
Fruit and Vegetable Intak in Relation to Risk of Ischemic Stroke 26
In Vitro and In Vivo Lipoprotein Antioxidant Effect of a Citrus Extract and
Ascorbic Acid on Normal and Hypercholesterolemic Human Subjects 26
Vitamin Supplementation and Breast Cancer 27
Natural and Synthetic Comparisons of Vitamin E 27
Scavenging Capabilities of Various Fruit and Vegetable Juices
Against Free Radicals 28
Disruption of the Vegetable Matrix to Enhance the Bioavailability of
The Effect of Vegetable Consumption on Selected
Biomarkers of Chronic Diseases 30
The Bioavailability of Carotenoids from Spinach and Tomatoes 30
Organic Selenium Causes Higher Selenium Deposition than did the
Inorganic Form in Lactating Women 31
Chapter 3 Design of Study 32
Methodology Data Collection and Analysis 32
Scope and Limitations 34
Chapter 4 Results and Findings 36
Analysis of Data 37
Chapter 5 Conclusions, Implications, and
Recommendations for Further Research 44
Conclusions and Implications 44
Recommendations for Further Research 47
Appendix A Depletions and Interactions by Vitamin 57
Appendix B Classification of Vitamins 61
Appendix C Graphic Depiction of the Contrasting Vitamins
And their Pathways 67
Statement of the Issue
There are many types of nutritional supplements available. Some supplements contain standardized isolated or synthetic vitamins, minerals, or other chemical nutrients, along with fillers and other additives. Other food supplements are produced by adding isolated chemical nutrients to a liquid broth containing yeast, and then processed into tablets along with herbs, dried food binders, and other common manufacturing substances. There are also some products that actually use real foods and whole herbs to produce tablets, capsules, or powders. These products tend to be rich in symbiotic, whole food complexes; however, according to the label, the product appears low in potency.
How nutrients affect the body is increasingly gaining attention, even with mainstream medical researchers. Data that defines particular properties of individual nutrients has been accumulating. When a particular compound is isolated, it is not always clear that it is the most physiologically important ingredient.
Foods are complex, interacting mixtures of compounds containing many more physiologically active nutrients, phytochemicals, and other known and unknown components, than the active ingredients that can be separated and studied in the laboratory. Since researchers do not fully understand how the body uses individual chemicals, it is questionable whether purified components are of more benefit than the
whole food. Not all supplements are created equal. Supplements may differ in quality or their ability to provide desired bioactivity.
Man has evolved over millions of years to be able to take the nutrients from food as nourishment, in order to grow, maintain, and repair the body. Only recently, over the last 50 years, has it been considered to replace food with chemicals. Many Americans do not understand the difference between a vitamin that comes in the form of food and a United States Pharmacopoeia (USP) vitamin, which one may take in the form of an over-the-counter multivitamin. The addition of the USP vitamins, to many of the processed foods consumed, can lead to a false sense of adequate nutrition derived from these foods. Americans may assume that USP vitamins are replacing the nutrients missing in a diet, even though a typical multivitamin contains only a fraction of the components found in food.
The definition of what a vitamin is and where it comes from has changed over the last century. Vitamins were once only available in its natural state which was from food. Now vitamins can be and are produced synthetically in a laboratory.
(Thiel 2000) defines the vitamin as an:
organic substances that are essential in small amounts for the health, growth, reproduction, and maintenance of one or more animal species, which must be included in the diet since they cannot be synthesized at all or in sufficient quantity in the body. Each vitamin performs a specific function, hence one cannot replace another. Vitamins primarily originate in plant tissues (p. 1).
In contrast, USP synthetic vitamin isolates are not naturally included in the
diet, they do not necessarily originate primarily in plant tissues, nor have all of them
been proven to safely and fully replace all natural vitamin activities (US Pharmacopeia
Most vitamins found in processed foods are USP vitamins. These USP vitamins need to be added into foods due to the depletion of natural vitamins by our processing activities, including irradiation, bleaching, and homogenization. USP vitamins are not food, even though they are often called natural and are sometimes added to foods. (US Pharmacopeia Convention, 1986) In nature, vitamins are never isolated: they are always present in the form of food vitamin-complexes (Thiel 2000). For example, if an individual ingested a supplement containing a USP vitamin, such as vitamin E, with just DL-alpha tocopheryl, the individual would be missing at least five other important nutrients, as well as hundreds of other nutrients that occur within the whole vitamin E complex. The intact nutrients are only available by consuming natural, whole food forms of vitamin E, such as wheat germ oil, pea vine, green leafy vegetables, nuts, and sunflower seeds.
Bioavailability is multifaceted. There are numerous known and unknown influences that enable the body to breakdown and absorb vitamins. If scientist can not understand and recognize the cofactors involved in the absorption of vitamins, then they could not possibly recreate the molecular structure of a vitamin or produce the same results. “The bioavailability of orally administered vitamins, minerals, and trace elements are subject to a complex set of influences.” “Although some health professionals believe, the body cannot tell whether a vitamin in the bloodstream came from an organically grown cantaloupe or from a chemist’s laboratory” (Thiel 2000, p. 2).
The complex set of influences, as Thiel describes, are the missing nutrients (co-factors) required in order for the body to use the vitamin. A small amount of a vitamin in whole food form is far more important to the human body than a large dose of an isolated vitamin. This is because the isolated form is just a fraction of the whole and is missing important nutrients that the body needs. Taking more of the isolated form will not make up for these deficiencies.
In 1906, English biochemist and professor of biochemistry at Cambridge from 1914 – 1943, Sir F. G. Hopkins, (1861–1947), found that vitamins were accessory factors. Among his contributions, were important studies in carbohydrate metabolism and muscular activity, and the discovery of the relationship of lactic-acid formation to muscular contraction.
In 1912, while working at the Lister Institute in London, Polish biochemist Dr. Casimir Funk isolated the first vitamin, thiamine (B1). Funk discovered that the substance, thiamine (B1), could prevent beriberi, which led him to propose the vitamine theory of disease causation. Dr. Funk believed that this substance was the building block of proteins, and so named it Vita, which means life, and amine, which refers to essential amino groups. Funk’s vitamin theory proposed that the four diseases of scurvy, rickets, pellagra, and beriberi were the result of a lack of four different vital “amines” in the diet (DeCava, 1997).
Vitamins were originally classified according to their solubility in water or fats, and as more and more were discovered, they were classified alphabetically: the fat-soluble vitamins are A, D, E, and K; the B complex and C vitamins are water-soluble. However, the groups of substances that decrease blood capillary fragility, called the vitamin P group, are no longer considered vitamins. The chemical structures of the vitamins are all known, and all of them have been synthesized.
DeCava (1997) points out three significant periods that have taken place over the last hundred years concerning vitamins (p. 11):
- The realization of the connection with deficiency diseases.
- During the period between 1954 and 1974, about 25 new diseases in human beings were found as metabolic disturbances, which could be treated with vitamins.
- Since the 1980’s many unknown properties of vitamins, as well as other constituents of their complex nature have been discovered.
Recognizing that vitamins are essential for health maintenance and to the avoidance of disease has been a great milestone in nutrition/vitamin history. Reference Daily Intake (RDI) is the daily dietary intake level of a nutrient considered sufficient to meet the requirements of nearly all (97–98%) healthy individuals in each life-stage and gender group. The RDI is used to determine the Recommended Daily Value (RDV), which is printed on food labels in the U.S. and Canada. RDI was formerly called Recommended Dietary Allowance (RDA). RDI is based on the Dietary Reference Intake (DRI). Dietary Reference Intake (DRI) is a set of guidelines set up in 1997 to give more detailed guidance than the Recommended Dietary Allowance (RDA) system that preceded it.
The DRI is composed of:
- Estimated Average Requirements (EAR), expected to satisfy the needs of 50% of the people in that age group.
- Reference Daily Intake (RDI).
- Adequate intake (AI), where no RDI has been established.
- Tolerable upper intake levels (UL), to caution against excessive intake of nutrients (like vitamin D) that can be harmful in large amounts.
In 1997, at the suggestion of the Institute of Medicine of the National Academy, RDA became one part of a broader set of dietary guidelines called the Dietary Reference Intake used by both the United States and Canada (Wikipedia, 2007). The Recommended Dietary Allowance (RDA) of each vitamin is the standard guideline put forward by the Food and Nutrition Board, National Academy of Sciences–National Research Council. The standard guideline is based on the nutritional needs of an average, healthy person. Different amounts may be recommended for children, older people, lactating mothers, or people dealing with an ongoing disease process. The U.S. RDA is the federal government’s interpretation of the National Research Council’s RDA. Since 1994, the U.S. RDA has been replaced on food labels by a Percent Daily Value (the percentage of the U.S. RDA that the labeled food offers). Listings for vitamins A and C are required, others are optional.
Another major milestone concerning vitamins can be seen through enforced regulations. In 1994, the US Congress enacted the Dietary Supplement Health and Education Act (DSHEA). U. S. Food and Drug Administration defines a dietary supplement as:
a product (other than tobacco) that is intended to supplement the diet and that bears or contains one or more of the following dietary ingredients: a vitamin, a mineral, an herb or other botanical, an amino acid, a dietary substance for use by man to supplement the diet by increasing the total daily intake, or a concentrate, metabolite, constituent, extract or combinations of these ingredients. (U. S. Food and Drug Administration. Center for Food Safety and Applied Nutrition, 1995)
Further defined, dietary supplements are intended for ingestion in pill, capsule, tablet, or liquid form; dietary supplements are not represented for use as a conventional food or as the sole item of a meal or diet, and are labeled as a dietary supplement.
The DSHEA broadened the availability of all dietary supplements by authorizing its claims for functional specific health benefits, but not claims to specific disease prevention or cure. The Food and Drug Administration (FDA) established a Center for Food Safety and Applied Nutrition (CFSAN) with responsibility for oversight of new supplemental products, including the marketing of clearly identified products declared to be of known composition and strength. New dietary supplements are reviewed by the FDA under the rubric of the same good manufacturing practice regulations that apply to conventional foods. Only the manufacturer is responsible for ensuring that the supplement facts label and ingredient lists are accurate, dietary ingredients are safe, and that the content matches the amount declared on the label. The FDA still does not require accurate chemical analysis as a basis for the identification and quantification of ingredients, putting the onus on the manufacturers. According to the U. S. Food and Drug Administration, Dietary Supplement Health and Education Act of 1994, a label must also contain the disclaimer “This product is not intended to diagnose, treat, cure, or prevent any disease (¶ 9). This policy bypasses the usual FDA procedures of requiring proof of safety from the manufacturer before approval of a drug for public consumption, and puts the post-marketing burden of proving significant risk on the FDA. Supplements that were produced before 1994 are assumed safe, whereas the safety of those marketed after 1994 is the responsibility of the manufacturers (Zeisel, 1999).
Although some manufacturers still produce natural vitamins, a significant number of the vitamins currently found on the pharmacy shelves are made synthetically through chemical processes, rather than derived directly from plants or other materials. In fact, manufacturers of synthetic vitamins and some of their adherents claim they are superior to natural vitamins. An additional way to compare natural and synthetic vitamins is to consider the differences in their molecular structures.
The seeming consensus of natural health authorities is that synthetic vitamins are useless and ineffective. In contrast, it appears as though the consensus of orthodox doctors, and even some nutritionists, is that synthetic vitamins have a molecular chemical structure identical to the natural vitamin and that synthetic vitamins are just as effective. What are the differences between natural and synthetic vitamins?
According to one study (Giacoia, Venkataraman, West-Wilson, Faulkner, 1997), only 1% of American children aged 2 to 19 maintain healthy diets. With a rapidly growing children’s vitamin industry, it is apparent that more and more parents are turning to vitamins to supplement their children’s diets. How safe are these products, and can they fully replace the nutrients in spinach or apples?
Small animals, seeds, roots, and tubers, seafood, and wild fruits characterize the evolution of the human diet. The diet revolved around the environment, and food that was consumed was based on the availability of what nature offered. The time lag from harvest to consumption was often almost zero, and the range of plant and animals eaten was much greater than today. Today’s nutritional guidelines are historically based on the intake of vitamin and minerals that are sufficient only to prevent the onset of relatively immediate and outwardly obvious deficiency disease. Nutritional guidelines are not based on the normal vitamin and mineral level, fat type or composition, of the ancestral foods we hunted and gathered from the wild. In addition, today’s natural foods may not have the same vitamin content as wild fruits and foods. Furthermore, storage of some natural foods causes decline in the vitamin content over time.
DeCava’s research supports the view that whole, natural foods are essential to the human diet, as apposed to synthetic vitamins, which offer insufficient and sometimes potentially harmful side effects:
People need food, particularly nutrient-dense food, rather than fractionated chemicals or manufactured imitations, which can be toxic and cannot perform as well as food complexes in the body. Many people are deficient in some nutrients; others appear to be exceeding the upper limits when it comes to isolated and synthetic fortification and supplement use. Consumed in large amounts, fractionated and synthetic vitamins can result in side effects, such as diarrhea, liver or nerve damage, headaches, birth defects as well as affect the absorption of other nutrients leading to their depletion. Food does not present such problems. Presented with all the nutrients in a whole food, selective absorption allows the body to increase or decrease uptake of what is needed at that particular time. Foods contain ingredients that balance each other properly. Whole, natural foods do not imbalance, deplete, overly stimulate, or excessively suppress the human body (DeCava 1997).
In many cases, whole foods also provide the minerals that are necessary for optimal vitamin activity. For example, sunflower seeds are an excellent whole food source of vitamin E and the mineral selenium, both of which need each other to offer their full health benefits. When choosing nutritional supplements, it appears that the supplement that offers the greatest benefits would be products that list actual foods as their ingredients, providing complete vitamins rather than fractions, as seen with the synthetic and isolated vitamins.
How much nutrition an individual needs varies considerably from person to person. It depends on an individual’s age, gender, build, and other physiological factors, as well as one’s daily energy expenditure.
No one can determine how much of a specific nutrient or food/herb constituent should be taken by an individual. Each person needs all the vitamins, all the minerals, all the trace minerals, all the amino acids, all the fatty acids, all the enzymes, all the co-enzymes, all the known and unknown nutrients that only whole food complexes can provide (DeCava 1997).
Human nutrition is complex. There is no authoritative instruction manual for the operation of the human body. Many food choices have been socially conditioned and only dimly relate to biological necessity. Many of the foods consumed, as human digestive systems evolved, are no longer available. All of the nutrients interact with each other in unforeseen ways; therefore, improvement of one’s personal nutrition is highly subjective. In order to make sense of the subject, certain general principles are required to point the way: the optimum diet is the one humans evolved to eat; it tends toward the unprocessed, the fresh, the naturally appetizing, and the varied. A nutrient is a substance that is required for life. Because each individual is biologically different, nutritional requirements are individually different.
Significance of the Study
Although the early nutritional pioneers believed that whole foods were the main foundation for a return to optimum health, modern medicine has claimed for many years that foods are not therapeutic. Challem (1997), a leading health reporter in the United States, who has been writing about advances in nutrition, vitamin, and mineral research since 1974, eloquently sums up the burden of vitamins and its struggles for acceptance:
By the 1920s and 1930s, it became clear that small amounts of vitamins easily cured severe deficiency diseases. But lacking imagination, most researchers and physicians believed vitamins had little other value. It was a faulty belief, based on the idea that scurvy and pellagra were the first signs of vitamin deficiency, not the last signs before death. Unfortunately, it’s a belief that many doctors still hold dear. (www.nutritionreporter.com paragraph #11).
These beliefs are a major hurdle for the vitamin and supplement industry. Until the power of vitamins is truly recognized, there will be no serious respected research, and therefore no major advancements in medicine involving vitamins. FDA regulation, as seen with the pharmaceutical industry, would drive and fulfill the needs that are lacking in the vitamin and supplement industry. However, history has also shown that nutritional information on research studies has been funded by the special interests of pharmaceutical companies, which manufacture fractionated, crystalline-pure, and synthetic chemicals. This hurdle may be extremely difficult to overcome.
Commercialism and marketing is another dilemma for the vitamin and supplement industry, and a great obstacle for consumers. Breaking through the onslaught of opinions, claims, and commercialism directed toward nutrition, supplements, and vitamins has been an ongoing challenge for interested parties. Commercial giants have thrived on the consumers’ needs for healthier foods. To help sort through the confusion and misleading labels, in 1990, the Nutrition Labeling and Education Act was announced, requiring all packaged foods to bear nutrition labeling and all health claims for foods to be consistent with terms defined by the Secretary of Health and Human Services. The law preempts state requirements about food standards, nutrition labeling, and health claims and, for the first time, authorizes some health claims for foods. The food ingredient panel, serving sizes, and terms such as low fat and light are standardized (U. S. Food and Drug Administration, 1999).
Commercialism and strong marketing campaigns from vitamin and supplement companies may be misleading consumers into believing that they can achieve optimal health through their products. Some vitamin and supplement companies target the consumers’ desire for health through various health claims. For example, Bayer HealthCare (2007) claims that its product One-A-Day Women’s is a complete multivitamin plus extra calcium to help keep one strong and healthy. Consumers, in an attempt to improve their health or avoid illness and disease, may purchase products, such as a multivitamin, based on these types of health claims. This marketing trend has steadily continued to rise. This may be due to consumer demand and because vitamin fractions such as vitamin A, vitamin C, beta-carotene, and vitamin E, along with trace minerals such as zinc and selenium, coenzyme Q10, and many other specific nutrients, can be cheaply manufactured and sold at huge profits.
The average consumer has no idea of the real sources of synthetic vitamins, and just accepts that these vitamins are healthy and beneficial. Unfortunately, because of the current laws surrounding the labeling of vitamins and supplements, the supplier does not have to follow FDA regulations to proclaim or prove the potency and molecular structure of the vitamin or supplement. This truly leaves the consumer uniformed, as well as ignorant due to the complex nature of vitamins and supplements.
It is possible that cellular malnutrition, as a cause of disease, has been avoided in orthodox medicine, while synthetic vitamins have been embraced. The synthetic vitamin, unlike whole food concentrates, can be easily mass-produced by large pharmaceutical companies, who can store and distribute them. As a result, these isolated synthetics are used in nearly all nutritional supplements, whether found in a drug store, health food store, or nutritionist’s office. The scientific studies ignore the human element by substituting rats or other lab animals to determine recommended daily allowances.
Although there is always much debate about which supplements are best, owing to the large numbers of companies selling them, they are different. Whether one supplement is better than another, may amount to the particular physician’s goals, naturalist philosophy, and food research data. The purpose of this analysis is to look at as much related research and literature available, compare the information on whole food and synthetic supplements, and provide evidence for the case that the best source of supplementation is whole food supplements.
Definition of Terms
This is the process of absorbing nutrients into the body after digestion.
Indicates the presence of inflammatory bowel disease.
Vitamin C or L-ascorbate is an essential nutrient for higher primates, and a small number of other species. The presence of ascorbate is required for a range of essential metabolic reactions in all animals and in plants and is made internally by almost all organisms, humans being one notable exception. It is widely known as the vitamin whose deficiency causes scurvy in humans.
These acids are the building blocks of proteins.
These are molecules that slow or prevent the oxidation of other chemicals. Antioxidants are also widely used as ingredients in dietary supplements in the hope of maintaining health and preventing diseases such as cancer and coronary heart disease.
Is the effect of a given agent, such as a vaccine, upon a living organism or on living tissue.
This is a measurement of the extent of a therapeutically active drug that reaches the systemic circulation and is available at the site of action.
Flavonoids are most commonly known for their antioxidant activity Flavonoids are also commonly referred to as bioflavonoids in the media – the terms are equivalent and interchangeable, for flavonoids are biological in origin.
Carotenoids are organic pigments that are naturally occurring in plants and some other photosynthetic organisms like algae, some types of fungus and some bacteria.
These small organic non-protein molecules carry chemical groups between enzymes.
These are natural carotenoid pigments that have been isolated from a variety of sources including the petals and flowers of plants in the genus Physalis, orange rind, papaya, egg yolk, butter, and bovine blood serum.
In humans are thought to be directly or indirectly related to nutrition, these include, but are not limited to a lack of essential nutrients.
Enzymes are proteins that catalyze (i.e. accelerate) chemical reactions.
These cells are what line the inner and outer surfaces of the body.
These acids are a major component of fats that are used by the body for energy and tissue development.
Flavonoids form a group of chemical compounds naturally found in certain fruits, vegetables, teas, wines, nuts, seeds, and roots that are antioxidants.
Folic acid and folate (the anion form) are forms of the water-soluble Vitamin B9. These occur naturally in food and can also be taken as supplements.
Meaning to add nutrients to foods, such as fortified milk.
This is the capillary tuft surrounded by Bowman’s capsule in nephrons of the vertebrate kidney. It receives its blood supply from an afferent arteriole of the renal circulation.
A tripeptide which contains an unusual peptide linkage between the amine group of cysteine and the carboxyl group of the glutamate side chain. Glutathione, an antioxidant, protects cells from toxins such as free radicals.
Pertaining to or affecting the liver; hepatic ducts; hepatic cirrhosis
Peroxidase catalyzed oxidation of lipids using hydrogen peroxide as an electron acceptor.
A ligand is an atom, ion, or molecule that generally donates one or more of its electrons through a coordinate covalent bond to, or shares its electrons through a covalent bond with, one or more central atoms or ions.
Lutein is one of over 600 known naturally occurring carotenoids. Found in green leafy vegetables such as spinach and kale, lutein is employed by organisms as an antioxidant and for blue light absorption.
This bright red carotenoid pigment, is a phytochemical found in tomatoes and other red fruits. Lycopene is the most common carotenoid in the human body and is one of the most potent carotenoid antioxidants.
This occurs in a state arising from abnormality in digestion or absorption of food nutrients across the gastrointestinal(GI) tract. Impairment can be of single or multiple nutrients depending on the abnormality.
Malnutrition is a general term for the medical condition caused by an improper or insufficient diet. It most often refers to under nutrition resulting from inadequate consumption, poor absorption, or excessive loss of nutrients.
This is a modern nutritional model inspired by the traditional dietary patterns of some of the countries of the Mediterranean basin, particularly Greece and Southern Italy. Common to the diets of these regions are a high consumption of fruit and vegetables, bread, wheat and other cereals, olive oil, fish, and Red Wine. The diet is often cited as a beneficial one for that it is low in saturated fat and high in monounsaturated fat and dietary fiber.
Any substance produced by metabolism or by a metabolic process.
Essential dietary elements or organic compounds that are required in only small quantities for normal physiologic processes to occur.
A dietary mineral refers to inorganic compounds necessary for life and good nutrition.
A vitamin existing in or produced by nature; not artificial or imitation.
Oxidized – Oxidation describes the loss of electrons by a molecule, atom or ion.
Phytochemicals are compounds in plant-derived foods that have biological activity in the body. Phytochemicals naturally occur in vegetables and fruit.
Polyphenols (formerly vegetable tannins) are a group of vegetable chemical substances, characterized by the presence of more than one phenolic group. Their phenolic reactions produce gelatines, alkaloids and other proteins. The polyphenols are responsible for the colouring of some plants.
A polyp is an abnormal growth of tissue (tumor) projecting from a mucous membrane.
Meaning in shorthand a reduction/oxidation reaction, describes all chemical reactions in which atoms have their oxidation number (oxidation state) changed.
Of or relating to the kidneys.
Standardized & Isolated Vitamins
Vitamins that lack accompanying cofactors found in whole vitamin complexes.
Biology that is used of organisms, especially of different species living together but not necessarily in a relationship beneficial to each.
Vitamins that are made synthetically through chemical processes, rather than derived directly from plants or other materials.
Vitamin E which is a fat-soluble vitamin in eight forms.
Relating to or caused by a toxin or poison.
These are microminerals or trace elements include at least iron, cobalt, chromium, copper, iodine, manganese, selenium, zinc, and molybdenum. They are dietary minerals needed by the human body in very small quantities (generally less than 100mg/day) as opposed to macrominerals which are required in larger quantities.
Very Low Density Lipoprotein (VLDL) is a lipoprotein subclass. It is assembled in the liver from cholesterol and apolipoproteins. It is converted in the bloodstream to low density lipoprotein (LDL). VLDL particles have a diameter of 30-80 nm. VLDL transports endogenous products where chylomicrons transport exogenous (dietary) products.
A xenobiotic is a chemical which is found in an organism but which is not normally produced or expected to be present in it. It can also cover substances which are present in much higher concentrations than are usual. Specifically, drugs such as antibiotics are xenobiotics in humans because the human body does not produce them itself nor would they be expected to be present as part of a normal diet.
Review of Related Literature and Research
Natural Supplements Have More Advantages Than Synthetic Counterparts
There have been many studies that suggest that the bioavailability of natural food complex vitamins is better than that of most of the isolated USP vitamins. These same studies also imply that these natural food complexes are preferentially retained by the body, and therefore have better effects on maintaining aspects of human health beyond traditional vitamin deficiency syndromes.
Comparative Bioavailability to Humans of Ascorbic Acid Alone or in a Citrus Extract
One study (Vinson, Courey & Maro, 1992) found the combination of ascorbic acid and citrus extract to be more effective than ascorbic acid alone, as a supplement, to increase lens ascorbate and slow down the progression of galactose cataracts. In another similar study, (Vinson, Hsu, 1992) observed the effect of Vitamin A, E, and a Citrus Extract on in vitro and in vivo Lipid Peroxidation. The study illustrates that antioxidant supplements, especially in combination where additivity is possible, should be investigated as therapy for lowering Lipid Peroxidation.
Vinson, Bose, Lemoine, and Hsaio (1989) studied nutrient availability, and found yeast trace elements and natural vitamins are more slowly absorbed in animals and man; are more bioavailable; and are therefore the preferred form for supplementation.
Vinson and Bose (1988) wanted to determine whether synthetic ascorbic acid (AA) alone or in a natural citrus extract containing bioflavonoids, proteins, and carbohydrates was more bioavailable to human subjects. The effect of a single 500-mg ascorbate dose of the two forms and a placebo citrus extract on plasma ascorbate was examined in eight fasting subjects. A comparison of the areas under the plasma concentration-time curves showed that the citrus extract was 35% more absorbed than AA and was more slowly absorbed than AA. In six ascorbate-saturated male subjects, the ascorbate in the citrus extract produced a greater ascorbate excretion than AA alone in 24-h post-dose urine (p less than 0.05). Citrus extract ascorbate was less excreted than AA (p less than 0.05) in 12 nonsaturated subjects. Ascorbate in the citrus extract was found to be more bioavailable than AA alone in human subjects.
Vinson and Bose (1987) continued to study the bioavailability of synthetic ascorbic acid and a citrus extract and determined that citrus extract in guinea pigs and humans is more absorbed than ascorbic acid and remains in the body for a longer period of time. Citrus extract is thus the preferred form of ascorbate for supplementation.
When comparing natural and synthetic vitamin C on the formation of sugar cataracts, Vinson saw that natural vitamin C was more effective than synthetic Vitamin C in decreasing both the rate of cataract formation and the severity of such cataracts. Additional studies by Vinson on the bioavailability of vitamin C found that citrus extract was 1210% more bioavailable than USP Ascorbic Acid. Vinson also found overall an 80% decline in risk in heart attacks that occurred due to citrus extract supplementation.
Cahill et al. (1993) studied the effects of vitamin antioxidant supplementation on cell kinetics of patients with adenomatous polyps. Their findings indicated that prolonged supplementation with vitamin C may reduce the recurrence of adenomatous polyps.
One study (Giannakopoulou et al 2002) from the Department of Neonatology at the University of Crete, found in a comparative randomized study of the administration of natural and synthetic supplements on premature newborns with respiratory distress syndrome, that the use of natural supplementation seemed to offer more advantages in comparison with its synthetic counterpart.
When looking at the dietary intake of micronutrients versus synthetic supplements Woodside, McCall, McGartland and Young (2005) of the Center for Clinical Science in Belfast, found that the complex mixture of micronutrients found in a diet high in fruit and vegetables more effective than large doses of a small number of micronutrients found in synthetic supplements. This study concluded that the uses of single micronutrient supplements are unlikely to produce lowering of disease risk.
Fruit and Vegetable Intake and Risk of Major Chronic Disease
Studies of fruit and vegetable consumption in relation to overall health are limited. One study (Hung, Joshipura, Jiang, Hu, Hunter, and Smith-Warner, 2004) reviewed and evaluated the relationship between fruit and vegetable intake and the incidence of cardiovascular disease, cancer, and deaths from other causes. Total fruit and vegetable intake was inversely associated with risk of cardiovascular disease but not with overall cancer. Of the food groups analyzed, green leafy vegetable intake showed the strongest inverse association with major chronic disease and cardiovascular disease. For an increment of one serving per day of green leafy vegetables, relative risks were 95% for major chronic disease and 89% for cardiovascular disease. The conclusion was that increased fruit and vegetable consumption was associated with a modest although not statistically significant reduction in the development of major chronic disease. The benefits appeared to be primarily for cardiovascular disease and not for cancer.
The Effect of Fruit and Vegetable Intake on Risk for Coronary Heart Disease
Many constituents of fruits and vegetables may reduce the risk for coronary heart disease, but data on the relationship between fruit and vegetable consumption and risk for coronary heart disease is sparse. Joshipura, et al. (2001) evaluated the association of fruit and vegetable consumption with risk for coronary heart disease. The main outcome measure was incidence of nonfatal myocardial infarction or fatal coronary heart disease. Diet was assessed by using food frequency questionnaires. After adjustment for standard cardiovascular risk factors, persons in the highest quintile of fruit and vegetable intake had a relative risk for coronary heart disease of 95% compared with those in the lowest quintile of intake. Each 1-serving/d increase in intake of fruits or vegetables was associated with a 4% lower risk for coronary heart disease. Green leafy vegetables, and vitamin C-rich fruits and vegetables contributed most to the apparent protective effect of total fruit and vegetable intake. The conclusion was that consumption of fruits and vegetables, particularly green leafy vegetables and vitamin C-rich fruits and vegetables, appears to have a protective effect against coronary heart disease.
Fruit and Vegetable Intake in Relation to Risk of Ischemic Stroke
Few studies have evaluated the relationship between fruit and vegetable intake and cardiovascular disease. Joshipura, et al. (1999) examined the associations between fruit and vegetable intake and ischemic stroke. This study concluded that the data supported a protective relationship between consumption of fruit and vegetables-particularly cruciferous and green leafy vegetables and citrus fruit and juice-and ischemic stroke risk.
In Vitro and In Vivo Lipoprotein Antioxidant Effect of a Citrus Extract and Ascorbic Acid on Normal and Hypercholesterolemic Human Subjects
Polyphenols and particularly flavonoids are well known in vitro antioxidants. Their consumption in foods has been shown to decrease the risk of heart disease in epidemiological studies. Because flavonoids are consumed with vitamin C in the diet, the combination may prove to be more beneficial than either alone. The combination of citrus extract and vitamin C was found to produce a synergistic antioxidant effect in an in vitro lipoprotein oxidation model. Vinson and Jang (2001) did a double-blind, placebo-controlled study with 26 normal and hypercholesterolemic subjects, the citrus extract and vitamin C, but not vitamin C or vitamin E alone, significantly lowered triglycerides. The combination of citrus extract and vitamin C increased the lag time of lipoprotein oxidation, compared with vitamin C alone or a placebo, and was a significantly better antioxidant than vitamin E. These results and other published studies are highly suggestive of in vitro and in vivo antioxidant synergism between citrus extract and vitamin C.
Vitamin Supplementation and Breast Cancer
Recent observations by several research groups on many thousands of women have yielded the disappointing view that mega-dose vitamin supplementation does not provide significant protection against breast cancer. A report by Rose (1998) reviewed pertinent literature with the goal of identifying testable hypotheses that might explain the epidemiology and be helpful in designing subsequent evaluations. In one hypothesis presented, the vitamin content of peripheral cells that protect breast epithelium is not markedly affected by supplementation. In the second hypothesis the metabolic status (redox state) of epithelial cells is more important than the absolute level (reduced plus oxidized) of each antioxidant. In either case, extremes in diet fail to alter inherent homeostatic mechanisms.
Natural and Synthetic Comparisons of Vitamin E
Alpha-CEHC is a urinary vitamin E metabolite. Traber, Elsner, and Brigelius-Flohe (1998) tested whether natural and synthetic vitamin E is similarly converted to alpha-CEHC. They found that the synthetic compared with natural vitamin E is preferentially metabolized to alpha-CEHC and excreted. Burton, et al. (1998) reported a comparison of natural and synthetic vitamin E in humans using deuterium labeling to permit the two forms of vitamin E to be measured independently in plasma and tissues of each subject. Differences in natural and synthetic vitamin E concentrations were measured directly under equal dosage conditions. Two groups of five adults took 30 mg of the mixture as a single dose and as eight consecutive daily doses, respectively. The results indicated that natural vitamin E has roughly twice the availability of synthetic vitamin E. In a study done by Traber, Burton, Ingold, and Kayden (1990), they observed that plasma contained similar concentrations of both natural and synthetic forms until after 11 hours, when the natural vitamin E concentration became significantly greater. These results suggest the existence of a mechanism in the liver for assembling VLDL preferentially enriched in natural relative to synthetic vitamin E.
Scavenging Capabilities of Various Fruit and Vegetable Juices Against Free Radicals Oxidative stress in humans is associated with damage to DNA, proteins, and biological membranes. Oxidative stress, which often arises as a result of an imbalance in the human antioxidant status, has been implicated in aging and a number of human diseases such as cancer, atherosclerosis, and rheumatoid arthritis. In a study (Ko et al., 2005) researchers investigated the scavenging capabilities of various fruit and vegetable juices against free radicals; electron spin resonance (ESR) spin trapping was used for free radical detection and measurement. Using a colormetric assay, study also investigated the protective effects of fruit and vegetable juices against lipid peroxidation induced in cell membranes by hydroxyl radicals. The study showed that the free radical scavenging capability of each individual juice, but not its ascorbic acid content, is correlated with its protective effect on free radical induced lipid peroxidation. The results indicate that ascorbic acid is only one facet of the protective effect of fruit and vegetable juices. It appears that consumption of whole fruits and vegetables would be superior to an ascorbic acid supplement for antioxidant effectiveness. Another study (Ko, et al., 2005) comparing the antioxidant activities of nine different fruits in human plasma and was performed to test the hypothesis that the consumption of fruit juices may improve antioxidant status in human plasma. Their results suggested that the consumption of fruits or fruit juices may reduce damage from oxidative stress, and that this effect may be a consequence of the antioxidant activity of fruits in scavenging the reactive oxygen species generated in human plasma.
Disruption of the Vegetable Matrix to Enhance the Bioavailability of Micronutrients
Currently, knowledge on the bioavailability of carotenoids, folate, and vitamin C from vegetables is limited. A study (Van Het, Tijburg, Pietrzik and Westrate, 1999) compared the efficacy of different vegetables, at the same level of intake (i.e. 300 g/d), increasing plasma levels of carotenoids, folate, and vitamin C, and investigated if disruption of the vegetable matrix would enhance the bioavailability of these micronutrients. The study found that all vegetable meals increased the plasma concentrations of lutein and vitamin C significantly. When expressed per mg carotenoid consumed, broccoli and green peas were also more effective sources of lutein than spinach. A significant increase in plasma folate concentration was found only after consumption of the spinach-supplemented meal, which provided the highest level of folate. Disruption of the spinach matrix increased the plasma responses to both lutien and folate, whereas it did not affect the response to beta-carotene. The conclusion was that the bioavailability of beta-carotene and lutein vary substantially among different vegetables and that the bioavailability of lutein and folate from spinach can be improved by disruption of the vegetable matrix.
The Effect of Vegetable Consumption on Selected Biomarkers of Chronic Diseases
To gain more insight into the relation between vegetable consumption and the risk of chronic diseases, it is important to determine the bioavailability of carotenoids from vegetables and the effect of vegetable consumption on selected biomarkers of chronic diseases. In a study to assess the bioavailability of beta-carotene and lutein from
vegetables and the effect of increased vegetable consumption on the ex vivo oxidizability of LDL, Van Het et al. (1999) looked at plasma concentrations of vitamin C and carotenoids (i.e., alpha-carotene, beta-carotene, lutein, zeaxanthin, and beta-cryptoxanthin), and found that they were scantly higher after a high vegetable diet, rather than after a low-vegetable diet. In addition to an increase in plasma beta-carotene and lutein, a pure carotenoid-supplemented diet induced a significant decrease in plasma lycopene concentration. The responses of plasma beta-carotene and lutein to the high-vegetable diet were 14% and 67%, respectively, of those to the pure carotenoid- supplemented diet. Conversion of beta-carotene to retinol may have attenuated its plasma response compared with that of lutein. There was no significant effect on the resistance of LDL to oxidation ex vivo. They concluded that increased vegetable consumption enhances plasma vitamin C and carotenoid concentrations, but not resistance of LDL to oxidation. The relative bioavailability of lutein from vegetables
is higher than that of beta-carotene.
The Bioavailability of Carotenoids from Spinach and Tomatoes
Few published studies have described the bioavailability of the different
carotenoids in vegetables. A study was done to evaluate the effects on plasma carotenoid concentrations of a daily consumption of spinach (rich in lutein and beta-carotene), alone or together with lycopene-rich tomato puree. This study done by Riso,
Brusamolino, Scalfi and Porrini (2004) evaluated the bioavailability of carotenoids from spinach and tomatoes. The results of this study confirm that a regular intake of selected vegetables leads to a progressive increase in plasma carotenoid concentrations. The addition of tomato puree to spinach does not decrease lutein plasma concentrations. Furthermore, baseline plasma levels of lutein and lycopene are important variables affecting the relative increase in their levels after supplementation: i.e. more depleted subjects are expected to have a greater percent rise in plasma carotenoid concentrations.
Organic Selenium Causes Higher Selenium Deposition Than Did the Inorganic Form in Lactating women
A very interesting study by Trafikowska, Sobkowiak, Butler, Whanger, and Zachara (1998) was done with lactating mothers who were given either organic or inorganic selenium supplements and then blood and milk selenium concentrations were evaluated in both the mothers and babies. The aim of this study was to determine the effect of selenium (Se) supplementation to lactating women on Se concentrations and glutathione peroxidase (GSH-Px) activities in blood components of mothers and breast-fed infants and on milk Se levels and Se intake by breast-fed infants. After 3 months, organic concentrations both in whole blood and in plasma from mothers and infants were significantly higher than the initial values. In conclusion, this study shows that organic Se causes higher Se deposition than did the inorganic form.
Design of The Study
This historical research will collect data and other information concerning the history of the use of supplements. By analyzing the data and information collected from scientific, professional, and peer-reviewed journal articles, this paper attempts to identify the clinical differences between various types of supplements, as well as which vitamins and minerals may have the best bioavailability and optimal health benefits.
Data Collection and Analysis
Primary data has been collected through internet searches including websites such as Pubmed.com, and various university and professional websites. Data has also been gathered from several books that were included in the curriculum from Clayton College, newsletters from Judith DeCava, Bruce West, and other experts in the field of nutrition. This data will answer key questions, as well as examine the history and current opinions regarding the use of supplements.
As an example, in reading Judith DeCava’s (1997) book “The Real Truth about Vitamins and Antioxidants”, at the end of chapter 6 regarding potency is a list of endnotes. One of these endnotes is a reference to a paper written by Royal Lee called “Information on Nutritional Concentrates” which was published in 1947. By conducting an internet search on Royal Lee, a website of the International Foundation for Nutrition and Health (IFNH) is referenced. The IFNH website covers whole food nutrition and health, and represents over 140 years of collective research conducted by renowned leaders in the fields of medicine, biochemistry and dentistry, such as Drs. Price, Pottenger, Page, Lee, Harrower, Howell, Myers, Wiley, Tilden, Bechamp, as well as many others. In addition, articles from the Melvin Page and Robert Peshiek Library’s were reviewed.
Other websites that were utilized in the collection of data include:
The American Journal of Clinical Nutrition
The American Society for Nutrition
The Journal of the American Medical Association
The British Journal of Nutrition
The Mayo Clinic
Sloan – Kettering
There appears to be a tendency to label those in the health care community, who profess that natural vitamins are better than synthetic vitamins, as frauds. This paper attempts to challenge this misconception, which may also be stifling legitimate nutritional research. This study describes physiochemical differences between certain natural and synthetic vitamins, and proven clinical advantages of natural vitamins. It concludes that lessons of history, as well as modern science, support the view that natural vitamins are nutritionally superior to synthetic ones.
Scope and Limitations
Nutrition is a relatively new field, coming into existence only about 100 years ago, which may have been spurred further due to food processing. Scientists are just beginning to understand the factors influencing nutrient absorption and utilization. It is not unreasonable to expect that additional food factors will be discovered that further distinguish food nutrients from synthetic ones.
Most observational studies look at diet and then make assumptions about specific nutrient intake based on nutritional data and on the particular nutrients being studied at the time. There is very little research supporting real and significant benefits from taking supplements of isolated nutrients. Some studies measure blood or tissue levels of certain nutrients as an indicator of bioavailability, but without determining if the subjects are actually able to use the nutrient in their biochemistry. Furthermore, there are problematic and influencing factors, such as the health of the body’s cells, which are not based solely on adequate levels of nutrients, and equally important, is decreasing the exposure to unhealthy agents such as chemical toxins and excessive stress. Conventional research attempts to focus on single factors or determinants, even though the question or problem addressed is multifaceted. There is no way to know or test for all the factors involved in health (DeCava, 2002). Research is detriment to the growth of vitamin supplements. The true benefits of whole food supplements, as well as the side effects of isolated vitamin supplements will never be known until fully explored. Clinical trials should be mandatory for vitamin and supplement companies, as it is with the pharmaceutical industry.
Jenson describes the randomized clinical trial, as regarded by the scientific community, as the “gold standard” for the validation of the safety and efficacy of pharmaceutical products. Because of the Dietary Supplement and Health Education Act of 1994, classifying nutritional products as dietary supplements, there is no perquisite for randomized clinical trials to market these products, including whole food nutrients. Presumably, in the future, the use of randomized clinical trials for the validation of safety and effectiveness of whole food nutrients will increase as the scientific community, discerning consumers, and responsible manufactures demand evidence concerning the safety and efficacy of dietary supplements (Jensen, 2001).
Consumers should have valid and scientific information readily available in the form of labeling on all vitamin and supplement products. FDA regulation is sorely needed.
Results and Findings
There are three basic ways to increase micronutrient status, and in turn help reduce the risk for chronic disease, these options include, increasing the intake of foods rich in nutrients, fortifying foods with nutrients, or simply taking supplements. Even though observational studies have shown an association between lowered risks of chronic disease with an increase in micronutrient status, randomized intervention trials have failed to prove that supplements do indeed work to prevent chronic disease. The results from studies and clinical trials vary greatly and largely remain unexplained. Perhaps the complexity and number of micronutrients found in foods, such as fruits and vegetables, are more effective in lowering the risk of chronic disease than the use of single isolated high potency synthetic vitamins. This may be due to the body’s inability to recognize and efficiently absorb the synthetic vitamin. One report (Woodside, McCall, McGartland & Young, 2005) supports this theory and states, “Studies concentrating on whole foods (e.g. fruit and vegetables) or diet pattern (e.g. Mediterranean diet pattern) may be more effective in demonstrating an effect on clinical end points.”
Analysis of Data
The processes in which whole vitamin complexes and synthetic vitamins progress through the body from ingestion to metabolism, clearly demonstrates the contrasts and exemplifies the complexities of the whole vitamin, as compared to the synthetic vitamin. Standard Process, 2003 describes the journey of these distinctive elements and the actions that occur on the pathways (See Appendix C for a graphic depiction of the contrasting vitamins and their pathways):
Separation of whole vitamin complexes within food particles occurs as digestion progresses and the vitamin complexes move toward the villi for absorption. Although concentration of whole vitamin complexes in food is lower compared to the high concentration in synthetic or isolated vitamins supplements, they appear to be preferentially absorbed. Whole vitamin complexes are delivered to the liver via the portal vein. The whole vitamin complex enters the hepatic sinusoids, and those complexes that are not utilized or metabolized by hepatic parenchyma, move into the central vein and into the hepatic vein for distribution via systemic circulation. Since the whole vitamin complex is not perceived as a xenobiotic (any substance, harmful or not, that is foreign to the biological system), metabolic energy is not wasted for elimination of these nutrients. Once a synthetic vitamin enters the hepatic sinusoids, it is metabolized by the appropriate cells as well. However, some of the synthetic vitamin structures undergo a partial reassembly in which some of the cofactors are taken from tissue storage and attached to the base structure leading to a more functional vitamin. This process can lead to a relative depletion of the cofactors stored in the body. Additionally, the synthetic vitamin is perceived as a xenobiotic; it is metabolized as a foreign substance. The synthetic vitamin may be conjugated for excretion in the bile and / or conjugated for elimination via the kidney.
Individual whole vitamin complexes present in the systemic circulation travel through the capillaries of the renal glomerulus. As a functional nutrient utilized for cellular metabolism, it is not actively excreted by the kidney and thus, it will remain in the blood stream to circulate until utilized. The two forms of synthetic vitamins, conjugated and partially reassembled, will pass into the renal glomerulus. The water-soluble conjugated forms are eliminated in the urine. The partially reassembled forms are allowed to remain in circulation where they might be utilized at some cellular site or undergo further metabolism by the liver for elimination.
Cellular utilization of the nutrients can be impacted by the ability of the vitamin receptor to effectively bind the vitamin complex ligand to the associated receptor sites within the cell membrane. If the cell membrane receptor site does not match all configurations of the synthetic vitamin ligand, this lack of receptor–ligand complementary prevents effective receptor–mediated utilization of the synthetic vitamin.
This process of absorption and the pathways each vitamin takes clearly outlines the body’s ability to recognize the difference between a synthetic vitamin and a whole food vitamin. The synthetic vitamin offers a simplistic version of the whole food vitamin. However, this replica, which mirrors the image of the ligand of the whole food vitamin, is deficient in cofactors, is less effectively absorbed, depletes existing cofactors, which are taken from tissue storage, and may be eliminated and excreted by the kidneys or become further metabolized by the liver for elimination.
Most studies have demonstrated that synthetic vitamins do not offer the same nutritional benefits as compared to whole food vitamins. Some studies suggest that the synthetic vitamin may be potentially harmful to the body, and even toxic at high doses. A report by Arroyave (1988) stated:
There is no evidence of any nutritional benefit derived from the consumption of vitamin supplements in excess of the daily intakes recommended by the various international and national expert committees. Furthermore, in the case of certain vitamins, such as vitamin A and vitamin D, excessive intakes result in toxic effects. To a lesser extent, this is also the case for vitamin C and nicotinic acid. In addition, the use of high supplements or megadoses of any vitamin results in a wasteful misuse of economic resources. This reduces the capacity to acquire foods, which would have clear nutritional benefits for the whole family. Consequently, the indiscriminate use of these mega doses must be discouraged. Their application is exclusively justified in clinical situations under direct medical supervision.
Although labeling laws require the posting of the recommended daily intakes of vitamins, and require warning labels, as in the case of noted vitamins A and D, there are additional cautions and contraindications for most vitamins. Because each individual physiological makeup is unique, there is no one standard to follow. Therefore, the only sure way to determine synthetic vitamin status, while avoiding toxicity or contraindication, is through a medical professional or healthcare practitioner who has the capabilities of measuring vitamin levels, through blood work and follow up. Although the synthetic vitamin presents such problems, the whole food vitamin does not hold such prevalent disadvantages, and toxicity does not appear to be an issue. DeCava (1999) confirms this hypothesis:
Every individual human body is unique in its nutritional requirements. [ ] Dr. Roger Williams wrote extensively about biochemical individuality, revealing, “every individual has nutritional needs which differ quantitatively, with respect to each separate nutrient, from his neighbors. Although each person needs all the same nutrients, the quantities of each nutrient needed daily are “distinctively different. Each has a “pattern of needs all his own” which, in itself may vary due to environmental and circumstantial conditions.” [ ] With natural foods and food concentrates, the body can choose to assimilate its needs, and excrete what it does not need. This is selective absorption. In contrast, fractionated or synthetic supplements allow no choice. The body must deal with the chemical in some manner and can suffer consequences of biochemical imbalances and toxic overdose. [ ] Sometimes taking a synthetic vitamin can cause an unhealthy or harmful reaction when taken at the same time as a drug. Certain nutrients might reduce the amount of medication absorbed into the body, thereby reducing its effectiveness. Synthetic vitamins, like drugs, may also cause depletion of nutrients in the same manner.
A recent study done by The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) recognized the importance of drug-nutrient interactions and educating patients to prevent adverse effects. The results of their study showed that most medical doctors reported they had little or no formal training in drug-nutrient interactions in medical school (83%) or residency (80%). However, 79% believed it was the physician’s responsibility to inform patients about drug-nutrient interactions, although many thought pharmacists (75%) and dietitians (66%) share this responsibility. Overall, residents correctly answered 61% +/- 19 of fourteen drug-nutrient interaction knowledge items. There was a slight increase in drug-nutrient knowledge as year of residency increased (Lasswell, DeForge, Sobal, Muncie & Michocki, 1995).
Knowledge of drug-nutrient interactions could be improved by including nutrition education in the topics taught by physicians, nutritionists, and pharmacists. Nutrition educators, in particular, can play a role in teaching about drug-nutrient interactions by developing, refining, and evaluating materials and educational tools. Nutrition educators can provide this information in academic settings for the training of all health professionals, as well as in patient education settings, such as hospitals and public health clinics. Thomas (1996) highlights the need for educating healthcare professional on the public use of vitamin supplements:
Research has extensively covered the effects of nutrient ingestion on the pharmacological effectiveness of drug dosing. From a nutritional perspective, however, many practitioners are not aware of how the drugs that their patients are already taking, or self-medicating, affect nutrient absorption and the impact it has on the effectiveness of nutritional supplementation. This is especially dangerous for the fast-growing elderly population, who takes more medication than any other population group.
Further complications arise from nutritional status and diet, which can affect the action of drugs by altering absorption, distribution, metabolism, and excretion. Nutritional status may also influence drug response. Conversely, drugs can alter nutrient absorption, metabolism, utilization, and excretion. The effect of these interactions may result in altered nutritional status. Drug-nutrient interactions can be categorized into three groups: effect of drugs on nutritional status, drug-food incompatibilities, and drug-alcohol incompatibilities. Trovato (1991) describes drug-induced alterations in nutrient absorption as primary or secondary. The primary drug-induced malabsorption is due to the direct effects of the pharmacologic agent on the intestinal mucosa or on the intraluminal processes. The secondary drug-induced malabsorption is due to preexisting poor physiologic status.
Synthetic vitamins have too many negative considerations, which outweigh any possible benefits. Biochemical imbalances, toxic overdoses, contraindications, and interference are continually noted in studies. Moreover, due to the lack of education in the health system / medical community, it would be unwise to choose a synthetic vitamin as a source for maintaining optimal health.
Studies have noted that the body views the synthetic vitamin as a foreign substance; additionally, due to missing co-factors, the body cannot efficiently absorb the synthetic vitamin. This may be the possible rationale behind mega-dosing. Studies have also shown that mega-dosing with synthetic vitamins is potentially harmful and toxic. An additional consideration to be noted is the extraction process of most commercial supplements. DeCava (1999) describes this process, which uses powerful chemical solvents such as ether, benzene, and methyl alcohol, and precipitants such as barium chloride, lead, and aluminum salts. The chemical processes denature nutrients, isolates them from their natural synergists, destroys their related enzymes, and leaves toxic residues. In addition, most commercial supplements are distilled high temperatures. These extraction methods remove the bioactive functional processes. The body does not recognize the synthetic vitamin as a food, but as a foreign substance or drug.
Conclusions, Implications and Recommendations for Further Research
Conclusions and Implications
The average American diet includes mostly processed foods that have been stripped of their nutrients. In addition, the average American diet does not include sufficient amounts of fresh produce, whole grains, and quality protein. Therefore, society has the tendency to lean toward the multivitamin in order to maintain optimal health.
The nutrients within foods work synergistically to provide the body the tools it needs to maintain optimal health. A typical complete multivitamin contains only a fraction of the components found in food. Often times, multivitamins contain fractionated, isolated nutrients, which are missing many of the nutrients and phytonutrients found in whole foods. Because the American diet is plagued with fast foods and processed foods, it is vital to those choosing a multivitamin, to choose one that works. Carsten (2002) examined the importance of whole vitamin complexes and its benefits, and noted the significance of synergy, which is absent in synthetic vitamins:
Whole foods vitamins provide superior nutrition for preventing disease and giving support during illness. Their whole vitamin complexes facilitate the physiological effects of whole foods far better than synthetic isolates. Synthetic vitamins do not have the necessary accompanying cofactors to manifest the synergistic response that is seen with whole food vitamins. Without this critical synergy of enzymes, coenzymes, trace minerals, and antioxidants, the synthetic vitamin must be delivered in much higher doses to achieve comparable results.
The quality of supplements are far more important than quantity. Taking more of an isolated form of vitamin will not make up for nutritional deficiencies because so many of the important nutrients that the body needs are missing. Only whole food ingredients can provide an individual with all the nutrients contained within food. If an individual were to consume a supplement with just dl-alpha tocopheryl for example, which many manufactures call vitamin E, the individual would be missing at least five other important nutrients, as well as hundreds of other nutrients that occur within the whole vitamin E complex. Researchers (Thiel 2000; Burton et al., 1998, as cited in Carsten, 2002) have shared this viewpoint “some estimates have suggested natural alpha-tocopherol may be twice as bioavailable as its synthetic counterpart (p.10).” The nutrients that occur within the whole vitamin E complex are only available by consuming natural, whole food forms of vitamin E, such as wheat germ oil, nuts, and sunflower seeds.
Additional physiological factors must be considered when examining the influence of synthetic or whole food vitamins. Carsten, (2002) noted that some processes to consider include the health of the digestive tract, body stores of synergistic factors, metabolism, and the rate of elimination. Multiple digestive conditions influence the absorption of both whole vitamin complexes and synthetic vitamins. Therefore, plasma concentrations after ingestion can be variable.
There are many implications based on feeding studies done with synthetic vitamins. It appears that synthetic vitamins may require some degree of reassembly following absorption as the body tries to convert them to biologically useful forms. The missing components that would complete the vitamin complex are not present in the synthetic form and therefore are derived from the body’s endogenous stores. This reassembly of the vitamin complex would then lead to potential depletion of body stores of these factors possibly interfering with normal biochemical processes, as has been suggested by Thiel (2000). Synthetic vitamins can be classified as chemicals that the body must eliminate. Elimination occurs through the liver and kidney. Preferential elimination has been demonstrated for some synthetic vitamins (Hoppe and Krennrich, 2000; Habash, Van der Mei, Busscher & Reid (1999); Traber, Elsner, & Brigelius-Flohe, 1998, as cited by Carsten, 2002). Carsten (2002) further explains the elimination of these xenobiotics as:
foreign chemicals that require metabolic processes that utilize cellular constituents. This creates cellular metabolic stresses that, generally, are appropriately managed. However, it has the potential to further compromise an already diseased and/or nutritionally depleted organ. This reduces the ability of the tissue to heal and regenerate.
Consequently, the vitamins an individual consumes in order to improve health, may actually be harming the body. Most individuals are unaware of the differences between eating food and supplementing with a whole food vitamin, and the outcomes when an isolated synthetic vitamin is ingested. The unfavorable conclusion is that individuals with the intention of seeking a multivitamin as a way of supporting the immune system during illness or disease may be actually causing himself or herself further harm. Until there are changes, and the vitamin and supplement industry is regulated, health practitioners have a responsibility to educated themselves, and in turn share this education with their patients. This is essential, especially those professionals in the field of orthodox medicine, where patients are turning to alternative medicines to alleviate symptom, illness, and disease. Patients that are facing serious illness and/or disease are most vulnerable and may be more likely to experiment with high dosing synthetic vitamins.
Recommendations for Further Research
As Standard Process (2004) demonstrated the process of absorption and the pathways each vitamin takes clearly outlines the body’s ability to recognize the difference between a synthetic vitamin and a whole food vitamin. These two molecules, although having a replica ligand, are widely divergent. Modern science needs to recognize this dynamic, and acknowledge the important role of the cofactors that are missing in the synthetic vitamin. Gidley (2004) supports this view:
in many cases it is difficult to be precise about the molecular origins for whole food benefits, as intervention studies with specific molecules have not shown convincing effects. It could be argued that the failure to reproduce expected benefits via intervention with vitamins/minerals is due to some combination of the underestimation and importance of the cellular structure of plants in providing the matrix from which molecules are released during digestive processing.
Researchers will need to study the molecular structure of whole foods, their cofactors, and their interdependent and interactive components. This cause should take precedence over studies involving isolated and synthesized vitamins. Some researchers have suggested post-genomic or nutritional genomics as a way to tackle the issue. Gidley (2004) proposes utilizing post-genomic biology of raw food materials to better define molecular composition, and exploit modern spectroscopic and microscopic methods to define the effect of food structure on molecular release.
Kaput and Rodriguez (2004) suggest nutrigenomics or nutritional genomics, calling it the next frontier in the post-genomic era. Nutrigenomics is described as a way to provide a molecular genetic understanding for how common dietary chemicals (i.e., nutrition) affect health by altering the expression and/or structure of an individual’s genetic makeup.
Like the human body, food is complex, full of unknowns, and very responsive and interactive with its environment. Due to the complex nature of food, science has been driven to find a simpler solution, the synthetic vitamin. However, if we compare the synthetic vitamin to the whole food vitamin with a molecule-based approach, we may as well compare apples to oranges. Instead of trying to replicate nature, science should try to improve on what nature has provided.
Some of the problems that arise when looking at the science of nutrition are due to the complexity of the nutritional components found in food. There are several hundred nutrients and phytonutrients that we know of in a carrot, and over 10,000 different chemical components in a spinach leaf, most of which is unknown physiologically. Because this complexity is so great, even today’s advanced scientific methods cannot sort out what is going on inside the cells of the human body. Identifying individual nutritional needs is almost impossible.
Scientific studies have shown how real whole foods work when it comes to improving health. These studies also show that isolated chemicals or synthetic vitamins do not work the same way food does. There is reference to optimal intakes of nutrients to allow people to maintain their health. However, optimal intake of nutrients varies among individuals based on their sex, age, and many other environmental, and biological factors. The amount of isolated nutrients needed to reduce the risk of one disease may not be optimal to reduce the risk of another disease. Synthetic nutrients may actually increase the risk of some disease in some people. When food is consumed, the body can selectively absorb what it needs at any particular time. These synergistic ingredients do not imbalance or deplete, are dose limiting because of the bulk of whole foods, and therefore they are safe.
Mega-doses of any one nutrient or phytochemical can adversely affect nutritional status in relation to other nutrients. In real food, beta-carotene never appears alone; it is accompanied by many other nutrients and carotenoids. Research has shown that these carotenes work together and when one of the compounds is isolated, the synergistic benefits are lost. The body tries to put back the missing pieces by using substances in the body to make up for it.
The study of nutrition is multifaceted and cannot be understood by conventional research focusing on a single factor. It is a fact, that real whole food is the best source for nutrients for health, not synthetic vitamins. Therefore, if using a supplement there is no other choice than the use of whole food supplements as an addition to real foods.
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Depletions and Interactions by Vitamin
A remedy’s contraindications lets one know when it is unsuitable to be used. Contraindications may include pregnancy, meaning the product should not be used during pregnancy, or a particular medicine, such as aspirin, which should not be combined with some other nutrients or herbs.
A caution means that it is possible that the remedy will not be recommended in some circumstances; it is not as strong as a contraindication. Cautions include the fact that some nutrients irritate the stomach. It is up to the individual to decide if they mind the possibility of that side effect.
Side effects of a medicine are effects, which may occur to the body due to taking the medicine, in addition to the desired effect. Side effects may include effects that are seen in most people taking that medicine, or side effects that may have occurred only once.
An interaction occurs when the administration of one medication, whether a nutrient or a drug, affects the action of another medication. These interactions can occur either by one medication directly acting on the other, or through their effects on the human body. Examples of Interactions:
(1) Adverse interaction – avoid these vitamins when taking this medication because taking them together may cause undesirable or dangerous results.
(2) Reduced drug absorption or bioavailability – avoid these vitamins when taking this medication since the vitamin may decrease the absorption and activity of the medication in the body.
Contraindications: Vitamin A supplementation is contraindicated if one is are pregnant, or are likely to become pregnant, except on the advice of a qualified medical practitioner.
Cautions: Excessive supplementation with Vitamin A over extended periods of time can lead to toxicity, as the vitamin is stored in the liver.
Cautions: Long-term daily intake of 500mg., or a shorter-term intake of 2000mg of vitamin B6, has been shown to cause nerve toxicity in some people.
Interactions: Supplementation with vitamin B6 should be avoided if one is taking Levodopa for Parkinson’s disease.
B6 Folic Acid
C Mixed Amphetamines
Cautions: Vitamin D can also cause toxicity if taken for an extended period of time. It is therefore important that daily intake does not exceed 1000 IU.
Interactions: Vitamin D supplementation should not be taken if one is taking digoxin, thiazide diuretics, or calcitonin, unless supervised by a qualified medical practitioner.
D Estrogens (combined)
Contraindications: High doses of vitamin E are contraindicated prior to surgery or going into labor, due to its anti-clotting effects.
Interactions: High doses of vitamin E should not be taken in combination with anti-coagulant drugs as it may enhance their effects.
E Aspirin, Warfarin
Classification of Vitamins (High Beam Encyclopedia, 2007)
Vitamins are a group of organic substances that are required in the diet of humans and animals for normal growth, maintenance of life, and normal reproduction. Vitamins act as catalysts; very often, either the vitamins themselves are coenzymes, or they form integral parts of coenzymes. A substance that functions as a vitamin for one species does not necessarily function as a vitamin for another species. The vitamins differ in structure, and there is no chemical grouping common to them all.
Vitamin A (retinol) is a fat-soluble vitamin that is found in foods such as liver, egg yolks, cream, or butter, carrots, sweet potatoes, and leafy vegetables. Vitamin A is essential to skeletal growth, normal reproductive function, and the health of the skin and mucous membranes. A deficiency of vitamin A can cause retarded skeletal growth, night blindness, and other various abnormalities of the skin and linings of the genitourinary system and gastrointestinal tract. Deficiency of vitamin A can also lead to permanent blindness. Over consumption of vitamin A can cause irritability, painful joints, growth retardation, liver and spleen enlargement, hair loss, and birth defects. The National Research Council recommended daily dietary allowance for adults is 1,000 micrograms (retinol equivalents) for men and 800 micrograms for women.
Vitamin B is actually a complex of eight water-soluble vitamins.
Thiamine (vitamin B1) is very important for proper carbohydrate metabolism. B1 is found in yeast, whole grains, lean pork, nuts, and legumes. This vitamin helps maintain healthy appetite, normal intestinal function, and the health of the cardiovascular and nervous systems. A deficiency of the vitamin may lead to beriberi. The recommended dietary allowance for adults is 1.2 to 1.4 mg for men and 1.0 to 1.1 mg for women.
Riboflavin (vitamin B2) is important in biochemical oxidations and reductions. Deficiency leads to fissures in the corners of the mouth, inflammation of the tongue, skin disease, and often-severe irritation of the eyes. The recommended dietary allowance for adults is 1.4 to 1.7 mg for men and 1.2 to 1.3 mg for women. Riboflavin is found in plant and animal tissues, milk, and organ meats.
Niacin (nicotinic acid) and niacinamide (nicotinamide) deficiency causes skin disease, diarrhea, dementia, and ultimately death. Lean meats, peanuts and other legumes, as well as whole-grain bread and cereal products are some of the best sources of niacin. The recommended daily dietary allowance for adults is 16 to 19 mg niacin equivalents (60 mg of dietary tryptophan to 1 mg of niacin) for men and 13 to 14 mg for women.
The vitamin B6 group pyridoxine, pyridoxal, and pyridoxamine all combine with phosphorus in the body to form the coenzyme pyridoxal phosphate, which is necessary in the metabolism of amino acids, glucose, and fatty acids. The best sources of B6 vitamins are liver and other organ meats, corn, whole-grain cereal, and seeds. Deficiency can result in central nervous system disturbances (e.g., convulsions in infants) due to the role of B6 in serotonin production. The recommended dietary allowance for adults is 2.0 to 2.2 mg for men and 2 mg for women. Additional doses are required in pregnancy and by those taking oral contraceptives or the tuberculosis drug izoniazid. Severe nerve damage has been reported from mega doses.
Pantothenic acid, another B vitamin, is a component of coenzyme A, which is involved in the metabolism of many biochemical substances including fatty acids, steroids, amino acids, and carbohydrates. Sources of this B vitamin include liver, kidney, eggs, and dairy products. There is no known naturally occurring deficiency state and no known toxicity to pantothenic acid. The estimated safe and adequate daily intake for adults is 4 to 7 mg.
Biotin is a B vitamin that functions as a coenzyme in the metabolism of carbohydrates, fats, and amino acids. Naturally occurring biotin deficiency disease is virtually unknown. Sources of this vitamin include egg yolk, kidney, liver, tomatoes, and yeast. There is no known toxicity to biotin. The estimated safe and adequate daily intake for adults is 100 to 200 micrograms.
Folic acid (pteroylglutamic acid, folacin, or vitamin B9) occurs abundantly in green leafy vegetables, fruits (e.g., apples and oranges), dried beans, avocados, sunflower seeds, and wheat germ. This vitamin is involved in the synthesis of nucleic acids. The retarded synthesis of blood cells in folic acid deficiency results in several forms of anemia, while failure to replace rapidly destroyed cells in the intestinal wall results in a disease called sprue. Inadequate amounts of folic acid in the diet of pregnant women have been strongly associated with neural tube defects (i.e., spina bifida and anencephaly) in newborns. Adequate folic acid also reduces the risk of premature birth. The recommended daily dietary allowance for adults is 400 micrograms.
Vitamin B12 (cobalamin) is necessary for folic acid to fulfill its role and is involved in the synthesis of proteins. Pernicious anemia in humans is caused not by a vitamin B12 deficiency in the diet, but rather the absence of a substance called the intrinsic factor, ordinarily secreted by the stomach and responsible for facilitating the absorption of B12 from the intestine. The only site of cobalamin synthesis in nature appears to be in microorganisms; neither animals nor higher plants are capable of making these vitamin B12 derivatives. Animal tissues such as the liver, kidney, and heart of ruminants contain relatively large quantities of vitamin B12. Clams and oysters) are also good sources of B12. The recommended daily dietary allowance for adults is 3 micrograms.
Vitamin C, or ascorbic acid, is a water-soluble vitamin that is found in citrus fruits and tomatoes and red pepper as well as berries, green and yellow vegetables, white and sweet potatoes. Vitamin C is readily oxidized, and therefore is easily destroyed in cooking and during storage. All animals except humans, other primates, guinea pigs, and one bat and bird species are able to synthesize ascorbic acid. Ascorbic acid is necessary for the synthesis of the body’s cementing substances: bone matrix and collagen. Deficiency of vitamin C results in scurvy. The use of mega doses of ascorbic acid to prevent common colds, stress, mental illness, cancer, and heart disease is a continuing subject of research. The recommended daily allowance for adults is 60 mg.
Vitamin D consists of two fat-soluble compounds, calciferol (vitamin D2) and cholecalciferol (vitamin D3). They are now known to be hormones, but continue to be grouped with vitamins because of historical misclassification. Vitamin D3 plays an essential role in the metabolism of calcium and phosphorus in the body and prevents rickets, which is bone disease caused by a deficiency of vitamin D or calcium. A plentiful supply of 7-dehydrocholesterol, the precursor of vitamin D3, exists in human skin and needs only to be activated by a moderate amount of ultraviolet light (less than a half hour of sunlight) to become fully potent. Symptoms of vitamin D deficiency in children include bowlegs, knock-knees, and more severe (often-crippling) deformations of the bones. In adults, deficiency results in osteomalacia, characterized by a softening of the bones. Excessive vitamin D consumption can result in toxicity. Symptoms include nausea, loss of appetite, kidney damage, and deposits of insoluble calcium salts in certain tissues. The recommended daily dietary allowance for cholecalciferol is 5 to 10 micrograms (200 to 400 IU) depending upon age and the availability of sunlight.
Vitamin E occurs in eight molecular forms, 4 each of tocopherols and tocotrienols. In humans, the most biologically active form has generally been considered to be alpha-tocopherol, which is also the most common. The best sources are vegetable oils, green leafy vegetables, wheat germ, some nuts, and eggs. Vitamin E is necessary for the maintenance of cell membranes. It is helpful in the relief of intermittent claudication (calf pain) and in preventing problems peculiar to premature infants. In large doses, it has an anticoagulant effect. The recommended daily dietary allowance for adults is 10 mg (tocopherol equivalents) for men and 8 mg for women.
Vitamin K consists of substances that are essential for the clotting of blood. Two types of K vitamins have been isolated: K1, an oil purified from alfalfa concentrates, and K2, synthesized by the normal intestinal bacteria. The best sources for vitamin K are leafy green vegetables, such as cabbage and spinach, and intestinal bacteria. Vitamin K is required for the synthesis in the liver of several blood clotting factors, including prothrombin. In the deficiency state an abnormal length of time is needed for the blood to clot, and there may be hemorrhaging in various tissues. The estimated safe and adequate intake for adults is 70 to 140 micrograms.
Graphic depiction of the contrasting vitamins and their pathways (Standard Process, 2004)
Whole Vitamin Complex
1) note the complexity of structure representing the vitamin and associated cofactors including enzymes, coenzymes and mineral activators in a protein matrix.
2) synthetic vitamin showing the vitamin structure and two possible stereoisomer ligands that have the same structural formula, but different confirmation.
Whole Vitamin Complex in the Kidney / Synthetic Vitamin in the Kidney
Whole Vitamin in the Liver Synthetic Vitamin in the Liver