Medicine for the Outdoors
Medicine for the Outdoors

Dr. Paul Auerbach is the world's leading outdoor health expert. His blog offers tips on outdoor safety and advice on how to handle wilderness emergencies.

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Vitamins E and C in the Prevention of Cardiovascular Disease

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By now, most of you have probably figured out that I am not confining my posts to wilderness and outdoor medicine in the strictest sense. In recognition of the fact that medicine is multi-disciplinary in nature, and that many interrelationships are worthy of exploration, I am always on the lookout for new information and new associations. Such is the case with this brief discussion of an article entitled, "Vitamins E and C in the Prevention of Cardiovascular Disease in Men: The Physician's Health Study II Randomized Controlled Trial," authored by Howard D. Sesso et. al. in the Journal of the American Medical Association (downloaded from www.jama.com on November 10, 2008).

Many of us try to maintain good health in part by taking vitamin supplements, including vitamins E and C. The putative benefits of these two vitamins as supplements is in their antioxidant capacity, for the purpose of reducing cardiovascular disease. Many of my healthy, active and outdoor-minded colleagues take these supplements regularly, and some even believe that they improve their performances under situations of physical stress, including brisk exercise and when suffering viral illnesses. However, no one has heretofore had data to support the utility of vitamin E or C supplementation to reduce cardiovascular disease.

The investigators enrolled 14,641 U.S. male doctors in this study, which began in 1997 and concluded in in 2007. The enrollees were 50 years of age or older, and 754 of them (5.1%) had known pre-existing cardiovascular disease. The supplements were 400 international units of vitamin E ingested every other day, and 500 milligrams of vitamin C taken daily. The study was a randomized, double-blind, placebo-controlled trial, which means that until the completion of the study, no one knew which enrollee was taking real vitamins and which enrollee was taking the placebo products.

The conclusions of the study were that in this study group, neither vitamin E nor vitamin C supplementation reduced the risk of major cardiovascular events (such as heart attack or stroke). This was true for each vitamin alone and when they were taken in combination. The investigators noted an increase in hemorrhagic (bleeding) stroke in the vitamin E group.

The investigators looked for adverse effects from these vitamins, such as bleeding, diarrhea, nausea, fatigue, skin rashes, headache, etc. No increase in these parameters was noted in the active vitamin groups.

The take-home message is that we need more studies like this, to look at many, if not all, of the vitamin and mineral supplements that are taken for suspected, but not proven benefit. We may find that these supplements not only do not improve our health, but might had a deleterious effect(s). There are is no end of theories about how various substances, allopathic and naturopathic, might improve our health, but most of them are just that - theories. Supra-normal quantities of chemicals, be they vitamins or otherwise, that go beyond our established nutritional needs, should be proven useful before their ingestion is adopted as necessary or desirable.

I see large handfuls of vitamin pills popped by my peers and friends on the trail, under the assumption that if a little is good, a lot must be better. Not necessarily true!

photo courtesy of www.mizar5.com

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Dr. Paul S. Auerbach is the world’s leading authority on wilderness medicine.

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