The amazingly complex and varied tapestry of health claims skillfully weaved by the supplement industry seems to defy reason. This is because the majority of the implied health benefits have actually not been validated. At best, the sum of these assertions can only be described as either a hopelessly tangled web of deceptive claims or a meaningless morass of well meaning and unfettered propaganda.
Scattered amongst this maelstrom of mostly vacuous assumptions (because of insufficient scientific support), are points of interest that might reflect, albeit in a hopelessly twisted and contorted way, glimpses of what the real world of scientific inquiry has discovered. For example, nutritional researchers are opening new horizons into the world of functional foods- those foods that impact health in certain ways as compared to others.
The research is literally buzzing with studies evaluating everything from whole food matrices to individual food related components poring over innumerable potential biological actions, effects, or physiological events these substances might produce in human or animal health. They include a broad category of substances such as vitamins and other bioactive compounds that seem to have actions at genetic, epigenetic, and biochemical levels and promise possible new therapeutic modalities.
However, there is still much to be resolved and elucidated and precious little hard dependable data from which to make the monumental claims often heard from supplement advocates. One of the interesting and reliable threads of observational information is the anticlimactic fact that regular food- whole food- has generally beneficial effects on people. In other words; it seems that the best way to maintain ourselves; this “bag” of chemicals we call our body is to have access to a variety of chemicals from the “outside”. To date and to our knowledge, this is best represented as good old food, preferably of the wholesome variety type.
In essence, there remains a large fog of undetermined effects from food related compounds; some may provide exciting new therapeutic or nutritional avenues many others will not. That the sum total of these elements- the food matrix- appears to be beneficial is a definite no brainer. The relationship between health and nutrition is real and there is much yet to be learned towards optimizing any benefits of nutrients with respect to possible targets such as health and age.
Unfortunately, many alternative practitioners take the leap from there to asserting that all disease is a result of some kind of "nutritional deficiency". Here is where so many supporters of supplement support tend to begin to fill in the blanks, so to speak, and literally create an incredibly muddled litany of food based products for these “conditions”. Some of the more intriguing health related claims come from those in the industry that “specialize” and promote the concept of natural whole food supplements. From here, comes a steady and persistent drum beat of support for the concept of whole food substances that are processed and packaged, often in mysterious proprietary ways, into tablets, capsules, powders, power bars, and liquids.
The obvious claim is that if wholesome food is good for you, then whole food based supplements are also good for you. There is a fuzzy undulating thread of reason that leads from this basic assumption, dips into the above mentioned incomplete and equivocal research, then leads back again to the creation of a cornucopia of whole food based products that are linked to an endless stew of nutritional recommendations built on falsehoods, half-truths, and even solid facts- though slightly tinted to favor the theme at hand (i.e.; sub-clinical nutritional deficiencies exist; therefore every body has some form of sub-clinical deficiency and needs “something”).
Among the more common nutritional recommendations and claims of whole food supplement advocates has to do with their clear and assured statements regarding vitamin supplementation. In particular food based vitamins or natural vitamins as opposed to synthetic vitamins implying that these are two different things and that the natural vitamin is inherently superior to synthetic vitamins. This claim has become increasingly loud with the growing number of negative studies regarding vitamin supplementation and benefit.
Some whole food supplement claims include:
A) Whole food vitamins claim special status because they come from wholesome and nutritious foods. For example, vegetables are dehydrated at low temperature and undergo a “process” such that the “vital” vitamin substance is extracted in it entirety. Because these vitamins are natural they have the correct three dimensional (sterio) isomeric configurations to fit the bodies’ physiological machinery.
Synthetic vitamins, on the other hand, contain all the possible isomers mixed in equal amounts1. Non identical synthetic isomers often differ in their biological effect and in many cases are non-functional or partially functional. Sometimes they are actually antagonistic to the naturally occurring isomer.
B) Whole vitamins are powdered food substances that contain an unknown number of additional co-factors, other vitamins, enzymes, fiber, minerals, and synergistic factors, compounds that synthetic vitamins do not have. These substances enhance the bioactive function of the supplement.
Synthetic vitamins are chemically created and form an isolated or incomplete vitamin product. They do not contain the complex of organic chemicals found in natural products. People can not absorb vitamins that are synthesized into “analogues” of vitamins extracted from food. Additionally, they can not absorb non- chelated minerals.
What some of the facts tell us:
A) The actual chemical structures of most vitamins are identical whether they are natural or synthetic in origin. Additionally, most synthetic vitamins are synthesized having the correct sterio-isomer. An exception is vitamin E where the synthetic (dl) version has various isomers all of which have some effects2.
For example, biotin and panthothenate are the correct d forms, ascorbate is the correct L, and vitamin B12 is not synthesized- it is made by bacteria utilized from that source by the supplement industry. Interestingly, many vitamins such as folate, niacin, B6, and beta-carotene do not even have sterio-isomers.
B) The idea of a “natural” source of vitamins does not really exist as all chemicals are natural and derive from natural chemical precursors. Even “natural” vitamins claimed to be extracted from food- undergo a process that necessarily changes their original place in that food. As such, they are not the same as the sum of compounds found in food.
The amount of vitamins found in many of these whole food supplement tablets, capsules, or whatever are often miniscual (same for other important elements such as fiber) and often far from accepted RDAs or other accepted dietary intake parameters. These groups claim that this is a good thing and the therapuetic effects are due to the additive synergies of ingredients
However, there are no broad independent studies corroborating the claim that “hundreds” of co-factors, enzymes…and other synergistic factors are actually in the capsule or tablet and that they potentiate the core vitamin. Even if they are, there is no evidence that these supplements are effective- even necessary in the general population beyond well known caveats. Additionally, the evidence is clear that the positive effects of vitamins, factors, and synergistic substance actually describe real food- not food extracts. A tiny dribble of dehydrated food extracts being linked to positively benefiting and "promoting" (code for treating) health is unconvincing. Also, there are no obvious generalized critical deficiencies in the general food supply even with the significant issues and problems regarding food production and distribution.
The absorption of vitamins can vary depending upon whether they are ingested as food or not. Otherwise, in general, a chemical is a chemical. For example, most minerals from the ground are absorbed quite well without the need to be chelated (more expensive). Some vitamins and related substance actually need to be metabolically changed by the body before they can be utilized. For example, synthesized folate is more active than the "natural" forms found in food as these configurations need to undergo biochemical changes before the body can take advantage of them.
The bottom line seems to be that food, in and of itself, is the key and vehicle through which vitamins and other substances should be ideally “administered”. The question and thrust of optimizing health from a micronutrient and macronutrient stand point needs to focus more on food distribution, safety, and quality rather than on non food supplementation.
On the other hand, there is a critical need to understand the effects of substances found in food and identify those substances that could very well benefit the general population as well as target groups of populations (i.e.; gerontology, nutrition in chronic diseases, metabolic disorders). As always, advancing scientific knowledge will continue to shed light on many of today’s tentative assumptions regarding the continuum of food, health, and function and shed light on truly effective possibilities.
Zempleni and Rucker in “Handbook of Vitamins” note that in the case of vitamins “Recent advances in molecular and cellular biology, analytical chemistry, and nanotechnology have dramatically improved the understanding of vitamin biomechanics and the requirements for human function. Vitamin-dependant signaling cascades, alterations in gene expression due to variations in vitamin supply, and DNA stability and packaging are just a few of the new roles for vitamins that these sciences reveal”. There is yet much to be learned- the right way.
1) A classical mantra is that these isomers can be compared to a pair of gloves identical in size, shape, and composition, but their 3-D configuration is different. Only one glove fits- they are not interchangeable.
2) As for vitamin E, products that contain dl-tocopherols have 8 isomers one of which is natural. Other products contain d-alpha tocopherols that are semi-synthetically derived where the isomer is in the ‘natural’ configuration. The question of whether the dl version of vitamin E is less efficacious is a good one and the varying effects of these variable isomers may have an impact. It may be that more of this form needs to be ingested to get similar result than for the d form of vitamin E. That said, the recent accumulating evidence does not support the use of tocopherols beyond what is found in food anyway.
Critics of these studies claim that only synthetic vitamin E was used. Though this is worth another post, a couple of points on this are that this may be, in part, a “the poison is in the dose” issue along with a possible vitamin E effect between opposing pro-inflammatory/anti-inflammatory actions.