With the recent report in The Journal of the American Medical Association (see accompanying article in “News & Events”) that Vitamin E supplementation may increase the risk of prostate cancer, patients are left wondering why a natural substance that is an antioxidant wouldn’t be beneficial. The answer is two-fold.

First of all, a little science (bear with me here): while it is known that oxidative stress plays a role in disease processes—from many cancers to something closer to home here at Desert Cardiology, i.e. coronary heart disease—it’s only a theory that taking an anti-oxidants is going to reverse that process. And, even assuming that blocking oxidation is the right thing to do, how do we know how to do it to therapeutic benefit. Does everything that is an anti-oxidant have equal benefit? Do some anti-oxidants have other properties that might negate their benefits? What dose would be the right dose? Does a particular anti-oxidant work best by itself or in the company of other compounds in order to achieve it’s best effect (see point number two below)?

In various blogs, we at Desert Cardiology have stressed why the scientific method, particularly randomized controlled clinical trials, are the only accurate means to assess these questions. Scientists perform research, come up with their best hypothesis as to the answer to those questions above and then conduct a study like the one just published, in order to test that hypothesis. In this case, the hypothesis turned out to be wrong. (Of note, in the field of cardiology, only one supplement has actually been proven to be beneficial in heart disease: fish oil. Another, Vitamin D, is showing some promise, but hasn’t yet undergone rigorous clinical trials.)

The second point that I alluded to above is that supplements aren’t “natural.” While they are found in living organisms, it is artificial to pull them out of their natural environment and package them into pills (or juices or powders). Many of the benefits of natural substances are present only in the context of all the other good things that come along with them, pre-packaged in the food that we eat. Since it’s summarized so well in the other article I placed in “News & Events,” I’ll quote directly from it:

“The latest theory is that vitamin isolates don’t work quite as well on their own . . . Rather, it may take the full blend of antioxidants and phytochemicals found within the context of a whole food in order to deliver any potential benefits . . . ‘[Patients] should stop trying to look for health in a pill . . . Health is not found in pills. It’s found in good food and regular exercise. There’s something in our psyche that makes us want to believe in magic, and that desire to believe has focused on vitamins.’”

Bottom line: you can’t trust marketers (I’m including the internet, as well as TV) who push supplements—even if they have an MD after their names. There is no short cut to bona fide medical information and there is no short cut to good health—regular exercise and a healthy diet are the best natural medicine.

-Greg Koshkarian, MD, FACC