Plants, not Pills, for Vitamins and Minerals
People are looking for a
magic bullet to offset all their destructive habits and fix the resulting
bad health. One superficial solution for 70% of people in the USA is to
take supplements of vitamins and mineral blends. These concentrated
mixtures enter our bodies by way of pills, nutrition bars, “health”
drinks, and cereals. “Vitamania” intoxicates the modern world. Vitamin
users are more likely to be female, older, better-educated, affluent,
non-smokers, light-drinkers, frequent-exercisers, and to consume diets
lower in fat and higher in fruits and vegetables.1 Sounds
like a nice group of people. Unfortunately, some of these same people
don’t like me much because of my stand on this matter.
Nearly a decade ago, my syndicated radio show was
threatened by people offended by my stand on supplements. During my
2-hour broadcast all over the entire West Coast (USA) each Sunday evening,
I tried to balance “negative” articles, like vitamin A causing a 1 in 57
chance of birth defects when taken by a pregnant woman, with “positive”
ones, like folic acid supplementation taken before pregnancy reduces risk
of serious birth defects. However, this wasn’t enough for a group of
“vitamin activists” from
Los Angeles who worked to cause me to lose my sponsors. They
recorded my show and edited into one tape everything that could possibly
be detrimental to supplement sales. By the very next morning, the
activists had called and left this anti-supplement message on the
answering machines of health food stores up and down the West coast.
Unfortunately, many of these same businesses were my radio show sponsors,
and a good percentage of their livelihood came from sales of vitamins and
minerals. Fortunately, I survived that battle.
The Best Vitamin and Mineral Sources
Vitamins are organic compounds that cannot be synthesized
by the human body and therefore must be consumed to prevent serious
illnesses. Fruits and vegetables are the main sources and primary
manufacturers of most vitamins (11 of 13 known vitamins are synthesized by
plants – D comes from the sun’s actions on our skin and B12
from bacteria). Plants are also the most direct source for minerals – all
of which originate in the ground and enter into living systems through the
roots of plants – and then into animals. Unfortunately, only 20% to 30%
of the people living in Western populations consume the 5 or more servings
recommended daily of fruits and vegetables. The elderly, alcoholics, and
those with chronic illnesses are also at higher risk of suffering real
deficiencies. But the solution is more plants, not pills.
Even your local supplement salesperson readily admits
fruits and vegetables are the ideal sources of these essential
nutrients…BUT, they add, “because of our depleted soils these sources are
now inadequate and therefore supplements are necessary.” I will address
this argument later.
Three Reasons I Do Not Recommend Supplements:
1) They Provide No Bang for the Buck
When I lecture I am always asked, “Dr. McDougall, what do
you think about taking supplements of vitamins and minerals?” My response
is, “How many of you know people who have lost 100 pounds taking
supplements? How about people who were able to stop blood pressure pills,
diabetic, or pain medications? Do you know anybody who has found complete
relief of their inflammatory arthritis (rheumatoid arthritis), chest pains
(angina), or headaches by investing in these potions?”
I never see a hand rise.
Compare this dismal response to the fact that I meet people
every day, either in person or by e-mail, who have these very results and
more by following a healthy low-fat, plant-based diet, and exercise –
approaches that are cost-free. Until I see the same with supplements I
will not waste my time and effort. Nor should you.
2) Your Friends Don’t Have Deficiency Diseases
How many friends and relatives do you have with deficiency
diseases? Pellagra (niacin), Beriberi (vitamin B1), or Scurvy (vitamin
C)? Protein deficiency? Essential fat deficiency?
The answer is,
Nearly a century ago vitamin supplements would have been heralded as
miracles for curing these deficiency diseases. Today in modern Western
societies these diseases are essentially unknown, because of better
nutrition for most people (more fruits and vegetables) and correction of
deficiencies which had been created by manufacturing processes (such as
the refining of rice).
Now, turn your vision 180 degrees.
I’ll ask you the opposite question. How many of your friends and
relatives have diseases of “excess”? Like excess cholesterol, fat, sodium,
and protein? The answer is clearly,
“most of them.”
paradox of today’s living is that with all of our modern developments and
technical advances we have developed another form of deadly malnutrition –
properly labeled “overnutrition.”
An additional problem for those people caught up in
vitamania is that the over-enthusiastic use of supplements can result in
diseases of excess of these very vitamins and minerals. For example,
Vitamin A supplements increase the risk of hip fractures (osteoporosis)
and birth defects.2-4 Iron supplementation can cause a fatal
liver disease called hemochromatosis.5 Magnesium
supplementation has been found to increase the risk of heart attacks and
sudden death especially among people with heart disease, and those who
have recently undergone coronary artery bypass surgery.6 Zinc
and iron supplements may also increase the risk of death from heart
3) Nature (God) is Smarter than the Lab Technician
Vitamin manufactures do not improve upon nature’s design.
Vitamins and minerals are found in natural packages called fruits and
vegetables. These nutrient-rich foods have been under development for
hundreds of millions of years. Their interactions with living animals
have been tested and proven correct over eons of successful living.
Possibly thinking they are smarter than Nature (God), lab technicians now
take selected nutrients from their original environments, isolate and
concentrate them, package them in capsules, and then sell them to us with
claims that these “new and improved” potions are necessary for good
health. At best the results are medications, and at worst, they are
Manufacturing creates serious problems because nutrients do
not work in isolation, but rather function properly, along with thousands
of other substances that are found within the food, all in correct amounts
Harmful Imbalances Cause Diseases
More Cancer with Beta-carotene Supplements
In concentrated, isolated, forms these vitamins and mineral
supplements cause nutritional imbalances that can have serious
consequences. The classic example of this imbalance problem was seen
with beta-carotene supplementation for cancer. Two recent well-designed
studies found an increase in lung cancer when smokers were given
supplements of beta-carotene (a precursor of vitamin A).8,9
These studies were performed because a reduced risk of several forms of
cancer has been found in people with high intakes of beta-carotene –
however, these findings simply reflected a diet high in plant foods.
Beta-carotene is a vitamin precursor (pro-vitamin) found only in plants.
Beta-carotene is one of over 600 substances classified as
carotinoids found in yellow and orange fruits and vegetables.
Inside our cells are receptors for carotinoids – these are the sites where
carotinoids attach and function. When the cell is flooded with
beta-carotene by vitamin supplementation (pills), then there is
overwhelming competition for these receptor sites that excludes their use
by the other 599-plus carotinoids – creating a serious nutritional
Supplements Cause More Heart Disease
Taking antioxidant vitamins which are supposed to help the
heart seems to do the opposite because of imbalances created. In the
Heart Protection Study multiple vitamins (600 mg synthetic vitamin E,
250 mg vitamin C, and 20 mg beta-carotene daily) increased risk factors
for heart disease (triglycerides, LDL-cholesterol, and total cholesterol.10
This same combination of antioxidant vitamins was found to interfere with
the effectiveness of commonly prescribed cholesterol-lowering medications
(statins like Mevacor, Lipitor, Zocor, etc.) by blunting the rise in HDL
“good” cholesterol.11 The bottom line may be reflected
in one study of 1,862 male smokers with a history of heart attack. Taking
either vitamin E or beta-carotene, together or singly, resulted in a
significantly increased risk of fatal coronary heart disease.12
Folic acid supplementation is supposed to be the newest
answer for heart disease prevention. However, after six months of
supplementation in 636 heart patients with stents (stents are supports
placed in the coronary arteries during angioplasty), the Folate After
Coronary Intervention Trial found those taking folic acid had
significantly more narrowing of the arteries compared to those taking
placebo – the exact opposite of what investigators had expected to find.13
The experimental group received
folic acid (1 mg), vitamin
B6 (5 mg) and vitamin B12 (1 mg) IV immediately after angioplasty with a
stent inserted, followed by daily oral doses of folate (1.2 mg), vitamin
B6 (48 mg) and vitamin B12 (0.06 mg).
To summarize the research on vitamins and heart disease
prevention, the U.S Preventive Services Task Force (USPSTF) published a
report July 1, 2003 concluding, “…that the evidence is insufficient for
or against supplements of vitamins A, C, or E; multivitamins with folic
acid; or antioxidant combinations for the prevention of cancer or
cardiovascular disease.” 14
Elderly Harmed by Vitamin E
A study of elderly persons found vitamin E supplementation
(200 mg) resulted in more severe and frequent upper respiratory
infections.15 Those taking the vitamins had longer total
illness duration, more symptoms, and a higher frequency of fever and
restrictive activity. Investigators suspected an imbalance created by
long-term supplementation was the root cause. This finding becomes even
more relevant when you realize 50% of the elderly take vitamin and mineral
supplements that usually include vitamin E. Also important to the elderly
and others is the observation that in high doses vitamin E antagonizes the
functions of other fat-soluble vitamins resulting in bone loss, reduced
liver storage of vitamin A, and blood clotting problems.16
Mineral Imbalances Cause Disease
Imbalance problems are also created with mineral
supplementation.17 For example, intestinal absorption of copper
is inhibited by zinc.18 The intestinal competition of
zinc with copper, iron, lead, calcium and cadmium may accentuate
nutritional deficiencies or toxicities from these environmental metals.19
Vitamins also influence mineral activity; for example, ascorbic acid
(vitamin C) strongly promotes iron absorption.20
Considering the complexity of interactions of the body with
our nutrients, unless you believe some man or woman sitting in a
laboratory is smarter than Nature (God), then you would be prudent to take
your vitamins and minerals only in their natural packages – whole grains,
vegetables, and fruits.
When Supplements Benefit
Vitamins and minerals can be used as medications to cause
effects – this is different than supplementation to promote natural
health. Realize that all medications have adverse effects accompanying
their intended, positive effects.
Vitamin C will not prevent common colds but may provide a
modest benefit in reducing the duration of symptoms of colds.21
Vitamin D may delay loss of bone in elderly, but sunlight
is the right source of this vitamin.22
Folic acid lowers homocysteine, but there is no evidence
yet from controlled studies that this translates into reduced
cardiovascular disease or cancer.23
Folic acid will prevent birth (neural tube) defects.23
Vitamin B12 should be taken when following a strict vegan
diet – like the McDougall diet
– if followed for more than three years or
if pregnant or nursing.
Iodine supplementation prevents thyroid disease in areas of
the world where iodine deficiency is endemic.24
Iron supplementation is used for treating iron deficiency
diseases, like anemia (most of the time iron deficiency is due to other
correctable causes, like bleeding, dairy products, etc.)
Sometimes I Use Supplements as Medicines
I have used vitamins as medicines – hoping to cause more
good than harm in my patients. For example, I have taught for years that
high cholesterol levels can be lowered with 2 grams of Vitamin C, 400 mg
of Vitamin E, and/or 500 to 3000 mg of Niacin daily. The literature
supports this reduction in risk factors for heart disease by using these
supplements. (See my September 2002 and February 2003 Newsletters.)
The “Depleted Soils” Sales Pitch
The sales pitch is: “You must take supplements because of
the poor condition of the soils – depleted soils – our plants are now
grown in.” First understand that minerals are from soils and vitamins are
synthesized by plants. If a plant is going to bear roots, seeds, flowers,
and/or fruits fit for sale in your market, then it is going to have to
produce all the necessary “vitamins” for its own survival.
Mineral deficiency is theoretically possible – but highly
unlikely to affect anyone living in a modern society. The classic example
of a mineral deficiency is iodine deficiency, which has caused goiters in
underdeveloped parts of the world today, such as in
prior to the recent introduction of iodized salt.22 (There are
also some rare cases of selenium deficiency and possibly zinc deficiency
in underdeveloped countries.) These deficiencies occur because of the
limited supply of foods for these people. They eat only foods grown in
their local region, and the soil in their neighborhood may well be
deficient in one of these minerals.
However, the risk of you suffering from vitamin or mineral
deficiency caused by depleted soils is so incredibly small that a single
case would make national headlines. This is simply because you eat foods
grown from a wide variety of soils: corn grown in Nebraska soils, grapes
from Chili, bananas from Panama, etc. In the unlikely chance that one
food was low in a mineral, your next bite would likely contain an abundant
Still Perplexed? What to Do?
For anyone not willing to buy fully into my arguments –
that is someone with an incurable case of vitamania – an appropriate
response for his unsupported fears would be to take an inexpensive
one-a-day, vitamin-mineral capsule – costing less than $20 a year. Spend
the money saved by not buying that shelf full of supplements on a better
pair of walking shoes, a shopping trip to the farmers’ market, or a
1) Patterson RE. Cancer-related behavior of vitamin
supplement users. Cancer Epidemiol Biomarkers Prev. 1998
2) Michaelsson K.
Serum retinol levels and
the risk of fracture. N Engl J Med. 2003 Jan 23;348(4):287-94.
3) Dolk HM.
Dietary vitamin A and
teratogenic risk: European Teratology Society discussion paper. Eur J
Obstet Gynecol Reprod Biol. 1999 Mar;83(1):31-6.
4) Rothman KJ.
Teratogenicity of high
vitamin A intake. N Engl J Med. 1995 Nov 23;333(21):1369-73.
5) Schumann K.
Safety aspects of iron in
food. Ann Nutr Metab. 2001;45(3):91-101.
6) Galloe AM.
Influence of oral magnesium
supplementation on cardiac events among survivors of an acute myocardial
infarction. BMJ. 1993 Sep 4;307(6904):585-7.
7) Black MR.
Zinc supplements and serum
lipids in young adult white males. Am J Clin Nutr. 1988
8) The effect of vitamin E and beta carotene on the
incidence of lung cancer and other cancers in male smokers. The
Alpha-Tocopherol, Beta Carotene Cancer Prevention Study Group. N Engl
J Med. 1994 Apr 14;330(15):1029-35.
9) Omenn GS.
Effects of a combination of
beta carotene and vitamin A on lung cancer and cardiovascular disease.
N Engl J Med. 1996 May 2;334(18):1150-5.
10) MRC/BHF Heart Protection Study of antioxidant vitamin
supplementation in 20,536 high-risk individuals: a randomised
placebo-controlled trial. Lancet. 2002 Jul 6;360(9326):23-33.
11) Brown BG.
Simvastatin and niacin,
antioxidant vitamins, or the combination for the prevention of coronary
disease. N Engl J Med. 2001 Nov 29;345(22):1583-92.
12) Rapola JM . Randomised trial of alpha-tocopherol and beta-carotene
supplements on incidence of major coronary events in men with previous
myocardial infarction. Lancet. 1997 Jun 14;349(9067):1715-20.
13) Lange H. Folate After
Coronary Intervention Trial” (FACIT).
14) U.S. Preventive Services Task Force.
supplementation to prevent cancer and cardiovascular disease:
recommendations and rationale. Ann Intern Med. 2003 Jul
15) Graat JM.
Effect of daily vitamin E
and multivitamin-mineral supplementation on acute respiratory tract
infections in elderly persons: a randomized controlled trial.
JAMA. 2002 Aug 14;288(6):715-21.
16) Chandra RK. Graying of the immune system. Can
nutrient supplements improve immunity in the elderly? JAMA. 1997
17) Roughead ZK.
Dietary copper primarily
affects antioxidant capacity and dietary iron mainly affects iron status
in a surface response study of female rats fed varying concentrations of
iron, zinc and copper. J Nutr. 1999 Jul;129(7):1368-76.
18) Sandstead HH.
Requirements and toxicity
of essential trace elements, illustrated by zinc and copper. Am J Clin
Nutr. 1995 Mar;61(3 Suppl):621S-624S.
19) Abdel-Mageed AB.
A review of the biochemical
roles, toxicity and interactions of zinc, copper and iron: I. Zinc. Vet
Hum Toxicol. 1990 Feb;32(1):34-9.
20) Sandstrom B.
effects on absorption and bioavailability. Br J Nutr. 2001 May;85
21) Douglas RM. Vitamin C for preventing and treating the
common cold.Cochrane Database Syst Rev. 2000;(2):CD000980.
22) Gennari C.
Calcium and vitamin D nutrition and bone disease of the
elderly. Public Health Nutr. 2001 Apr;4(2B):547-59.
23) Bender DA.
Daily doses of multivitamin tablets. BMJ. 2002 Jul
24) Kalk WJ.
Dietary iodine deficiency in South Africa.
Surveys before the introduction of universal salt iodisation.
S Afr Med J.
1998 Mar;88(3 Endocrinology):357-8.