Table of Contents
SHARI LIEBERMAN
dedicates this book to the memory of her father and mother, Mort and Sheila Lieberman.
NANCY BRUNING
dedicates this book to the memory of her mother,
and to her extended family of friends and colleagues,
who continue to nourish her in ways beyond comprehension.
Acknowledgments
DR. SHARI LIEBERMAN would like to thank Kirk Hamilton for CP Currents, his superb monthly newsletter review of the scientific literature.
Preface to the Fourth Edition
ITS BEEN more than ten years since the first edition of The Real Vitamin & Mineral Book was written and published. With each edition we sift through voluminous amounts of research, since science in the field of nutrition grows at an exponential rate. What did we find with this edition? That there are even more data that confirm the use of nutritional supplementation at ODI (Optimum Daily Intake) levelsmost of which are well beyond the RDIs or RDAs. There are very few negative studies, and we address the important ones in this bookmeaning the ones that have gotten the most media attention. The most glaring issue is when one negative study that flies in the face of virtually all other studies hits the media and is quickly disseminated to the public. And the numerous experts who respond to these studies virtually never see airtime to explain the flaws. One major example is the study that claimed vitamin E supplementation increased death (see page 107).There have been numerous rebuttals written by well-known antioxidant experts (none of whom were the authors of the study) that agreed the analysis of the authors was flawed and the information about increased death rates was erroneous. If we take an imaginary scale and put all the positive vitamin E studies on one side and all the negative vitamin E studies on the other sidethe scale tips quickly to the positive side. If we further go through the studies and separate those studies that either used natural vitamin E (often with mixed tocopherols or tocotrienols) in food or supplements versus those studies that used synthetic vitamin E, the scale tips even further to the positive side. For example, well-designed studies that show vitamin E supplementation may prevent Lou Gehrigs disease (amyotrophic lateral sclerosis), which is always fatal, as well as a host of other diseases, including cardiovascular disease, cancer, and diabetes, are largely ignored by the media.
Did you know that there are negative drug studies as well? These appear to only get out to the public when the end point is death, such as with Vioxx. However, there are often other dangers. Did you know that acetaminophen is one of the leading causes of emergency room visits, liver failure, and a need for a liver transplant? This obviously suggests that the warning label for its use is sorely lacking in getting the message across. Even using it properly over many years can increase blood pressure, which is a risk factor for cardiovascular disease. Adverse drug reactions (including prescription drugs) cause more than 100,000 deaths per year. There is no dietary supplement that carries anywhere near the risks associated with any over-the-counter or prescription drug.
Why the bias? There are many theories. An excellent article, Selling Sickness: the Pharmaceutical Industry and Disease Mongering, written by Ray Moynihan and colleagues (British Medical Journal 2002, 886-91), discusses the huge amount of money to be made from telling healthy people theyre sick. This medicalization is better described as disease mongering, which extends the boundaries of treatable illness in order to expand markets for new products. Disease mongering can include turning ordinary ailments into medical problems, seeing mild symptoms as serious, treating personal problems as medical ones, seeing risks as diseases, and framing prevalence estimates to maximize potential markets. There is a vested, financial incentive to sell sickness to the world. Its all about the money, and the vast majority of dietary supplements are not patentable. Therefore, millions of dollars of research funding need to come from somewhere. It costs more than $400 million to bring a new drug to marketa number out of the reach of any dietary supplement company. And even with great research, supplement companies lack the funds to compete with the billions spent on advertising and lobbying by the pharmaceutical industry.
It is still extremely difficult to get accurate information about preventing, treating, or mitigating any disease when you buy a dietary supplement despite all the research. While we hope this drastically changes in our lifetime, until it does, we will just have to keep updating this book. Even when there are literally thousands of studies, such as there are on fish oil, you will still not know when you pick up a bottle that it can dramatically decrease your risk of sudden death.You will not know exactly how much of a particular nutrient (or combination of nutrients) will specifically impact your immune system, cardiovascular system, or even brain function. And the media does very little other than promote the newest drug of the week or the month to the public. The public is given very little information about how to naturally deal with everyday problems, such as allergies or asthma.
Dietary supplements and lifestyle changes can help us live healthier lives.Yet instead, prescription drugs are being advertised to the public for most health problems. For example, if you have high cholesterol, then you are prescribed statins. However, if we simply look at the research on lowering blood lipids, niacin is the treatment of choice. It is safe, effective, and comes in forms that are flush free and far less toxic than the use of statins. Studies have even shown that statins work better when combined with niacin (although one could argue: why not use niacin alone?). Nancy and I are not against the use of drugs. Statins certainly have their place for folks who have had a history of heart disease. But to put people on statins simply because they have a high level of cholesterol or LDL (bad) cholesterol is not thoughtful medicine. After all, the side effects of niacin are a lowering of total cholesterol, LDL cholesterol, and triglycerides and an increase in HDL (good) cholesterol. Do you know of any prescription drugs that have such beneficial additional effects? On the contrary, people often end up taking additional medications to deal with the side effects of the original medication.
Another example of the efficacy of nutritional healing is fish oil. If we look at the research on fish oil and sudden death by heart attack, we see that it has been shown to be the most effective preventive by fareven compared to baby aspirin. And if we look at fish oil versus statins for lowering C-reactive protein (an inflammatory marker for heart disease risk), fish oil is equally effectivewhether it is consumed in your diet or taken as supplements. There are also many studies in the field of integrative medicine that combine conventional treatment with nutritional intervention to maximize resultsusing the best of both worlds.
Life is about choicesand you have the choice to take charge of your health using safe and effective dietary supplements. This book is not intended to replace your medical treatment or medical advice, but to empower both you and your health-care provider to use the power of nutrition to help you be healthy and stay healthy.
