Dr. Arturo M. Volpe

CNN and various newspapers, including The New York Times and the Houston Chronicle, recently reported on a Swedish study (The New England Journal of Medicine, January 2003; 348: 287-294, 347-349) linking Vitamin A with an increased risk of fractures in aging men. These reports have led many people to wonder if supplements containing Vitamin A are safe, and many media outlets are advising readers against the use of any Vitamin A.

Since I often recommend cod liver oil (which does in fact contain Vitamin A) and other Vitamin A supplements, I was very puzzled by these reports and read the study in its entirety. I was surprised to see how little is known about the participants in the study. Basically all that was recorded was their level of Vitamin A in blood and the incidence of fractures over a thirty-year period. To conclude with certainty from this scant information that Vitamin A is dangerous seems quite a stretch to me.

Before we start thinking of Vitamin A as hazardous, let’s remember that it plays many important roles, including in vision, cell differentiation, early fetal development, immunity, taste, appetite and growth. Vitamin A is an important antioxidant and may have anticancer and antiviral actions. Signs of deficiency include night blindness, acne and other skin conditions, reduced immunity, chronic viral conditions, complications from measles and, conceivably from the measles vaccine.

The US RDA (recommended daily allowance) for Vitamin A is 5,000 IU (international units) a day for adults and proportionately less for children. The most important recognized risk of Vitamin A is that doses exceeding 10,000 units a day in pregnant women were associated with a higher risk of certain birth defects in one study (Lancet 1988;1:236). However, another study found such doses to be associated with a reduction of the same type of birth defects (Lancet 1996;347:899-900). In total there have been fewer than 20 cases reported worldwide of birth defects possibly caused by Vitamin A overdose.

In numerous studies, doses far greater than the RDA were found to be both safe and effective. Doses of 400,000 units a day for 5 months in adolescents with acne were found to be effective and caused no side effects (Int J Dermatol 1981;114:1776 and Br Med J 1963;2:294). The short-term administration of doses of 200,000 to 400,000 units in small children were also studied, and were found to reduce the occurrence of complications from measles and pneumonia while enhancing immunity, again with no side effects reported. Incidentally, the benefits were documented both in children who were deficient in Vitamin A as well as in children who were not (J Trop Pediatr 2002;48(2):72-7, Clin Infec Dis 1994;19(3):489-99, Am J Epidemiol 1997;146(8):646-54, and many other published studies. You may e-mail me for a full list).

Interestingly, this most recent study linking Vitamin A with fractures in aging individuals was performed in Sweden, a country not known for its abundant sunshine. Since we know without a doubt that Vitamin D is associated with bone health and that much of our intake of Vitamin D comes from the sun, it is possible that Vitamin D deficiency is rampant in Sweden. This may explain why Scandinavians in general have higher rates of fractures in comparison to other Europeans.

One possible explanation of why fracture rates were higher in the study participants who had more Vitamin A in their blood is that vitamins A and D need to be balanced. Everything in nature is a matter of balance, and excessive intake of Vitamin A without enough Vitamin D may cause a relative Vitamin D deficiency, possibly leading to brittle bones.

Cod liver oil is apparently a very popular supplement in Sweden, and some experts suggested that the individuals with high levels of Vitamin A in their blood may have consumed ample doses of cod liver oil, over many decades, and this may have depleted them of Vitamin D.

Cod liver oil actually contains both vitamins A and D, but is tilted towards Vitamin A. It is plausible that consuming it without being exposed to sufficient sunshine or taking additional Vitamin D explains the results of this study. This theory may be the best we have, but is not entirely convincing since cod liver oil, in spite of its high Vitamin A to Vitamin D ratio, was used successfully in the 1800’s to treat rickets, a childhood disorder of bone development caused by Vitamin D deficiency.

In my opinion, a normal intake of Vitamin A from cod liver oil or other sources within the RDA should not be of concern, especially if properly balanced with Vitamin D through sunlight exposure or supplements. In special cases much higher doses of Vitamin A can be greatly beneficial, but these doses should be taken only under the supervision of a trained professional, and this study clearly points out some of the risks of not doing so.

Tags: Osteoporosis
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All we seem to hear about on the news is that moderate alcohol consumption is good for the heart. I often wonder who sponsors these studies and how they manage to get reported so regularly. The flaw of all these studies is that they only look at the relationship between alcohol consumption and heart disease, disregarding other aspects of health.

A very large British study (Br J Cancer, 2002 Nov 18; 87 (11): 1195-6) that looked at the relationship between alcohol consumption and breast cancer reached a different conclusion. It found that for every alcoholic drink consumed on a daily basis the risk of breast cancer goes up by 6%. Although 6% may not sound like much, it is cumulative and may come on top of other risk factors. It should also be noted that this study only looked at breast cancer, but there is no reason to believe that other cancers might not behave similarly.

If you are concerned about your risk of breast cancer, there is a new simple and inexpensive urine test that looks at the ratio between two estrogens: 2 and 16 hydroxy estrogen.

While every woman and man has both of these estrogens, research has shown that an overabundance of the 16 in relation to the 2 hydroxy estrogen leads to an increased risk of breast cancer and other hormone sensitive cancers (possibly including prostate cancer in men). The reason for this increased risk is that the 16 estrogen is aggressive whereas the 2 has a protective action, and when they are properly balanced the risk of cancer is greatly reduced.

Tags: Cancer
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©1994 Elaine Gottschall

3 cups grated zucchini
3 eggs, beaten
3 cups nut flour
1/3 cup melted butter
2 teaspoons cinnamon
1 teaspoon baking soda
1/2 teaspoon salt
1/2 to 2/3 cup liquid honey (use less, if desired)

Mix nut flour (try finely ground almonds), melted butter, honey, and zucchini. Add beaten eggs, cinnamon, salt, and baking soda. Mix well. Bake in muffin tins, lined with papers, at 350 degrees F (180 C) for about 20 minutes or until done.

From “Breaking the Vicious Cycle” by Elaine Gottschall

Tags: Diet, Recipes
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In the ongoing debate on modern medicine one argument always wins out: we now live longer so today’s medical approach must have it right! However, the facts surrounding long life and how we got to this point are not always clear in everyone’s mind. First we must distinguish between life expectancy and longevity.

Life expectancy is calculated by averaging the age of death of all the people in a society. It will fall if more people die at a young age from accidents, disease or war, but doesn’t really tell us much about how long the oldest people in society live, or their longevity.

After a long period of stability, life expectancy started to increase with the industrial revolution and has more than doubled over the past few centuries. Historically, many people died prematurely from a variety of conditions. Because of poor food distribution and widespread poverty, malnutrition was endemic. Children died from complications of childhood diseases or simple infections. Those who survived into adulthood faced many more challenges. For example, not too long ago childbirth was a common cause of death for young women, and TB prematurely ended many lives.

Factors that have been credited for increasing life expectancy include improved sanitation, hygiene, increased wealth, refrigeration, improved waste removal, better water quality and so on. For example, until the late 19th century, physicians did not understand the importance of something as basic as handwashing and thus contributed to the spread of disease.

Medicine certainly played a role in this evolution, but its role has generally been overestimated. Vaccines are thought of major lifesaver, but it is a well-documented fact that most childhood diseases were no longer significant killers by the time vaccines were introduced. For a detailed and referenced discussion of this important point, see www.HealthSentinel.com and click on “vaccines.”

Although antibiotics saved many lives, the incidence of major killers like TB were already in steep decline when penicillin was first introduced, probably as a result of better hygiene and improved nutrition.

Even when life expectancy was at its lowest, a few individuals who were fortunate enough to survive into and past middle age lived out long and full lives, well into their eighties and beyond. This has been documented throughout history, and in fact longevity, or how long people can live, is a genetically predetermined limit that has never been shown to change.

Extending human life past these programmed limits is an old dream that some extremist groups are now claiming they can achieve by creating a breed of “genetically engineered” humans. In fact no drug, vitamin, or hormone has ever been shown to increase longevity. This genetic limit can simply not be exceeded through these means. However, a diet was shown to do just this: extend life past its genetic limits!

This diet is described in a book entitled “The 120-Year Diet” by Roy Walford, MD. Unfortunately this book is now out of print, probably because of lack of reader interest, but can be obtained from websites specializing in out-of-print books like www.alibris.com.

The diet described by Dr. Walford is backed by a large body of animal research that is, in all likelihood, applicable to humans. If this animal data is extrapolated to humans, then we could expect to live to be 120 if we cut back drastically on caloric intake (basically, eat much less) but without sacrificing our intake of essential nutrients to avoid malnutrition.

If you are like me, this diet may look good on paper, but it’s not too likely you’ll actually follow it for very long. However, a new study (Science, January 24, 2003; 299: 572-574) performed on genetically engineered mice suggests that it is insulin control, not calorie restriction, that is responsible for prolonging life. To control your insulin forget the dessert, bread and pasta, but enjoy your steak (organic and grass-fed, of course) and lots of fresh vegetables.

Tags: Diet
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