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 Interviews with Nutritional Experts: Antioxidant Vitamins Prevent Heart Disease: Verification from the American Heart Association  
The good news is that the American Heart Association (AHA) is learning that vitamins prevent heart disease! The bad news is that it has taken them nearly twenty years. "Most of us in medicine have poo-pooed megadoses of vitamins, but this research has a good ring to it," AHA president Dr. W. Virgil Brown of Emory University told reporters covering the AHA annual science writer's meeting in Galveston, Texas. [1]

When Prevention magazine held a press conference in 1975 to report my study of the effectiveness of vitamin E in preventing heart disease, one reporter asked me how long would it take for this research to be used by medical doctors. [2] I replied, "In the past, it would have taken twenty years, but with the improved communications of today, it should take only about ten years."

Although it has taken longer than I had expected, the research pace is quickening. Medical researchers can't help but see the many articles showing that the real heart disease culprit is oxidized lipoprotein, and now they will be seeing several articles on how antioxidant nutrients prevent these harmful reactions from occurring. Also, many researchers have read the recent article in the American Journal of Clinical Nutrition showing the single most reliable risk factor for heart disease is a deficiency of vitamin E! Soon this information will trickle down to "practicing" physicians.

In the meantime, I note that physicians at the forefront of research are starting to take vitamin supplements themselves. The number of physicians who teach at Harvard Medical School and who take vitamins regularly has essentially doubled in the last ten years. [3] In 1982, fourteen percent admitted to taking vitamin supplements, today twenty-three percent take vitamin supplements. I suppose that they were impressed by the Harvard study that showed that beta-carotene cut heart disease in half. [4]

Notice that we are not hearing so much about cholesterol at the first level of research these days. We virtually never hear about dietary cholesterol anymore in research. The point that I made in 1972 in American Laboratory and again in 1975 in "Supernutrition: Megavitamin Revolution," and further expanded upon in my 1977 book, "Supernutrition For Healthy Hearts," that dietary cholesterol wasn't an important factor in the majority of people has now been well taken. [5-7] The importance of this is that the public can now pay better attention to the most important factor instead of being sidetracked by minor factors or factors that don't even apply to the majority of the population.

Also, we have now learned to use genetic markers to tell just who should be concerned about dietary cholesterol and blood cholesterol levels. The rest of us, which is actually the most of us, have to pay more attention to our antioxidants. If we don't know if we are genetically prone to abnormal cholesterol metabolism, then we can watch our cholesterol and antioxidants both. My point is that even in cholesterol-sensitive people, antioxidant protection is more important than cholesterol level. Don't concentrate on the minor problem and ignore the major factor. [8]

A reporter called to ask why I have said all along in my books that vitamin E prevented heart disease, and others are just now "discovering" that fact? I said there were three main reasons:

    1. My 1974-5 study, which I will discuss shortly.

    2. My study of the scientific and medical literature. I have most of the articles or at least the abstract of every scientific paper published mentioning vitamin E all the way back until 1939. I also have a bibliography of every paper back to 1921 -- even though the first paper by Drs. H. Evans and K. Bishop officially recognizing vitamin E (referred to as "vitamin X" at the time) was not published until 1922. [9] (There were papers that recognized that there was an unknown factor in foods that was responsible for health parameters not attributed to known vitamins.) Most researchers use data banks that go back only as far as 1967, and many researchers don't even bother to read the scientific literature published more than ten years before their research.

    3. Dissatisfaction with the cholesterol theory which claimed at the time that eating cholesterol was the main cause of heart disease. (This was soon changed to the "prudent" approach of adding fat to the diet to prevent heart disease -- yes, adding a cup of polyunsaturated oil daily to "balance" the polyunsaturated-to- saturated fat ratio.) Later this was again modified to concentrate on total dietary fats and blood cholesterol levels, but even this modification explains only a minor percentage of heart disease cases. [10]

I don't have the space here to review the cholesterol theory, but other more promising explanations including the vitamin B-6 deficiency, insulin excess, chromium deficiency, estradiol excess and fibrinogen excess relationships seem certain to account for many cases of heart disease. These theories are discussed in my newest book, "The New Supernutrition." [11] Of course, the newest research on antioxidant nutrients and oxidized lipoproteins is also discussed more fully in the book.

The Big "News"
Yes, it has been startling to read twice this year in USA Today that vitamins prevent heart disease. [12,13] The news made the front page once, and the first page of the "Life" section the other time.

The latest news is that Dr. Ishwarlal Jialal of the University of Texas Southwestern Medical Center in Dallas showed that

Vitamin E could block the adverse changes to low-density lipoprotein (LDL) that leads to plaque formation and blockages in arteries. Actually, as I will show in another article in this series, the oxidation of LDL and/or high-density lipoprotein (HDL) causes most of the cases of heart disease.

Dr. Jialal explained, "researchers are now of the opinion that fats in the bloodstream become lodged in artery walls and begin to clog arteries only when their transporters , the lipoproteins, have chemically combined with oxygen to turn rancid."

Smoking promotes the oxidation of lipoproteins, as do fats when they are not protected from oxidation by antioxidant nutrients such as vitamins C and E, and beta-carotene. Normally, smokers and diabetics have low levels of vitamin C in their blood, unless they take supplements.

Beta-carotene and vitamins C and E have previously been shown to block the oxidation of LDL "in the test tube." Dr. Jialal said that his is the first study to demonstrate that an antioxidant nutrient can actually prevent LDL oxidation in the body. [14]

It may be only a matter of semantics as to who was the first to actually show "prevention of LDL oxidation in humans."

This special AHA symposium for science writers helps communicate research results to the public. The research reported there by Dr. Jialal was previously published in Arteriosclerosis and Thrombosis . [15] Twelve men were given 800 IU of vitamin E daily and their blood was monitored for LDL and oxidized-LDL content for three months. Dr. Jialal reported that there were no adverse effects from taking the 800 IU of vitamin E daily. That is not news in itself, but at least now cardiologists have heard it at an officially sanctioned AHA symposium.

In an interview, Dr. Jialal said that in the test tube, vitamin C seems to have the greatest potency (95%) at blocking oxidation of blood fats, followed by beta-carotene (90%) and vitamin E (45%). [16] However, it was easier to follow the progress of the experiment in people using vitamin E. Another study examining the efficiency of vitamin C will be forthcoming. He also suggested that giving combinations of these antioxidants would be even more effective.

Yes, they will find synergism -- the same synergism of these antioxidants that I have found in my longevity and cancer experiments -- but they haven't even thought of selenium yet. Selenium is a mineral required in two enzymes that reduce "background" free radicals which would otherwise be available to promote oxidation of LDL. The same is true for zinc, copper and manganese being required in the enzyme superoxide dismutase (SOD).

Just two months before, USA Today reported a related story from the regular annual meeting of the AHA in Anaheim. [13] There Dr. JoAnn Manson of Brigham and Women's Hospital in Boston described her study of the diets of 87,245 nurses over more than eight years. She found that women who take supplements of more than 100 IU of vitamin E daily have thirty-six percent fewer heart attacks than those who consume less than thirty IU daily.

Dr. Manson also found that women who consumed 25,000 IU of beta-carotene daily had 40 percent less stroke and 22 percent fewer heart attacks than those women who consumed less than 10,000 of beta-carotene daily.

Also in 1991, it was "news" that people with angina pectoris (chest pain due to heart disease) have low levels of vitamin E. [17,18] As we will see later, this is really very old news that has been ignored for decades.

Add to this, the fact that many medical researchers are still reeling from the disclosure that vitamin E deficiency is the single most important risk factor in predicting heart disease incidence. [19]

Perhaps Dr. Jialal's group is not the first to publish that supplements of vitamin E (tocopherol) inhibit the oxidation of LDL in humans. Dr. Hermann Esterbauer's group at the University of Graz (Austria) has reported that the "oxidation of polyunsaturated fatty acids in LDL is preceded by a sequential depletion of antioxidants in the following order: alpha-tocopherol, gamma-tocopherol, lycopene and beta-carotene. Oxidation of LDL can begin only when these antioxidants have been depleted...The effectiveness of vitamin E in protecting LDL from oxidation varied from person to person...The present study clearly shows that in humans , the oxidation resistance of LDL can be increased by vitamin E supplementation." [20,21]

These news stories are breaking faster than I can provide you with a background to help explain the biochemistry involved. In this series of articles on antioxidants and heart disease, I have been building a foundation for discussing this newest research. Last April, I discussed how oxidized-LDL accumulates in macrophages (special white blood cells) causing their death, and in turn, these "dead" macrophages accumulate and injure the arterial lining resulting in plaque formation [22]

Then in September, I discussed the structure and function of LDL, HDL and their receptors. [23] Hopefully, these articles have provided the background to better to understand the role of oxidized-LDL and oxidized-HDL in causing heart disease, and to see how the antioxidant nutrients, such as vitamins C and E, and beta-carotene are protective.

A good review article for the professional was recently published in "Circulation." [24]

The First Evidence of Prevention
The newest research is much more sophisticated than my 1974-5 epidemiological study. This is what is needed to convince the closed-minded skeptics, and this is what I have been working so hard to bring about. I have spent considerable time promoting the concept that antioxidant nutrients protect against heart disease and cancer, and cajoling other researchers to look into this line of research.

As science reporter Judith Randall wrote in the New York Daily News in 1975, "Passwater hopes his findings will spur the scientific community to mount a more sophisticated research effort to prove or disprove what he has found." "While some experts believe," he said, "that vitamin E has no role to play in medicine, it is really more important that the scientific community get in there and prove or disprove what I have found." [25]

Reporter Susan Fogg of the Globe-Democrat National Service, reported my findings and then checked with the National Institutes of Health. [26] A spokesman there said "So far the scientific data collected does not indicate that vitamin E prevents heart disease, but it is only useful in the amelioration of vitamin E deficiencies, and such deficiencies are almost unheard of."

"Passwater, who is one of the nations foremost experts in fluorometry, which is the use of fluorescent materials to trace the biochemical effects of drugs and other substances in body tissues, said the data from this study should prompt further research into what role vitamin E plays in heart disease."

"Passwater said that he had spoken with researchers at the National Heart and Lung Institute, but they could not help him for fear of being put in jeopardy."

That restrictive environment continued to prevail. During the next year, after extensive lecturing and writing to researchers led to no follow-up studies on my research, it became apparent that the conventional approach was not going to work. This led to my coming to the Health Industry, and I am so glad that the Solgar Nutritional Research Center was established in 1977 to allow me to continue my research!

My 1974-5 Study Showing Vitamin E Prevents Heart Disease
My study of 17,894 persons between the ages of 50 and 98, showed that heart disease dropped dramatically among those taking vitamin E over a long period of time. I found that the length of time vitamin E was taken was more important than the amount. This trend was especially apparent above nine years of usage.

I found that taking 400 IU or more of vitamin E daily for ten years or more was strongly associated with reducing the incidence of heart disease prior to eighty years of age to less than ten percent of the normal rate.

Among persons taking vitamin E over ten years, I found only four suffered from heart disease out of a total of 2,508. Ordinarily, in a sample of that size, approximately 836 persons would be expected to suffer from heart disease. Appropriate statistical models reveal that high confidence can be given to the statement that taking 400 IU of vitamin E daily for more than ten years will lower the heart disease incidence to ten percent of the then current (1975) age-adjusted rate of 32 per 100 to 3 per 100.

I found that those who took 1200 IU of vitamin E daily for four years or more also had a dramatic decrease in heart disease incidence, though not as strong as the prior group.

Among persons who took 1200 IU of vitamin E daily for four years or more, their incidence of heart disease was reduced by about one-third. Instead of the expected 32 per 100 age-adjusted rate, the statistics showed that there is high confidence that the rate is only 10 per 100.

The observation that length of time taking vitamin E is strongly associated with reduced heart disease is strong statistically. The Spearman-Rho statistical association value was 0.96, where 1.00 is perfect association. The correlation is significantly different from zero or chance occurrence at the 0.01 level. Figure 1 shows the relationship between the years of taking vitamin E and heart disease incidence.

Now the reason seems obvious. For any given age, this means that the longer time taking vitamin E, the longer the arteries have been protected from oxidized-LDL. Protection was started earlier and the arteries are cleaner.
The details of my study are published in several books and articles available to the general public. [8, 27-31]
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 About The Author
Richard Passwater PhDRichard A. Passwater, Ph.D. has been a research biochemist since 1959. His first areas of research was in the development of pharmaceuticals and analytical chemistry. His laboratory research led to his discovery of......more
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