| ||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. 
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.  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.  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. 
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. 
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.  (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
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. 
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." 
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. 
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 .  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%).  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.  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. 
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 
Then in September, I discussed the structure and function of LDL, HDL and
their receptors.  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."
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
Reporter Susan Fogg of the Globe-Democrat National Service, reported my
findings and then checked with the National Institutes of Health.  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
"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
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]
|Richard 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