Experts Applaud New Vitamin Recommendations
April 13, 2000 (Philadelphia) -- If ordinary Americans end this week with
more questions than answers about vitamins and supplements, take heart -- most
physicians are just as confused.
Since the beginning of the year, there has been a flurry of papers and
studies on vitamin and supplement use -- often with contradictory findings --
and just this week, the prestigious Institute of Medicine (IOM) released a
report stating that antioxidants like vitamins C and E have no proven role in
the prevention of disease. That report came a day after a report in a medical
journal suggested that increasing vitamin C intake may protect women from
gallbladder disease. No wonder confusion reigns.
After sorting through the headlines and the hype, John La Puma, MD, tells
WebMD that the best advice for patients remains "eat healthy foods, not
pills." La Puma spoke here at the annual meeting of a group that represents
many of American's primary care physicians.
La Puma, who is medical director of the Cooking, Healthy Eating &
Fitness (CHEF) Clinic in Elk Grove Village, Ill., says that the report from the
IOM -- rather than adding to the confusion -- may help sort things out for both
doctors and patients.
For example, the IOM report recommends changes in the recommended daily
intake for vitamins C and E and selenium. "The original recommendations for
vitamin C were based on the amount needed to prevent scurvy [weakening of bone
and cartilage due to vitamin C deficiency]," says La Puma. He says that in
modern America, scurvy is not the public health concern that it was 100 years
ago. The IOM recommends increasing the levels to 75 milligrams per day for
women and 90 milligrams per day for men. Additionally, the report says that
smokers need an additional 35 milligrams per day. "Adding the
recommendation for smokers is especially important" because smokers have
increased damage that could be helped by antioxidants, La Puma says. He says,
however, "I've never seen vitamin C sold in anything less than 250
milligrams, so this is what most patients will be taking."
The IOM suggests that vitamin E recommendations be increased to 15
milligrams per day for both men and women. It also changed the recommended
intake for selenium to 55 micrograms per day.
La Puma says that instead of vitamins, he advises patients to get their
vitamin C from "two handfuls of strawberries and their vitamin E from a
quarter cup of almonds, which is actually a good handful of almonds. For
selenium, I recommend taking two Brazil nuts a day. That's what I do."
While increasing the recommended daily intakes, the report also sets upper
limits and warns that exceeding those limits may cause side effects. The
recommended upper limit for vitamin C is 2,000 milligrams per day and for
vitamin E is 1,000 milligrams, or 1,100 IU of vitamin E that's labeled
"natural source vitamin E."