Whole (26 page)

Based on what I shared in
chapter six
, this just makes sense. The process of nutrition is profoundly wholistic, in that the way the body uses a particular nutrient depends on what other nutrients are ingested along with it. If we just take an isolated vitamin C pill, we miss out on the cast of “supporting characters” that may give vitamin C its potency. Even if we add many of those characters into the pill too, which some manufacturers have done with bioflavonoids, we are still assuming that whatever is in the apple and not in the pill is somehow unimportant.

The results of Professor Liu’s study were published in the prestigious science journal
Nature
⁴
and attracted considerable media attention. In that article, Liu’s group concluded “that natural antioxidants from fresh fruit could be more effective than a dietary supplement [of vitamin C].” What a profound finding! The outcome of a fully reductionist study design (measuring the amount of vitamin C in an apple) demonstrated the utter fallacy of the reductionist toolkit.

Dr. Liu’s subsequent research provided an even clearer picture of the mind-blowing complexity of a simple food like an apple. Once he discovered that an apple was far more powerful a vitamin C delivery system than it “should” have been, he wondered about the mechanisms that might explain that huge difference. His lab focused on searching for the kinds of chemicals that might account for the rest of the vitamin C-like activity in apples. Liu and his graduate student (now Dr.) Jeanelle Boyer eventually summarized their work—along with the findings of others—to show that there is a treasure trove of such vitamin C-like compounds in apples.
⁵
These include other antioxidants with names like quercetin, catechin, phlorizin, and chlorogenic acid found only in plants, each of which may exist in many forms within the apple. The list of these chemicals in apples and other fruits is long, and likely reflects just the tip of the iceberg. It’s as if the inside of the apple is bigger than it looks from the outside.

Something else to keep in mind: This growing list of vitamin C-like compounds may have many important biological effects that may or may not depend on their antioxidant activities. Liu and his research group have used at least four laboratory tests to determine these various effects, including the ability of these compounds to inhibit the proliferation of cells (potentially stopping or even reversing cancer), decrease serum cholesterol (affecting cardiovascular disease and stroke), and generally block unwanted oxidation (implicated in cancer, aging, cardiovascular disease, and many other degenerative processes). Of course, there also are many other health functions that he could have tested as well.

It is now clear that there are hundreds if not thousands of chemicals in apples, each of which, in turn, may affect thousands of reactions and metabolic systems.
⁶
This enormous number and concentration of vitamin C-like chemicals in apples poses a serious challenge to the notion that a single chemical—vitamin C or anything else—is responsible for the major health-giving properties of apples. Even if we measure the amount of vitamin C two apples contain, we can’t assume that one apple has twice the health value of a second just because it has twice the amount of vitamin C; the amount of vitamin C in a given apple may not tell us very much about that apple’s antioxidant power. Add to this what we discussed in
chapter six
about the complexity of nutrition—that sometimes a combination of nutrients is more (or less) than the sum of its parts, and that the body plays a role in determining how many nutrients from the foods we consume are actually used—and it’s hard to avoid the conclusion that knowing how much vitamin C (or even all vitamin C-like nutrients) there is in a given apple doesn’t tell us anything of value.

This dilemma is not unique to vitamin C-like antioxidants, or any other fruit or vegetable for that matter. The same is true for any nutrient isolated from any whole food. Many chemically similar groups of health-giving chemicals present in food and circulating in the body are composed of dozens, if not hundreds or even thousands, of analogs that have the same kind of activities but very different potencies.

The problem here is not that we
can’t
provide an accurate answer to how much of a nutrient there is in a given food, or even that we can’t figure out how much we need for optimal functioning (though this is still currently beyond our grasp). The problem is that we are asking the wrong questions—questions based on a fundamental misunderstanding
of the wholistic nature of nutrition. We’re asking, “How much vitamin C are we getting?” when we should be asking, “What foods should we be eating to support our bodies’ ability to maintain health?”

The reductionist mind cannot see the apple as promoting health and leave it at that. If apples are good for us, it can’t be the whole apple. There must be some tiny part of the apple, some chemical inside the apple, that is responsible for its beneficial effects. And our job is to extract that thing from the apple and figure out exactly how much of it people need on a daily basis.

Under the reductionist mindset, healthy eating becomes a crapshoot of nutrient micromanagement—a list of individual nutrients that must be consumed in specific, regimented quantities. But in nature, you don’t find beta-carotene on its own. You can’t cut a slice of beta-carotene out of a carrot.

Unfortunately, that doesn’t stop the supplement industry from trying.

The two-part assumption inherent to this reductionist thinking about nutrition—that there is a single active ingredient in healthy foods, and that we can take it out of context while still maintaining its effect—is the foundation of the supplements industry. Founded on the techno-fantasy that we can get all our nutritional needs met by powders, pills, or cubes, this industry has been relentless in analyzing foods known to promote health so it can extract and synthesize their active agents. We’ve already seen how the medical community treats disease with individual chemicals synthesized or isolated from their natural origins. As should now be clear, so does the “natural medicine” community. And it’s no more effective there than it is in mainstream medicine. More than that, supplements, as with their formally tested medical counterparts, can actually cause harm.

You may find it hard to swallow the truth of the ineffectiveness and potential harm of supplements. Arguably, the supplement industry has been even more effective in spreading their propaganda than the pharmaceutical industry. After all, supplements are “natural”; they are the same nutrients you find in food. And you can see ads for natural supplements in yoga magazines, at natural-living expos, and in your local health shop.
Your chiropractor may recommend or even sell some pills in his or her office. You may find yourself aligned socially, politically, and even spiritually with the supplement industry. But there’s nothing natural about consuming these nutrients in isolation. And the main issue is not whether you like the marketing of natural pills, but what effects these vitamins and related supplements have on your long-term health.

There are many examples demonstrating the failure of individual nutrient supplements to do what they are expected to do. In fact, sometimes these supplements do exactly the opposite. While some individual studies may occasionally show a statistically significant health benefit for vitamin supplements in the short term (and a presumed benefit for the long term), when the findings of a large number of studies are collectively evaluated, there is little or no evidence that routine vitamin supplementation improves health. Researchers have looked long and hard, in vain and using lots of money, for verifiable reductions in cardiovascular disease,
⁷
cancer,
⁸
and total mortality
⁹
as a result of supplementation. Some of the best studies show that not only is reductionist supplementation not beneficial, it can actually be harmful. Let’s take a look at three of the most studied supplements—vitamin E, beta-carotene, and omega-3 fats—to show what I mean.

Vitamin E was first discovered in green leafy vegetables in 1922.
¹⁰
Since then, studies have shown that vitamin E is integral to a large number of biochemical functions, suggesting a wide range of health benefits. Indeed, the higher the levels of vitamin E in the blood, the lower the risk for a large number of diseases. Vitamin E is fat soluble (rather than water soluble), so it can work in fatty environments such as cell membranes, where it protects the membranes and their enzymes from oxidation damage.
¹¹

In recent years vitamin E has become a popular and routine supplement for the prevention of cardiovascular and other diseases,
¹²
on the theory that if vitamin E in food is so important to good health, then isolated vitamin E supplementation must be good as well. In the natural health community, vitamin E pills are widely thought of as the “wonder nutrient.”

Even theoretically this doesn’t add up. For one thing, vitamin E, like the other nutrients we’ve looked at in this book, seldom if ever acts
independently; it can be substantially influenced by many other nutrients, including selenium, sulfur-containing amino acids, and polyunsaturated fatty acids. So removing vitamin E from its context within plant foods is like sending a general into battle without any troops. What’s more, what we usually call vitamin E is actually not one vitamin, but a family of eight similar but slightly different varieties (called
analogs
).
¹³
While sharing many of the same functions, they vary significantly in potency
¹⁴
and the tissues they target.
¹⁵

The market for vitamin E supplementation surged after a 1993 study found an association between higher vitamin E levels in the blood and lower incidence of major coronary disease.
¹⁶
What the study measured, however, was vitamin E that came from foods, not supplements. The authors made a small leap of faith when they concluded that low blood levels of vitamin E are what cause heart health (since the study was designed to detect an association, not a causal relationship), and a bigger one when they suggested that “vitamin E
supplements
may reduce the risk of coronary heart disease” (Emphasis mine). To their credit, the authors cautioned that more trials were needed before recommending widespread use of vitamin E supplements. But too many people have ignored the caution and interpreted this study to mean that vitamin E supplementation prevents heart disease.

The media hype about this study has fueled the huge market for vitamin E supplements over the past two decades. But all this interest has also brought about additional studies, which tell a very different story. Based on randomized controlled trials, vitamin E supplements do not decrease risk of cardiovascular diseases,
¹⁷
cancer,
¹⁸
diabetes,
¹⁹
cataracts,
²⁰
or chronic obstructive lung disease.
²¹
These findings are broad based and quite convincing. Their size, their breadth (they look at multiple diseases), the number of studies, and the contrary researcher expectations support a compelling case: that vitamin E supplements do not work the way reductionists expect them to, based on the demonstrated benefits of vitamin E-containing foods. Although there may be a few special groups of people for whom vitamin E supplementation might offer marginal benefits, the vast majority of people receive no advantage from it.

And that’s actually way too kind an assessment, according to recent research. One recent review of over six-dozen randomized trials involving nearly 300,000 subjects found that taking supplemental vitamin E
(as well as vitamin A and beta-carotene, which we’ll discuss below) was associated with greater overall mortality.
²²
That’s right; not only does supplemental vitamin E not make you healthier, it actually can contribute to your premature death.

Advocates of vitamin E supplementation have responded to these findings in a few rather expected ways. Some have blamed these studies’ experimental design or the interpretation of their findings
²³
—a fair, even desirable response among scientists, whose job it is to seek valid conclusions from imperfect data. But a responsible scientist can hardly ignore the growing consistency of findings among many studies questioning the supplemental use of this nutrient.

Other researchers have pointed out that the first four analogs of vitamin E (the tocopherols) were the ones used in these last trials. They’ve suggested that perhaps focusing on their brethren (the tocotrienols) might be a good idea because, in some systems, they are more active, supposedly to do good.
²⁴
But this fails to mention that these analogs also may have more potential of doing bad.

Last, still other advocates of vitamin E supplementation have responded by searching for special groups for whom the benefits might outweigh the risks, including people with various genetic susceptibilities.
²⁵
But this strategy still ignores the real possibility that a WFPB diet could do the same thing at lower cost and with fewer side effects like heart failure
²⁶
and death.
²⁷

It’s hard to argue with the mounting evidence: the beneficial effects of vitamin E are clearly lost when vitamin E is removed from its original plant-based environment and sold to us in bottles. But you wouldn’t know it from the hype masquerading as legitimate research.

Like vitamin E, omega-3 fatty acids are essential to our bodies’ functioning. As with all “essential” nutrients, we cannot manufacture these fatty acids, so we have to get them from our diet. There are three types of essential omega-3s: ALA, DHA, and EPA (although DHA is not usually considered essential under the right dietary conditions, as when one’s diet includes adequate omega-3 in relationship to omega-6 and total fat). They are found in certain plants and also in some types of fish and edible algae.