As Caveman Doctor often posts on nutrition and its impact on health and cancer, he appropriately receives many emails (whatever an email is) regarding specific vitamins to take. From personal experience, Caveman Doctor has trouble answering this question. In his time, Caveman Doctor obviously never took any vitamins. While there were no labs to check his blood and the only time he ever gave blood was while wrestling grizzly bears, Caveman Doctor is pretty sure his vitamin and mineral levels were well above the recommended daily allowance. So what vitamins should we take?
Vitamins, Nutrition, and Health
I applaud those of you who are trying to get vitamins and minerals in your diet, as this likely means you’re also health-conscious and thoughtfully considering your food choices. In doing so, many of you are buying vitamins from the exploding supplement industry. Two years ago, a New York Times article discussed the recent surge in profits by this booming industry. Their profits were even up during the recession! While this article is interesting, all we need to do is take a trip to a local shopping center to witness the vitamin industry’s growth. Malls used to have one vitamin store, now there are usually three or four.
There is a big misconception that we need to take pills synthesized in a factory to be healthy (and don’t forget, when you buy those vitamins somebody else is making money). I fell into this trap as well and used to have over a dozen pill bottles on my kitchen counter at all times. Similar to the misguided food pyramid or the anti-fat recommendations, what if our “vitamin overload” is just another installment in our series of misguided health movements?
For example, one person discussed in the article above who was training to be a physician assistant, “pared back on fresh fruits and vegetables and stocked up instead on fish oil capsules and antioxidant supplements.”
Is this person making a wise choice or fooling herself? Let’s look a little further.
Can Vitamins Replace Our Food as the Source for Nutrients?
I thought so. In fact, I rarely ate a vegetable for a several year period during my college and medical training. Why would I eat vegetables when I could just pop a handful of pills with my morning coffee? The amazing part is that, not only did I consider this OK, but I was viewed as overly health conscious by friends, family, and medical colleagues. But was this the case? Many of you may have fallen into a similar trap, however, this may be a good thing as it at least illustrates that we are working to get healthier and avoid our doctor. The question is whether we are taking the right steps to achieve these goals. Let’s consider several important facts before we can answer this question and see whether we need to redirect the ship.
Point 1: Vitamin Sales Are Big Business
$23 billion per year in domestic sales, to be exact. There is nothing wrong with the central theme of big business and this is definitely not another article complaining about it, especially when it provides us with a cheap and easily accessible product that can enrich our lives. However, we often make the mistake of shunning Big Pharma (appropriately) only to support Big Vitamin. Malls used to have one GNC, but now contain a GNC, Vitamin Shoppe, and Vitamin World (along with drug stores like Walgreens and Rite Aid, which have vitamins and supplements). Meanwhile the food court is full of processed grease and cardboard (also referred to as food). The vitamin industry is often viewed as the naturopathic means to good health while pharma is viewed as that of manufactured chemicals. Unfortunately, the two may not be very different. What if we can avoid both? What if we can get all the vitamins and minerals the way Mother Nature intended: through those same natural foods we should be eating anyways, like nutrient-dense vegetables and meat?
Point 2: When We Don’t Get Nutrients Through Our Food, Our Body Revolts
Our body is a lot smarter than we are, which is a good thing, because personally if this weren’t the case I wouldn’t have made it through preschool, grade school, high school, and (especially) college. Let’s get that out in the open. It tries very hard to keep us in a steady state of health (homeostasis). When we try to knock it out of homeostasis, it knocks back much harder and revolts. Along these lines, it has been programmed for millions of years to run on certain foods and when we don’t give it those foods, it gets angry. Diseases follow. We are lucky enough to live in a period where we have the technology to reflect on what life was like over the past millions of years and take an educated guess on how closely we can follow this history and give our body what it was designed to run on. If you bought a Ferrari and knew that it used high octane gas, would you give it 89 unleaded? So why do the same to your body, which hopefully is your personal Ferrari. We also have the luxury of modern technology, which allows us to look back at history and view which “gasoline” is best for us under the confines of modern society, with its shelter from the environment, safety, and easy accessibly to food (the double-edged sword of modern society).
Take for instance Dr. Terry Wahls, who cured herself of the incurable multiple sclerosis1. She realized that her modern diet was causing her body to attack itself and decided to replace nutrient-sparse foods like wheat with the foods we were meant to eat like leafy greens. She first tried to supplement her diet with vitamin pills galore, with little help or results. Medicines more expensive than BMWs did little to help her as well. Amazingly, she switched from her modern diet and medicine bill of $10002 per month to a caveman diet, and with NO medications the results were colossal. She literally went from being bed bound to working as a physician and leading essentially a normal life (exercising included). This is a prime example of what happens when we switch from a modern diet that necessitates taking vitamins in pill form (to supplement all the nutrient-sparse foods) to a natural diet in which the foods you eat contain more than adequate essential components (in a more bio-available form, meaning your body can absorb them better). Dr. Wahls switched back from unleaded to high octane and is reaping the benefits. Below is is Dr. Wahls talking about her experience during a Ted Talk.
Just as Dr. Terry Wahls cured herself from multiple sclerosis, the disease with no cure, by eating a hunter-gatherer diet and markedly increasing her vitamin and nutrient intake naturally, we can also improve our health. For those of you unfamiliar with multiple sclerosis, it is an absolutely devastating disease that drastically can change someone’s life, and the gravity of Dr. Wahls curing herself through diet alone is one of the most powerful things I have ever seen. We may not have multiple sclerosis, or any modern named disease, however whether we know it or not, eating a modern diet which our body doesn’t recognize will eventually bring with it health problems. She dramatically increased her leafy green vegetable intake and eats organ meat weekly and grass-fed meat daily. Of note, she has incorporated her “treatment” into clinical trials and we are desperately awaiting the results (see TED talk).
Let’s Throw Away our Pills and Use the Money on Better Food!
Point 3: How Do We Know Caveman Doctor Wasn’t Vitamin Deficient?
While modern day foods like bread and grains have to be fortified with synthesized vitamins to make up for their deficits, hunter-gatherer diets of the modern-era (i.e. the Innuit and Masai tribe) supply 2-10 times the recommended daily allowance of vitamins and nutrients3. Do they need to take vitamins? No! So why do you? In fact, a hunter-gatherer diet is much higher in vitamins and minerals AND antioxidants, phytochemicals, protein, fiber, and omega-3 fatty acids4. This includes the Inuit Eskimos in the far north who drink no milk and take no calcium pills.
Point 4: Vitamins and Nutrients in Food Are Much Different than those in Pills
Time and time again we hear about the latest mega-vitamin or super-antioxidant found in some food. This inevitably leads to isolating this compound, synthesizing it into a pill, and charging an arm and a leg to provide us with an “easy way out”. How do these pills compare to the normal nutrients found in food?
There are instances where supplementation is beneficial, as certain medical conditions can lead to roadblocks in normal eating. For instance, often patients with cancer of the head and neck region experience treatment-related toxicity and are unable to swallow solid foods and therefore must turn to supplements.
Unfortunately, our governing bodies have recommended diets that are big business for many groups, including the same ones that stuff cows into each other’s filth and stuff them full of grains, antibiotics, and pesticides (avoid these businesses by going grass-fed!). The public has had grains, processed food, and other nutrient-deficient foods pushed on them, and then have to pay double for vitamins and minerals pills to supplement their nutrient-sparse diet. This of course further profits Big Pharma and the supplement industry as they try to provide us with the nutrients that these foods are lacking. Not to mention that the vitamins are often encased in processed substances and contain vegetable oils as fillers.
A typical western diet, under the guidance of the food pyramid and other dietary recommendations, has resulted in over half the US population failing to meet the recommended dietary allowance (RDA) for vitamin A, vitamin, B-6, magnesium, calcium, and zinc5. Even worse, a third of our population is under the RDA for folate. What would happen if we took the typical Western diet, which provides us with a trifling amount of vitamins and minerals6, and replaced it with a hunter-gatherer diet? I asked this question to several colleagues of mine, and their responses were usually along the lines of “all that meat would leave you needing vitamins”. First and foremost, a caveman diet includes leafy vegetables and berries, and secondly, a caveman diet actually provides a diet that has 2-10 TIMES the RDA of vitamins! There would be little need for many of the pills Big Pharma and the supplement industry make billions selling.
Point 5: Studies with Antioxidants Provide a Birdseye View of What Happens When We Supplement Nutrients
A modern caveman diet and lifestyle constantly aims to avoid stress though diet, exercise, and lifestyle. This is in tune that the theory that inflammation, free-radicals, and oxidation are a central cause of disease. Accordingly, obtaining antioxidants through our diet only helps to provide reinforcements to our body’s arsenal against free-radical and inflammatory damage.
Mainstream medicine also knows about the benefits of stopping inflammation, and instead of pushing a diet and lifestyle to help stop it, they have turned to pills, as usual. Several randomized controlled studies, the gold-standard of medicine, have addressed the issue of adding antioxidant supplements into the diet. So how have their efforts panned out?
1. The MRD/BHF Heart Protection Study: adults with cardiovascular disease or diabetes were given vitamin E, vitamin C, and beta carotene or placebo7. Results showed no significant reduction in mortality from vascular disease or cancer. Similar studies in women with these vitamins8 and B vitamins also showed no benefit9,10.
2. GISSI-Prevenzione Trial: looked at patients given omega-3s, vitamin E, none, or both, and found that while omega-3s helped, the antioxidant vitamin E provided no benefit11. Epidemiologic data shows that getting vitamin C through fruits and leafy green vegetables (the old fashioned way) decreases the risk of heart disease12, but we have no good randomized trial to show such data.
3. (The famous) SELECT Trial supplemented men with selenium and vitamin E to help reduce the risk of prostate cancer13. The results showed no benefit, and in fact, vitamin E supplementation trended toward an increase in prostate cancer.
4. Norwegian Vitamin Trial and Western Norway B Vitamin Intervention Trial: A trial looking at Norwegian women with heart disease showed that supplementation with folic acid and vitamin B12 SIGNIFICANTLY INCREASED the risk of cancer and death!!!14
Interestingly, grain products in the US are fortified with folic acid, which has shown an increase in cancer and death. Once again, you have to get your antioxidants the way in which Mother Nature planned and trying to fool her is futile and often works in reverse.
Point 6: Getting Our Vitamins and Nutrients from Pills Does Not Work!
Many people avoid nutrient-dense foods like grass-fed beef and eggs, and replace them with grains and other empty calories. Beef and animal products are nutrient-dense, providing large amounts of iron, zinc, selenium, folic acid, and vitamins A, B6, B12, D, and, E15, while grains are so nutrient-deficient, they must have synthesized vitamins added to “enrich” them (even though we know from the randomized trials above that synthetic vitamins don’t work, and may even be detrimental to our health). The irony is not lost on Caveman Doctor’s simplistic mind that people shun foods like eggs and beef, with their abundance of vitamins, minerals, and antioxidants, but then go to their local pharmacy to buy iron pills. How many people take similar pills when they could be getting it naturally from their food?
As we discussed already, when we tried to replicate the health benefits of CLA, it did not work. Along these lines, when we eat grains and take calcium pills (and drink milk) instead of eating calcium-dense sources like leafy greens, our bone health suffers and it does not work. Vitamins and minerals in pill form are not the same as eating them directly from the source.
Point 7: Dump the Vitamins and Return to the Foods We Have Eaten for Millions of Years
We have eaten plants, animals, and fish for millions of years, and our bodies have adjusted to consume these same foods. It’s no surprise when we compare those who eat animal products with vegetarians, like in the Lugalawa study in Tanzania16, or West-coast Eskimos in Greenland17, we find that the animal-consumers have lower blood pressure, better cholesterol levels, and lower triglycerides. Modern vegetarians have tried to discredit the benefits of animal products and red meat through statistics and flawed modeling and by following cohorts, but cannot show this in any trials or experiments, because in reality, these nutrient-dense foods are the healthiest for us. And note when I say animal-consumers I am not talking about those on a western diet, as studies often interchange a meat-eating and western diet (this is an unfair comparison that caveman dieters often get lumped into). Remember, along with lots of vegetables and fish, we eat grass-fed and free-roaming animals, a more humane and healthy source of meat.
Throw away your multivitamin, and eat some kale which provides:
1. 206% daily value (DV) vitamin A
2. 134% DV vitamin C
3. 684% DV vitamin K
4. 26% DV manganese
5. 90.5 mg calcium
6. 22.8 mg magnesium
7. 19.4 mcg folate
8. 299 mg potassium
Throw away your iron pills and eat some red meat which provides:
1. 86% DV of niacin
2. 78% DV vitamin B6
3. 45% DV vitamin B12
4. 97% DV selenium
5. 67% DV zinc
6. 52% DV phsophorous
7. 22% iron
Throw away your morning vitamins and eat some eggs for:
1. 21% DV vitamin D
2. 68& DV riboflavin
3. 29% DV folate
4. 46% phosphorous
5. 52% vitamin B12
6. 35% DV pantothenic acid
7. 110% selenium
Wild salmon for dinner (not farmed!) contains:
1. 4 g omega 3 fatty acids
2. 78% DV niacin
3. 105% DV vitamin B12
4. 103% selenium
5. 44% riboflavin
6. 30% thiamin
So if you eat a kale and some pasture-raised eggs for breakfast, a salmon salad for lunch, and a nice big grass-fed steak for dinner with a plate of greens, how many vitamins do you need to take before bed? Not many, and you can use the money you saved from the vitamin store to support your local farmer.
Vitamins/Supplements Caveman Doctor Takes:
1. Vitamin D for the times he can’t get enough sun. Unfortunately for Caveman Doctor and his long hours, this happens often.
2. Fish oil or krill oil for when he can’t eat enough salmon or omega-3 fatty acids.
3. Whey protein when it is impossible to consume a good source of animal protein. Caveman Doctor also drinks these with fruit before and after a workout.
The evidence is here and it’s abundant! Throw away your pills, tablets, and capsules and replace them with nutrient-dense foods like green-leafy vegetables and healthy meat sources. Caveman Doctor’s been doing it for years (several million actually). This way when it comes back in style, you will be ahead of the curve!
Eat the foods Nature has supplied us with to be healthy. We have made some amazing advances in science and technology, however, the evidence is all around us in the form of rising rates of obesity, diabetes, and cancer that we are not smarter than nature or our bodies. Don’t get the elements it needs to survive and thrive from a bottle sitting in a fluorescent 24-hour grocery store aisle. Get it from Nature itself. In short, follow nature’s lead: give your Ferrari (i.e. your body) the best fuel possible, and enjoy a long, healthy ride.
1. Wahls T: The Seventy Percent Solution. Journal of General Internal Medicine 26:1215-1216, 2011
2. Wahls TL: Telling the World. Annals of internal medicine 149:61-62, 2008
3. O’Keefe Jr JH, Cordain L: Cardiovascular Disease Resulting From a Diet and Lifestyle at Odds With Our Paleolithic Genome: How to Become a 21st-Century Hunter-Gatherer. Mayo Clinic Proceedings 79:101-108, 2004
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7. MRC/BHF Heart Protection Study of antioxidant vitamin supplementation in 20,536 high-risk individuals: a randomised placebo-controlled trial. Lancet 360:23-33, 2002
8. Cook NR, Albert CM, Gaziano JM, et al: A randomized factorial trial of vitamins C and E and beta carotene in the secondary prevention of cardiovascular events in women: results from the Women’s Antioxidant Cardiovascular Study. Archives of internal medicine 167:1610-8, 2007
9. Albert CM, Cook NR, Gaziano JM, et al: Effect of folic acid and B vitamins on risk of cardiovascular events and total mortality among women at high risk for cardiovascular disease: a randomized trial. JAMA : the journal of the American Medical Association 299:2027-36, 2008
10. Zhang SM, Cook NR, Albert CM, et al: Effect of combined folic acid, vitamin B6, and vitamin B12 on cancer risk in women: a randomized trial. JAMA : the journal of the American Medical Association 300:2012-21, 2008
11. Dietary supplementation with n-3 polyunsaturated fatty acids and vitamin E after myocardial infarction: results of the GISSI-Prevenzione trial. Gruppo Italiano per lo Studio della Sopravvivenza nell’Infarto miocardico. Lancet 354:447-55, 1999
12. Joshipura KJ, Hu FB, Manson JE, et al: The Effect of Fruit and Vegetable Intake on Risk for Coronary Heart Disease. Annals of internal medicine 134:1106-1114, 2001
13. Lippman SM, Klein EA, Goodman PJ, et al: Effect of Selenium and Vitamin E on Risk of Prostate Cancer and Other Cancers. JAMA: The Journal of the American Medical Association 301:39-51, 2009
14. Ebbing M, Bonaa KH, Nygard O, et al: Cancer incidence and mortality after treatment with folic acid and vitamin B12. JAMA : the journal of the American Medical Association 302:2119-26, 2009
15. Williamson CS, Foster RK, Stanner SA, et al: Red meat in the diet. Nutrition Bulletin 30:323-355, 2005
16. Pauletto P, Puato M, Caroli MG, et al: Blood pressure and atherogenic lipoprotein profiles of fish-diet and vegetarian villagers in Tanzania: The Lugalawa study. Lancet 348:784-788, 1996
17. Bang HO, Dyerberg J, Nielsen AB: Plasma lipid and lipoprotein pattern in Greenlandic West-coast Eskimos. Lancet 1:1143-1145, 1971
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