Fast Food Genocide

by Dr. Joel Fuhrman

  Many studies have evaluated whether taking a standard multivitamin-mineral supplement wards off heart disease, cancer, and dementia or extends life span. Overall, the results of the majority of such studies show very little benefit, if any. A meta-analysis conducted for the U.S. Preventive Services Task Force assessed the evidence from twenty-seven studies on vitamin and mineral supplementation that included more than 450,000 people and found no evidence of benefit for preventing heart disease and only a minimal benefit for reducing cancer risk.1 A significant number of studies also show that the commonly included nutrients in multivitamins can cause harm. These data are a bit complicated and need to be explained and understood further.

  Any study looking at the risks and benefits of long-term multivitamin use is by its nature poor science. That’s because multivitamins have too many variables and mix together some potentially useful elements with other potentially harmful ones. Studying multivitamin use is as illogical as studying the Mediterranean diet: Is it the fish that is good or bad for you? Or the tomato sauce, walnuts, and olive oil? Or did the oil cause more weight gain and death? Does the white pasta and cheese in the Mediterranean diet promote a longer life span, or the pizza crust? You can see the point: Too many variables are lumped together to be able to get any useful information about which elements are good or bad when they are included all together in one study.

  We need to evaluate one intervention at a time to really learn which are the most favorable or unfavorable components of a diet. When we do that with the Mediterranean diet, we invariably find out that the white flour pasta and the pizza crust are unfavorable. Clearly, a Mediterranean diet is far from an ideal diet, and just because it is better than the SAD, it is not scientific to position it as such.

  Likewise, a study evaluating the benefits of a multivitamin lumps together elements such as vitamin D, vitamin B12, and zinc supplementation, which may have benefits in certain populations, with other elements such as beta-carotene, folic acid, vitamin A, and copper, which most likely have overall harmful effects.

  These studies are examples of poor science and wasted resources; they tell us almost nothing. Therefore, the inconsistent and marginal benefits shown by these studies on whole multivitamins do not offer us any insights on which elements, if any, aid health or are effective in reducing cancer or extending life span. We have to study each micronutrient individually to ascertain its risks and value. I explain this in more detail below and offer suggestions.

  FOLIC ACID IS NOT FOLATE

  Let’s consider the practice of supplementing flours and foods with folic acid and vitamin A and look at the benefits and risks. If you understand the complexity of this issue, you will be able to better understand why supplements cannot take the place of eating right.

  Folate is a B vitamin that is universally present in plants. A synthetic form of folate called folic acid is used in dietary supplements and fortified foods. Folic acid is derived from petroleum and is not the same compound as the real folate that is found in fruits, vegetables, and beans.

  Synthetic folic acid is highly absorbable, but then the body has to modify it so it can behave like real folate. The body can convert only a limited amount of folic acid into folate, so most people ingesting folic acid have unmodified folic acid circulating in their bloodstream and in the tissues of their body. Remember: Folic acid is a manufactured chemical substitute for folate, and throughout human history, folate has been the protective vitamin ingested from eating real food. Only in our recent fast food era have people been encouraged to supplement with folic acid because they no longer eat sufficient vegetation, which is naturally high in folate.

  The problem begins with folic acid competing for absorption into the body, thus decreasing the absorption of the folate in fruits, beans, and vegetables. Once inside our body’s cells, the real competition begins where folic acid binds to folate-dependent enzymes, creating potential hazards in their function. DNA synthesis is affected, leading to more DNA errors in dividing and replicating cells, which potentially can increase the risk of developing cancer.

  Almost every obstetrician today prescribes a folic acid–containing supplement to pregnant women to protect the growing fetus from neural tube defects. The neural tube is the embryo’s precursor to the central nervous system, which comprises the brain and spinal cord. Neural tube defects occur during early fetal development because modern women are not eating vegetables—not because they require a petroleum-derived chemical to have a normal child. Modern health authorities repeatedly try to solve health issues with pills instead of fixing the real problem, in this case, the lack of green vegetables in the diet.

  Instead of encouraging women to eat more vegetables and beans to give birth to normal children, we give them folic acid pills. Instead of encouraging people to eat more vegetables and lose weight to reverse type 2 diabetes, we give them pills. Instead of encouraging people to eat more vegetables so they can lower their cholesterol and prevent heart disease, we give them statin drugs. The problem with these “pill solutions” is that they have unintended side effects. It is more effective and safer to lower your blood pressure and reverse your diabetes through an excellent diet and exercise, not medication. It is more effective and safer to maintain a normal level of folate in your body by eating properly, not by taking a supplement containing folic acid.

  When people ingest folic acid routinely in multivitamins and fortified foods, their bodies get overloaded with the stuff, and unintended consequences result. For instance, we know from animal studies that the presence of artificial folic acid promotes the progression of precancerous lesions to cancer and the spread of cancer, including breast cancer.2 In addition, taking folic acid during pregnancy to prevent neural tube defects may actually damage the child. Let’s look at some of the evidence, but remember, it can take thirty to fifty years to see increases in cancer occurrence from ingesting folic acid.

  •A study compared breast cancer death rates between women who took folic acid during their pregnancies and those who did not. Thirty years later, those women who took a hefty dose of folic acid were twice as likely to have died from breast cancer.3

  •A ten-year study on more than thirty-five thousand women taking multivitamins showed that women who took a multivitamin containing folic acid had a 20 percent increased occurrence of breast cancer compared with women not supplementing with folic acid.4 (Note that ten years would underestimate the increased cancers that could have been created.)

  •Researchers looking to find a benefit from using folic acid to prevent breast cancer followed more than twenty-five thousand women and were shocked to find the opposite—folic acid supplement use was associated with a higher incidence of breast cancer.5

  •A 2011 meta-analysis of folic acid supplementation and colon cancer found people taking the supplement for three years or longer increased their risk of developing advanced adenoma by 50 percent. A 2012 meta-analysis of folic acid supplementation found a 21 percent increase incidence of cancers at all sites.6

  •One randomized controlled trial of folic acid supplementation reported that men who took folic acid had triple the prostate cancer risk compared with men who took a placebo.7

  Some studies looking at this issue have not shown an increase in breast cancer incidence in women supplementing with folic acid. This is most likely because the studies are not well-controlled and do not follow the study populations long enough. When atomic bombs exploded in Hiroshima and Nagasaki in Japan to end World War II, cancer deaths began to appear about ten years later, and the rates were still climbing after forty years. We cannot look at studies performed for fewer than ten years to ascertain the potential cancer-promoting effects of an intervention.

  Today, even people who do not take a supplement containing folic acid still have a large exposure to supplemental folic acid in fortified foods, so this is a difficult subject to study when our entire population is exposed to folic acid from multiple sources every day. A systematic review and met
a-analysis of nineteen studies discussing this issue was published in 2012 and showed an increase in prostate cancer in men taking folic acid in supplements and a borderline increase in overall cancer.8 Remember, even a negative study does not mean folic acid is safe; it just means that the study could not detect the harm. Given that our modern population ingests multiple carcinogenic substances, it is nearly impossible to isolate every contributor to determine individual effects.

  When people eat commercial baked goods, they don’t just ingest cancer-causing additives, such as bromate and sodium phosphate, and bleaching and softening agents, such as benzoyl peroxide and azodicarbonamide; they also consume a load of folic acid because all of these things are added to the fortified white flour used in commercial baking. Add the underlying risks of the high-glycemic flour as well as the synthetic folic acid in a multivitamin, and you have a witches’ brew for cancer promotion.

  Unlike supplemental folic acid, we know that eating real food with real folate offers significant protection against cancer. Folate is abundant in all green vegetables, and folate-containing foods include hundreds of protective nutrients. We do not need synthetic folic acid supplements to meet our daily folate requirements. Here are a few examples of folaterich foods (as a reference point, the U.S. recommended daily allowance for folate is 400 micrograms).

  MICROGRAMS OF FOLATE

  Asparagus (1.5 cups cooked) 402

  Edamame (1 cup cooked) 358

  Lentils (1 cup cooked) 358

  Broccoli (2 cups cooked) 337

  Chickpeas (1 cup cooked) 282

  Adzuki beans (1 cup cooked) 278

  Romaine lettuce (3 cups raw) 192

  Brussels sprouts (2 cups cooked) 187

  Spinach (3 cups raw) 175

  When you eat produce to get your folate, you radically improve your nutritional status in many ways, as these are all micronutrient-rich foods in general, containing many antioxidants and phytochemicals.

  However, it is not healthy to be deficient in folate, and certainly for people who can’t or won’t eat vegetables, taking some folic acid is better than nothing. But everyone should be informed that ingesting an excessive amount of folic acid from a combination of fortified foods and supplements can be dangerous. Too much exposure to folic acid during pregnancy may increase respiratory problems in children such as asthma and pneumonia.9 There is even evidence that excessive blood levels of folate (which likely is from excessive exposure to folic acid) at childbirth is associated with doubling the risk of autism in children.10

  One thing we know for sure: If women ate more green vegetables and beans throughout their lives, they would get plenty of folate, and their offspring not only would be protected against neural tube defects but also would get hundreds of other beneficial compounds that offer protection against childhood cancers. It has been known for years that a lack of green vegetables in mothers’ diets increases the risk of childhood cancers in their offspring.11 The diet before conception also affects these risks. If the public were fully informed on all these issues, maybe more people would eat right and we would have many fewer children with autism, brain tumors, and leukemia. Now is the time for public health authorities to promote a diet with adequate folate from plant foods.

  Future studies may indicate that some people metabolize folic acid and vitamin B12 differently and are at higher risk than others from excesses. However, this would not be an issue if women got their needed folate from a healthy diet. We can’t stop the folic acid recommendations across the board yet, because so many women still don’t eat healthfully, but at least we can start to reeducate our population about the necessity of getting these nutrients from their natural sources, and the profound benefits from doing so.

  This is a complicated issue, and most people are in the dark about it. But it has important implications because excluding accidents, cancer is the leading cause of death in children younger than 15. This missed opportunity to educate young women about the critical importance of a healthy diet that contains adequate folate to have a normal and healthy child leads to many subtle medical issues in children that can affect them throughout their lives—including allergies and autoimmune diseases. Advocating folic acid supplements, instead of sufficient vegetables and beans to obtain folate, likely harms and even kills thousands of children every year.

  SUPPLEMENTS AND FORTIFICATION OF FOODS IS PART OF THE PROBLEM, NOT THE SOLUTION

  When you eat a healthy diet, you are exposed to a huge amount of carotenoids, such as beta-carotene, a precursor to vitamin A in the body. The body converts beta-carotene (as well as alpha-carotene and beta-cryptoxanthin) into vitamin A, so if people eat enough colorful vegetables, there would be no need for vitamin A supplementation. People are exposed to preformed vitamin A in supplements and in fortified foods, and it has been shown that even in ranges not normally considered toxic, it can be harmful. A review of sixty-eight randomized trials of vitamin A supplementation, with a mean dose of 20,000 IU, showed an average 16 percent increased mortality over an average of three years.12 Since this analysis was not over decades, it likely underestimates the damage from excess vitamin A intake.

  The amount of vitamin A in typical multivitamins has been shown to increase the risk of osteoporosis and hip fractures, and excess vitamin A in fortified foods makes these effects even worse. One study showed a doubling of the hip fracture rate with more vitamin A, comparing an intake of 1,500 IU vitamin A with 4,500 IU, the latter being the typical amount found in vitamin supplements.13 High doses of vitamin A during pregnancy have also been linked to birth defects.14

  A more recent evaluation of all relevant trials carried out around the world showed that taking vitamin A, beta-carotene, and vitamin E supplements increased mortality—that is, the risk of sudden death was higher for those who took such supplements. Some skeptics doubted these findings, claiming that people taking supplements likely had worse diets because they believed that the supplements would improve their health. These doubts were rejected in later randomized trials, which means that study participants were randomly assigned to take the supplements or a placebo. The results showed the same dangers from the supplements as the earlier studies had shown. This new study carried out in 2011 was based on eleven new trials and used ordinary dosages typically found in vitamin pills that were linked to the increased death rate.15 The researchers tested both single vitamins and multivitamins, and they found increased mortality in both cases.

  The full spectrum of natural vitamin forms that is found in natural foods, such as eight separate vitamin E fragments or hundreds of carotenoids, behaves much differently from the vitamins we take as supplements or get from fortified foods in our diet. As the saying goes, “You can’t fool Mother Nature.”

  Supplements cannot take the place of a healthy diet and should be avoided—especially the widely available inexpensive varieties. This does not mean that the judicious use of supplements to cover nutritional gaps in a person’s diet is not important; it just means we have to review the data carefully regarding each ingredient and the precise form of supplement being used, and assure that the dosage used is not excessive.

  3. WHAT ABOUT THOSE WHO DON’T EAT RIGHT? AND, DO PEOPLE WHO EAT HEALTHFULLY NEED ANY SUPPLEMENTS AT ALL?

  Unquestionably, people who eat fast food, commercial baked goods, processed meats, fried foods, and soft drinks are dangerously deficient in micronutrients, especially antioxidants and phytochemicals. We have to recognize that despite the potential dangers of certain supplemental ingredients, this group is more likely to be better off with a carefully chosen assortment of supplements, including powdered whole food extracts, phytochemical isolates, and a full spectrum of low-dose antioxidants.

  Of course, supplementation will not grant them optimal health, but it is better than being severely deficient in micronutrients. However, it is important to remember that individual nutrients and isolated nutrient extracts and synthetics can still be potentially harmful. Take care not to overdose on any
micronutrient that could have negative effects, especially in excess amounts.

  A large number of Americans eat what they consider a “healthy” diet, but so often that diet still does not include sufficient vegetables, beans, onions, mushrooms, berries, and seeds and still is too close to the SAD (meaning they eat too many processed foods and animal products). These people are not exposed to enough micronutrients and phytochemicals. For these people, a supplement with a dehydrated vegetable-based formula with dozens of phytochemical extracts from superfoods is likely beneficial, though not as valuable as eating an excellent diet. There are other groups of people who may benefit from supplementing their diets with certain vitamins and minerals:

  1.The elderly: Vitamin B12 absorption decreases with age, and elderly people may also need higher amounts of calcium and vitamin D. Zinc is also important for the elderly, as the body’s ability to absorb zinc can decrease and immunity wanes in later life, increasing the risk of a person developing influenza and pneumonia. A significant amount of research indicates that such supplementation is particularly important in the aging population to decrease the risk of infections, especially life-threatening pneumonia.16

  Calcium can also be an issue for the elderly, as bones age and grow brittle. Green vegetables, beans, and seeds are generally rich in calcium, and a diet including these foods is healthful for the bones. Taking too much supplemental calcium in a concentrated form can lead to increased blood vessel calcification and may increase heart disease risk.17 So even in postmenopausal women, the right diet and the moderate use of food-derived calcium in small amounts (such as 150–250 milligrams) with meals is a better choice than a high dose (500–1000 milligrams) of calcium taken at once, which may have detrimental health effects.18

  2.Vegans and vegetarians: Vitamin B12 is found only in animal foods. Depending on food choices and the care taken to cover insufficiencies, vegans and vegetarians may also have suboptimal levels of vitamin K2, zinc, iron, vitamin D, and omega-3 fatty acids (see Omega-3 Index in Vegans chart).