Life Extension Magazine March 2005
False and Misleading
On November 10, 2004, researchers at the prestigious Johns Hopkins University School of Medicine released a study that startled the world. According to this report, vitamin E not only is ineffective, but also shortens the lives of those who use it.1
Since vitamin E is a popular dietary supplement, the media turned this negative report into one of the day’s top news stories.
Life Extension received numerous calls seeking a rebuttal to this report that appeared to discredit the value of vitamin E. Instead of issuing an uninformed reactionary response, however, Life Extension researchers meticulously examined every detail of the report.
What we found reveals that this attack on vitamin E is baseless. The main reason the media fell for this charade is that the authors of this negative report work at Johns Hopkins, a bastion of establishment medicine.
Life Extension Foundation researchers were not the only ones to identify numerous flaws in the report. Other nutritional scientists inundated us with their critiques demonstrating that the claims and conclusions of this vitamin E study were unfounded.
Why We Are Not Biased
The basis for the negative attack on vitamin E was an analysis of 19 final studies evaluating the effects of various doses of alpha tocopherol on population groups. Many of the study subjects had already developed serious disease.
For the past seven years, we at Life Extension have suggested that those who take only alpha tocopherol (vitamin E) might encounter health problems because alpha tocopherol displaces critically important gamma tocopherol in the body.2
In fact, since January 1, 1998, we have promoted the benefits of gamma tocopherol and have strongly urged our members to consume this form of vitamin E.3 From a standpoint of bias, it would have been in our interest to say, “look at this negative report on alpha tocopherol—we told you to take gamma tocopherol a long time ago.”
While a tremendous amount of data substantiates the importance of gamma tocopherol, the negative report on alpha tocopherol emanating from Johns Hopkins still has no basis in fact.
Although scientists at Johns Hopkins concur that gamma tocopherol may be an essential form of vitamin E, this does not in any way lend credence to the horrendously flawed alpha tocopherol report released by researchers working at this same institution.
The Johns Hopkins vitamin E report contains so many technical flaws that its conclusions have no basis in fact.1
One of these flaws is so apparent that even someone with no understanding of molecular medicine or statistical analysis could readily recognize it. Of the thousands of human studies on vitamin E archived in the National Library of Medicine, the authors of the negative report selected just 36 studies.
When they could not attribute enough deaths to vitamin E in 17 of these 36 studies, they further reduced the number of studies to be included in their analysis to only 19. Had the omitted studies been included, the Johns Hopkins researchers would not have been able to attack vitamin E as being “life shortening.”
The basis for attacking vitamin E was the analysis of the remaining 19 selected studies. Based on these hand-selected studies, the Johns Hopkins researchers proclaimed that supplemental vitamin E was not effective in extending life span and may have slightly shortened it in seriously ill people. Omitted were all the positive studies showing decreases in disease risk in those taking supplemental vitamin E.4-23
Instead of raising questions about the omitted positive studies on vitamin E, the media hyped this seriously flawed report by proclaiming that experts say that vitamin E supplements should be avoided.
The Johns Hopkins report was not a new study of humans and vitamin E. Instead, it was a review of selected past studies primarily evaluating the effects of varying doses of alpha tocopherol. The majority of study subjects had already developed chronic disease, with some confined to nursing homes.
The report was published in the on-line edition of Annals of Internal Medicine, a respected medical journal. Less than a month later, however, some of the world’s best scientists had unleashed a fire-storm of criticism and rebuttals, challenging the study’s design, methodologies, selection bias, findings, and conclusions. Al-though rebuttals debunking the Johns Hopkins report were posted on the Annals of Internal Medicine’s website,1 they were completely ignored by the news media. Perhaps the media did not want the world to find out that their sensationalized reports of just a few weeks prior were baseless. Here is an excerpt from the very first rebuttal found on the Annals of Internal Medicine’s website:
“The meta-analysis by Miller et al has become part of the public landscape, because of the sensational headlines in newspapers around the world: “High Doses of Vitamin E Deadly,” “Vitamin E’s Fatal Flaw,” “Lethal Consequences of Vitamin E Overdose.” The wall-to-wall press makes it seem like one of the most important health warnings of our era, but this meta-analysis is nothing more than a tempest in a teapot brewed from a statistical study that many epidemiologists would not give much credence to.
For physicians (or their patients) unable to read past the alarming headlines, here’s the story: The authors combined the findings in 19 previously published studies on vitamin E over the last 12 years. Virtually all of them failed to show any statistically significant harm—much less any increase in deaths. However, by combining the 19 old studies, the authors believe they have found a statistically significant increase in deaths from all causes of mortality.
I believe the authors’ bias is clear when they cite an apparent 0.4% increase in all-cause mortality at doses over 400 IU vitamin E while providing almost no comment on hundreds of excellent studies that show no increase in all-cause mortality—while also demonstrating benefits of vitamin E supplementation. Certainly as physicians assess the risk of vitamin E, its documented benefits must be factored into the equation. Yet the authors fail entirely to acknowledge the benefits of vitamin E that were reported in the very same studies that they included in their own meta-analysis: Reduction in the risk of Alzheimer’s disease, heart and blood vessel disease, age-related macular degeneration and several forms of cancer.
How narrowly informed is this meta-analysis? I believe the overwhelming fact is that the increase in mortality was just 39 out of 10,000 for those taking 400 IU of vitamin E or more. That’s less than a one half of one percent increase in all-cause mortality, which may include floods, famine, earthquakes, homicides, suicides and accidents!”1
Note the significance of the last sentence above: because the Johns Hopkins study authors considered “all-cause mortality,” if a vitamin E user was murdered or died in an accident, this would have counted as a person whose life was shortened because he took vitamin E. When we say this Johns Hopkins study is baseless, we are not exaggerating!
Some Hopkins Researchers Endorse Vitamin E
Johns Hopkins is a huge institution whose scientists have varying opinions about the value of supplements. Johns Hopkins, for instance, was an early pioneer in discovering the benefits of gamma tocopherol, and continues to publish research showing that this may be the preferable form of vitamin E.
On January 23, 2004, the media reported that “Johns Hopkins Endorses Vitamin E for Age-Related Macular Degeneration.” This report was based on a study showing that daily doses of 400 mg of vitamin E along with vitamin C, beta-carotene, and other nutrients reduced the likelihood of the progression of a blinding eye disease. Until this study was released, there was no proven treatment to slow the progression of age-related macular degeneration (AMD).24,25
In a report published in the Archives of Ophthalmology, Johns Hopkins researchers concluded, “if every American with intermediate AMD took these vitamins and minerals, more than 300,000 people could avoid AMD-associated vision loss over the next five years.”25
More than 1.6 million Americans over the age of 60 have age-related macular degeneration, which is the most common cause of visual impairment and blindness in the US.
Clearly, not all Johns Hopkins scientists are opposed to vitamin E supplements.