Some Frequently Asked Questions, first published in SAGA Magazine (12)
Professor George Lewith
I’ve just read a report saying that taking antioxidant vitamin supplements can actually shorten your life. I’ve taken them for years because I thought they could protect against cancer and heart disease – what’s the truth?
The debate about antioxidants, vitamins and minerals has been with us for the last 30 years. I think you are referring to a recent article by some Danish researchers, published in the Journal of the American Medical Association. What they did was search all the available electronic databases prior to 2005 to identify all the randomised trials that involved single vitamin supplements, and selenium (antioxidants), to see if they could assess whether people lived longer if they took these products. They were able to locate 68 randomised controlled trials, which used these products. We don’t know very much about the patients entered those trials, so we are not really sure whether these individuals were generally “sicker than average” or “the worried well”. What we do know is that taking individual supplements of vitamin A, vitamin E and beta carotene (a product that is closely related to vitamin A) seems to be associated with an increased chance of death. Vitamin C was pretty neutral, it didn’t extend or diminish life, and (possibly) the mineral selenium may have improved life expectancy. Because we know so little about the individuals recruited to these trials and their nutritional needs, it is very difficult to understand what this really means in practice; perhaps an overdose of Vitamin E may be harmful, but if you are undernourished it may improve life expectancy. Some people may take nutritional supplements to see themselves through a very difficult period while having chemotherapy for cancer, others may use them to help manage chronic illness. For instance vitamin A is often used in supplements that are purported to benefit patients suffering from macular degeneration, which is the type of retinal decay that tends to occur as we get older, and affects vision; does the use of Vitamin A in this context hasten death? You can see that it is difficult to interpret these studies. It is possible that selenium might help protect against cancer, and it is possible that some of the vitamin B supplements might help to protect against heart disease, but the article didn’t specifically look at these questions.
I think it is fair to say that the old adage of eating well and not too much, making sure you have lots of fruit and vegetables in your diet and taking regular exercise, are all important in maintaining a healthy lifestyle. Having an interest in what you are doing and keeping your brain active is also vital. The evidence that antioxidants act to prolong or improve life is still unclear; we probably need to look at nutrition on a much more individual basis than is possible in these very large studies, and it is almost certain that in some instances we will find that supplementation will help, while in other instances we will find it won’t. I think the jury is still out, in spite of this new study. The authors themselves were far more cautious than the media about suggesting that the use of particular vitamins would increase mortality! The debate I suspect will run and run!
Do you think Emotional Freedom Therapy is worth trying to treat panic attacks? I’ve heard that it works by tapping energy points on the same meridians that acupuncturists use.
Emotional Freedom Therapy draws from two disciplines; the first is Neuro Linguistic Programming, which tries to “reprogramme your innate reflexes” and the second is acupuncture. The idea behind this is that if you tap gently on particular acupuncture meridians, it is rather like having acupuncture and so should adjust the body’s energy in an acupuncture like fashion. If this is indeed an acupuncture based therapy, then the first question we need to answer is: Does acupuncture help anxiety and panic attacks? There does seem to be some evidence that acupuncture does help with anxiety and panic attacks. There haven’t been a large number of very good clinical trials, but the ones that do exist all indicate that there is positive benefit to be had from acupuncture with anxiety related disorders. The next issue is, of course, whether Emotional Freedom Therapy really is an acupuncture technique, and I think many acupuncturists would disagree this assertion. If tapping on particular acupuncture points can have that much of an effect on you, then sitting on the bus and bumping along the road might either turn out to be a disaster, or the best thing since sliced bread for your acupuncture meridians! When you visit a therapist who takes time and effort with you, of course that is going to help, and Emotional Freedom Therapy like many different forms of “mind, body or psycho therapies” may be having most its effect through simply just having the therapy. It sounds a pretty harmless therapy and I would think it certainly worth a try; it might work. Whether it works through the acupuncture meridians is a matter of considerable debate!
I’m tempted to buy a supplement I’ve seen advertised, which says it helps weight loss by metabolising fat and turning it into energy. I suppose this is too good to be true?
There are some supplements that in theory might help to very gently increase your metabolic rate. There are small structures called mitochondria inside cells; these are present in all the millions of cells in our bodies and generate the energy we need inside our cells. Sometimes they get a bit ‘clogged up’, particularly after infections and in individuals who develop chronic fatigue syndrome (CFS) or ME. Sometimes they don’t work properly because we have been born without the right sort of mitochondrial enzymes. There is a supplement called Coenzyme Q10, which can help improve mitochondrial function, thereby improving energy generation in the cells, which might in theory help us burn up excess energy such as unnecessary fat. There haven’t been any clinical trials on Coenzyme Q10 as a treatment for obesity, so while in theory it may be a good idea, in practice we really don’t know whether it works. In very general terms, the majority of people who market a herbal or nutritional supplement that says ‘it will help weight loss’ by metabolising fat, are doing so on the basis of very flimsy, and in all probability totally absent evidence, so I would treat such claims with great caution; the majority of them are “too good to be true”.
Once it starts getting light very early, I wake and can’t get back to sleep. I don’t want to take sleeping pills – can you recommend any natural remedies?
We do all sleep slightly less during the summer, as our brains are quite responsive to the amount of sunlight that is ‘out there’. I think the first thing to do is to try and make sure that the sunlight doesn’t penetrate your bedroom. I would suggest that you get some blackout curtains or blinds and make sure that they are tightly drawn, so that the early morning sunshine simply doesn’t wake you up. If that fails, then the other alternative is to go to bed slightly earlier (again with the sun) so that you get enough sleep and can then tolerate waking early. There are a couple of natural remedies that might help if these two ideas fail. We have been running some experiments with Lavender oil in our research group in Southampton, and we find that Lavender oil dropped on to your pillow does help with mild insomnia. It will relax you and help you sleep, so it is worthwhile trying 2 or 3 drops of Lavender a night, and seeing if that works for you. There is also evidence that the herb Valerian can be of benefit in people suffering from sleep disturbance. You often need to take a reasonable dose (follow the manufacturer’s instructions on the bottle), and you need to be prepared to take it for 3 or 4 weeks to see if it will help you establish a normal sleep rhythm, it won’t work instantly. Both these remedies have some evidence behind them, neither appears to be addictive, and both might help you if you are still suffering after making your bedroom “light tight”.
I have been told by a nutritional therapist that my digestive problems and fatigue are caused by a candida infection. My GP says I have IBS and avoiding foods containing yeast won’t help at all – who’s right?
We have recently been conducting some studies on just this very issue. When you look at people who have irritable bowel, it seems that about 25 or 30% of them could easily be fitted into the diagnosis of intestinal candida. They seem to have a history of reactions to antibiotics, sometimes they get recurrent vaginal or oral thrush, and they seem to have allergies to yeast, which frequently present with symptoms relating to a runny nose and itchy eyes, particularly in spring and autumn when there are lots of mould spores about in the atmosphere in the UK. Sugar craving is another common symptom, which seems to be associated with so-called “gastrointestinal candida”. There is now some very clear evidence from clinical trials that those with IBS, who may fall into the “candida” group, do respond to treatments that kill off Candida in the gut. Anti-fungal treatments, such as Nystatin, combined with diets that avoid yeast and sugar, have quite definitely been shown to benefit this sub group of individuals with irritable bowel. I am afraid, therefore, that your GP is wrong, avoiding yeast and sugar will almost certainly help some people with irritable bowel, but certainly not everybody. If you do have Candida, as your nutritional therapist suggests, then you may need some herbal or conventional medicines to help manage the Candida. As always, things are more complex than they seem at first, and irritable bowel covers a large group of individuals and symptoms. Some may develop irritable bowel after a severe gastroenteritis, or a prolonged course of antibiotics, while others will have it because they have a tendency to get worried and stressed. If worry is at the basis of your irritable bowel, then avoiding yeast and sugar won’t help. If there is a yeast or candida connection to your problem, then avoiding yeast and sugar might well provide you with significant benefit.
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