In a recent article by the Journal of the American Medical Association (JAMA, June 19, 2002 – Vol 287, No. 23) it was highlighted that an inadequate intake or even subtle deficiencies in several vitamins are risk factors for several Chronic Diseases like cardiovascular disease, cancer, and osteoporosis.

Vitamins are organic compounds that cannot be synthesized by humans and therefore must be ingested to prevent metabolic disorders.

The elderly are particularly at risk for vitamins B12 and D deficiency, alcohol dependent individuals are at risk for folate, B6, B12 and thiamine deficiency, and hospitalised patients are at risk for deficiencies of folate and other water soluble vitamins. In addition, pregnancy or alcohol use may increase vitamin requirements.

B Vitamins and Coronary Heart Disease (CHD)
Many studies have shown an increased risk of CHD or ischemic stroke associated with low folate intake or low blood folate levels.

Folate appears to be the critical vitamin in determining plasma homocysteine levels. Elevated plasma total homocysteine levels is a major risk factor for CHD. People with the highest homocysteine levels have an approximate 2-fold increase in risk of CHD – similar to the increased risk associated with cigarette smoking or hypercholesterolemia. This effect is independent of other known factors.

Studies show that folate lowered plasma homocysteine by 25% and additional B12 lowered homocysteine another 7%.

In fact the JAMA Report went so far as to recommend that it is prudent for most adults to take a daily multivitamin to reduce the risks above. For people with premature CHD or a family history of premature CHD, they recommend a folate intake of 800µg.

Folate and Cancer
Higher dietary folate intake appears to reduce the risk of colon and breast cancer, particularly amongst moderate consumers of alcohol.

In the Health Professional Follow-up Study, men who consumed folate from multivitamins for longer than 10 years had a 25% reduction in colon cancer risk. The Nurses’ Health Study found similar effects for women where those who had taken multivitamins (with folate) for 15 years or more had a 75% reduction in colorectal cancer risk.

Folate is also necessary for embryogenesis, and supplementation reduces the risk of neural tube defects. Because the neural tube closes within 3 weeks of conception (before most women know they are pregnant), supplementing all women who might become pregnant with 800µg of folate is the best way of preventing this birth defect.

Vitamin E
Vitamin E is fat soluble and like other antioxidants, can scavenge free radicals and prevent oxidative damage to lipid membranes and low-density-lipo-protein (LDL). Vitamin E is also needed in immune function and in particular enhances the immunity of the elderly.

Vitamin E also has a protective factor for CHD. Vitamin E prevents atherosclerotic disease not only by its antioxidant effects, but also by its inhibitory effects upon smooth muscle proliferation and platelet adhesion.

The Nurses’ Health Study found that women taking more than 100IU of Vitamin E had a 44% reduction in major coronary disease.

In the Cambridge Heart Antioxidant Study (CHAOS), participants who received between 400-800IU of Vitamin E demonstrated a 80% reduction in non-fatal myocardial infractions with people with known CHD.

In the Alpha-Tocopherol Beta-Carotene (ATBC) trial, strong evidence suggests that Vitamin E may decrease the risk for prostate cancer in smokers.

Carotenoids
Carotenoids are a class of yellow, orange, and red plant derived compounds. All of the more than 600 known carotenoids are antioxidants, and approximately 50 are vitamins.

A recent report combining updated observational data from the Nurses’ Health Study and the Health Professionals Follow-up Study noted a 32% reduction in risk of lung cancer for people consuming a diet high in a variety of carotenoids.

Vitamin C
Vitamin C (ascorbic acid) is water soluble and is important in the synthesis of collagen. Vitamin C also promotes hormone synthesis, wound healing, and iron absorption.

Vitamin C may also lower the risk for cancers of the oral cavity, esophagus, and stomach. A high dietary intake of Vitamin C has also been reported to lower the risk for breast cancer by 20%.

Conclusion
As can be observed, suboptimal vitamin status can have a significant impact on the development of many chronic diseases. Therefore it is important to identify individuals with poor nutrition or other reasons for increased vitamin needs.

By Khushwant S. Dhanoa