Originally published in Nutrition News and Views, Vol. 20, No. 2, March-April 2016, “Whole Versus Parts” will be featured in the third edition of Judith DeCava’s The Real Truth About Vitamins and Antioxidants, available from Selene River Press in 2019.
Many supplement makers, food fortifiers, and scientists would like us to believe that our bodies cannot tell the difference between nutrient parts or synthetic chemical versions and nutrients in real food. They insist there is a single chemical structure for a nutrient part that they have labeled as a nutrient. But parts are not the same as whole nutrient complexes or whole foods, and our bodies can tell the difference.
Researchers isolate one part to investigate its effects without considering how the part inevitably works cooperatively with numerous other nutrients and compounds. Yet biochemistry textbooks disclose the abundance of synergistic nutritional relationships. When nutrient parts, separated from food or manufactured in a lab, are dispensed, it amounts to “nutritional pharmacology” with drug-like effects. There is an “inappropriate use of the drug trial paradigm in nutrition research.” This is not synonymous with food or nourishment. Cellular health and replenishment require nourishment from foods containing complete nutrient entireties, with each part benefitting the whole. High doses of nutrition parts have actions that differ from nutrient complexes in foods, actions that can cause adverse effects. Although “nutritional pharmacotherapy” is generally safer than drug therapy, there should be clear indications for using it that justify potential side effects, and it should be used only temporarily. The longer it is taken, the greater the risk for adverse effects, including imbalances of other nutrients that can detrimentally influence health.1
All nutrients in a food complex are needed to make any single part effective and nourishing. A separated part or laboratory-produced imitation has very limited, if any, value in the body. In nature, nutrients are never found alone or in pure crystalline states. They are always a composite of numerous components. High doses of isolated or synthetic pseudo-nutrients can cause adverse reactions; natural food complexes do not. The body’s response to a nutrient fraction or imitation is different from its response to a natural complex containing all its synergists. The body can have difficulty in eliminating isolates and chemical versions. It will also try to combine the separate part with other compounds that normally occur with that part in foods. It has to acquire those other nutrient compounds from the body, so a deficiency of those other nutrients can develop.2
Reductionist scientists think everything in nature can be understood if all its component parts are understood. Wholist scientists find that the whole is often greater than the sum of its parts. Although reductionist research with proper experimentation has led to many scientific discoveries, viewing everything in nature, including food and nutrition, in a reductionist manner vastly limits understanding and perspective. Food is a connected whole. Reductionism is inadequate for understanding the whole.
Most of what people believe about nutrition is based on a reductionist model, viewed only as a mathematical summation of the effects of separated nutrients. For example, we hear that “vitamin A is needed for good eyesight,” “folic acid will prevent neural tube defects,” “potassium will lower blood pressure,” “calcium builds strong bones,” and the like. These are true, but only a small part of the story. Many similar beliefs come from a reductionist view that identifies and labels component parts of food and supposedly computes exactly what each one does in the body and how much of it we need.
Mathematical quantitative modes include Recommended Dietary Allowances (RDAs), Daily Values (DVs), Tolerable Upper Intake Level, (UIL), Dietary Reference Intake (DRI), Adequate Intake (AI), and Estimated Average Requirement (EAR). All of them reflect a reductionist and pharmacological model. Some scientists contend that the “RDA is both unneeded and lacking a sound scientific basis.” But because of the drug-like approach, people check the “nutrient” list on food packages, supplement bottles, and recipes. Research usually focuses on one nutrient and one explanation of its effect—a measurable outcome. The chemical structure of the nutrient is considered; measurements are made of absorption, transport, storage, excretion, amount required, specific reactions, alterations in chemical levels, and the like. Only occasionally does it get into “messy” things like human behavior, lifestyle, total dietary patterns, or effects of foods and diet on overall health and long-term wellbeing. People taking supplements of detached parts or fabricated facsimiles think they’re getting good nutrition. But instead of fixating on specific amounts of specific nutrient parts, we need to build and maintain health the way nature intended: with real whole food complexes.3
Interactions among nutrients in food are substantial and powerful with important implications. A meta-analysis reviewed effects of a large number of nutrients on the immune system and how they influence each other. For example, there are interactions between vitamin E and selenium, vitamin E and vitamin C, vitamin E and vitamin A, and vitamin A and vitamin D. Magnesium influences the effects of calcium, manganese, vitamin E, potassium, phosphorus, iron, and sodium, and through them the activities of hundreds of enzymes that process them. Copper interacts with iron, zinc, molybdenum, and selenium. Protein exerts effects on zinc. Vitamin A and fats affect each other’s ability to influence immune responses. Even closely related nutrients can greatly influence each other. Various fatty acids, for instance, affect immune system activities of other fatty acids. Magnesium is an essential part of the function of more than 300 enzymes. Mentioned here is only an infinitesimally small fraction of the total number of interactions operating every moment in our bodies. This says a lot about possibilities for almost unlimited nutrient interactions with effects on every bodily system. The belief that the effects of a single isolated nutrient can be investigated without considering potential modifications by other biochemical factors is foolish. Our bodies deal with nutrient combinations and interactions.4
Although reductionist-type studies provide some valuable nutrient information, plying out one contributor and ignoring the rest does not provide a complete—or sometimes a correct—picture. Humans and food have so many complicated, interrelated and interactive characteristics themselves and with each other that much more needs to be considered. Most studies seek to identify “active agents” of food. But that is impossible. Scientists “cannot identify all the parts, what they do, and how they do it.” They just know that food “does work.” Active agents function as they do because of the presence of all the other parts making them functional. In the reductionist view, a food is a composite of ingredients rather than an interrelated inseparable whole; somewhere in the food is a chemical that can do the work in isolation. Separate ingredients are studied, interpreted, and applied to dietary guidelines, nutrition labeling, food engineering, food marketing and most supplement production.
Research with a more wholistic approach reveals real solutions to nutritional deficits and imbalances. Plus, each individual is biochemically unique with different requirements for each nutrient. Food allows selective absorption—our bodies can choose to absorb more or less of the nutrients in the food as needed. Individual requirements can differ widely.5
The reductionist view of vitamin C is that oranges are good for us because they contain ascorbic acid. So ascorbic acid is good for us even when extracted and isolated from an orange or synthesized in a lab and placed in a pill or used to “fortify” a refined nonfood. But there is no evidence that this is the case. In food, ascorbic acid is always found with a multitude of other compounds, such as rutin, flavonoids, amino acids, ascorbate oxidase and tyrosinase (copper-containing enzymes), which researchers have confirmed are necessary to completely prevent or cure scurvy or any other detriment due to vitamin C deficiency.
Studies by Rui Hai Liu, PhD, and his team first focused on vitamin C and its antioxidant effect in apples. They found that 100 grams of fresh apples (about half a cup) had an antioxidant vitamin C-like activity equivalent to 1,500 milligrams of ascorbic acid. However, when the 100 grams of apple were chemically analyzed, they found only 5.7 milligrams of actual ascorbic acid—far below the 1,500 milligrams of antioxidant vitamin C-like activity. This activity was 263 times as potent as the same amount of the isolated chemical. Ascorbic acid accounts for far less than one percent of the vitamin C-like activity in an apple; the other 99-plus percent is due to other components. The potential capacity of vitamin C complex is far more effective in context of the whole apple than an isolated, single chemical ascorbic-acid form. The way the body uses a nutrient depends on which other nutrients are ingested with it. Even taking supplements that add other nutrient parts (like separated flavonoids added to ascorbic acid) still assumes that whatever is in the whole food and not in the pill is not important.6
In subsequent research, Dr. Liu and colleagues searched for other compounds that might account for the rest of the vitamin C-like activity of apples. They found a windfall. A few were quercetin, catechin, phlorizin, and chlorogenic acid, each of which can exist in many forms in the apple. The average apple contains a significant amount of vitamin C, vitamin K, vitamins B2 and B6, potassium, and fiber; it’s got smaller amounts of carotenes, vitamin E, niacin, magnesium, phosphorus, copper, manganese, and a host of other nutrients. The various compounds in apples make a long list and likely reflect only a tiny fraction of its components. The growing number of vitamin C-associated compounds being found can have many important biological effects. Findings so far indicate they may help stop cancer, normalize cholesterol levels, block degenerative processes and cellular damage. Many other health functions could and should be tested.
There are obviously hundreds or thousands of components in apples and other whole foods, each of which may affect thousands of bodily reactions and metabolic systems. This refutes the idea that a single chemical is responsible for major health-giving properties. The amount of ascorbic acid in one apple can be more than that of another apple, but this does not reveal much about that apple’s functional power in the body. The combination of nutritional factors in a food is more than the sum of its parts, and the body plays a role in determining how many of the nutrients are used. Simply knowing how much ascorbic acid or any other nutrient part is in a food does not reveal its value.
“Many chemically similar groups of compounds present in food are composed of dozens, if not hundreds or even thousands, of analogs that have the same kind of activities but very different potencies.” The current system is “nutrient micro-management,” nutrients to be consumed in specific, regimented quantities. In nature, no nutrient is ever on its own. “You can’t cut a slice of beta-carotene out of a carrot.”7
Real vitamin E contains four tocopherols, four tocotrienols, selenium, polyunsaturated fatty acids, and sulfur-containing amino acids. What is usually called “vitamin E” and virtually always used in studies is only alpha-tocopherol, isolated from food or synthetically manufactured. While tocopherols and tocotrienols share some functions, they also vary significantly and target various tissues. Isolating one means it can’t work properly.
The link between higher vitamin E levels in the blood and lower incidence of coronary disease initially found in a 1993 study measured vitamin E that came from food, not separated alpha tocopherol. Yet it spurred the production and use of alpha-tocopherol supplements. Studies find that such supplements don’t decrease risk of cardiovascular diseases, cancer, diabetes, cataracts, chronic obstructive lung disease or other disorders associated with vitamin E deficiency. Food sources are linked to prevention of these ills. The beneficial effects of the whole E complex are essentially lost when only a fraction of it is removed from its food environment or artificially produced in a lab.
High doses of d-alpha tocopherol are linked to risks of some types of cancer and bleeding including hemorrhagic stroke. A large study found that the use of synthetic alpha tocopherol and isolated selenium after an average of 5.5 years, taken individually or together, didn’t reduce the risk of lung, prostate, or colorectal cancers or cardiovascular disease. In a follow-up 18 months after the study’s end and discontinuation of the supplements, those who had taken the isolate had a 17 percent higher risk of prostate cancer than those who had taken the placebo. Taking alpha-tocopherol alone lowers other members of the complex, such as delta- and gamma-tocopherols; this adversely affects areas such as inflammation, cancer protection, bone formation and repair. The complete food form does not cause imbalances.8
Whole foods “contain the family of vitamin E compounds” important to brain health. Taking separated alpha tocopherol “does not afford the same protection—the whole food does it best.” In a large randomized trial, synthetic alpha-tocopherol and synthetic ascorbic acid did not help protect participants from cancer, even long-term. Foods containing vitamin C and E complexes do have a protective effect. High doses of isolated, synthetic vitamins C and E may reduce beneficial effects of exercise. Synthetic ascorbic acid offers no protection against knee osteoarthritis and may worsen it. People taking at least 250 mgs a day of ascorbic acid were 83 percent more likely to have lower urinary tract symptoms than those who did not take such supplements. But a supplement of rose hip powder, a natural food, reduced pain and stiffness of osteoarthritis of the hand. Women in their 70s with the highest levels of vitamin C in their blood scored higher on tests that measured physical strength and stamina; they did not take ascorbic acid supplements but got their vitamin C from foods. The variety of functions of vitamin C complex in foods is the reason for its reputation as an immune booster.
Ascorbic acid is synthesized in a lab from corn or rice starch via a heavily chemical-dependent process; it is extremely acidic and can lead to stomach upset, gas, diarrhea, excessive iron absorption, calcium loss from bones, blood sugar elevations in diabetics, kidney stones in susceptible people, and fluid loss, especially if taking more than 2000 mg daily.9
Beta-carotene is just one of numerous carotenes in foods. Food sources are linked to decreases in cancers such as lung cancer. But a study among smokers showed that isolated beta-carotene supplements given for 6.5 years increased lung cancer deaths by 46 percent and cardiovascular deaths by 26 percent. The adverse effects were so prominent that the study was terminated early. Yet in this same study, baseline beta-carotene intake from food was linked to lower lung cancer risk. This finding was confirmed in other large studies. Scientists now concede that beta-carotene supplements do not decrease cardiovascular disease or cancer. Yet if 20 mgs or more per day is consumed in foods (accompanied by many other carotenoids and other nutrient associates), it is protective.10
So far, it’s known that there are about 8000 bioactive compounds in fruits and vegetables. Flavonoids are a diverse group of some of these compounds. A wide variety of biological activities have been identified for them—a multitude of benefits including positive effects on blood pressure, blood-vessel-wall function, thrombosis, inflammatory processes, platelet function, blood sugar metabolism, blood fats, and much more. But high intakes of isolates or imitations can have negative effects on health.11 A meta-analysis looked at prostate cancer and the consumption of tomatoes. Men who ate higher amounts of tomatoes had about a 20 percent decreased risk of prostate cancer than those who did not eat much in the way of tomatoes. The assumption was that the “active ingredient” in tomatoes that helped is lycopene. But no difference was found in blood lycopene levels between the tomato eaters and those who declined. While lycopene is a factor, other tomato ingredients participate. Speculating that lycopene is the primary reason tomatoes are linked to reduced cardiovascular disease, another meta-analysis found that tomatoes have an edge over lycopene supplements on oxidative stress, blood pressure, cholesterol levels, and more. Tomatoes provide other food compounds, including potassium, fiber, vitamin C, carotenes, and lutein.12
Multivitamin/mineral supplements are supposed to augment one’s diet, but they’re often used to try to make up for a poor diet. If a person is eating primarily junk nonfoods, no supplement—even one with dozens of separated nutrient parts—can make up for all the nutrients and other beneficial compounds in real foods. Even if a diet is merely “suboptimal,” there is no convincing evidence that there will be benefits from a multi. Large trials of high doses of separated or fabricated “nutrients” sometimes found drug-like “benefits,” but most findings have “disproven some health claims for these supplements and identified health risks that may not have otherwise been detected.” Such supplements can have negative impacts on the body, “possibly affecting blood sugar, blood clotting, blood pressure, hormone activity, liver function, and more.” “Most randomized clinical trials on multis have yielded disappointing results.” The U.S. Preventive Services Task Force concluded that there is still “not enough evidence to assess the balance of benefits and harms” of taking multis for areas such as prevention of cancer or cardiovascular disease. Results of large studies found that taking multis did not reduce cardiovascular events or cardiovascular mortality even after more than a decade of follow up. Three studies found that a daily multi does not help boost the average person’s health and should not be used for chronic disease prevention. A meta-analysis of 21 trials found that multis have no effect on mortality risk.13
High amounts of vitamin A isolates can cause headache, nausea, loss of appetite, dizziness, blurred vision, liver problems, birth defects and increased risk of fractures.
Taking 1 gm or more per day of isolated synthetic niacin causes significant risk of adverse effects such as intense itching, a burning sensation of the skin, rash, low blood pressure, and dizziness. Liver and/or gastrointestinal toxicity can occur over time; uric acid and blood sugar levels can be affected. Two major studies found no added benefit of adding high-dose extended-release synthetic niacin in people treated with statin drugs to lower cholesterol; instead, it increased rates of adverse events.
Excess isolated vitamin B6 can cause sensory neuropathy, a nerve condition that can lead to loss of control of bodily movements, skin lesions, sensitivity to light, nausea and heartburn. Large amounts of the nonactive pyridoxine form of B6 can overwhelm the body’s ability to activate it into pyridoxal-5- phosphate and eventually result in a B6 deficiency.
Although folate and B12 are essential to cognitive function, taking separated folic acid and B12 improve cognition marginally if at all; homocysteine levels may decline but mental function is not really supported.
Vitamin D megadoses are linked to cognitive issues, appetite loss, weakness, intestinal problems, damage to soft tissues and kidneys. Even small amounts of synthetic forms of fat-soluble vitamins (A, D, E and K) may be toxic. Yet consuming upwards of ten times the RDA of A and D in real foods is not harmful.14
Breastfeeding women with infants who are deficient in vitamin B1 (thiamine) given synthetic B1 show an increase in breastmilk levels of the chemical, yet their babies remain B1 deficient.15
High intake of separated calcium is associated with increased risk of cardiovascular disease, constipation, and interference with absorption of iron and zinc. Isolated calcium is ineffective in preventing bone fractures and slightly increases risk of kidney stones. Calcium must be balanced with magnesium, vitamin D, vitamin K, and more. Excess calcium and insufficient magnesium create a tendency in muscles to spasm with consequences on the heart. The heart’s left ventricle requires a lot of magnesium; the body will take magnesium from muscles and bones to supply the heart as long as it can. Muscle and nerve function can be diminished without sufficient magnesium. If too much calcium and not enough vitamin K2 are taken, calcium can begin to accumulate in the wrong places, such as soft tissues. Large doses of isolated vitamin D without sufficient magnesium and vitamin K2 can lead to vitamin D toxicity, magnesium deficiency, and inappropriate calcification that may damage the heart. Excess calcium is implicated in elevated vascular risk and may also be associated with brain lesions due to temporary deficiency of blood flow.16
Excess separated zinc creates deficits of copper, molybdenum, manganese and other minerals. Low copper can lead to depression and poor detoxification, among other things.
Chromium in foods benefits blood sugar, insulin sensitivity and resistance, cholesterol and triglyceride levels, immune function, eye health, and more. Large doses of separated chromium “having pharmacologically, rather than nutritionally relevant effects,” do not have such effects. Isolated chromium can cause headache, insomnia, irritability, mood changes, and other problems.
Potassium supports a multitude of functions and structures, including blood pressure, blood vessel health, nerves, bones and a lot more. Potassium-rich foods generate alkali in the body. It’s not just the potassium, but the citrate, malate, and other compounds that potassium is bound to, that produces alkali. If there is inadequate alkali to balance the acid load from proteins and grains, calcium is lost in the urine and bone loss, among other detriments, occurs.
A deficit of iodine can lead to hypothyroidism and goiter; excessive intake of isolated iodine can lead to thyroid dysfunction, including hyperthyroidism, hypothyroidism, and possibly thyroiditis. Iodine in food does not have such effects.
Excess isolated iron can lead to gastrointestinal problems, compete with zinc absorption, and cause other iron overload troubles.
Excess separate selenium can cause gastrointestinal ills, skin rashes, hair and nail loss or brittleness, fatigue, irritability, nervous system abnormalities, and may increase prostate cancer risk.17
Antioxidants are touted as substances that may prevent, delay or repair cell damage caused by free radicals. The term “antioxidant” is plastered on food labels and supplements to identify antioxidant values. Yet scientists don’t really know enough about how they work in the body.
Substances with antioxidant properties are found in a wide variety of foods, particularly plant-based foods. These foods contain thousands of different compounds and nutrients, so the benefits can be due to any number of factors working together that go way beyond antioxidants. Other bioactive components in foods are indispensable in working with antioxidants. The level of antioxidants in foods or supplements is based on chemical laboratory analyses such as Oxygen Radical Absorbance Capacity (ORAC) to measure antioxidant capacity. When a food or supplement company refers to the high antioxidant level of their product, it’s usually based on such a lab analysis. But this can be misleading. Jeffrey B Blumberg, PhD, Professor and Director of the Antioxidants Research Laboratory at Tufts University, says, “Many of these compounds act to quench free radicals effectively only in vitro (test tube experiments), not in vivo (living organism experiments).” The compounds are bioactive, but ORAC analysis does not account for bioavailability and metabolism in the body. So, “While they are powerful antioxidants in the test tube, we don’t really know whether they have an antioxidant effect in the human body.”
Scientists don’t yet fully understand which compounds appear in particular foods, how they are absorbed and broken down, what amount gets into the tissues, and when there, exactly what they do. Blumberg says, “The reason plant foods are good for you is because of everything they contain. There is synergy for all of these ingredients—synergies between ingredients within one food and between multiple foods.” Synergy, in part, explains why the same benefits from eating whole foods do not occur from consuming isolated antioxidants.19
“Antioxidant” does not mean a supplement containing an isolated or synthetic substance can prevent or treat disease. It may not even be healthful. Clinical trials of antioxidant supplements such as ascorbic acid and alpha tocopherol have had disappointing results. Resveratrol, proanthocyanidins, flavonoids, and other substances are healthful when consumed in foods, but there is no real evidence that separated or contrived versions are beneficial. The plethora of nutrients in foods support antioxidants and vice versa. Some minerals (such as selenium, zinc, and copper) don’t perform as antioxidants themselves, but are essential parts of antioxidant enzymes. Polyphenols and other natural compounds in plant foods support antioxidant functions. Excess intake of isolated antioxidants can cause disturbances in the balance of nutritional interactions. A clinical trial demonstrated, for example, that supplementing with separate beta-carotene and lutein caused a decrease in plasma lycopene. A 2003 study indicated that consuming a wide variety of vegetables has a greater bearing on lung cancer risk in both smoking and nonsmoking women than intake of any specific carotenoid or carotenoids. These results support earlier findings.18
In some people, separate nutrients with proposed antioxidant properties can raise cancer risk. Findings imply that “taking extra antioxidants might be harmful and could speed up the growth of many tumors,” says biologist Martin Bergo. A review of dozens of studies found “no clear evidence of a beneficial effect of [such] supplements” on heart disease, cancer or mortality. There are warnings that “beta carotene, vitamin E, and possibly high doses of vitamin A supplements are harmful,” while other antioxidants “are ineffective.” People can take large amounts of isolated antioxidants and still have very little antioxidant function in their cells. Recent research indicates that every cell in the body can produce its own protection against free radicals and oxidative or chemical stresses. Our cells have the ability to generate antioxidants on demand.
Many foods are powerful activators of this biochemical pathway. Even if the foods are not rich in antioxidants, they directly and dramatically amplify our ability to produce protection. Large doses of separate antioxidants have “generally failed to prevent human disease, in part because they do not decrease oxidative damage in vivo [in human bodies].” They can make things worse. Not only do they not lower all-cause mortality, they may increase mortality risk. Studies with ascorbic acid show no change in oxidation markers or clinical benefit. Isolated or synthetic alpha-tocopherol, ascorbic acid, and selenium don’t reduce inflammation markers “despite significant baseline correlations between oxidative stress and inflammation.” The idea that free radicals are generally dangerous and must be counteracted is still theoretical. Fear of free radicals may be grossly exaggerated. Foods contain a huge complexity of components, and “unlike antioxidant supplements, no concerns have been raised about the safety of antioxidants consumed in foods.”19
Expecting that an isolated nutrient part—an assumed “active ingredient” of food—will mimic what happens when whole foods are eaten is fantasy. Two large studies and other analyses concluded that supplements of isolated or synthetic vitamins and antioxidants or isolated minerals do not provide any clear benefit to prevent chronic disease. The most convincing data links diet patterns and foods to lower risk of a host of ills. Each nutrient is “accompanied by other nutrients and potentially beneficial compounds that work synergistically.” But by extracting one, “all you have is the chemical.” Real food supplements containing concentrates of vegetables and fruits, fish oil, or other foods do improve health in people who suffer with any number of disorders. The body recognizes, uses, and reaps benefits from real whole foods, and real whole-food supplements.20
“Visit Judith’s author page for a list of her published works with Selene River Press.”