Do You Need Milk For Optimal Health & Strong Bones? Marketing Says Yes But Science Says No.

“Milk helps build strong bones and teeth!”

Like many, I first heard this mantra when I was a child in elementary school and it is a message that is firmly ingrained in the minds of most as one of the few universal truths in nutrition. The need for dairy products as an irreplaceable part of the human diet for building and maintaining strong bones and warding off the ravages of osteoporosis is considered common knowledge, an unshakable truth, and  a message repeated ad nauseum in the media. A message that few would find reason to question. It’s no secret that milk contains calcium- a key mineral for maintaining bone health. Thus there would appear to be little reason to question it’s importance as a protective shield against bone loss.  As popular and seemingly rational an idea as it may be, the scientific evidence doesn’t support it. Very early in my career I myself was quite surprised to learn that my early indoctrination to the health benefits of dairy consumption didn’t come from credible peer reviewed scientific research, but from a rather successful marketing campaign on the part of the dairy industry. A campaign influential enough to have the US government (and many others around the world) classify milk as a food group- a decision made based on profit and not sound nutritional science.

Contrary to popular belief billions of people on the planet do just fine without having milk as a part of their diet. Not hundreds of thousands or millions, but billions. Surprisingly enough, people in countries where milk consumption is minimal have some of the lowest incidences of osteoporosis and hip fractures on earth. A revealing statistic that somehow never seems to find its way to American audiences, nor does the fact that for hundreds of thousands of years milk most humans on the planet didn’t drink milk and that many enjoy rather robust health without it. There is a reason for our rather myopic understanding of milk and what it can and cannot do for us and it’s the dairy industry. The reach of the dairy industry’s influence is impressive to say the least, spreading information designed to help them sell more milk not just nationally but globally.

Using a consumer creating model sanctioned by government entities, teaching material for young children in schools about the role of milk in building strong bones and teeth is graciously supplied by the American Dairy Council. Presented as educational material at an early age, such influence affects our perception of milk as a required part of our diets and it is hard, if not impossible for a child to question such authoritative information. An effective model that ensures that as adults the party line that milk is a requirement for optimal health is firmly rooted in our core set of beliefs. It’s a similar methodology used by fast food chains like McDonald’s to market to children, knowing fully well that it will guarantee another generation of customers.

Not only is milk taught at an early age to be an essential part of our diet, it is provided to us as well. As a food product produced far in excess of what we as a nation can consume thanks to heavy government subsidies secured by the dairy lobbies, it can be literally given away and dairy producers still make profits. With the early consumer marketing model in mind it thus makes sense that milk is distributed to young children in schools through government food programs. Good business as it helps to cement the thought process of milk being a necessity as an unquestioned view.

Milk & Calcium- Understanding The Science

As adults we are bombarded by messages and dairy lobby funded ‘studies’ reminding us about the calcium content of milk and dairy products. Most notably for women and the steadily aging American population, mill’s supposed prophylactic effects against bone loss are emphasized. But can the calcium in milk really make a difference in bone density? Looking internationally at the dairy-equals-calcium-which-equals-strong-bones idea, we see clearly that the countries with the highest rates of osteoporosis are the largest consumers of dairy products.

The dairy consumption of countries like the United States, Australia, New Zealand, Switzerland, the UK and Northern Europe is enormous when compared to Asian countries such as China where dairy consumption is rare, yet those very countries where less dairy is consumed have they have the lowest rates of hip fracture and osteoporosis in the world.[1,2,3,4]

The Rate Of Osteoporosis & Hip Fracture Is Lower In Populations Who Do Not Consume Milk & Dairy Products.

To give an idea of the prevalence of osteoporosis, estimates are that 40% of American Caucasian women and 13% of Caucasian men aged 50 years will experience at least one bone loss related fracture in their lifetime. At age 50, a Caucasian woman has a 17% chance of sustaining a hip fracture, 15% chance of vertebral fracture and 16% chance for forearm fracture, with comparable figures of 6%, 5% and 2.5%, respectively, for fractures in white males.[2] Interestingly enough among the female African American population the age-adjusted prevalence of hip related osteoporosis is only 6%, compared to 17 % for postmenopausal White women- difference consistent with the much lower fracture rates observed in African Americans.[5] African Americans, by the way consume almost 40% less milk and dairy products as their Caucasian counterparts[6] which if by itself renders the milk/dairy-equals-strong-bones theory to be questionable.

Statistics from the observation of low dairy intake in Asian population contradict the milk/dairy-equals-strong-bones theory completely. Using China as an example, where cheese and other popular dairy products are not a part of their regular diet and where milk consumption is 10% of the American per capita consumption rate[7] age standardized incidences of hip fractures is far lower than their milk drinking American and European counterparts. Based on the 1990 China census figures hip fracture rates were only 87 per 100,000 for women and 97 per 100,000 for men. Contrast these numbers with 510-559 per 100,000 for white American women and 174-207 per 100,000 for American Caucasian men[8]. In fact, hip fractures in Beijing are reportedly among the lowest rates of occurrence in the world- and with a population where milk is by no means a staple.

Debunking The Need for Milk- It’s The Calcium Lost Not Calcium Consumed That Causes Osteoporosis

As much as the good (and well paid) folks at the American Dairy Association would like you to think that increasing your calcium intake by drinking milk would decrease your risk of osteoporosis, the science behind this premise simply doesn’t support it. From what we do know about bone loss, it happens not so much from not having a high enough calcium intake, but rather from having a high level of calcium loss due to dietary and lifestyle choices. [8] According to the findings of the 1994 National Institutes of Health Consensus Conference,  at least one third of calcium balance and bone density is dependent on the ratio of intake to loss and not solely on calcium intake alone as the marketing campaigns would have you believe. To be frank, meta analysis of literature meeting the provisions for unbiased scientific research found there were no significant relationships proved between milk consumption or any other dairy product to measures of bone health nor were there no correlations between calcium intake and bone loss.[9,10,11,12] Similarly, an 18 year analysis of 72 337 postmenopausal women published in the February 2003 American Journal of Clinical Nutrition, found that an adequate vitamin D intake was associated with a lower risk of osteoporotic hip fractures in postmenopausal women. Neither milk nor a high-calcium diet in the study had any correlation with a reduction in risk of osteoporosis.

Milk Isn’t The Only Source Of Calcium

So we have established that bone loss has little to do with intake, but for those concerned nevertheless about their calcium intake, it should be noted that a 1990 report in the American Journal of Clinical Nutrition found that green leafy vegetables such as broccoli and kale have high levels of calcium and is absorbed at least as well as the calcium in milk. [12,13,14] Proper calcium balance on a non-dairy diet is easily attained because ALL vegetables and legumes contain calcium.[15] Thus within the context of a balanced diet it is more than adequate to prevent frank deficiencies which are rare to nonexistent in developed countries such as the United States.[16]

In terms of the ultimate source of calcium, however no other food source can compete with the bioavailability of calcium from bones. That’s right, bones. You don’t hear much about it since eating bones isn’t that popular here in the United States and given that both dairy producers and supplement manufacturers would be hard pressed to sell their wares if the general population was aware that eating small amounts of bone is how humans got most of their calcium for several hundred thousand years. The small and soft bones of fishes like sardines are a perfect source of calcium in a form our bodies can easily absorb, as is the use of bone meal that can be added to soups and broths. Since these sources are better absorbed (and it makes sense that bones would be the best source of building material for bones) our body retains more of it as opposed to being mostly excreted in urine as is often the case with dairy products and artificial supplements.

Osteoporosis is a very real concern for many women, as they make up 80% of those affected by this condition. Osteoporosis is a major public health threat for an estimated 44 million people here in the United States with almost 10 million individuals estimated to already have the disease and almost 34 million more are estimated to have low bone mass, placing them at increased risk for osteoporosis. It is time we paid more attention to what has been proven to be real risk factors, such as soda consumption, high sodium diets, smoking, excessive caffeine consumption, alcohol and an inactive lifestyle , than simply falling for the marketing hype that somehow drinking  milk or eating yogurt and cheese will magically protect you from low bone density.

Getting the recommended daily allowance of calcium at all ages is important, preferably from dietary sources. But bone nutrient requirements are wide and far more complex than simply drinking milk or taking a calcium supplement. A diverse diet of natural foods that includes meat, fish, fresh vegetables, fruits and nuts will always cover the diverse nutritional needs of our bones as long as we stay away from high fat, high sugar and high sodium processed foods. Limit high fat protein sources, keep your salt intake low, reduce your alcohol consumption and don’t smoke and you’ll be fine. Also important is the amount of time spent outdoors. Get sunlight on your skin at safe times of the day for vitamin D as it plays an integral role in helping our body use calcium efficiently. As much as commercials warn us of the dangers of sunlight, recent studies have suggested that avoidance of sunlight is associated with higher risks of certain cancers- which should not be surprising as we did in fact evolve outdoors and not in the confines of fluorescently lit cubicles.

Dairy Products and Weight Gain

As early as the 1950’s when bodybuilders wanted to decrease body fat and increase their muscular definition the first thing they would cut out of their diet was milk and dairy products. Among natural bodybuilders who don’t resort to the use of powerful and potentially dangerous drugs to get into shape, milk and dairy products are a big no-no when trying to reduce body fat- whey protein shakes as well (see my article on protein shakes here). A mixture of water, sugars, fats and salt, milk is in essence nature’s ultimate weight gain formula, helping infant mammals increase their body mass significantly in relatively short periods of time. Milk helps baby elephants and cows pack on hundreds of pounds and interestingly enough, no adult mammal living in a natural environment drinks milk past infancy. Only humans and the animals we train drink milk as adults and it bears mentioning that the very countries with the highest dairy consumption are also the ones with the highest rates of obesity.

Finally, it is important to stress the role of exercise and not diary intake as a way of increasing bone density. Weight training in particular plays a poignant role in maintaining and building healthy bone mass levels (Read my article here on weight training and osteoporosis). It’s a simple and scientifically proven way for prevention of low bone mass and in helping those with low bone mass levels build up their bones. So put down that glass of milk and start pumping some iron!

References:

1. Xu L, Lu A, Zhao X, Chen X, Cummings SR.Very low rates of hip fracture in Beijing, People’s Republic of China the Beijing Osteoporosis Project. Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Beijing, People’s Republic of China. Am J Epidemiol. 1996

2. Cummings SR and Melton LJ (2002) Epidemiology and outcomes of osteoporotic fractures. Lancet 359:1761.

3. Kanis JA, Johnell O, De Laet C, et al. (2004) A meta-analysis of previous fracture and subsequent fracture risk. Bone 35:375.

4. Kanis JA and Johnell O (2005) Requirements for DXA for the management of osteoporosis in Europe. Osteoporos Int 16:229.

5. Melton LJ, Cooper C 2001 Magnitude and impact of osteoporosis and fractures. In: Marcus R, Feldman D, Kelsey J (eds.) Osteoporosis

6. Gender and ethnic differences in intakes of dairy foods and related nutrients, obesity, and metabolic outcomes: NHANES, 1999–2004

7. Per Capita Consumption of Milk and Milk Products in Various Countries, International Dairy Federation, Bulletin 423/2007.

8. Heaney, R.P., Evaluation of publicly available scientific evidence regarding certain nutrient-disease relationships

9. Wachman, A., et al. Diet and osteoporosis. Lancet May 4, 1968, p. 958.

10, Recker, R., The effect of milk supplements on calcium metabolism, bone metabolism, and calcium balance. American J Clin Nutr 1985; 41:254.

11. Nilas, L. Calcium supplementation and post menopausal bone loss. British Medical Journal 1984; 289: 1103.

12. Kolata, G. How important is dietary calcium in preventing osteoporosis? Science 1986; 233: 519-20.

13 Institute of Medicine. Dietary reference intakes for calcium, phosphorus, magnesium, vitamin D, and fluoride. Washington, DC: National Academy Press, 1997.

14. Alaimo K, McDowell MA, Briefel RR, et al. US Department of Health and Human Services. Dietary intake of vitamins, minerals, and fiber of persons ages 2 months and over in the United States: third National Health and Nutrition Examination Survey, Phase 1, 1988–91. Hyattsville, MD: National Center for Health Statistics, 1994. (Advance data from vital and health statistics no. 258.)

15. Weaver CM, Plawecki KL. Dietary calcium: adequacy of a vegetarian diet. Am J Clin Nutr 1994;59(suppl):1238S–41S

16. Dietary Supplement Fact Sheet. US Office of Dietary Supplements

Kevin Richardson is an award winning health and fitness writer, one of the most sought after personal trainers in New York City and creator of Naturally Intense High Intensity Training™. Get a copy of his free weight loss ebook here. If you live in the New York metropolitan area and need help losing weight or taking your body to the next level give Kevin and his team a call at 1-800-798-8420 or click here to get started with 50% off your trial personal training session.

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Oatmeal- A Great Carbohydrate Choice For Breakfast

First, let me say that with the exception of human breast milk for babies, there is no such thing as a perfect food. Superfoods and the like are little more than advertising propaganda designed to make you buy more products, but it has no anchor in the science of nutrition and biochemistry. Not one food can be termed as better than another since we tend to be the healthiest when we have our nutritional needs met by eating a wide variety of different natural foods- each one providing different micro and macronutrients. That being said, there are foods that are not good for us- and that list would encompass the vast majority of products you would find on the inner isles of any supermarket. Processed foods and refined products make up the lion-share of what most people eat today- but at a price. Obesity and the slew of diet related diseases that have become commonplace in our society are silent testaments to the fact that there are indeed foods that should not be part of our regular diet. Almost unheard of in societies untouched by industrialized food products, obesity and metabolic disease are preventable as they are brought on not by inevitable genetic factors, but rather by the choices we make everyday at the dinner, lunch and breakfast table. While there are no superfoods that can come to our rescue- there are better food choices available to us as opposed to the refined goods that we have come to rely on for our sustenance. When it comes to breakfast- oatmeal is one such better choice.

Oats and Gluten- Understanding the Relationship

Oatmeal is made from ground oats, steel-cut oats, crushed oats, or rolled oats. Steel cut oats are very much a la mode these days but they are nothing more than smaller cut oats that are steamed and flattened.  With the exception of instant type oats and brands with added sugars, all forms of oatmeal are pretty much the same in terms of health benefits. Oats and oatmeal do not contain gluten, but many associate it with gluten as individuals with celiac disease (who must avoid gluten in their diets) can often have adverse reactions to it. The reaction has nothing to do with gluten sensitivity however, but rather a protein high in proline and glutamine called avenin.[1] Studies have found that oats can indeed be part of a gluten free diet for individuals suffering with celiac disease, as having this disorder does not necessarily mean that avenin will negatively affect you.[2] That being said, here in the United States oats are usually processed in the same factories that refine wheat, barley and other grain products and so there is always some risk of cross contamination and they are sometimes listed as containing gluten for this reason. It can be a bit confusing but oats themselves are gluten free and many steel cut and higher priced organic brands advertise as being processed in factories that do not manufacture wheat and grain products. In Europe where wheat and oats are not usually milled together oats are always classified as gluten free. Should you avoid oats made in factories that may have some degree of gluten contamination? My take would be that unless you have celiac disease and have been recommended specifically by your physician to avoid all traces of gluten, I wouldn’t worry about it. Microscopic amounts of gluten aren’t going to do much to you if you are healthy and if the cheaper brands make it easier for you to eat oatmeal consistently, then I say by all means go for it.

Instant Oatmeal- Junk Food Disguised As A Healthy Product

Instant oatmeal in all of its incarnations should be avoided. Unlike other forms of oats which are dehusked  by pounding and then heated, instant oats are cut into smaller pieces and pre-cooked. Rolled and steel cut oats require longer cooking times and the shorter cooking times required by instant oats may seem like a great idea for those pressed for time, but there are some problems created by the refinement process. Instant oats have much less fiber than its counterparts as the fiber is removed to make it cook faster and to give it a lighter taste. In so doing, the glycemic index value increases. Glycemic index is a tool used in nutrition to measure the effect of a food on our blood sugar levels. Foods that breakdown quickly during digestion and rapidly release sugars into our system are said to have a high glycemic index. Foods that digest slowly and gradually release glucose into the bloodstream are said to have a low glycemic index. Foods with a high glycemic index value such as candy bars, white bread and table sugar wreak havoc with our insulin levels and increase the likelihood of visceral abdominal fat storage.

Instant oatmeal has a glycemic index of 62- the which is the same as ice cream and that’s without the sugar usually added to instant varieties which effectively turns a potentially healthy food choice into a junk food. A fact that doesn’t stop food manufacturers from claiming it to be healthy even though it clearly isn’t.

Benefits Of Oatmeal As A Breakfast Food

For decades, oatmeal has been the standard morning meal of bodybuilders and athletes. (Wheaties and Corn Flakes may be marketed as the breakfast of champions but unless your sport is being overweight and out of shape you’ll do best to put cold cereals on your avoid list.)  Oatmeal is high in slow burning complex carbohydrates and water-soluble fiber that not only fills you up but also stabilize your blood sugar levels. High as well in B vitamins, fats and proteins, oatmeal provides a calorie rich food that can help you start the day on the right foot.

Due to the high beta-glucan and fiber levels found in oats- oatmeal was a bit of a health fad in the eighties when research found positive associations between oatmeal  consumption and lower blood cholesterol. This lead to a glut of oat bran products on the market masquerading as healthy foods. Oat bran muffins, instant oatmeal and other foods containing little in the way of fiber and filled with sugars, salt and artificial ingredients were vigorously promoted as being heart friendly and in turn adding even more misinformation to the clamor of misleading nutritional information.

Oatmeal is a great breakfast food, but don’t fool yourself into thinking that simply eating a bowl of oatmeal and then having junk for the rest of the day is going to do much. Instead, it is a valuable addition to the arsenal of wholesome and natural foods that can help you maintain an optimal body weight, help you lose weight and decrease your risk of diet related disease. Avoid the temptation to look at any one food as a magic formula and don’t negate the health benefits of your oatmeal by adding milk, sugars and sweeteners, instead stick with fruit and berries  for added flavor.  So have some oatmeal for breakfast- you’ll feel better and look better as a result. For more information on oatmeal and healthy choices for breakfast feel free to download a copy of my free breakfast ebook here.

References

1. Rottmann LH (2006-09-26). “On the Use of Oats in the Gluten-Free Diet”. Celiac Sprue Association/United States of America, Inc. (CSA)

2. Janatuinen, E.K., Kemppainen, T.A., Julkunen, R.J.K., Kosma, V-M., Mäki, M., Heikkinen, M. and Uusitupa, M.I. (2002) No harm from five year ingestion of oats in celiac disease, Gut, 50, 332–335

Kevin Richardson is an award winning health and fitness writer, the creator of Naturally Intense High Intensity Training™ and one of the most sought after personal trainers in New York City. If you live in the New York City area and need help losing weight or getting into shape give Kevin and his team a call at 1-800-798-8420.

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Cane Sugar Is Not Healthier Than High Fructose Corn Syrup

For the past several decades high fructose corn syrup silently snaked its way into the American food steam. Before its potential harmful effects were know, high fructose corn syrup was the perfect solution for food manufacturers seeking a product that was cheaper than cane or table sugar, sweeter than table sugar and that would make consumers eat or drink more of their product. Today over 10% of all the daily calories ingested by American adults come from fructose yet there is still a dearth of information on exactly how high fructose corn syrup impacts your health.[1] Once a food ingredient that the general public paid little mind to, it is pretty much common knowledge that high fructose corn syrup isn’t good for you, but it isn’t taken out of our food supply thanks to the inherent difficulties in declaring a food unhealthy. Such a declaration would bring about dramatic economic consequences for the agricultural and food manufacturing industry here in the United States and would require control studies that are practically impossible to conduct under normal circumstances. Such research would require a large group of people eating only one food in a completely controlled environment while being monitored for a significant period of time. Our current study methods have a hard time picking out products and ingredients that are not immediately harmful to your health as it is a daunting task to place the  blame for the development of any disease when everyone eats so many different things. That being said, high fructose corn syrup is out and good old fashioned cane sugar is enjoying a comeback as a healthier alternative. So much so that many major food manufacturers (especially organic labels) have high fructose corn syrup free versions of their foods. In these foods cane sugar is listed a natural and healthier choice which isn’t exactly true. As much as the advertising campaigns would like you to believe otherwise,  the chemical composition of sucrose (regular sugar) hasn’t changed. It’s still bad for you and the idea of it being a healthier alternative is blatantly absurd.

Thanks to the lobbying and billion dollar public relations campaigns put forward by the Sugar Association- one of the most powerful food lobbies in the country, sugar is placed to seem like a better choice when compared to high fructose corn syrup. Since the eighties the use of high fructose corn syrup has been gaining in popularity. At one time it even threatened to overtake sugar as the main sweetening ingredient in our foods. However thanks to the new high-fructose-corn syrup-is-bad-cane-sugar-is-good marketing strategies, this trend is starting to shift. High fructose corn syrup saw a continued increase in its use as compared to sugar up until 2003 and then began a decline ever since. In 2007 the US Department of Agriculture reported that American adults consumed an average of 44 pounds of sugar per person (an alarming statistic by itself) as compared to (only) 40 pounds of high fructose corn syrup. A clear about-face from the pattern of rising high fructose consumption and a very clear sign that the ploy of making high fructose corn syrup the bad guy and cane sugar the good guy is indeed working.

Cane Sugar & High Fructose Corn Syrup Are Equally Bad For Your Health

Is cane sugar better than high fructose corn syrup? Absolutely not. Chemically both cane sugar (sucrose) and high fructose corn syrup are made from glucose and fructose but in high fructose corn syrup the fructose concentrations are about 5% higher. Research has found that there are many negative health effects from a high fructose intake, especially in the liver where it is metabolized. Studies found that an overabundance of fructose (which doesn’t occur with eating fruits and other natural sources as the high fiber content limits the concentration of fructose at any one time) adversely affects the liver in the same way that alcohol does. This happens regardless of whether the sweetener you’ve consumed comes from cane sugar or high fructose corn syrup. Both provoke rapid rises in blood glucose levels and can contribute to the development of metabolic syndrome.[2] Studies also suggest that drinks containing sugar or high fructose corn syrup may be linked to obesity, increased visceral abdominal fat, insulin resistance and type II diabetes[3, 4, 5] in addition to its confirmed role in bringing about tooth decay. That being said, given the epidemic of obesity and diet related metabolic diseases that continue to extract an enormous health toll on the general population the act of marketing sugar as a healthy alternative is both unethical and immoral. It’s naïve to believe that public interest would ever be more important than increasing profits for corporate shareholders, but the unfortunate aspect of these practices is that it works to further confuse the public as to what they should and should not eat to stay healthy.

Arguing Whether Sugar Is Healthier Than High Fructose Corn Syrup is Useless As They Are Both Bad For Your Health And Should Be Avoided

Today the laws of what I call ‘Health Relativity rule. The idea that one bad food is somehow better than another.  These laws are marked by one constant- they are always wrong no matter how convincing and appealing an argument they may present. Saying cane sugar is a better health choice over high fructose corn syrup is akin to choosing to leap from the 70^th floor of a skyscraper as opposed to the 71^st floor. Both choices lead to the same result and thus the only sensible choice would be to not make a choice in the first place. Similar arguments are made for agave (which actually has more high fructose syrup than high fructose corn syrup), fruit concentrate (a natural sounding code name for an artificially concentrated high fructose product) and honey (which is also high in fructose and most certainly no healthier than any other sweetener).

Coming from the islands of the West Indies, I know all too well the often forgotten environmental impact of cane sugar. Most are unaware of the vast rainforests and their inhabitants that were effectively destroyed in the Caribbean islands and many other tropical parts of the world to facilitate the widespread sugar cane plantations during the 17^th to 19^th centuries. Ludicrously profitable slave-powered plantations that were meant to satisfy the world’s growing sweet tooth and the irony that so many resources, energy, effort and suffering went into the production of a product with no nutritional value whatsoever should never be overlooked. Cane sugar holds the distinction of one of the first processed unnatural junk foods and is not only a waste of valuable ecological reserves but an additive that historically has caused us nothing but poorer health.

At the turn of the 20^th Century a dentist named Dr. Weston Price did extensive surveys of primitive and close to the ground societies in Africa and Europe and he found that those cultures had little or no incidence of tooth decay whatsoever when compared to Europeans who had already incorporated sugar into their diets. What was even more significant was the lack of diseases common in the Western world at that time and today. Type II diabetes, heart disease, hypertension, cancer, obesity and other metabolic related diseases were almost nonexistent in those societies thanks almost completely to the absence of refined sugars in their diet and processed foods. Dr. Price was one of the first to recognize the link between Western diets and the maladies that we face today, yet a hundred years later we have yet to accept the idea that life without refined sugars, sweeteners and junk food isn’t a death sentence. In fact it is very much the opposite. Make the right choice and let whole fruits and vegetables be your source of sugars.

Kevin Richardson is an award winning health and fitness writer, one of the most successful personal trainers in New York City and the creator of Naturally Intense High Intensity Training™. Get a copy of Kevin’s free weight loss ebook here. If you live in the New York Metropolitan area and need help losing weight or getting into shape give Kevin and his team a call at 1-800-798-8420. Check out Kevin’s training services here.

References

1. Vos MB, Kimmons JE, Gillespie C, Welsh J, Blanck HM. Dietary fructose consumption among US children and adults: the Third National Health and Nutrition Examination Survey.Medscape J Med. 2008 Jul 9;10(7):160.

2. Alexander Aguilera, Alfonso; Hernández Díaz, Guillermo; Lara Barcelata, Martín; Angulo Guerrero, Ofelia; Oliart Ros, Rosa M. (2004). “Effects of fish oil on hypertension, plasma lipids, and tumor necrosis factor-alpha in rats with sucrose-induced metabolic syndrome”. J. Nutr. Biochem. 15 (6): 350–57. doi:10.1016/j.jnutbio.2003.12.008. PMID 15157941.

3. Ten, Svetlana; Maclaren, Noel (2004). “Insulin resistance syndrome in children”. J. Clin. Endocrinol. Metab. 89 (6): 2526–39. doi:10.1210/jc.2004-0276. PMID 15181020.

4. Fukuchi, Satoshi; Hamaguchi, Kazuyuki; Seike, Masataka; Himeno, Katsuro; Sakata, Toshiie; Yoshimatsu, Hironobu (2004). “Role of Fatty Acid Composition in the Development of Metabolic Disorders in Sucrose-Induced Obese Rats”. Exp. Biol. Med. 229 (6): 486–93. PMID 15169967.

5.  Lombardo, Y. B.; Drago, S.; Chicco, A.; Fainstein-Day, P.; Gutman, R.; Gagliardino, J. J.; Gomez Dumm, C. L. (1996). “Long-term administration of a sucrose-rich diet to normal rats: relationship between metabolic and hormonal profiles and morphological changes in the endocrine pancreas”. Metabolism 45

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A lot of people ask me what I eat for breakfast so I thought I would give everyone another glimpse into what our mornings look like with all the kids. If you ever thought that you didn’t have enough time to make breakfast- this article should set you straight! Enjoy and Happy Fathers Day to all the dads who wake up to make breakfast!

Breakfast On The Run- Healthy Eating With Kids

At 5:45 am Lucien, my 2 year old starts singing the theme song from Superman at the top of his lungs. I try to ignore him and pretend that I am still asleep in the hope that the universe will take pity on me and make him go back to sleep for another half hour- but no such luck. With no reaction, he starts belting out the theme from the Good The Bad And The Ugly- one of his favorites. Realizing that his Royal Highness had no intention of going back to bed, I get up and pluck him out of the crib. The kids are still asleep- thank goodness and my better (by far) half is still in dream world. After a night of ninjutsu classes- (I am the head instructor and Steph is one of my senior teachers) that go on until a little after midnight, we are both pretty beat. But today is my day to wake up and do the breakfast run, so I let her sleep a little longer.

Right now, my first order of business is dealing with Lucien’s diaper as a nighttime of use makes him feel about five pounds heavier when I lift him out of his crib. Thankfully, there are no unwanted surprises this morning and he is all too happy to have his pamper changed while humming the tune from the Spiderman cartoons (see a pattern here?). Pampers changed, Lucien runs off into the kids bedrooms screaming at the top of his lungs. For a second, I think of running after him so the other kids won’t be startled into consciousness by their little brother jumping on their chests and screaming their names in delight- but I think of the times that each one of them woke me up in just that fashion and leave him be. Payback! I am alone in the kitchen for a second before the cats get me. I’m their best friend first thing in the morning when they haven’t eaten in about 7 or 8 hours and are about to expire from lack of nourishment. It’s hard to walk with two cats rubbing against your shins competing for your attention but somehow I am able to feed them both without stepping on anyone.

My two year old Lucien

Cats fed, the morning routine begins and I start getting breakfast ready. I have a total of five hungry kids to feed none of whom possess simple tastes. That being said, it isn’t uncommon for me to cook 5 different meals for each of them, in addition to what Steph and I will eat as well. Many have wondered if my family eats the way I do and the answer is yes and no. Yes, we as whole, only eat healthy foods- but I don’t really think it would make sense for my five year old to eat the same things his 225lb father with 6% body fat would eat. The cats would love to – but that’s another story. Stephanie, my (very) significant other eats extremely healthy as well and in a way the system of diet and exercise that I branded as Naturally Intense isn’t simply a platform created for my personal training business. It is instead very much our way of life and I am certainly fortunate to have a life partner who eats as healthy and who is as supportive as Stephanie is. Sustaining the body that I have worked the better part of 23 years building isn’t easy and having someone by your side who understands and respects your need to eat clean at all times is truly a Godsend. Very often when one person eats a certain way and their partner doesn’t, it can create major tension. The key is to always respect the other person’s choices and to be very much aware that just because you decide to change your life and eat better it doesn’t mean that anyone else around you is obligated to change theirs.

Breakfast On The Run- The Kids Wake Up

I punch in my for my shift as a short order cook at 6:30 am and I can hear the tribe waking up one by one as Lucien welcomes them into the new day at the top of his not so small lungs. The younger ones  file into the kitchen one by one hugging my leg until I can’t walk very much anymore and again I am trying to not step on anyone. My 16 year old peeks into the kitchen bleary eyed and with the look of a man who hasn’t seen food since the 90’s and asks what’s for breakfast. The kids join in and I answer with my usual answer- which is ‘You’ll see’ and get the usual groans and complaints that I never say what I am cooking ahead of time. They file into the living room to watch Nick Jr. much to the chagrin of  the older kids, but Lucien rules pretty much most of the time when it comes to what they watch on TV and so they sit to watch Elmo cavorting on the screen while my 16 year old pops out his tablet and starts surfing the web.

My daughter Indi loves a big breakfast!

Everyone is having oatmeal today but along with it each of them have their individual orders to go with their main course. My 6 year old daughter, Indi, walks in to say good morning and hugs me so hard that I have to tap out! She always finds it strange that Daddy can’t breathe when she hugs my neck so hard that my eyes pop out! For breakfast, Indi will be having anywhere from 2 to 3 egg whites (often as much as 6 when she is in the mood!) so I put some eggs in some water to boil with Lucien helping me count them out.  I put in 3 or 4 for Stephanie as well as she eats them but you won’t find me eating eggs anytime soon. Seventeen years of eating anywhere from 6 to a dozen eggs every morning has permanently blunted my taste for anything egg related. One day, I decided I couldn’t take it any more and haven’t had any for years. They are still a great source of protein but the memory of all those eggs- some of them eaten raw when I was back home in Trinidad and salmonella was not an issue keeps them off my plate.
My step-son, Paolo is 7 and quite the performer and the intellectual. He has a standing order of a special omelet that I make so I fire up the pan with some olive oil while he stands in the vestibule while I quiz him on his multiplication tables and we discuss the hardness of diamonds. Reid is the muscle of the group. Six years old but about as big as his two older siblings, he has a penchant for running into you at full speed and bringing home all sorts of animals that don’t really belong indoors. Reid isn’t into eggs- perhaps something he inherited genetically from the millions I ate before he was born, but has a taste for tuna fish, not unlike some cats that are still lingering in the kitchen waiting for the much anticipated sound of the can opener. Reid is an eater- he asks what’s for lunch right after breakfast and will hug you hard and not let go if you cook him curry chicken, but not a big breakfast eater. He’ll have some tuna with his oatmeal and of course some fruit.
Lucien is for all intents and purposes the man of the house and doesn’t wait for such trivialities as breakfast time to eat so he saunters into the kitchen and demands to be fed. He

My step-son, Paolo

spots the watermelon I’ve already cut and put into plates and grabs as much as his hand can hold while scurrying off into the living room to see Elmo- whom he affectionately refers to as ‘La-La’. Kuvonn, my 16 year old come in to see what’s ready to go to the table. He’s on the track team which is code for the fact that he will eat just about anything that isn’t bolted down. I’m making him 4 scrambled eggs (with one yolk tossed in) just the way he likes it with black pepper some Ms. Dash, Angostura bitters (don’t ask) and some green seasoning that I make myself. Paolo doesn’t like anything spicy in his eggs so I have to cook them separately sometimes. Sigh. Along with the fruit and oatmeal Kuvonn is all set for his day.
Most of the food is ready so Kuvonn starts bringing out the plates while looking on in dismay at the piling dishes in the sink. He has permanent dish washing duties until the others are tall enough to reach the sink and he dreads the aftermath that comes with cooking for seven of New York’s hungriest. While he carts stuff out, I have more countertop space to start preparing lunch for the little kids. Kuvonn goes to a private school where the meals are outstanding but I don’t put much faith in the public school lunches so we try to make something for the little ones every day. They really appreciate a home cooked meal at school- unless it’s Friday which is pizza day and then all bets are off. Sigh.

Breakfast On The Run-Getting Lunch Ready For The Day

Reid isn't terribly fond of oatmeal but he eats it!

Today the horde will be feasting on rice, peas and beef- a universal favorite. The rice is on and I am sautéing some steak strips in olive oil and by now I must have lost at least five pounds from the beads of sweat that are pouring down my brow.  It’s a lot of work but it’s a small investment given the fact that all of our kids have learned to eat well and actually prefer home cooked meals to fast foods. You can’t really put a price on that! With the beef added to the rice and peas and the pot simmering nicely it’s time to make my breakfast. I make a huge batch of oatmeal which is prepared several different ways- I eat mine plain while Steph, Kuvonn and Lucien eat theirs with a hint of vanilla essence some strawberries, blueberries or whatever is in season and some raisins. Indi likes hers with the berries but no raisins. Paolo likes the raisins sometimes while Reid isn’t crazy about anything in his oatmeal except for the vanilla. All orders fixed, Kuvonn carries them in to the dining area (and he’ll make a great waiter one day I tell him) while I get the tuna fish.
I eat tongol tuna with no salt if I am not eating fresh fish of some sort as my protein for the morning. The cats get the tuna water and hopefully they will ignore me for the better part of the day. I will also have a grapefruit- although it is more like half a grapefruit these days as Lucien has taken a liking to them and insists on eating what is in my plate. Sigh. I always have some fruit for breakfast, (I try to eat them as they come into season as opposed to eating the same thing day in day out and today watermelon is in season so the kids will have a little treat. I’ll have 16 oz of water with all of my meals and I have a truly ugly cup that I use to get my water all in. It isn’t aesthetic as Steph has pointed out on occasion but it does do the job and is easier for me that having to drink two glasses of water. Besides there isn’t that much room on the table for another glass anyway!

The kids all drink water as well- thankfully- and we all sit down to eat. Lucien complains a bit when the TV goes off but we think it important for breakfast together to be an activity in

My 16 year old Kuvonn get to do the dishes!

itself. Not something we do while watching TV. With breakfast eaten and the table and dining area looking very much like an active warzone it’s time for teeth to be brushed, clothes to be put on, and lunches to be packed. It’s 8:10 and we have to be at school to drop them off at 8:40 am. Kuvonn catches a school bus, but it is quite a challenge getting the others all to school on time as Indi and Reid go to one school and Paolo attends another about 10 minutes drive away. We strap them into the car seats and we are off to school with the sounds of the Good The Bad & The Ugly blaring in the car- one of Lucien’s special requests and we start the next phase of just another day with the kids. Thankfully Stephanie has cooking duties tomorrow!

Kevin Richardson is an award winning health and fitness writer and one of the most sought after personal trainers in New York City and the creator of Naturally Intense High Intensity Training™. Get a copy of his free weight loss ebook here.

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Multi-vitamins And Vitamin Supplements Can Do More Harm Than Good

“Except for persons with special medical needs, there is no scientific basis for recommending the routine use of dietary supplements”- Food & Drug Administration

In a rather ironic twist, sales of vitamin supplements have surged as the economy has slowed. Once the mainstay of the health and fitness minded, vitamins are now seen by the general public as a quick, inexpensive and convenient way to improve their health and reduce their chances of getting sick. Thanks to savvy marketing on the part of the supplement industry vitamins now serve as an unofficial insurance policy for those who don’t have medical benefits and can’t afford to see a doctor. There is also the ever-growing number of people  who for one reason or another prefer to avoid Western medicine as much as possible. Vitamins are also popular among those who believe that taking a multivitamin will not only improve their health, give them more energy but also compensate for their poor dietary habits.[1] With over 15,000 dietary supplements on the market racking in over 17 billion dollars in sales each year[2] estimates are that anywhere from 25% to 50% of American adults have taken some form of vitamin supplement over the past year.[1,3] However as ubiquitous as these supplements have become there is still little credible and unbiased research to show that vitamin supplements have any effect in improving our health. On the contrary, many studies raise the issue that most supplemented vitamins are not  just ineffective but may be bad for your health.

Multi-vitamins & Vitamin Supplements Don’t Improve Your Health

“If a product says on the bottle that it isn’t meant to treat, diagnose or cure disease, what is it supposed to do?”

In 2009 researchers from the Women’s Health Institute concluded a 15 year study of methods to prevent heart disease and cancers in post menopausal women. The study was monumental in its scope, observing a total of 161,808 women using vitamin supplements for eight years and then checking in on them for several years afterwards. The conclusions were not very positive as researchers noted that there was ‘convincing evidence that multivitamin use has little or no influence on the risk of common cancers, CVD or total mortality.’[4] Another recent meta analysis of over 27 studies encompassing a total of 355,080 women had a similar finding- namely that multivitamin use had no effect on decreasing the risk of breast cancer.[5] A study on the intake of vitamins E and C by 15,000 male physicians over the course of ten years found absolutely no health benefits as well.[9] These results don’t come from small scale, industry-sponsored, single nutrient research but from credible and peer reviewed scientific study. Nevertheless these findings do little to dissuade the public from using them as the cacophony of self promoting misinformation disseminated by the supplement industry effectively drowns out any negative findings, regardless of how conclusive it may be. What is more cause for concern  are other studies have shown that vitamin supplements may actually increase your risk of certain diseases.

Using  Multi-vitamins & Vitamin Supplements May Increase Your Risk Of Disease

One of the initial warnings for not using vitamin supplements came in 2005 with a study finding that a high percentage of men who were white, well educated, and who had active and healthy lifestyles with prostate cancer had one thing in common. They regularly took vitamin supplements.[6] Following up on this was a trial of 295,344 men enrolled in the National Institutes of Health Diet & Health Study. The trial found that while vitamin supplements didn’t seem to increase the risk of localized prostate cancer, those who took them frequently had in some cases twice the risk of developing advanced prostate cancer. Frequent users were also were more likely to die from prostate cancer than those who never took vitamin supplements at all [7]- a sobering conclusion to say the least.  Positive cancer associations with excessive multivitamin use were strongest in men with a family history of prostate cancer or among those who took individual micronutrient supplements.  Including selenium, beta-carotene and zinc.

The use of individual vitamins as antioxidants has also raised concerns in the medical community after one of the most comprehensive reviews of randomized trials of 232,606 adults using beta-carotene, vitamin A, vitamin C (ascorbic acid), vitamin E and selenium. Researchers found that not only did participants not receive any health benefits from using vitamin supplements, but that supplemented intake of beta carotene, vitamin A, and vitamin E may actually increase mortality.[8] More studies were recommended to research the possible effects of vitamin C and selenium on mortality but in 2008 a study on the ability of vitamin E and selenium to lower the risk of prostate cancer was halted amidst fear of potential harm to participants. The study was stopped after it was found that supplemental vitamin C may do more harm than good as it may serve to protect cancer cells.[9]

It gets worse. A recent control study in the United Kingdom found that high circulating blood levels of Vitamin B(12) and (in cohort studies) folate were associated with an increased risk of prostate cancer [10] casting severe doubts on the use of vitamin B12 supplements and folic acid in men. Another study found that long term use of zinc from multivitamins or single nutrient  supplements was associated with a doubling in the risk of prostate cancer. Adding to the growing evidence for an unfavorable effect of zinc on prostate cancer carcinogenesis.[11]

It doesn’t end there; a study published in the Journal of the American Medical Association concluded that, ‘in patients with vascular disease or diabetes, long-term supplementation with 400 IU/day of vitamin E may increase the risk for heart failure.’[12] It isn’t all bad feedback on vitamins as there is compelling cause and effect data linking the use of folic acid with consistent and significant reductions in adverse pregnancy outcomes in women. But on the other side there are also studies demonstrating no beneficial effects of calcium and vitamin D supplements in improving bone strength and reducing fractures.[9] It’s a complex issue but not one where the use of supplemented vitamins seem to make sense, especially given the alternatives.

Vitamins and Anti-Oxidants May Inhibit The Benefits of Exercise

It should be noted that ‘effective’ doses of many vitamins and minerals can be toxic and that high levels of any single nutrient being ingested into our bodies is an unnatural occurrence. In nature it isn’t possible to consume just one nutrient as they always coexist with a host of other valuable compounds. Not surprisingly studies have found that high levels of single nutrients can interfere with the functions of other nutrients and the way our body works. Of concern to anyone engaged in an exercise program is the study which found that large amounts of antioxidants can actually reduce the benefits of exercise. A study published in 2009 evaluated the effects of a combination of vitamin C (1000 mg/day) and vitamin E (400 IU/day) on insulin sensitivity in exercising men and the results were eye opening to say the least. They found that supplementation with antioxidants inhibit the beneficial reduction in insulin sensitivity usually produced by exercise[13] and the conclusion was that anti-oxidants may preclude the health-promoting effects of exercise in humans.

Exercise appears to cause some degree of damage to cells in addition to increasing oxidative stress. While not conclusive, some studies have reported that supplementation with vitamin C and E, other antioxidants, or antioxidant mixtures can reduce symptoms or indicators of oxidative stress while having no beneficial effect on performance.[15] This reduction inhibits the otherwise positive benefits of exercise and researchers advise that until studies fully substantiate the long term safety and effects of antioxidants physically active individuals should avoid them and instead ingest a diet of foods rich in antioxidants.[14, 15.16]

Vitamins Can’t Make You Healthy- Eating Well & Exercising Makes You Healthy

Studies questioning the safety and effectiveness of vitamins are numerous- and yet there are hundreds if not thousands of studies that confirm that regular exercise can decrease your risk of everything from depression to cancer and cardiovascular disease. Vitamin supplements however don’t have very convincing records. What has also been proven time and time again is that diets high in natural foods which contain vitamins, minerals and antioxidants are associated with lower incidences of chronic disease. Taking vitamins in pill form doesn’t yield similar advantages. It sounds like a broken record but whenever we try to duplicate the health benefits of natural foods with an artificial substitutes it usually doesn’t work and or produces negative outcomes. The use of omega-3 fortified foods and the many dietary supplements on the market are glowing examples of how the supplement industry promotes the use of synthetically produced ‘nutraceuticals’- all of which have questionable effects on public health. While vitamin supplements have seemed to show some benefit among individuals with severe deficiencies, in the United States it is almost impossible to find such a case- even among poorer populations as improvements in food supply and varieties in diet eradicated such deficiencies earlier in the 20th Century.

Dispelling The Myths: Vitamins Replace Micronutrients Not Found in Modern Diets

“Deficiency symptoms have been induced only under experimental conditions and there is no convincing evidence that the ordinary diet requires supplementation with these nutrients.” Food & Drug Administration

While there is no arguing that the average American diet is one in need of improvement, even with a food intake high in sugars, refined foods, salt and fats micronutrient deficiency to the point of severity is almost non-existent. Our problems stem from the overabundance of food which can lead to obesity and the syndrome of metabolic related diseases but deficiencies are the least of our problems today in spite of what you may hear in the media and from studies funded by the special interest groups who want you to buy their products. A good example is a recent study that made headlines reporting that 90% of Americans are nutrient deficient. The ‘research’ found that nine out of ten Americans are deficient in 11 key nutrients including calcium, vitamin D and potassium. It sounds alarming but before you run to buy some vitamins you might want to consider two important facts;

1. The study wasn’t reviewed or recognized by any scientific authorities on nutrition and
2. The fact that the study was done by the Milk Processor Education Dairy Research Program and that the study came with a recommendation that drinking more milk would alleviate these deficiencies.

It’s a typical industry-centered public relations campaign which is designed to looks like a scientific study, but is really just another way to make you buy more products. (Read more on industry marketing practices in The Economics of Obesity)
Throughout history we humans have been able to meet our vitamin and mineral needs by consuming available plant and animal foods. With the exception of human breast milk no one food is better than another or absolutely necessary for optimal health, and by mixing and matching our foods we are naturally able to create healthy diets that not only meet our nutrient needs but also suit our tastes, cultural, religious and ethnic preferences.

Dispelling The Myths: Foods Grown Today Have Less Vitamins and Minerals Than Several Years Ago So You Need Vitamin Supplements To Replace Them

“Vitamins and minerals are supplied in abundant amounts by the foods we eat. The Food & Nutrition Board of the National Research Council recommends that dietary needs be satisfied by foods.” – Food & Drug Administration

The depleted soil theory has been a popular selling point for manufacturers in the vitamin industry for years. The theory holds that soils today have been depleted due to intensive agriculture practices so fruits and vegetables today contain less nutrients than they did 50 years ago. Following that logic you need a vitamin supplement to get the missing nutrients. Sounds good but again it isn’t exactly true. Studies have found some reduction in nutrient content in vegetables grown today as opposed to 50 years ago, but his has nothing to do with soil quality which has remained the same. So what is the real story? Well, the marked increase in American food production over the past several decades occurred as farmers developed crops that grew faster and thus produced the greatest yields. The consequence of a faster growing plant is that it can’t acquire the same amount of nutrients from the soil or from synthesis as much as their slower growing counterparts. The differences vary between varieties of plants with declines found in six macronutrients and micronutrients- protein, calcium, phosphorus, iron, riboflavin and vitamin C. The reductions ranged from 6 % for protein, 20 % for vitamin C, 15 % for iron, and 38% for riboflavin.[17]

That being said the study’s author, Donald Davis a biochemist at the University of Texas, affirmed that it was wrong to stop eating vegetables on the grounds they lack nutrients or that vitamin supplementation is in any way necessary. What he did say, was that fruits and vegetables are still extremely high in vitamins, minerals and beneficial phytochemicals and remain our best sources of these nutrients. Valuable nutrients that are not present in vitamin supplements. His study also concluded that while there was a decline in the amount of certain nutrients it must be remembered that this came with the benefit of more available fruits and vegetables available for consumption which have gone a long way towards eliminating severe deficiencies.

More Vitamin Myths Dispelled

There are other arguments put forward by vitamin distributors, all answered by very basic science.

Does cooking reduce the amount of nutrients in our foods?

Absolutely, but not very much and most certainly not to the point where we develop vitamin deficiencies. If this were the case given the laws of natural selection humans would have either died out several hundred thousand years ago when we began using fire to cook out foods or stopped cooking. Either way cooking foods isn’t a valid reason for supplementation. Furthermore- if cooking does reduce vitamin content slightly, what do you think happens when those vitamins are processed and refined by machines and stamped into pill or powder form?

People feel better when they take vitamins.

This argument is equally flawed. Most of the ‘benefits’ of supplements can be explained by the placebo effect and the often ignored ability of the human body to heal itself. Studies showing that people taking vitamins are in better health also conveniently forget to say that statistics show that these people tend to be better educated and have higher incomes. Thus putting them in a subgroup of society that is healthier whether or not they take vitamin supplements.

Unfortunately selling vitamins is often a major source of income for many in the health and fitness fields and few are willing to jeopardize losing their commissions by speaking out against them. Vitamin distributors spend a lot of time convincing professionals in the field to sell their products- I get at least two or three requests a week. All from companies with vitamins purportedly made with ingredients that are more natural and of better quality of what you find on the market. They can be quite persuasive and the compensation is often substantial so it creates a legion of professionals who consumers really trust pushing the use of vitamins. A brilliant marketing ploy, but one that puts profits before public health. The magic pill ideology also takes away from the important and proven effective message of eating more fruits, vegetables and natural foods while incorporating exercise into your life. Taking a pill here and there isn’t going to make you any healthier and in many cases may do more harm than good.

Kevin Richardson is one of the most sought after personal trainers in New York City, an award winning health and fitness writer and the creator of Naturally Intense High Intensity Training™. Get a copy of his free weight loss ebook here. If you live in the New York City area and need help losing weight or getting into shape give Kevin and his team a call at 1-800-798-8420. Check out Kevin personal training services here.

References :
1. Blendon RJ, DesRoches CM, Benson JM, et al. Americans’ views on the use and regulation of dietary supplements. Archives of Internal Medicine 2001
2. The Nutrition Business Journal, 2001
3. Dietary supplement survey 2004- Insitute of Medicine
4. Neuhouser ML, Wassertheil-Smoller S, Thomson C, Aragaki A, Anderson GL, Manson JE, Patterson RE, Rohan TE, van Horn L, Shikany JM, Thomas A, LaCroix A, Prentice RL.Multivitamin use and risk of cancer and cardiovascular disease in the Women’s  Health Initiative cohorts. Arch Intern Med. 2009
5.Chan AL, Leung HW, Wang SF.Multivitamin supplement use and risk of breast cancer: a meta-analysis.Ann Pharmacother. 2011
6. Wiygul JB, Evans BR, Peterson BL, Polascik TJ, Walther PJ, Robertson CN, Albala DM, Demark-Wahnefried W.Supplement use among men with prostate cancer.Urology 2005
7. Lawson KA, Wright ME, Subar A, Mouw T, Hollenbeck A, Schatzkin A, Leitzmann MF.Multivitamin use and risk of prostate cancer in the National Institutes of Health-AARP Diet and Health Study J Natl Cancer Inst. 2007
8. Bjelakovic G, Nikolova D, Gluud LL, Simonetti RG, Gluud C.Mortality in randomized trials of antioxidant supplements for primary and secondary prevention: systematic review and meta-analysis.JAMA. 2007
9.Soni MG, Thurmond TS, Miller ER 3rd, Spriggs T, Bendich A, Omaye ST.Safety of vitamins and minerals: controversies and perspective.Toxicol Sci. 2010
10. Collin SM, Metcalfe C, Refsum H, Lewis SJ, Zuccolo L, Smith GD, Chen L, Harris R, Davis M, Marsden G, Johnston C, Lane JA, Ebbing M, Bønaa KH, Nygård O, Ueland PM, Grau MV, Baron JA, Donovan JL, Neal DE, Hamdy FC, Smith AD, Martin RM. Circulating folate, vitamin B12, homocysteine, vitamin B12 transport proteins, and risk of prostate cancer: a case-control study, systematic review, and meta-analysis.Cancer Epidemiol Biomarkers Prev. 2010
11. Zhang Y, Coogan P, Palmer JR, Strom BL, Rosenberg L.Vitamin and mineral use and risk of prostate cancer: the case-control surveillance study.Cancer Causes Control. 2009
12. Lonn E, et al. Effects of long-term vitamin E supplementation on cardiovascular events and cancer: a randomized controlled trial. JAMA 2005;293:1338-1347.
13. Ristow M, Zarse K, Oberbach A, Klöting N, Birringer M, Kiehntopf M, Stumvoll M, Kahn CR, Blüher M. Antioxidants prevent health-promoting effects of physical exercise in humans. Proc Natl Acad Sci U S A. 2009
14.Clarkson PM, Thompson HS.Antioxidants: what role do they play in physical activity and health? Am J Clin Nutr. 2000 Aug;72(2 Suppl):637S-46S.
15. Evans WJ. Vitamin E, vitamin C, and exercise. Am J Clin Nutr. 2000
16. Sacheck JM, Blumberg JB. Role of vitamin E and oxidative stress in exercise. Nutrition. 2001
17. Davis DR, Epp MD, Riordan HD.Changes in USDA food composition data for 43 garden crops, 1950 to 1999. J Am Coll Nutr.

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