COLUMN ONE : The Rags to Riches Story of E : Discovered in the ‘20s, the vitamin was long touted as an aphrodisiac. Now it is being heralded as a protector against heart disease, cancer and many ailments linked to aging.
Herbert M. Evans was baffled. The year was 1922 and the UC Berkeley scientist was tinkering with the diet of his laboratory rats. It seemed that a mysterious substance in the wheat germ oil he was feeding them helped the rodents reproduce.
“Factor X,” he dubbed it. He hadn’t the foggiest notion what it was.
And so it happened that Evans and colleague Katharine S. Bishop stumbled upon what was to become one of the most overlooked developments in modern medicine: the discovery of Vitamin E.
The big news out of Berkeley did not do much for the image of the pale yellow oil with the almost imperceptible taste. The notion that Vitamin E was, as one researcher put it, “good for the sex life of rats,” made people think it was good for humans too. Soon, the vitamin was enshrouded in a tantalizing myth that hailed its power as an enhancer of virility and fertility. Its nickname: “the shady lady of vitamins.”
But the lady has had a make-over, and now she is turning heads in respectable places.
These days, Vitamin E is gaining attention in scientific circles as a protector against degenerative diseases. Recent research suggests that it defends against the ill effects of smog, smoke and sun, and it might help prevent certain cancers and aging of the skin. Other studies show that it shores up the immune system, staves off cataracts and could play a role in slowing the progression of Alzheimer’s disease.
The biggest boost came last month with the release of two massive reports from Harvard showing that people who took daily megadoses of E had a 40% lower risk of heart disease. The studies, published in the New England Journal of Medicine, have helped to solidify the vitamin’s place on the nutritional map.
E has never had a champion to sing its praises the way Linus Pauling, the two-time Nobel laureate, ballyhooed Vitamin C. Two Canadian doctors--brothers Wilfrid and Evan Shute--tried in the late 1960s, but their work never gained the same attention and they, like Pauling, were laughed off by others.
Today, the Shutes’ ideas no longer seem that far-fetched. In the two decades since their book “Vitamin E for Ailing and Healthy Hearts” was published, the cure they promoted has quietly worked its way into the scientific mainstream. Now, the slow, steady drumbeat of support is reaching a crescendo.
“We’ve come into the era of Vitamin E,” said Max Horwitt, an 85-year-old nutritionist at St. Louis University. He has researched the substance for so long that he is known as the father of Vitamin E. “This has lay dormant for years. . . . You’re going to hear a lot more about this.”
“It’s all long overdue,” Lester Packer, a UC Berkeley biochemist, said of the sudden focus on E. “All the indications were there and have been increasing. The circumstantial and experimental evidence is becoming stronger and stronger.”
Despite all this buzz, most researchers, citing the need for more definitive proof, say it is too soon to recommend that the public start popping the yellow gel capsules. That caution, however, may be a case of “do as I say, not as I do.” Many of these scientists and doctors take the supplements themselves.
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For Packer, Horwitt and other researchers, there is nothing especially surprising about the Harvard work. Instead, it represents one of those unusually neat turns of science when an experiment seems to bear out the theory it was intended to prove.
The theory, in this case, is the free-radical hypothesis of aging.
Proposed in 1956 by University of Nebraska scientist Denham Harman, the hypothesis may sound more like an analysis of a protest movement than a scientific theory about what makes us grow old. And in a sense, free radicals are protesters. Tens of thousands of them wage a raucous demonstration inside the body each day.
Free radicals are essential to many bodily functions, including the workings of the immune system and our ability to digest food. They are inescapable; we generate them as we breathe. These unstable molecules swagger through the body, bumping into and damaging whatever cells pass by. Cigarette smoking and pollution increase their production. Ironically, so does exercise, although a body in good shape can combat the ill effects of the extra free radicals it generates.
Scientists believe free radicals contribute to sagging skin, organ deterioration, cancer, heart disease, a host of degenerative illnesses, and even the flu and the common cold. In much the way that a car rusts or lettuce turns rancid, the theory says, the body--through oxidation that occurs along with breathing--is steadily destroyed over time.
“Free radicals are a part of life,” said Packer, who has made a career of studying them. “You can’t live without them, but you can’t live with them indefinitely. Life is an incurable disease.”
But you can engage them in a sort of molecular boxing match, with the hope of knocking them out before they knock you out. This is where Vitamin E and other “antioxidants,” primarily Vitamin C and beta-carotene, come in.
Antioxidants quench free radicals, stabilizing them before they harm the cells. Each antioxidant performs a slightly different function; Vitamin C works in the watery, sea-like center of cells, and E works in the fatty cell membrane.
As a source of nutrition, Vitamin E is not particularly important. Its absence in your diet will not make you sick, in the way a shortage of Vitamin C can cause scurvy.
But as an antioxidant, Vitamin E is crucial.
Its ability to dissolve in fat, researchers believe, gives it an important edge in protecting against heart disease. The vitamin is carried through the bloodstream in particles of LDL--low-density lipoprotein, the basis of so-called bad cholesterol. Heart experts theorize that in blocking the oxidation of LDL, Vitamin E can prevent bad cholesterol from infiltrating cells and clogging arteries.
The Harvard studies, which examined the links between diet and heart disease in 87,000 female nurses and nearly 40,000 male health professionals, provide compelling evidence for this hypothesis.
The studies found that Vitamin E benefited people who took daily supplements of more than 100 international units for at least two years, with the women taking a median dose of 208 units and the men 419 units. The federal recommended dietary allowance, set by the National Research Council, is 15 units; most Americans consume slightly less than that from such foods as vegetable oils, seeds, whole grains, nuts and leafy vegetables.
The Harvard work may also provide the strongest support for the argument that large-dose supplements of antioxidant vitamins--as opposed to the smaller amounts derived from diet--can help protect against disease.
“The Harvard study is very powerful,” said Dr. Ishwarlal Jialal, who performs research on LDL oxidation at the University of Texas Southwestern Medical Center. “This takes the whole concept and theory of oxidation one step further.”
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Such studies have pushed the esoterica of free radicals and antioxidants beyond the minds of scientists and into the minds of a health-conscious public. Consumers are snapping up bottles of E faster than you can say “low-density lipoprotein.”
A Culver City smoker said she rushed out and bought some after the New England Journal report. She desperately wants to believe the vitamin will do her some good, even though she knows she really should just give up cigarettes.
In a society that is always looking for the magic bullet, that one pill to make us young, beautiful and healthy, one thing is certain: This frenzy is doing wonders for the sales of Vitamin E.
Polls show that 35% of all Americans take vitamins and of those, 22% take E supplements; the most common dosage is 400 international units. Last year, sales of E supplements were $338 million--up 23% from the previous year--and industry analysts say the trend is likely to continue.
“We’re definitely not complaining, that’s for sure,” said Caron Blitz, spokeswoman for Henkel Fine Chemicals, the world’s largest producer of natural Vitamin E.
Although E is not the biggest-selling supplement--C holds the record--only beta-carotene has shown such rapid market growth. Companies have begun marketing Vitamins C and E and beta-carotene in one easy-to-take antioxidant supplement. In March, Lederle Laboratories was the first major American pharmaceutical company to put such a product on drugstore shelves.
Meanwhile, the Council for Responsible Nutrition, a trade association representing 70 vitamin manufacturers, is urging the government to recommend that Americans take E supplements.
“Most researchers are themselves taking vitamins,” the council says, “even while they decline to recommend the same action to the public. . . . Is this dual standard justified, or is this the scientific equivalent of ‘insider trading?’ ”
In the face of this flurry of interest, the Food and Drug Administration announced this week that manufacturers must have scientific proof of the benefits of vitamins and other nutritional substances before they can make health claims on product labels.
Indeed, most scientists say it is far too soon to make a public health recommendation that people take Vitamin E. Hard proof is needed, they say, that E really prevents heart disease. The recent Harvard studies--compelling though they may be--demonstrated only an association between the vitamin and reduced risk for heart disease, not a cause-and-effect relationship.
“That’s all very strongly suggestive,” said Daniel Steinberg, a UC San Diego professor who was the first to demonstrate that antioxidants can hinder the bad effects of cholesterol. “But I don’t think we, as physicians, can go around making recommendations to people when we have no proof that there is a benefit.”
What is needed, Steinberg said, is a “double-blind” clinical trial, in which half the subjects are fed Vitamin E and the other half a placebo, with rates of heart disease then measured.
Such studies are under way, and several others are being planned, including one proposed by Steinberg. But it may be years before the results are known.
Preliminary data from one double-blind trial has been promising. In 1990, Dr. Charles Hennekens at Harvard reported that among 333 men who had heart disease those taking E had a 40% decrease in heart attacks and stroke, and were also 40% less likely to require bypass surgery or angioplasty. But Hennekens’ results have been made public only in abstract form; complete details will not be released until his study is concluded in several years.
In the meantime, Steinberg said, there is good reason to be cautious. If people are encouraged to take Vitamin E, he said, they may abandon healthy habits such as exercise and a low-fat diet. He also noted there has been no study that shows E is safe to be taken over a lifetime.
In addition, Dr. Eliot L. Berson and his colleagues at Harvard Medical School recently reported that while supplements of Vitamin A slowed the progression of retinitis pigmentosa--a deterioration of the retina that leads to blindness--daily supplements of E seemed to speed up the disease.
Others, however, say the safety issue is a smoke screen. Noting that there are no known harmful effects of taking large doses of E, supporters cite a two-year study in which Parkinson’s disease patients were fed 2,000 units of the vitamin each day with no adverse reactions. And, they note, there are no studies proving that certain drugs are safe over a lifetime, but that does not stop doctors from prescribing them.
Perhaps the biggest stumbling block to recommending widespread use of E, or any dietary supplement, is this: It goes against the grain of what the medical Establishment has been preaching for years--that you can get everything you need to stay healthy in a well-balanced diet.
“The whole idea of taking pills is, shall I say, very undesirable for academic people like myself,” said Horwitt, the St. Louis nutritionist. “We have spent years teaching medical students that you don’t have to have any more vitamins in your diet than (are present) in your food.”
So if you ask Eric Rimm, the lead investigator on the Harvard study of male health professionals, whether the government should advise the public to take Vitamin E, he will say no. But if you ask him if he takes it himself, you will get a different answer.
“My grandfather had a heart attack when he was very young,” Rimm said, “and I take Vitamin E in addition to having a healthy diet and not smoking.”
And so it goes. Horwitt confesses somewhat sheepishly that he takes E supplements, as does Jialal, the Texas doctor, and Packer, the UC Berkeley expert.
“Of course I take them!” Packer bellows. “What do you think? I go to school and then I come home at night and forget what I learned?”
The only one waiting, it seems, is Steinberg.
“People ask me that question all the time,” he says, “and I want to be able to tell them no.”
Vitamin E: The Research
Studies indicate that Vitamin E may protect against cancer, heart disease and other degenerative illnesses. Here is a sampling of the evidence:
* Cataracts: Vitamin E reduced the degree and extent of cataract development in rats. And a recent study of 600 people showed that those with the most Vitamin E in their blood were much less likely to develop the most common form of cataracts. But no cause-and-effect relationship has been established.
* Heart disease: People who took large daily supplements of Vitamin E showed a risk of heart disease 40% lower than those who did not, according to studies of 120,000 health professionals. Early data from an ongoing clinical trial shows that of 333 men who suffered from heart disease, those taking Vitamin E were 40% less likely to have heart attacks and strokes than those taking placebos.
* Immune response: Studies show that Vitamin E supplements improved immune response in aged mice. Similar results were observed in small studies of humans; a study of 32 senior citizens showed improved immune function among those who took 800 milligrams of Vitamin E for 30 days.
* Cancer: Studies in Finland, Switzerland, England and the United States demonstrate a link between Vitamin E and reduced risk of various cancers, including those of the lung, stomach, colon, mouth, cervix and breast. A Finnish study showed that those with low blood levels of Vitamin E and the trace mineral selenium were far more likely to develop all types of fatal cancer.
