April 7, 2009

You Ask, I Answer: Supplements

Do you object to supplementation in general via a basic multivitamin/mineral product?

I recall [reading in the Center for Science in the Public Interest's] Nutrition Action Healthletter that adult males [should] avoid iron supplementation (perhaps due to a possible link between excessive iron intake and the development of a certain type of cancer?).

Is iron something that adult males should indeed avoid in a supplement?

[Lastly,] do you see any merit to taking curcumin or cumin supplements (especially for someone with an inflammatory disease such as asthma)?

Obviously, a whole food is preferable, but I think that massive amounts of curry would need to be ingested in order to derive any possible benefits.

-- Rob White

Boston, MA

My stance on supplementation varies depending on context.

I despise the notion that as long as you take a multivitamin once a day, you don't need to worry about the nutrient composition of what you eat the rest of the day.

Multivitamins do not offer the vast amount -- literally THOUSANDS -- of healthy phytonutrients and other compounds naturally found in foods.

Additionally, absorption from multivitamins is often lower -- and less effective -- than if that same nutrient is derived from actual foods that contain those nutrients.

I do, however, fully support the supplementation of Vitamin D. Unless you live near the Equator, your body can not synthesize this nutrient from sunlight between the months of October and April.

For the record, I recommend supplementing 2,000 International Units of Vitamin D a day.

I also don't have a problem with individuals supplementing a specific vitamin or mineral that they would otherwise be deficient in (i.e.: vegans without access to fortified foods and B12).

The issue of iron supplementation and men can also apply to post-menopausal women. Since iron is very hard for the body to excrete (menstruation being the exception), supplementation in these two populations raises the risk of a condition known as iron overload.

Iron overload can cause a variety of symptoms and problems, from heart arrhythmia and hypothyroidism to impotence and arthritis.

This is why, if you examine the label on a "men's formula" multivitamin, you will find that iron is MIA.

As far as curcumin supplements in regards to asthma, it gets complicated. There is very little data on the efficacy of these supplements. Consequently, dosage values have not been clearly determined.

Additionally, certain individuals (those with weakened immune systems, diabetes, and stomach ulcers) are advised to steer clear of these supplements, as they can aggravate those conditions.

I think you are better off implenting more curry-spiced dishes into your diet. After all, populations that are believed to benefit from this spice include it in their recipes, not swallow it in pill form.


McTwirly said...

You are right that there is not enough research to know if curcumin has side effects. However, eating more curry is kind of a joke. The curcumin in tumeric in food is not very bio-available. If you do take curcumin, the usual advice is to look for a brand that the curcumin is 95 percent present, and combined with either a certain black pepper or taken with an oil of some kind in order to be bio-available.
With or without meals, dosage, etc are all areas of controversy.

Andy Bellatti said...


The recommendation to eat more curry isn't a joke when you consider that populations that are believed to benefit from it are EATING it. They are not going to GNC and buying curcumin capsules.

McTwirly said...

Hmmm, how many years would it take you to catch up with people who eat ginormous quantities of curry several times a day? Even at that, the bio-availability is minimal.
I am, however, on the bandwagon and hoping there will be more clinical trials of the use of curcumin for cancer, cholesterol, Alzheimer's, etc etc etc so my doctor will stop arguing that we don't really know the downside and what else it interfers with.

Anonymous said...

From The October 2007 issue of Nutrition Action Heathlatter:

Can spices prevent cancer, diabetes, Alzheimer's, arthritis, and other illnesses? Western science has been slow in getting to the spice rack (spices have been used to treat disease for thousands of years). Here's the latest on three spices that hold some promise.


If you've ever ordered curry at an Indian restaurant or swabbed a sandwich with yellow mustard, you've eaten turmeric, a spice that researchers are testing as a possible cure for cancer, Alzheimer's disease, and other ailments. Actually, it's not turmeric that has caught the interest of scientists. It's curcumin (pronounced curr-CUE-min), the compound that makes turmeric yellow.


When lab rats and mice are given very high doses of curcumin, they get fewer tumors of the breast, skin, mouth, and colon. (1)

"Curcumin induces apoptosis, a form of programmed cell death, in the cancer cells," says Bharat Aggarwal, a professor of cancer research at the University of Texas M.D. Anderson Cancer Center in Houston.

"It also suppresses angiogenesis, which is the formation of new blood vessels to nourish tumors. And it slows down the metastasis, or the spread, of cancer cells."

In humans, the evidence is more limited. Large studies haven't tracked healthy people to see if curcumin eaters have lower rates of cancer. Researchers have mostly looked at whether patients with advanced cancer can tolerate high doses.

M.D. Anderson researchers, for example, gave 8 grams a day of curcumin to patients with inoperable pancreatic cancer. (The results haven't been published.) But those kinds of studies don't compare the patients to others who get a placebo, so they can't say whether the curcumin takers live longer than expected.

Seven new studies are recruiting participants--two in patients with advanced pancreatic cancer, four in people with precancerous colon lesions, and one in patients with multiple myeloma.

"They're small, pilot-type clinical trials with 10, 30, or 50 patients," notes Aggarwal. (Aggarwal is affiliated with Curry Pharmaceuticals, a company that hopes to patent an exclusive curcumin formula.)

The Aging Brain

"Curcumin protects the brain cells in every animal model of traumatic brain injury, whether it's stroke, Alzheimer's disease, Huntington's disease, or mad cow disease," says Gregory Cole, associate director of the Alzheimer's Disease Center at the University of California, Los Angeles.

"What's unique about curcumin," Cole notes, "is that it binds directly to beta-amyloid deposits in the brain and reduces their size." Beta-amyloid is a protein fragment that builds up between brain cells of people with Alzheimer's disease.

Results in animal studies are promising. For example, researchers at Massachusetts General Hospital injected curcumin into the bloodstream of mice with Alzheimer's disease-like plaques and then took images of their brains. (2) "In one week, curcumin reduced the average size of the plaques by 30 percent," says Cole. "They could see the plaques disappearing."

But research on curcumin and the human brain is just beginning.

Two preliminary studies are looking at how well Alzheimer's patients can absorb and tolerate 2 to 4 grams a day of curcumin, and whether it lowers inflammation, oxidative damage, and cholesterol levels. One of the studies will also see if it slows the decline of scores on cognitive tests.

But neither study compares curcumin takers to placebo takers, so they won't provide clear answers.

"There's real potential for curcumin in treating brain diseases," concludes Cole. "But we don't know enough yet to be using it beyond experimental trials."

How Much of What?

Researchers have yet to solve a major stumbling block: only a fraction of the curcumin in pills seems to be absorbed or retained by the body. "Even after swallowing large amounts, levels in the blood are miserably low," says UCLA's Gregory Cole.

The math for curcumin in food is no better.

Only some 2 percent of turmeric is curcumin, and curry powders vary more than ten-fold in their turmeric content. Bottom line: you'd have to eat anywhere from 8 to 80 cups of curry powder to get the 4,000 milligrams (4 grams) of curcumin that's being tested in the UCLA Alzheimer's study.

Cooking with curcumin may help. "The turmeric used in curry is put into hot oil and cooked," notes Cole. "Maybe that delivers curcumin better than capsules filled with curcumin that has been extracted from turmeric with an organic solvent."

Another question: "What happens if you reach levels strong enough to kill cancer cells?" asks Cole. "I don't think the current studies can say what the safety of curcumin would be under those circumstances."

Cole's bottom line: "It seems safe to take up to two grams of curcumin a day. But I can't tell you that it's going to do anything."

(Note: If you're on prescription drugs and want to take curcumin supplements, be careful about the kind with added pepper extract. While the extract may increase your body's absorption of curcumin, "it can also interfere with the metabolism of all kinds of drugs," says Cole.)

Andy Bellatti said...


That is precisely one of the fallacies, though. Catching up with people who have eaten curry for decades by instead popping pills does not necessarily promise the same results.

Like with other supplements, one has to wonder how effective curcumin is by itself (as opposed to within a matrix of other components found in curry).

Andy Bellatti said...


Thank you for sharing. As you see, data is VERY limited, particularly in regards to human studies.