EXCESS INTAKE OF VITAMIN E, SELENIUM, OR BETA CAROTENE MAY INCREASE CANCER RATES

 A consensus statement released by the U.S. Preventive Services and the results of a new study both find that there are potential downsides to taking some vitamins and minerals. 

A panel of experts was recently convened to give Americans better guidance on supplementation.  The 16-member panel took an in-depth look at studies conducted over the past 10 years on vitamins and minerals and found  there was no conclusive evidence multivitamin improve health.  The panel also stated healthy Americans should not take vitamin E or beta carotene supplements to help prevent heart disease or cancer and that, for smokers, beta carotene supplements may actually increase the risk of lung cancer.  In two large studies taking beta carotene increased the risk of lung cancer in smokers by 24%.  There is also limited evidence that taking high levels of folate can increase colon cancer rates.

Additionally, a large supplementation trial found men taking selenium or vitamin E supplements can double their risk of prostate cancer.  The study, begun in 2001, was prompted by early research suggesting the supplements might protect against prostate cancer. But, researchers found that taking selenium increased the risk of high-grade cancer by 91% among men with already high selenium levels.  Among men with low selenium levels, taking vitamin E increased the risk of prostate cancer by 63% and the risk of aggressive cancer by 111%.

Men can still take their daily multivitamin without fear, however.  The levels administered in this study significantly exceeded the recommended daily intake and were higher than would be found in most multivitamins.  During the trial, men took 200 mcg of selenium and 400 IU of vitamin E daily, either separately or in combination.  By comparison, the recommended daily intake of selenium for adults is 55 mcg, and for vitamin E it is 22 IU. 

What to do:  If you want to take a multivitamin it is likely doing no harm but it also may be doing no good.  As the study findings reveal, taking large doses of supplements can increase cancer risk.  Certainly, supplements are no substitute for eating a healthy diet, getting regular physical activity, and controlling body weight.  Instead of supplements aim for healthy foods naturally rich in vitamins and minerals.  To get adequate vitamin E and selenium aim for whole grains, nuts, and dark leafy greens.

Adapted from articles available at:

http://www.nlm.nih.gov/medlineplus/news/fullstory_144782.html

http://www.cancer.gov/newscenter/qa/2008/selectqa

Sources: 

Sources: 

Frankel PH, Parker RS, Madsen FC, Whanger PD.  Baseline selenium and prostate cancer risk:  Comments and open questions. Journal of National Cancer Institute. Available at dju060 doi:10.1093/jnci/dju060.

Kristal AR, Darke AK, Morris JS, et al.  Baseline Selenium Status and Effects of Selenium and Vitamin E Supplementation on Prostate Cancer Risk. Journal of National Cancer Institute.  Available at djt456 doi:10.1093/jnci/djt456 first published online February 22, 2014.

U.S. Preventive Services Task Force.  Vitamin, Mineral, and Multivitamin Supplements for the Primary Prevention of Cardiovascular Disease and Cancer.  Annals of Internal Medicine on 25 February 2014.  Available at: http://www.uspreventiveservicestaskforce.org/uspstf14/vitasupp/vitasuppfinalrs.htm#copyright

LEAVING THE WORKFORCE DETRIMENTAL TO HEALTH

A growing body of research indicates that leaving the workforce, whether one is retiring, going on disability, or simply cannot find work, has serious detrimental effects on mental and physical health.  Leaving the workforce changes one's physical environment as well as one's mental and physical activity patterns and researchers point out that these changes profoundly change individual's health behaviors, social interactions, psychosocial stresses.  

Retirement is often perceived as a golden opportunity to focus on healthy behaviors.  However, retirement, marked by reduced social interaction, less physical movement, and a loss of sense of purpose, actually increases the risk of health problems.  For example, a study published in 2008 by the National Bureau of Economic Research found retirement increased difficulties with mobility and daily activities 16%. A recent report published by the Institute of Economic Affairs in London concluded retirement , raises the risk of developing clinical depression by about 40%, increases the risk of developing at least one diagnosed physical condition by approximately 60%, and raises the risk of needing medication for a physical condition by 58%. 

Involuntary unemployment appears to be especially bad for health in the US where unemployed workers often lose health insurance.  It is estimated that in the United States, each percentage rise in unemployment leads to 6,000 deaths.  A review of more than 300 studies on mental health and unemployment found that unemployment was markedly linked to declines in mental health.  For instance, men who had lost jobs within the last four years were three times more likely than stably employed men to have recently abused alcohol. Likewise, women who had a stint of unemployment were three times more likely than other women to have suffered extended periods of depression.  According to a study out of Columbia University, long-term unemployment can reduce life expectancy by an average of 1 ½ years.   Parent’s unemployment even appears to have lasting effects on the success of their children.  A 2008 report based on a study that followed the earnings of 39,000 Canadian fathers and sons over 30 years beginning in the late 1970's found that when the sons of men who lost their jobs joined the workforce, they earned 9% less than the sons of otherwise comparable workers.

There is evidence that being out of the workforce is particularly damaging to heart and cardiovascular health.  A number of studies have found that persons in retirement or on disability decrease their amount of walking and other physical activity when they leave the workforce.  A recent study at the Harvard School of Public Health looked at rates of heart attack and stroke among men and women in the ongoing U.S. Health and Retirement Study. Among 5,422 individuals in the study, those who had retired were 40% more likely to have had a heart attack or stroke than those who were still working. The increase was most pronounced during the first year after retirement with mortality rates of the newly retired 50% greater.

What to do:  While the common perception is that if we could only quit our stressful jobs and focus on our health we would be better off, in fact, work is beneficial to health.  So, keep working as long as you can.  If you do leave the workforce, actively engage in behaviors that protect your health.  Foster a new social networks, pursue activities that keep you physically active and bring you joy, and continue to challenge your mind with structured and unstructured learning.  

Adapted from articles available at:

http://www.livescience.com/13578-unemployment-health-mortality.html

http://www.bloomberg.com/news/2013-06-11/retirement-will-kill-you.html

http://www.medicalnewstoday.com/articles/260622.php

http://www.health.harvard.edu/blog/is-retirement-good-for-health-or-bad-for-it-201212105625

http://consumer.healthday.com/encyclopedia/article.asp?AID=646671

http://economix.blogs.nytimes.com/2012/03/28/the-enduring-consequences-of unemployment/?_r=0

http://thinkprogress.org/economy/2012/04/02/456809/long-term-unemployment-decreases-life-expectancy/

Sources:

Centers for Disease Control and Prevention.  Current Depression Among Adults --- United States, 2006 and 2008. Mortality and Morbidity Weekly Report.  October 1, 2010 / 59(38);1229-1235

Paul K, Moser K. Unemployment impairs mental health: Meta-analyses. Journal of Vocational Behavior. Volume 74, Issue 3 June 2009

Jin RL. The impact of unemployment on health: a review of the evidence. Can Med Assoc J. 1995 Sept 1; 153(5)529-539.

Warr, PB. Work, Unemployment and Mental Health.  New York, Oxford University Press. 1987.

Warr, PB. Self-esteem and unemployment among young workers.  Le Travail Human.  1983,

46,355-366.