{1}{100}25.000 SUBTITLED BY ANDROMEDA
{106}{208}Britain is in the middle|of a health revolution.
{258}{340}We're spending three hundred|million pounds a year on pills,
{341}{462}that some believe to be an amazing|natural way to prevent, or even cure,
{473}{532}some of our most deadly diseases.
{583}{632}And every day,
{633}{696}millions of people take|vitamin supplements,
{697}{778}convinced of their power|to keep them healthy.
{849}{937}If you want to lead a|long and healthy life,
{938}{1031}eat right and take supplements.
{1072}{1176}But there is a growing|anxiety from scientists
{1177}{1255}that our habit of taking|large doses of some vitamins
{1257}{1352}could have very different consequences.
{1413}{1548}For most people there's|absolutely no benefit
{1549}{1593}in taking high dose vitamin supplements.
{1595}{1633}At best, they're a waste of money
{1634}{1700}and at worst, they could|seriously affect your health.
{1701}{1812}Tonight Horizon examines|the vitamin revolution,
{1813}{1857}and investigates the facts
{1858}{1940}about the nation's favourite vitamins.
{1991}{2017}Do they work?
{2018}{2068}And are they safe?
{2808}{2881}Maddie Walford is thirty-three
{2882}{2933}and leads an active life.
{3033}{3074}She eats well,
{3075}{3137}and exercises regularly.
{3137}{3254}And to make sure she stays healthy
{3255}{3323}she's convinced that she needs to take
{3324}{3400}three special pills every day.
{3481}{3522}I'm definitely a pill-popper.
{3523}{3593}There have been so many|jokes going on about,
{3594}{3622}sort of, me in the office,
{3623}{3690}because I line up my|vitamin jars every morning
{3690}{3712}and take all the pills.
{3712}{3776}There have been jokes about me rattling
{3777}{3794}when I walk.
{3815}{3887}Some of my family members just|think I'm a complete maniac.
{4018}{4124}Dina West teaches foreign|language students in London.
{4165}{4204}How many syllables in this word?
{4205}{4260}She has a hectic schedule.
{4261}{4307}So it's bungalow.
{4307}{4350}Bungalow.
{4351}{4383}Bungalow.
{4384}{4420}Bungalow
{4421}{4460}Perfect, ok well done.
{4461}{4527}She too is convinced that to feel good
{4528}{4609}and stay healthy she|needs extra vitamin pills.
{4670}{4711}I take a variety of vitamins,
{4712}{4734}a cocktail of vitamins,
{4735}{4836}probably about eleven a day.
{4897}{5035}I have taken them over a period|of twenty-five or more years.
{5106}{5157}And then there's Carol,
{5158}{5262}she's fit and healthy and|loves hill walking and climbing.
{5263}{5359}And every morning she|takes three vitamin tablets.
{5400}{5437}On a daily basis,
{5438}{5493}I take vitamin C and vitamin E,
{5494}{5545}and I take a general|sort of multi-vitamin.
{5586}{5644}She even carries some around|with her in her handbag
{5645}{5694}in case of emergencies.
{5695}{5781}And all of them have|bought in to the same idea
{5782}{5823}that vitamins are a simple,
{5824}{5938}and above all natural, way|to stay fit and healthy.
{6069}{6127}Like millions of people in Britain,
{6128}{6169}they believe vitamin supplements
{6170}{6263}are crucial to a happy|and vigorous future.
{6334}{6435}I hope my vitamins will protect|me from any form of cancer.
{6526}{6564}Premature ageing.
{6615}{6682}Keep my eyesight, hearing,
{6683}{6741}all my faculties intact as well.
{6822}{6921}But do vitamins really|have such remarkable powers?
{7082}{7121}Vitamins are nothing more
{7122}{7207}than chemicals that|occur naturally in food.
{7288}{7341}Our bodies cannot|produce them themselves,
{7342}{7382}and nearly a century ago
{7383}{7477}scientists discovered|just how vital they were
{7478}{7505}for our health.
{7506}{7566}Vitamins are essential|for a healthy body,
{7567}{7602}we can't exist without them.
{7653}{7697}They found that a whole host of diseases
{7698}{7769}weren't caused by infections|from viruses or bacteria,
{7770}{7858}but simply by the|lack of these vitamins.
{7859}{8017}It's very rewarding|when a person comes in
{8018}{8061}with a medical condition,
{8062}{8084}or clinical condition,
{8085}{8162}and we can identify that|as a vitamin deficiency,
{8163}{8241}treat them with vitamins|and see them get better.
{8292}{8374}Just by making sure people|ate the right vitamins,
{8374}{8505}a whole string of what became|known as deficiency diseases
{8506}{8552}could be eradicated.
{8613}{8687}Vitamin A, found in dairy products,
{8688}{8711}liver and fish,
{8712}{8786}prevents blindness|and growth deformities.
{8787}{8913}Vitamin C, from oranges|and other citrus fruit,
{8914}{8979}has all but ended scurvy.
{8980}{9037}And vitamin D,
{9037}{9068}found in fish,
{9069}{9163}means children need no|longer grow up with rickets.
{9303}{9364}Scientists have found our food
{9365}{9409}contained a cheap and simple way
{9409}{9463}to end the suffering|of millions of people
{9464}{9505}around the world.
{9536}{9589}The discovery of vitamins
{9590}{9632}was a landmark in modern medicine,
{9633}{9688}it was the first|example where we learned
{9689}{9786}that diseases may be caused|not just by infectious agents
{9787}{9829}but by the simple absence
{9830}{9886}of a single substance from our diet,
{9887}{9920}a vitamin.
{9921}{9983}That a vitamin deficiency|could be the cause
{9984}{10026}of disease and death.
{10027}{10149}Today, most of us take|for granted a life free
{10150}{10228}from the diseases caused|by vitamin deficiency.
{10299}{10331}Doctors now believe
{10332}{10395}that a balanced diet,|with a mix of fruits,
{10396}{10459}vegetables, grains and fats,
{10460}{10526}can give you the tiny|amounts of vitamins needed
{10527}{10589}to keep you in good health,
{10590}{10683}they have called it the|recommended daily allowance.
{10744}{10813}Only in special cases,|such as pregnancy,
{10814}{10926}do doctors normally recommend|taking higher doses of vitamins.
{10957}{11028}There are times when extra|vitamin supplements are useful,
{11029}{11074}for example, folic acid
{11075}{11148}is important in preventing|birth defects in babies,
{11148}{11216}so it's very important for|women considering pregnancy
{11216}{11263}to take a folic acid supplement,
{11264}{11297}before they're pregnant,
{11298}{11336}and for the first twelve|weeks of pregnancy.
{11396}{11428}But forty years ago,
{11429}{11538}someone came along who would transform|the world's perception of vitamins.
{11579}{11609}Someone so powerful
{11610}{11689}that he would take them out of the|hospital and the doctor's practice
{11690}{11777}and into millions of|homes and high streets.
{12178}{12274}Linus Pauling was a|scientific superstar.
{12274}{12334}For example if we consider a helium atom
{12335}{12375}with the nuclear atom.
{12376}{12402}As Albert Einstein remarked,
{12403}{12430}Linus Pauling was a genius.
{12451}{12483}He was so brilliant
{12484}{12594}that he is the only man to win|two individual Nobel Prizes,
{12595}{12677}once for chemistry and once for peace.
{12677}{12799}Two Nobel Prizes gave him|astonishing scientific credibility.
{12880}{12938}In addition to being|an incredible genius,
{12939}{13002}he was also a very charming|and charismatic man.
{13023}{13070}Though he died ten years ago,
{13071}{13130}his work on the structure of molecules
{13131}{13198}is still the basis of modern science.
{13199}{13280}Until Pauling came along|to revolutionise chemistry,
{13281}{13376}the nature of the bond that|held atoms and molecules together
{13377}{13406}really was not well known.
{13407}{13446}And Pauling provided this foundation
{13447}{13474}for modern chemistry.
{13525}{13578}It seemed he could go effortlessly
{13579}{13645}from one area of science to another.
{13696}{13772}He had an encyclopaedic|knowledge of chemistry,
{13773}{13815}physics, biology, medicine.
{13816}{13844}As a chemist,
{13845}{13896}I have a background of knowledge
{13897}{13983}that permits me to|appreciate the new ideas,
{13984}{14075}but I also like very much
{14075}{14132}having new ideas myself.
{14133}{14197}And in the late 1960s,
{14198}{14271}the great man had a huge idea.
{14344}{14392}Pauling became convinced
{14392}{14467}that vitamins could not only|prevent deficiency diseases,
{14468}{14565}they could do something far, far bigger. 
{14616}{14688}He believed they had the power to prevent diseases 
{14689}{14776}that had nothing to do with deficiency at all, 
{14777}{14836}diseases which threatened|every one of us,
{14836}{14869}like cancer. 
{14960}{14988}Heart disease. 
{15029}{15096}They could even delay ageing.
{15127}{15187}The key, according to Pauling,
{15187}{15252}was to take them in huge doses. |
{15323}{15365}It was a very revolutionary idea
{15368}{15394}because at the time 
{15395}{15456}most conventional|scientists and nutritionists
{15457}{15498}were interested in vitamins
{15499}{15586}with respect to their|associated deficiency diseases,
{15587}{15650}and not achieving optimal health 
{15651}{15691}by increasing the intake of vitamins.
{15741}{15806}When Pauling took his|message to the world,
{15806}{15863}the public loved it.
{15903}{15959}It was after all the 60s,
{15959}{16045}and vitamins seemed to offer a safe, easy remedy 
{16046}{16112}to the illnesses we most feel. 
{16142}{16218}You didn't always need big|pharmaceutical companies and drugs,
{16218}{16316}you just needed nature's|remedy in pill form.
{16349}{16393}The message was simple. 
{16394}{16518}If the amount of vitamin C required|to stave off scurvy was ten milligrams,
{16519}{16584}and could be found in a slice of orange,
{16585}{16657} then thousands of times more,
{16658}{16729}the equivalent of over one hundred oranges, 
{16730}{16830}and more than two hundred and fifty|times the recommended daily allowance
{16831}{16876}was even better. 
{16877}{16979}Because that could prevent you from|catching the most irritating of diseases,
{16987}{17042}the common cold.
{17102}{17223}The proper intake of vitamin C |helps keep one from catching colds. 
{17273}{17362}To this claim, Pauling's claim|that huge doses of vitamin C
{17363}{17498}can prevent you catching a cold| is popularly believed to be scientific truth.
{17529}{17587}It helps ward off colds.
{17588}{17671}Helps you to prevent colds.
{17672}{17774}Prevents colds and flu,|that's what I take it for.
{17781}{17877}A Nobel Prize winner says that it|cures the common cold.
{18028}{18100}Pauling's belief in taking|large doses of vitamins
{18120}{18194}has inspired a whole new|breed of health advisors.
{18254}{18345}Patrick Holford is one of the|most popular and well known.
{18386}{18434}He is the author of|more than twenty books,
{18435}{18521}promoting the use of|supplements for good health.
{18522}{18605}This is vitamin A,
{18605}{18635}it's great for your skin.
{18685}{18784}He has founded an institute|for optimum nutrition.
{18915}{18957}This is vitamin B,
{18957}{18985}it's good for energy
{18986}{19032}and it helps to keep your mood even.
{19083}{19131}He believes that optimum health
{19132}{19178}comes from physical activity,
{19178}{19229}a good state of mind,
{19230}{19292}and a nutritious diet.
{19332}{19371}All topped up
{19372}{19426}with large daily doses
{19426}{19448}of vitamins.
{19728}{19795}I believe that taking|vitamin supplements,
{19796}{19854}not only adds years to your life,
{19855}{19926}but also adds life to your years.
{19987}{20020}Between them,
{20021}{20062}Pauling and the nutritionists,
{20062}{20137}have helped spawn a vast industry.
{20197}{20219}In supermarkets,
{20220}{20266}health food shops and chemists,
{20267}{20316}you can buy vitamin supplements.
{20317}{20370}All marketed as a safe,
{20371}{20443}natural way to help|you stay feeling good,
{20444}{20477}looking beautiful,
{20478}{20521}and being healthy.
{20591}{20622}In Britain alone,
{20623}{20699}we spend three hundred|million pounds a year
{20700}{20742}on these pills.
{20973}{21050}Carol Reed is a typical customer.
{21050}{21145}She buys some of the twenty million|pounds worth of vitamin C tablets
{21146}{21197}that are sold every year.
{21218}{21299}It is far and away the|most popular vitamin,
{21299}{21374}and she takes five|hundred milligrams a day,
{21375}{21459}nearly nine times the|recommended daily allowance.
{21489}{21516}And all because
{21517}{21611}she has complete faith in|the theory of Linus Pauling.
{21612}{21658}I take vitamin C
{21659}{21739}because I believe it actually|builds my immune system
{21740}{21776}to the extent that I can fight off
{21776}{21800}the common cold.
{21851}{21918}But does vitamin C really|prevent the common cold
{21918}{21967}as Linus Pauling believed?
{21987}{22064}What is the actual scientific evidence?
{22275}{22321}On America's west coast
{22321}{22385}is Oregon State University.
{22435}{22503}It is home to the|Linus Pauling Institute,
{22504}{22595}which was founded to continue|his research in to vitamins.
{22595}{22639}I think Linus Pauling
{22640}{22687}was one of the first to really
{22688}{22796}understand the role of|vitamins above and beyond
{22797}{22845}preventing deficiency disease.
{22846}{22903}And he called that|orthomolecular medicine,
{22904}{22975}so the right molecule at|the right concentration,
{22976}{23030}which can provide optimum health,
{23031}{23092}and not just prevent deficiency disease.
{23132}{23177}Professor Balz Frei
{23177}{23226}is one of the world's leading experts
{23226}{23257}on vitamin C.
{23318}{23355}He has studied the evidence
{23356}{23429}from clinical trials involving|thousands of volunteers
{23430}{23460}from across the world,
{23461}{23527}designed to investigate Pauling's claim
{23528}{23583}that large doses of vitamin C
{23584}{23633}fights the common cold.
{23714}{23772}And at first it seems
{23773}{23840}that Pauling really was on to something.
{23921}{23977}Vitamin C does have an effect
{23978}{24005}on the common cold,
{24006}{24076}once you've already caught it.
{24116}{24161}I think there is a role for vitamin C
{24162}{24236}in shortening the duration of|the symptoms of the common cold,
{24236}{24270}by about twenty per cent.
{24271}{24341}And ameliorating the symptoms,
{24342}{24429}so you're not as sick as without|taking vitamin C supplements,
{24429}{24474}and I think he was right with that.
{24545}{24630}But then Professor Frei|examined Pauling's central claim,
{24631}{24729}the idea that first sparked|the vitamin revolution.
{24750}{24859}The proper intake of vitamin C helps
{24860}{24919}keep one from catching colds.
{24939}{24987}And for this claim,
{24988}{25081}that huge doses of vitamin C|can prevent you catching colds
{25082}{25101}in the first place,
{25102}{25182}the results are very different.
{25233}{25294}I've looked at the evidence
{25295}{25352}that vitamin C can|prevent the common cold,
{25352}{25397}but for the general population
{25398}{25479}there is really no evidence|from scientific studies
{25480}{25542}that vitamin C can lower the|incidence of the common cold,
{25545}{25600}or prevent it in the first place. 
{25601}{25673}So taking vitamin C|supplements is not going to help
{25673}{25719}prevent the common cold.
{25770}{25802}In other words,
{25802}{25910}the director of the very institute|set up to pursue Linus Pauling's work,
{25910}{25995}now believes that the|great man was wrong.
{26036}{26094}Taking large doses of vitamin C
{26095}{26189}does not prevent you from|catching the common cold.
{26390}{26476}Of course, that won't stop|millions of people like Carol
{26477}{26510}from taking it.
{26540}{26593}The results of those trials|are not going to influence
{26596}{26666}the fact that I go out and buy|vitamin C on a regular basis,
{26666}{26726}and take vitamin C,
{26726}{26813}because for me taking a vitamin|C tablet will help my body,
{26814}{26865}prevent my body catching a cold.
{26915}{26986}And while Carol is unlikely|to be doing herself any harm,
{26988}{27095}the fact remains that the overwhelming|body of scientific evidence
{27096}{27158}says that for most people in Britain,
{27158}{27245}taking high doses of vitamin|C to prevent getting colds,
{27245}{27306}is a waste of money.
{27506}{27581}Of course, there are other|reasons why people decide
{27582}{27632}to take vitamin C supplements.
{27803}{27905}It's one of a special group of|vitamins called antioxidants.
{27905}{27948}Vitamins of such power,
{27949}{28006}the believers ascribe to them properties
{28007}{28059}that are truly remarkable.
{28089}{28156}I believe they can protect your brain,
{28157}{28189}your body, your arteries,
{28190}{28271}and not only slow|down the ageing process
{28271}{28313}but keep you free of diseases,
{28314}{28372}from heart disease, cancer, Alzheimer's,
{28373}{28451}all the tragedies of|twenty first century living.
{28492}{28591}These huge claims are all|because of how antioxidants work
{28592}{28682}on something in our body|called free radicals.
{28752}{28817}Free radicals are unstable molecules
{28817}{28857}that exist in our cells.
{28918}{28972}They attack other nearby molecules,
{28973}{29052}stealing an electron and with it an atom
{29053}{29093}to become stable again.
{29094}{29173}When the attacked|molecule loses that atom,
{29174}{29239}it becomes a free radical itself,
{29240}{29291}beginning a chain reaction.
{29402}{29493}Normally the body can|handle these free radicals,
{29544}{29597}but if there are too many,
{29597}{29705}cells can be damaged with|devastating consequences.
{29805}{29873}Free radical damage is associated|with a number of diseases,
{29873}{29911}like heart disease and cancer,
{29912}{29959}and macular degeneration,
{29959}{30048}but we also think that free|radical damage to cells and tissues
{30049}{30121}is a fundamental part of|the ageing process itself,
{30121}{30156}why we grow old.
{30157}{30186}It's in part due
{30187}{30230}to the activity of free radicals.
{30348}{30368}But antioxidants,
{30369}{30440}in particular vitamins A, C and E,
{30440}{30485}mop up the free radicals
{30486}{30553}and stop them from attacking our cells.
{30742}{30774}A simple demonstration,
{30775}{30824}with nothing more than a piece of steak,
{30825}{30897}can show just how good vitamin E is
{30898}{30954}at preventing free radical damage,
{30954}{31009}or oxidation.
{31064}{31102}When you look at it in the grocery store
{31102}{31143}it's red and beautiful.
{31143}{31275}That's the vitamin E that's|protecting the meat from oxidation.
{31276}{31320}What I'm going to show you
{31321}{31361}is what happens
{31362}{31435}if you destroy the vitamin E.
{31561}{31606}So we're going to take this chemical
{31607}{31711}and place it on the surface of the meat.
{31797}{31887}That's going to actually|destroy vitamin E.
{31965}{32006}Once the vitamin E is destroyed
{32006}{32103}the cells in the meat are|swamped by free radicals.
{32103}{32149}Within just a few minutes
{32150}{32235}the meat starts to|turn brown and rancid,
{32236}{32321}the cells have been fatally damaged.
{32526}{32571}And the same thing|would happen to your body
{32571}{32669}if you didn't have the|protective effect of vitamin E.
{32772}{32808}Many large studies have shown
{32808}{32876}that people who eat a|diet rich in antioxidants,
{32877}{32988}found in foods such as fruits,|vegetables, grains and fats,
{32989}{33059}live longer, healthier lives.
{33153}{33195}The studies that have been done
{33196}{33229}in respect of food
{33229}{33311}indicate that individuals|with a good quality diet,
{33312}{33365}with lots of anti-oxidant|vitamins present
{33365}{33439}have a decrease incidence|of the major diseases.
{33509}{33536}But some people think
{33537}{33603}that the amount of antioxidant|vitamins you can get,
{33603}{33645}simple by eating a balanced diet,
{33646}{33682}are not enough.
{33725}{33785}They believe that you|need to take much more,
{33786}{33852}and that means popping high dose pills.
{34011}{34044}Dina West is one of them,
{34045}{34152}she takes a high dose|vitamin E capsule every day,
{34152}{34275}it contains forty times the|recommended daily allowance.
{34350}{34400}Vitamin E is an antioxidant,
{34401}{34501}and it helps to fight|the nasty free radicals,
{34501}{34542}which are toxins.
{34542}{34581}And I like that,
{34582}{34653}I don't want anything nasty|racing around in my body
{34654}{34675}thank you very much.
{34675}{34723}And they help, they help me a lot.
{34790}{34843}But recently there's|been a piece of research
{34844}{34922}that suggests Dina could|be missing any benefit
{34922}{34976}from her vitamin E supplements.
{35041}{35072}And it's all because
{35073}{35100}of how she takes them.
{35101}{35140}She's often in a rush,
{35141}{35169}skips breakfast,
{35170}{35248}and so swallows her pills|with a glass of water
{35248}{35288}on an empty stomach.
{35525}{35603}The idea that Dina could be|missing any potential benefit
{35604}{35634}from vitamin E
{35634}{35746}came from Maret Traber at|the Linus Pauling Institute.
{35827}{35891}Vitamin E is a fat soluble vitamin,
{35892}{36010}that means it has to be eaten|with some fat to be absorbed.
{36010}{36149}So popping a pill just with water|on an empty stomach like Dina does,
{36149}{36220}might be almost no good at all.
{36435}{36508}In an experiment Professor|Traber gave volunteers
{36508}{36635}a vitamin E pill and a glass of|virtually fat free skimmed milk.
{36740}{36776}She then analysed their blood
{36776}{36834}to see just how much vitamin E
{36834}{36866}had been absorbed.
{36919}{36962}The results were striking.
{36963}{37085}When the subjects took their|vitamin E pill with a glass of milk,
{37085}{37141}hardly any was absorbed.
{37142}{37245}I think the implication of our study
{37245}{37335}is that if you take a vitamin E pill,
{37336}{37410}you'd better take it with some food,
{37411}{37459}you'd better take it with some food
{37460}{37489}that has fat in it,
{37490}{37560}or you're not doing yourself any good.
{37600}{37638}In other words,
{37639}{37683}if Professor Traber is right,
{37684}{37773}then anyone who takes|vitamin E without a fatty meal
{37774}{37829}could be wasting their time.
{37925}{37983}But there was something|unusual about her experiment.
{37983}{38071}Professor Traber used|specially manufactured pills,
{38072}{38156}she did not use a|commercially available product.
{38217}{38300}Horizon decided to investigate|Professor Traber's ideas further.
{38301}{38348}Just how important was it
{38349}{38440}to take a vitamin E|pill with a fatty meal?
{38522}{38561}We commissioned King's College London,
{38562}{38638}one of the world's leading|research centres on vitamin E,
{38638}{38680}to run the experiment.
{38710}{38782}In charge was Professor Frank Kelly.
{38870}{38959}The pills he would test had been|bought in a high street chemist.
{38959}{39046}Dina and four other volunteers
{39047}{39136}agreed to take part in|a ground-breaking study.
{39186}{39273}Each volunteer was told to make|sure they had an empty stomach,
{39274}{39335}then they were given a vitamin E pill
{39335}{39387}with three different drinks.
{39558}{39644}Day 1, a glass of|water and no fat at all.
{39717}{39745}Four days later,
{39746}{39808}a glass of full fat milk.
{40073}{40102}After another four days
{40103}{40148}we upped the fat content again
{40148}{40253}and gave them a milkshake|containing over forty per cent fat.
{40354}{40400}After each pill was taken,
{40401}{40465}the volunteers returned every four hours
{40466}{40494}to give a blood sample
{40495}{40601}so we could see how much of|the vitamin E they had absorbed.
{40823}{40870}If Professor Traber's theory was right,
{40871}{40951}the volunteers should absorb|very little of the vitamin E
{40951}{40999}when the pill was taken with water,
{41000}{41051}and they should absorb it very well
{41052}{41110}when it was taken with|the fatty milkshake.
{41311}{41347}With the blood samples complete,
{41351}{41416}Professor Kelly analysed the data.
{41601}{41655}And after several weeks|of nervous waiting,
{41655}{41710}Dina returned to get the results.
{41843}{41898}So, it's time for the, the truth.
{41899}{41921}Good.
{41921}{42029}Here are the results. You were|actually subject number 5 in the study.
{42031}{42043}Ok.
{42044}{42194}And you can see here|that this is with water.
{42199}{42210}Yes.
{42211}{42346}This is with full fat milk,|and this is with the milkshake.
{42347}{42427}So, contrary to our expectations.
{42428}{42446}Yes.
{42446}{42495}You actually have absorbed
{42496}{42548}as much with water
{42549}{42610}as with either the other two diets.
{42610}{42732}So, the water was as good for|you as the milk and the milkshake,
{42732}{42793}which as I say was a|surprising result to us.
{42795}{42885}Contrary to every thing|Professor Kelly expected,
{42886}{42945}the amount of fat taken with the pill
{42945}{43005}had made very little difference to Dina.
{43005}{43100}And it wasn't just Dina's|results that were a surprise.
{43101}{43191}The group overall|showed a similar pattern.
{43316}{43357}When Dr Kelly looked for an explanation
{43358}{43439}he found that the capsules|used in the Horizon experiment
{43439}{43497}contained a tiny amount of fat.
{43537}{43580}The fat is often added
{43581}{43626}to make the vitamin E more runny
{43627}{43666}and easier to handle.
{43667}{43719}But he hadn't suspected
{43720}{43774}that it was enough to allow absorption,
{43775}{43878}and it might explain|the unexpected results.
{43883}{43969}The only possible explanation|I have at this point is
{43970}{44060}that there was enough fat|in the vitamin E supplement
{44060}{44105}to allow that absorption to occur.
{44136}{44167}In other words,
{44168}{44288}it means that Dina can carry on taking|her vitamin E just as she does today.
{44359}{44429}However, most doctors recommend people
{44429}{44489}to get the vitamin E|they need from food.
{44489}{44619}And because the Horizon study was|small and tested only one product,
{44620}{44698}for people who decide to|take vitamin E supplements,
{44699}{44762}it may still be advisable to take them
{44762}{44840}after a meal to give|themselves the best chance
{44840}{44892}of absorbing the vitamin E.
{45036}{45087}But there is another antioxidant vitamin
{45087}{45112}which is popular
{45113}{45161}and about which scientists
{45162}{45206}are much more cautious.
{45277}{45302}Vitamin A.
{45332}{45425}In vegetables there is a|chemical called beta-carotene,
{45425}{45502}which your body|converts in to vitamin A.
{45503}{45608}It is found in carrots|and leafy green vegetables.
{45608}{45723}And it's seen to have an|extraordinary health benefit.
{45723}{45782}Studies have shown
{45782}{45846}that people who eat a|diet rich in beta-carotene
{45847}{45941}are much less likely|to develop lung cancer.
{45972}{46019}And this seemed to offer
{46020}{46061}a genuine breakthrough.
{46141}{46248}Demetrius Albanes is one of the|leading cancer experts in America.
{46288}{46355}He hoped that beta-carotene pills
{46356}{46439}could be a simple way to fight|one of our biggest killers.
{46490}{46575}So he and his colleagues|organised a study
{46575}{46622}to confirm that high dose pills
{46623}{46711}really could save millions of lives.
{46712}{46831}We were thoroughly expecting to see|a reduction in lung cancer incidents.
{46831}{46913}We designed the study|actually to be able to detect
{46914}{46984}at least a twenty|five per cent reduction
{46985}{47035}and I would say many of us at the time
{47036}{47156}would have estimated we might observe a|twenty five to fifty per cent reduction
{47157}{47192}in lung cancer.
{47293}{47386}Fifteen thousand people were given|high dose beta-carotene pills,
{47387}{47526}each one containing the|equivalent of six carrots.
{47576}{47676}To have the best chance of seeing whether|the pills really could prevent lung cancer,
{47677}{47756}they were given to people|most likely to develop it,
{47757}{47799}smokers.
{47938}{47999}For eight years a team of safety experts
{48000}{48052}monitored the volunteer's health.
{48052}{48141}And it seemed that everything|was progressing normally.
{48210}{48270}But then, just before|the trial was due to end,
{48271}{48333}they called a surprise meeting.
{48491}{48567}The key investigators were|called in to the committee,
{48568}{48637}and they informed us that we had some
{48638}{48734}effect happening with|respect to the beta-carotene.
{48871}{48970}They informed us that we in fact|had a small increase in lung cancer
{48970}{49009}in the beta-carotene group.
{49059}{49109}It seemed that beta-carotene pills,
{49109}{49187}which every one had hoped|would prevent lung cancer,
{49187}{49277}were having the exact opposite effect.
{49278}{49386}I think there was a|mass panic to begin with
{49387}{49466}because this is really the way|we expected the science to work.
{49496}{49558}It was a devastating result.
{49558}{49626}The people taking the pill had shown
{49626}{49697}an eighteen per cent|increase in lung cancer.
{49697}{49780}My first response on|hearing these results
{49781}{49868}was being stunned and|not really believing it.
{49868}{49905}I thought the results were a fluke.
{49946}{49996}But it was no fluke,
{49996}{50078}eighteen months later the|news about beta-carotene
{50079}{50122}got even worse.
{50183}{50273}Another similar study was|stopped two years early.
{50304}{50350}An interim analysis
{50350}{50447}showed that there was a|twenty eight per cent increase
{50448}{50501}in the number of lung cancers
{50501}{50572}in those taking the intervention.
{50592}{50655}Scientists still do not fully understand
{50655}{50735}why beta-carotene appears|so beneficial in food
{50736}{50826}but seemed to have such a|devastating effect on smokers
{50827}{50890}when taken in a high dose pill.
{50990}{51036}But because of these studies,
{51037}{51127}in 2003 safety experts in the UK
{51127}{51235}advise smokers not to take|beta-carotene supplements.
{51236}{51278}And advised everyone
{51278}{51367}to limit their daily|intake from high dose pills.
{51368}{51461}These studies were a salutary lesson
{51462}{51493}that vitamin supplements
{51493}{51564}were not just some|harmless natural remedy.
{51564}{51658}In high doses they could have unexpected
{51659}{51724}and dangerous consequences.
{51724}{51844}When the results of the adverse effects of|beta-carotene were confirmed in later studies,
{51844}{51916}we began to understand that high doses
{51916}{51998}in certain populations and|under certain circumstances
{51998}{52032}really could be harmful.
{52032}{52069}I think we learned a great lesson.
{52120}{52233}So great is the fear that large doses|of some vitamins can be dangerous,
{52233}{52302}that some scientists are|now sounding the alert
{52302}{52388}about another common form of vitamin A.
{52466}{52509}It's called retinol.
{52659}{52706}Maddie Walford is one of the many people
{52707}{52790}who take this type of vitamin|A supplement every day.
{52791}{52896}She takes a high strength pill
{52897}{52930}containing nearly three times
{52931}{53001}the recommended daily allowance.
{53114}{53160}The reason I take a|high strength vitamin,
{53160}{53213}to be honest I'm not quite sure,
{53213}{53274}but I thought it was probably|because it had more potency.
{53275}{53316}And would therefore,
{53317}{53360}therefore be you know worth the money.
{53481}{53566}But the idea that the more|vitamin A you consume the better
{53566}{53685}can lead to terrible|consequences if taken to excess.
{53792}{53851}Doctor Rob Goldin is a pathologist
{53851}{53903}at St Mary's Hospital in London.
{53906}{54028}He specialises in diagnosing|the cause of liver disease
{54033}{54125}and recently he was given a biopsy
{54125}{54188}from a sick patient in his thirties.
{54249}{54309}I was referred some|slides on a liver biopsy
{54310}{54350}from a patient of another hospital
{54351}{54401}to try and ascertain the|cause of liver disease
{54401}{54445}because there was no obvious cause.
{54547}{54576}The first thing I did when I examined
{54577}{54633}the liver biopsy was to look|for evidence of viral hepatitis,
{54634}{54666}or alcoholic liver disease,
{54667}{54706}the commonest cause of liver damage.
{54706}{54826}I couldn't see any of these.
{54886}{54948}So Doctor Goldin had to look
{54949}{54990}for another explanation,
{54991}{55040}and he knew that vitamin A
{55041}{55086}might hold the answer.
{55086}{55158}If you consume more vitamin A each day
{55159}{55198}than your body actually require
{55199}{55257}then the vitamin A will|accumulate in your body
{55258}{55315}because there's no|easy way of excreting it
{55315}{55363}and the place where it|accumulates is the liver.
{55383}{55459}Doctor Goldin then examined the sample
{55460}{55569}to look for the telltale|signs of vitamin A damage.
{55716}{55733}On this half of the screen
{55733}{55766}you can see some normal liver
{55766}{55814}with normal healthy liver cells.
{55880}{55905}On this half of the screen
{55906}{55940}you can see the liver|biopsy from the patient,
{55940}{56004}and in this slide the|scar tissue stains blue,
{56005}{56045}and you can see there's blue scar tissue
{56046}{56096}surrounding the liver cells.
{56191}{56240}Now the pattern of this|scar tissue deposition
{56241}{56278}in this patient made me think
{56278}{56329}that the liver disease|could be caused by vitamin A,
{56330}{56390}and that this could be the|explanation of his liver problems.
{56431}{56475}But surprisingly
{56475}{56521}the patient's medical records
{56522}{56602}made no mention of him|taking vitamin A supplements.
{56642}{56714}I contacted the clinician|at the referring hospital,
{56715}{56796}to check whether his patient had been|taking excessive amounts of vitamin A.
{56796}{56845}He went back to the patient.
{56921}{56996}On close examining the patient said|they had been taking excessive amounts
{56997}{57033}but hadn't mentioned this earlier
{57033}{57081}because he didn't consider|vitamin A to be a drug.
{57082}{57193}Cases like this are extremely rare,
{57194}{57253}they normally involve|taking the equivalent
{57253}{57316}of many high strength vitamin A pills,
{57316}{57379}every day, for years.
{57380}{57477}But they serve to remind|us all that vitamin A,
{57477}{57505}in the form of retinol,
{57506}{57540}although not a drug,
{57541}{57614}is a powerful chemical.
{57704}{57775}And today, the safe level|of vitamin A consumption
{57775}{57838}is the subject of fierce debate.
{57931}{57962}Patrick Halford recommends
{57962}{58046}people take 2500 micrograms,
{58046}{58133}that's over three times the|recommended daily allowance,
{58134}{58172}because he is convinced
{58172}{58231}that it will lead to better health.
{58232}{58309}Vitamin A is absolutely essential
{58310}{58359}for every single cell in the body.
{58360}{58443}It helps to protect your DNA,
{58444}{58498}it helps to keep your skin healthy,
{58499}{58584}it helps to protect your|body cells from infection.
{58585}{58644}So it's an essential vitamin,
{58644}{58675}you need it every day.
{58676}{58732}But in recent years
{58733}{58794}evidence has emerged that suggests
{58795}{58886}even this amount could be harmful.
{58889}{58983}And everyone needs to think carefully
{58983}{59073}about the amount of|vitamin A they consume.
{59200}{59243}Sweden is a prosperous country,
{59244}{59311}where people live|long and healthy lives.
{59362}{59477}But surprisingly it has one|of the world's highest rates
{59477}{59599}of a debilitating disease, osteoporosis.
{59749}{59821}It most often affects women over fifty.
{59824}{59891}And its crippling condition
{59892}{59951}gradually thins and weakens your bones,
{59952}{60014}increasing the risk of fracture.
{60139}{60194}But for years it has been a mystery
{60195}{60248}why the disease is so common.
{60279}{60362}When we look at known risk|factors for osteoporosis,
{60362}{60431}such as age, smoking, physical activity,
{60432}{60477}they can partly explain
{60477}{60585}why it's so common with osteoporosis|and bone fractures in Sweden,
{60586}{60642}but that can not explain everything.
{60643}{60690}And then, even more surprising,
{60691}{60763}is that we have a diet rich in calcium,
{60764}{60810}which should protect our bones.
{60816}{60920}So Professor Melhus began to|look for another explanation.
{60967}{61053}And there was something in|particular about the Swedish diet
{61053}{61116}that made him suspicious.
{61187}{61257}It was exceptionally high in vitamin A.
{61278}{61338}We eat dairy products,
{61338}{61376}oily fish,
{61376}{61413}such as herring and salmon,
{61413}{61458}we consume cod liver oil,
{61459}{61506}vitamin supplements,
{61507}{61575}all which contain high|levels of vitamin A,
{61575}{61603}and on top of that
{61604}{61653}we are the only European country
{61654}{61738}which fortifies low fat|dairy products with vitamin A.
{61799}{61878}This triggered an alarm|for Professor Melhus.
{61879}{61931}Because there was evidence
{61932}{62023}that huge doses of vitamin|A damaged animal bones.
{62044}{62133}Since we knew about these|harmful effects of vitamin A
{62133}{62169}on animal bones,
{62170}{62253}we wanted to see if this also|could be occurring in humans.
{62433}{62512}So Professor Melhus launched|his own investigation.
{62513}{62625}From a database of sixty six|thousand women aged over forty,
{62625}{62712}he looked for cases of bone fracture.
{62717}{62803}He then checked the diet of these women
{62803}{62846}to see if their vitamin A intake
{62847}{62891}was particularly high.
{62941}{63036}And the results seemed|to confirm his suspicions.
{63056}{63117}When I saw the results from our study
{63118}{63160}I was really surprised,
{63160}{63255}although I knew the|experiments done in animals,
{63256}{63331}it was hard to accept|the fact that vitamin A,
{63331}{63430}a vitamin, had negative|effects on bone in humans.
{63471}{63562}Professor Melhus then went further.
{63563}{63688}He did a series of bone scans to|work out what level of vitamin A
{63689}{63748}was linked to weaker bones.
{63883}{63927}His results suggested
{63928}{64032}that long term consumption of even|relatively small quantities of vitamin A
{64032}{64093}were having a dramatic effect.
{64098}{64259}What we saw was that a vitamin|intake above 1.5 milligrams per day,
{64260}{64357}which is approximately twice|the recommended daily intake,
{64358}{64450}there was a reduction in bone|density about ten per cent,
{64451}{64521}and the risk of hip|fracture had doubled.
{64571}{64620}If Professor Melhus was right
{64621}{64689}then the implications were staggering.
{64698}{64806}An intake of 1.5 milligrams per day
{64807}{64885}is a level that can be|reached from food alone.
{64896}{64993}And it will be exceeded by|taking just a single capsule
{64994}{65079}of some high strength|vitamin A supplements.
{65080}{65166}So, tablets that people take every day
{65167}{65244}to improve their health|might actually be slowly,
{65245}{65324}silently, weakening their bones.
{65477}{65503}For Professor Melhus,
{65503}{65555}the implication is clear.
{65556}{65612}Based on our research
{65612}{65681}I think people should|continue to eat a healthy,
{65682}{65714}normal balanced diet.
{65715}{65833}But since supplements containing|high levels of vitamin A
{65833}{65870}may have adverse effects,
{65870}{65934}I cannot recommend people|to take them routinely.
{65965}{66043}Professor Melhus has|now done another study
{66044}{66122}that suggests the same|risk also applies to men.
{66193}{66256}And since his original work,
{66257}{66344}studies from America have|supported his findings,
{66344}{66416}but there has been some other research
{66417}{66480}which has not found the same link.
{66496}{66596}The evidence linking osteoporosis with,
{66597}{66672}with relatively small amounts|of vitamin A consumption,
{66673}{66728}I'm not convinced by it.
{66729}{66821}There are, there are studies|that show no such link,
{66821}{66863}and it simply doesn't make sense,
{66864}{66905}because we're talking about levels
{66906}{67027}that we could easily eat and|have eaten for millions of years.
{67028}{67098}So at the moment I'm|simply not convinced.
{67195}{67288}But some scientists see the|research very differently.
{67338}{67396}Professor Andrew Renwick
{67397}{67448}is a clinical pharmacologist
{67448}{67488}at Southampton University,
{67489}{67578}and one of Britain's leading|experts on vitamin safety.
{67619}{67694}For four years he was part|of an independent committee
{67695}{67781}advising the government|on the safety of vitamins.
{67792}{67942}He takes the emerging evidence|about vitamin A very seriously.
{67943}{67979}I am concerned,
{67979}{68092}although the, the evidence|is not totally consistent,
{68092}{68156}there have now been a number|of studies showing a link,
{68157}{68237}and I'm convinced that a|high intake of vitamin A
{68238}{68306}will give an increase|risk of bone fracture.
{68357}{68459}In 2003, the safety committee|Professor Renwick was part of
{68460}{68518}reported that they could not yet define
{68519}{68608}a safe maximum intake of vitamin A.
{68619}{68691}But they did sound a warning.
{68711}{68759}We evaluated all the data,
{68760}{68873}and concluded that an intake of more|than fifteen hundred micrograms per day,
{68873}{68945}of vitamin A, could be inappropriate.
{68945}{69034}Primarily because of an|increased risk of bone fracture.
{69039}{69156}Fifteen hundred micrograms is|less than the amount found in some
{69157}{69209}high dose vitamin A supplements,
{69210}{69262}available over the counter.
{69332}{69450}Maddie Walford has been taking a pill|containing over two thousand micrograms
{69451}{69516}of vitamin A for more than a year.
{69537}{69608}We asked Catherine Collins,
{69609}{69681}chief dietician of St|George's Hospital in London,
{69682}{69779}to analyse her diet and|advise her what to do.
{69839}{69902}What you can see from|our dietary analysis
{69902}{69966}is that you've actually|got a very healthy diet.
{69967}{70042}When we look at your vitamin A level,
{70043}{70097}we can see that you're|getting the full amount of
{70098}{70130}vitamin A you need in your diet,
{70130}{70179}from your small amount of animal source
{70180}{70239}and the rest of the fruits|and vegetables that you eat.
{70239}{70261}Right.
{70262}{70324}What is of concern is the|fact that you're taking
{70324}{70376}a very high dose|supplement of vitamin A.
{70376}{70395}Oh right.
{70396}{70501}And at this level there is a potential|risk of you developing osteoporosis
{70502}{70543}and fracture risk with long term usage.
{70544}{70557}Right.
{70558}{70633}Do you think that with the|amount of vitamin I've been taking
{70633}{70688}for the length of time I've been|taking it I will have done myself any,
{70689}{70724}any physical damage?
{70725}{70782}If you've only been taking|this for a year or so
{70783}{70818}it's probably fine.
{70818}{70898}But it's not a supplement we'd|recommend you take long term.
{70899}{70970}It certainly is associated|with an increase fracture risk.
{70981}{71083}I was very surprised about|the link between osteoporosis
{71084}{71102}and vitamin A
{71103}{71134}and risk of fracture,
{71135}{71220}because I'd never associated|vitamin A with osteoporosis.
{71241}{71309}It's definitely changed|my mind about taking that,
{71309}{71363}I'm actually going to be|stopping it as of today,
{71364}{71433}because it clearly doesn't|do any good for me personally,
{71434}{71469}and it might do more harm than good.
{71499}{71546}Vitamins without doubt
{71546}{71595}are vital to our health.
{71596}{71644}And it remains possible
{71644}{71700}that high dose vitamin supplements
{71700}{71778}will one day be proven to|protect against illnesses
{71778}{71839}like heart disease and cancer.
{71839}{71935}But so far, definitive|evidence for these claims
{71935}{71999}remains largely elusive.
{72039}{72103}And as we discover more|about some vitamins,
{72104}{72159}it is increasingly clear
{72159}{72241}that in large doses|they can have unexpected,
{72241}{72328}and sometimes dangerous consequences.
{72329}{72479}Until we understand more|about these powerful chemicals,
{72479}{72544}most doctors would advise everybody
{72545}{72669}to seek advice before joining|the high dose vitamin revolution.