No doubt every Gold Coast and Australian female sat up and took notice with the recent news that multivitamins increased the risk of breast cancer. Now normally I try and stay as far away as possible from female problems – you only have to read the cover of ‘Men are from Mars & Women are from Venus’ to understand that we are on totally different planets. However this news definitely registered with me. Especially as I recommend a good multivitamin to all my female training clients and the fact I had a host of Gold Coast’s top personal trainers emailing me asking for my opinion on this news.

The Swedish study that prompted this news was published electronically in March and is due for hard copy publication in the American Journal of Clinical Nutrition in May. They found that there was a 19% increased risk of breast cancer among female multivitamin users after adjustment for other breast cancer risk factors¹. The study also suggested that increased levels of folic acid from the multivitamin could compound this risk as it was linked to an increase in breast density – which is a strong indicator of breast cancer risk.

In the same week, another study that conflicted with these results was presented at the American Association for Cancer Research 101^st Annual Meeting. This study from the Ponce School of Medicine in Puerto Rico found that there was a 33% decrease in risk of breast cancer if you consumed a multivitamin². Independent of this was that the study also found a 41% decrease in breast cancer risk associated with calcium supplementation. The researchers concluded that the reason behind these results was that multivitamins increases the body’s ability to repair its damaged DNA. The reason why this DNA repair capacity is so important is that for every decreasing percent point in your capacity, your odds of getting breast cancer increase by 1.9 times². Now this study was the first to show that multivitamin (& calcium to a degree) intake could improve DNA repair capacity and the researchers backed their conclusions up with a validated blood samples. The lead researcher Dr Matta suggests taking a multivitamin – “it is a cheap insurance policy”.

So what to make of all these two different results?

Well to start with the first study from Sweden’s results were barely significant according to a number of academics, including Professor John Forbes who is one of Australia’s leading breast cancer researchers. Secondly epidemiological studies like the Swedish research can only suggest relationships between risk of disease and certain factors. These studies cannot determine the actual cause of the cancer i.e. that multivitamin intake caused the cancer. To highlight this, I will give you an example adjusted for obesity in Australia. We all know the rate of obesity increased dramatically while John Howard was in the prime minister’s office. Therefore, John Howard caused the increase in obesity in Australia. Do you see where I am going with this? It also should be pointed out, that the Swedish studies findings are in conflict with the vast majority of other large-scale studies including our aforementioned Puerto Rican one. 

Overall studies on multivitamins and minerals do not show any significant increase in risk when taking multivitamins^3,4,5,6. To be fair, most studies do not show any significant decrease in the risk of breast cancer for most people either. With breast cancer if you consume alcohol regulary⁷ or are at risk of developing estrogen receptor (ER) or progesterone receptor (PR) breast cancer⁶ however, the research is very clear – multivitamins will help decrease your cancer risk.

Well firstly I would suggest you keep taking your multivitamin. We know that it does not cause breast cancer nor any other type of cancer^3,4,5,6 and there are a number of other benefits you get from regular consumption of a multivitamin. 

One of these is that experts on the stress hormone cortisol consider your daily multi your first line of defense against stress⁸. Secondly, body fat stores toxins right? It is one of the reasons why we are told not to eat the fat of commercial meat. So when we lose body fat, we are releasing a whole heap of toxins into the body. If you do not have adequate vitamin and mineral status you need vitamins to bind or ‘chelate’ these toxins and get them out of the body, we actually become more toxic. This is one reason we so many people stall with their weight loss attempts when on a diet or personal training. 

Another great reason for using a multi is that, as Dr. Matta from the Puerto Rican study says, it acts as a cheap insurance policy; especially against malnutrition. Malnutirtion I hear say? I know you all thought the major problem we had now was ‘over nutrition’. And it is (kind of) but malnutrition is actually a major issue in the modern world. Why? Dr Rakowski highlighted this recently when he mentioned it takes 17 elements to make a healthy plant. With fertilizers depleting the soil, we only replenish three of those essential elements. So therefore the plants are malnourished, the animals eating the plants are malnourished and the animals (i.e. humans) eating the animals and the plants are malnourished also. Dr Rakowski also pointed out that research has also shown that we cannot reestablish these depleted systems with a great diet alone. These three reasons are not the only reasons why a multivitamin is a good idea for your health but they are definitely some of the major ones.

Ok so I am going to keep taking it but what kind of Multivitamin to use?

Now if you are going to use a multivitamin, make sure it is a high quality one. This was one aspect of all these studies which should have been considered when designing the study and reporting the results. I would hazard a guess that these results would be much clearer if the researchers had distinguished between high quality vitamins versus low quality products.

This is because all multivitamins are not created equal – what you get from a GMP certified product is vastly different from an off the shelf multi from the local supermarket. I definitely recommend you follow the advice of Jonny Bowden here when he says ‘there are three things in life not to buy cheap – parachutes, scuba diving gear and supplements.’ 

Because of this, I recommend Poliquin, Thorne or Metagenics lines of practitioner range supplements to my Gold Coast personal training and exercise physiology clients. The advantage with Poliquin’s line for those that are not on the Gold Coast, is that you do need to see a practitioner to purchase his top products. 

The last things to be aware of is that if you want a good multivitamin for men, you should purchase an iron free version due to iron toxicity reasons – CLICK HERE.

On this metallic subject, because of regular menstruation, most females should use a multivitamin that contains iron – CLICK HERE. 

Lastly if you want a multivitamin for your children, try these chewable versions - CLICK HERE.

 

1. Larsson S et al., “Multivitamin use and breast cancer incidence in a prospective cohort of Swedish women”, American Journal of Clinical Nutrition (May, 2010), 91(5):1268-72. Epub Mar 24 2010.

2. American Association for Cancer Research (AACR) 101st Annual Meeting: Abstract 4568. Presented April 18, 2010.

3. Meulepas, JM et al., “Multivitamin supplement use and risk of invasive breast cancer”, Public Health Nutr. 2009 Dec 3:1-6.

4. Neuhouser ML et al., “Multivitamin use and risk of cancer and cardiovascular disease in the Women's Health Initiative cohorts”, Arch Intern Med. 2009 Feb 9;169(3):294-304.

5. Feigelson HS, Jonas CR, Robertson AS, et al., “Alcohol, folate, methionine, and risk of incident breast cancer in the American Cancer Society Cancer Prevention Study II Nutrition Cohort”, Cancer Epidemiol Biomarkers Prev 2003;12:161–4.

6. Ishitani K, Lin J, Manson JE et al., “A Prospective Study of Multivitamin Supplement Use and Risk of Breast Cancer”, American Journal of Epidemiology. 2008;167(10):1197-1206. 

7. Zhang S, Hunter DJ, Hankinson SE, et al. A prospective study of folate intake and the risk of breast cancer. JAMA 1999;281: 1632–7

8. Talbott SM. “The Cortisol Connection: Why Stress Makes You Fat & Ruins Your Health - And What You Can Do About It”, Hunter House: Alameda CA (2007)