Dr Paul Clayton 2013


Regular readers of my newsletter know my position on supplements by now. Unlike the
nutritionists and medics who insist, against all the facts, that we can obtain all the micro- and
phyto-nutrients we need in a well-balanced diet, our position is science-based. There is a
wealth of evidence that most people are depleted in most nutrients(1-3) and that this is a
cause of widespread ill health, and health care costs of €170 billion a year in Europe alone.(4)

A tragedy – but utterly predictable and easily avoidable. Today’s low-energy lifestyles mean
that most folk do not consume more than 2,000-2,500 calories a day, but we were not
‘designed’ to live at such low energy levels. New calculations show it takes 3,000-3,500
calories of a nutrient-dense and well-balanced diet (full of chicken liver, oily fish, wheatgerm
and 7 or more portions of fruit and vegetables every day) to get everything needed for
sustained good health(5). This is manageable if you are an athlete or a manual worker with a
healthy appetite and a strong stomach! But for the great majority of us whose occupations and
lifestyle make such a diet unsustainable, the case for supplements is overwhelming.

The basic arguments were laid out in a series of three papers, published in the Journal of the
Royal Society of Medicine back in 2008,(6-8) which indicated that improved diet could cut
the burden of chronic degenerative disease by up to 90%. The authors are currently working
with a team of med-economists on a fourth paper which derives the public health savings
that would be made by improving our diet; the preliminary findings indicate that public health
costs could be cut by over 50%.(9)

These figures are staggering, but a new report from industry experts Frost & Sullivan goes a
long way to substantiating them.(10) This focuses mostly on North America but its
implications are almost universal. The research team conducted a systematic review of
hundreds of scientific studies on eight dietary supplement regimens across four diseases to
determine the reduction in disease risk from these preventive practices. The group then projected the rates of medical events across the high-risk populations and applied cost benefit
analyses to determine the cost savings if people at high risk took supplements at preventive
intake levels.

The supplement regimes they screened are outlined in the table below.

FROST & SULLIVAN TABLE OF POTENTIAL SAVINGS BY SUPPLEMENT USE
Supplement – For disease – Savings per year
Calcium + Vitamin D – Osteoporosis – $ 1.08 billion
Magnesium – Osteoporosis – $ 530 million
Lutein + Zeaxanthin – Age-related eye disease eg. AMD, cataract – $ 930 million
Omega 3 – Coronary Heart Disease (CHD) – $ 930 million
B vitamins B6, B12, Folic Acid – Heart disease – $ 560 million
Dietary fibre eg. psyllium – Heart disease – $ 2.3 billion
Phyto-sterols – Heart disease – $ 3.3 billion
Chromium picolinate – Diabetes-induced Heart disease – $ 970 million

These items alone amount to total annual savings of $12.5 billion – a considerable sum,
even in these inflationary times. How accurate is this accounting? There is a good deal of
uncertainty with the figures, but I submit that they are actually a gross under-estimate of the
savings that could be made.

To begin with, most micro- and phytonutrients exert multiple protective effects. Omega-3, for
example, not only reduces cardiovascular deaths but also depressive illness and self-
harm, up to and including suicide.

More seriously, the above supplement regimes are out of date and sub-optimal.

If you really wanted to reduce coronary heart disease, you would be foolish indeed to rely on
just Omega-3s, B vitamins, psyllium and phytosterols. If you based your cardioprotective
regime on up-to-date science you would replace the phytosterols and psyllium
and extend your supplements to the following.

SUPPLEMENTS FOR CORONARY HEART DISEASE updated
Omega 3 from fish oil – Helps lower blood pressure, reduce blood fat levels, cut risk of heart attacks.
B vitamins B6, B12, Folic Acid – B-complex vitamins are essential to produce energy and repair DNA
Polyphenols plant-derived compounds in fruit and vegetables, such as green tea, grapeseed, curcumin
Mixed tocopherols and tocotrienols – Compounds with powerful vitamin-E activity, but each with a different biological action
Carotenoids and xanthophylls – Anti-inflammatory and anti-oxidant eg. beta carotene, lutein, lycopene
Soy isoflavones – Associated with improved glucose metabolism
Vitamins C, D, K2 Selenium – K2 is especially important for cardiovascular health

Such a regime would cost more, but the overall savings would likely be an order of magnitude
greater.

And if you were to cut out fast foods—cooked at high temperatures, which produces higher
levels of pro-inflammatory toxins—your level of protection would be even higher.

Similarly, a supplement to reduce the risk or impact of diabetes would include not just
chromium, but also many of the above, as they all have powerful anti-inflammatory benefits,
and we know that diabetes is driven by chronic inflammation.

It’s noticeable that the Frost & Sullivan report does not mention or calculate the potential
impact of supplements on cancer health care costs. While this is possibly to avoid being
contentious, recent research indicates that chronic inflammation in tissues creates the
conditions in which cancer is far more likely to spread. So—again—a truly comprehensive
supplement should produce significant reductions in cancer care costs too.

REFERENCES

1. Krebs-Smith SM, Guenther PM, Subar AF, Kirkpatrick SI, Dodd KW. Americans do not meet federal dietary recommendations. J Nutr. 2010 Oct;140(10):1832-8
2. Fulgoni VL 3rd, Keast DR, Bailey RL, Dwyer J. Foods, fortificants, and supplements: Where do Americans get their nutrients? J Nutr. 2011 Oct;141(10):1847-54
3. Troesch B, Hoeft B, McBurney M, Eggersdorfer M, Weber P. Dietary surveys indicate vitamin intakes below recommendations are common in representative Western countries. Br J Nutr. 2012 Aug;108(4):692-8
4. MNI Report. ESPEN, Barcelona 2012
5. Clayton P. Out of the Fire (PharmacoNutrition Press, October 2013)
6. Rowbotham J, Clayton P. An unsuitable and degraded diet? Part three: Victorian consumption patterns and their health benefits. J R Soc Med. 2008 Sep;101(9):454-62.
7. Clayton P, Rowbotham J. An unsuitable and degraded diet? Part two: realities of the mid-Victorian diet. J R Soc Med. 2008 Jul;101(7):350-7.
8. Clayton P, Rowbotham J. An unsuitable and degraded diet? Part one: public health lessons from the mid-Victorian working class diet. J R Soc Med. 2008 Jun;101(6):282-9.
9. Clayton P, Rowbotham J. Personal communication 2013
10. Shanahan C, de Lorimier R. 2013. Smart Prevention—Health Care Cost Savings Resulting from the Targeted Use of Dietary Supplements. www.crnusa.org/CRNfoundation/HCCS/chapter/CRNFrostSullivanfullreport0913.pdf