One take-home message is that all fats are not created equal. Perhaps we already knew that. But in the largest-ever study of its kind, the investigators have shown that a controlled diet–modelled after the “Mediterranean diet”–can have a big impact on the heart in a relatively short period of time.
In the past few weeks, 3 scientific articles about vitamins caught my eye. Two articles published in the Journal of the American Medical Association reported on findings from the Physicians’ Health Study II Randomized Control trial of multivitamins–in the areas of cancer prevention and cardiovascular disease prevention. The third article reported on a survey of Canadian high-performance athletes and their dietary supplement practices.
Multivitamins and Cancer Prevention 
Multivitamins are the most common dietary supplement in the United States, used by as many as 30% of Americans. Data regarding their efficacy in preventing various forms of chronic disease have often been conflicting. As a result, in 2006 a National Institutes of Health consensus conference could offer no specific recommendation regarding the use of multivitamins to prevent chronic disease.
The Physicians’ Health Study II is an investigation that involved 14,641 American male physician subjects (mean age, ~64 years) who were randomized to receive either a daily multivitamin or a placebo tablet. Enrollment began in 1999 and follow-up continued for a mean of 11.2 years. At 4 years, the compliance rate (the percentage of subjects still taking the multivitamin or placebo) was approximately 70% and this declined further to approximately 67% by the end of the study period.
Compared with placebo, the subjects taking a daily multivitamin had signficantly fewer total cancers develop during the study period (17.0 vs. 18.3 cancers per 1000 person-years). It appears that multivitamin use did not affect the incidence of new prostate or colon cancers. And despite the findings regarding total cancers, there was no difference in cancer mortality between the 2 groups.
The investigators concluded that daily multivitamin use produced a small but meaningful reduction in cancer incidence. Whether the findings can be generalized to a broader population (including women and younger individuals) is not certain.
Multivitamins and Cardiovascular Disease Prevention 
Also from the Physicians’ Health Study II, but reported separately and more recently, the investigators studied several cardiovascular endpoints, including: composite end point of major cardiovascular events (nonfatal myocardial infarction [MI] plus nonfatal stroke plus cardiovascular death) and separate end points of MI or stroke, alone.
The study design was the same as noted above for the multivitamin study.
It turns out that multivitamin use was not associated with a discernible reduction in any of the end points studied. Essentially, a negative study. Again, whether the findings might be generalizable to a broader population is not certain.
Athlete Supplement Survey 
In a 2012 report in the International Journal of Sport Nutrition and Exercise Metabolism, a group of investigators from Calgary reported on a survey that was administered to 440 elite athletes (mean age, ~20 years) from a variety of sports who were affiliated with that country’s 8 Canadian Sport Centres. The top 10 sports represented included “athletics,” but did not include triathlon or cycling. The represented sports included endurance as well as power sports.
The survey results noted that 87% of athletes had taken at least 3 supplements during the preceding 6 months. The most common supplements were: sports drinks, in 24%; multivitamin and minerals, in 16%; and carbohydrate sports bar, in 11%.
Interestingly, among athletes training 21-25 hours per week, multivitamin use was reported by 63% of athletes and the usage was 59% in those training >25 hours per week.
Athletes reported a variety of sources for their information about supplements, including: family and friends, in 20%; strength trainer, in 14%; and teammates in 11%. Physicians were reported as an information source by only 4% of respondents.
For athletes, there may well be a need for vitamin supplementation and a daily multivitamin is probably the easiest and safest way. The scientific literature regarding mega-dose supplementation with various individual vitamins as well as the relationship between vitamin supplementation and performance remains murky at best. I’m not certain the Physicians’ Health Study is particularly applicable to young, healthy athletes, but it appears there might be a small benefit in terms of cancer prevention but no benefit in terms of prevention of cardiovascular disease. Given the complexities of cancer and cardiovascular disease, many authorities would say the findings aren’t surprising.
The Canadian athlete survey is interesting because I’ve seen very little simple reporting on dietary supplementation practices among athletes. It would be fascinating to see such information about age-group participants in running, cycling, swimming, and triathlon. What’s clear from the Canadian study is that athletes’ information about supplementation may not come from the most authoritative sources and the medical and sports physiology communities could probably do a better job with their educational roles.
1. Gaziano JM et al. Multivitamins in the prevention of cancer in men: the Physicians’ Health Study II randomized controlled trial. JAMA 2012;308:1871-1880.
2. Sesso HD et al. Multivitamins in the prevention of cardiovascular disease in men: the Physicians’ Health Study II randomized controlled trial. JAMA 2012;308:1751-1760.
3. Lun V et al. Dietary supplementation practices in Canadian high-performance athletes. International J Sport Nutrition Exercise Metabol 2012;22:31-37.
I’ve gotten several inquiries lately about (heart) healthy eating for athletes, asking about print or online resources for additional information.
I thought I’d draw your attention to a terrific online resource….the blog of my friend, Vince Matteo. You’ll see that he writes creatively about a variety of triathlon-related topics, but you should check out the “What’s for Dinner?” section, where he keeps what he calls a “recipe blog,” complete with pictures. I’ll put a link on my front page.
Recent recipes include:
Quinoa Veggie Stir Fry
Stuffed Bell Pepper with Salsa Verde
Pressure Cooker Pasta Dinner
Chicken Breast Chili
You can also follow Vince on Twitter at @felog and hear about new recipes as they’re posted. Like I said….a useful resource for athletes of all sorts.
Losing weight seems like such a simple thing, but in fact it is hard for many people. With well known diets on the market such as The South Beach Diet and Atkins’ Program, many have jumped on the low carbohydrate bandwagon. But what about athletes that need protein and carbohydrates to sustain energy? These types of diets do not address their needs. While they both advocate adequate protein, the carbohydrate levels are too low for anyone in sports activities or bodybuilding.
Athletes use carbohydrates for energy just before an event or competition. Also they need adequate amounts of protein because it helps to repair damaged muscle. A diet for athletes must meet these requirements. One such diet is The Mediterranean Diet. This diet advocates the use of grains, dairy and fats such as olive oil. Olive oil is good for your heart and also lowers cholesterol; Italians eat olive oil on their bread instead of butter or margarine. People living in the Mediterranean have eaten this way all their lives and are very healthy.
The diet is named after the area where it originated and is associated with good health and a long life. The dietary lifestyle of Italy and Greece has shown consistent low mortality rates for the past 25 years. The basics of the diet include whole grains, fruits and vegetables, poultry, eggs, and fish, nuts and seeds, cheese and yogurt, olive oil and a limited amount of red meat.
The diet focuses on healthy fats, whole grains, fruits and vegetables and protein. Complex carbohydrates break down slower in the digestive system and keep energy levels sustained. This makes the diet perfect for runners and triathletes. And although athletes normally limit the consumption of alcohol, one glass of wine a day is allowed.
An example of the daily menu:
Breakfast: Coffee, Oatmeal and whole wheat toast
Lunch: Pasta e Fagioli (pasta with navy beans), salad and piece of fruit
Dinner: Fish with vegetables and fruit for dessert
Some of the benefits of the Mediterranean Diet:
Lowered incidences of heart disease and lowered cholesterol. Studies done in Europe have shown this type of diet to reduce metabolic syndrome which is a precursor to Type 2 Diabetes. Also lower obesity rates, heart disease, cancer and high blood pressure. It is believed that this type of diet also promotes longevity and increases life expectancy.
The Mediterranean Diet is healthy, well balanced and perfect for anyone who wants to lose weight. This diet is approved by doctors and The American Medical Association.
About the Author
Valery Fortie is the Awareness Coordinator of the Mediterraneanbook.com organization. She is also the editor of the blog behind it. She focus her efforts to provide scientifically driven news on healthy Mediterranean Diet eating and drinking to prevent high blood pressure. Mediterraneanbook.com is a non commercial website created to preserve the Italian healthy eating traditions. Founded in 2004 in Italy, Mediterraneanbook.com feels very strongly about having informed consumers on duty in all healthy eating fields.