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Dr. Bernard Presser D.C.
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If asked about the difference between natural and synthetic vitamins, Dr. Royal Lee would become animated and say: "Well, I'm glad that question came up." A mini-lecture would follow beginning with: "One is a chemical and one is a living thing...." He emphatically believed that people should understand the difference. Today, the issue of distinguishing between isolated or manufactured chemical ‘nutrients' versus whole, natural biochemical food complexes is still urgent, still must be explained and emphasized. Just as the body knows the difference between grape-flavored juice or artificially-flavored grape candy and whole real grapes, it knows the difference between a separated chemical or a synthetic imitation and a real, multifaceted food. Look at antioxidants, for example.
The current theory is that antioxidants are "nutrients that prevent the production of free radicals, those unstable molecules that can attack healthy cells and lead to cancer, cardiovascular disease, aging processes and complications with diabetes," among other disorders "thought to be related to increased free radical formation." It is believed that the major culprit in free radical formation is oxidation - the same metabolic function that provides the body with fuel. In the process of being broken down for energy, oxygen molecules lose an electron, become unstable, and seek out a stable molecule from a "healthy" cell to pair with. This is thought to create more dangerous, unstable molecules. Antioxidants serve as "electron donors" which deactivate these molecules, preventing them from injuring cells.
However, the above process has only been observed under microscopes (in vitro) and then interpreted. Assumptions have been made in applying it to what goes on inside the living human body, but these have never been confirmed. Some scientists believe "free radicals" are a result of tissue insult, injury, or breakdown rather than a cause of damage.
Antioxidants, ‘against oxidation,' are protective against premature breakdown. In foods, antioxidants protect functional portions of nutrient complexes. They are like the shell of a nut, the skin of a banana, the hull of a grain, the rind of an orange. When they are broken or removed, the food begins to spoil or oxidize faster than if the protective shield were left intact. Thus, ascorbic acid is the antioxidant which serves with and protects the functional aspects of the vitamin C complex. Alpha-tocopherol is one of several tocopherols that prevent premature rancidity of other functional parts of the vitamin E complex. Some nutrients can play incidental antioxidant roles such as beta-carotene, other carotenes, selenium, flavonoids, and many others which are portions of complexes and have multiple roles. Taken into the body as isolated supplements, antioxidants can provide some protection to the natural cofactors normally found with them in food complexes. For example, tocopherols help protect the other functional constituents of the vitamin E complex that are present in the body. However, especially if synthetic, much or most of separated antioxidants are lost through the kidneys. High dosages have drug effects, can cause deficiencies of other portions of their natural complexes, and can cause imbalances. It is like eating the skin of a banana but not the banana, disregarding the protected portion which has the highest nutritional value.
It is not surprising, then, that isolated, often synthetic, antioxidants "flunk" in many scientific trials. For instance, a mixture of alpha-tocopherol (so-called ‘vitamin E'), ascorbic acid (so-called ‘vitamin C') and beta-carotene (one synthetic isolate out of hundreds of carotenes) failed to reduce the risk of heart disease in a study of more than 20,000 people aged 40 to 80. In another trial, 9,540 people with heart disease were put on either daily alpha-tocopherol or placebo; after 4½ years, those taking tocopherol had no fewer heart attacks or strokes than the others. Laboratory mice with brain tumors were given synthetic vitamins A and alpha-tocopherol while controls were given no supplements.
After four months the latter group had smaller tumors and more die-off of diseased and damaged cells. The "vitamin" takers fared worse than those without! Two studies (Rush and Rotterdam) looked at Alzheimer's disease and antioxidant intake. Both found that food was a key to risk reduction and to higher scores on mental status tests. A high intake of foods rich in vitamin complexes C and E was associated with the lower risk, but use of supplements of isolated vitamins was not.
When supplements of separated fractions are tested in intervention trials, results are "sometimes extraordinarily promising" (e.g., the 77% decrease in second heart attacks in patients with coronary heart disease given alpha-tocopherol), "sometimes extraordinarily disastrous" (e.g., the 18% increase in lung cancer in smokers given beta-carotene supplements), or "simply equivocal" (e.g., alpha-tocopherol supplements given to patients at high risk for cardiovascular events with no measurable effects). Some studies do find some benefits in isolated or synthetic antioxidants, but this is primarily due to limited protective effects they have on nutrients already present in the body. Researchers admit that human studies with such supplements have merely "raised more questions than they answered."
Conversely, it is consistently found that people consuming "high levels of antioxidants" in their diets (fresh fruits, vegetables, whole grains, nuts, seeds, etc.) have lowered risks for cardiovascular disease, cancer, respiratory disorders, and other problems. For example, people with diets rich in fruits and vegetables have a decreased risk of cancer and a higher level of carotenes in their blood. Supplements of isolated beta-carotene, though, "do not have an anti-cancer effect, rather the opposite in smokers." Fruit and vegetable consumption decreases the amount of DNA damage in the body (a risk for cancer development), but supplements of isolated ascorbic acid, alpha-tocopherol, or beta-carotene do not decrease DNA damage in most studies. Dietary intakes of vitamin C complex below the recommended daily allowance are associated with increased DNA damage, and so is supplementation with "high-dose" ascorbic acid.
Such data puzzle scientists who search for "the" ingredient in food that "works." Others concede that whole food packages must be the answer. "It's possible that antioxidant supplements in high doses, unlike the nutrients in food, may upset the antioxidant balance in the body. The many types of antioxidants do different kinds of work, and they often work together. Similarly, many other substances, often marketed as supplements, have antioxidant effects in the test tube, but probably not in the body." Biochemist Norman Krinksy explains: "Although a large number of population studies reveal a link between a diet rich in foods containing antioxidants and a lower incidence of certain chronic diseases, we cannot conclude at this time that antioxidants are the reason. Other nutrients or factors could be at play. While convincing scientific evidence may one day be available, the question of whether dietary antioxidants can prevent chronic disease still remains unanswerable."
A report from the National Academy of Sciences' Institute of Medicine claims that taking massive doses of antioxidants such as ascorbic acid or beta-carotene not only fails to prevent chronic diseases, but may also be harmful. Rather than rely on isolated supplements, "people should simply eat more fruits and vegetables if they need more nutrients." Scientists must acknowledge that "nutrient-dense foods" such as fruits, vegetables, nuts, seeds, whole grains, etc., "are the most concentrated source" of antioxidants as well as a plethora of other factors including vitamins, minerals, trace minerals, phytochemicals, phospholipids, and much more.
"When we eat foods," asserts Robert Jacob of the US Department of Agriculture, "we get a number of antioxidants, and it's very likely that no single one is the ‘magic key' to preventing oxidative damage and reducing chronic disease risk." He says that between 250 and 500 milligrams (mgs) of vitamin C per day "would be more than adequate" to achieve potential risk reduction of many health problems and is "probably obtainable by diet alone." Yet many scientists remain skeptical of ascorbic acid supplements which are used (often in large doses) in clinical trials with only "mixed results."
It should be stressed that "clinical trials are designed to test drug efficacy, not long-term nutrient intakes." So isolated, specific ‘nutrients' - as drugs - are used. The drug mentality prevails in research and practice. "Bioavailability" - a term that should refer to the condition of food and its potential for absorption, utilization, and function - is presently defined as "the plasma concentration of a...drug given orally compared with the concentration when the drug is given intravenously." (Emphasis added) Sadly, the "transfer of this concept from pharmacology to nutrition has been successful." For instance, one study on transplant-associated atherosclerosis reported on the bioavailability of ascorbic acid and alpha-tocopherol after supplementation.
However, the researchers "do not show whether or not there is a correlation between plasma concentrations of the vitamins and progression of coronary atherosclerosis." The presence of the chemicals in the blood was measurable; whether or not they performed any function was not. The Heart Protection Study Collaborative Group found that, although antioxidant vitamins were measured in blood, the regimen "did not produce any significant reductions in the 5-year mortality from, or incidence of, any type of vascular disease, cancer, or other major outcome."
Current scientific design and practice is to make nutrients into drugs. And, as is true with all drugs, there are side effects (unwanted effects): diarrhea from high-dose ascorbic acid, hemorrhage from excessive alpha-tocopherol, hair or nail loss from too much selenium, and so on. These are only quickly observable events; the internal biochemical imbalances are not so easily determined. For health's sake, "the best sources of these nutrients are foods." Half a century ago, Dr. Lee explained that we should get our nutrients from foods, from Nature's pattern. i
A CLOSER LOOK AT VITAMIN C
Vitamin C is a food complex containing many ingredients beyond just ascorbic acid, such as bioflavonoids, rutin, vitamin K complex, tyrosinase containing organic copper, "vitamin J" factors, and more, all bound to a protein. When ascorbic acid is present in high amounts in foods, other synergists, such as tyrosinase, are also high. These factors are linked together in a biochemical - live - complex. Without its synergists, ascorbic acid will little, if any, of the benefits of the entire complex. Without tyrosinase, for instance, ascorbic acid will not control fevers. Rutin and bioflavonoids with ascorbic acid are more effective together than either one alone in treating nasal and gingival hemorrhage. Natural vitamin C complex contains ascorbic acid in both its combined and free forms. The combined form, ascorbigen, is the more active of the two and is not present in the synthetic version.
Crystalline-pure synthetic ascorbic acid, devoid of synergists, cannot cure scurvy (overt vitamin C deficiency) in its entirety. The scurvy may be is relieved to some small degree, but to afford a real cure, the complete vitamin C complex is necessary. Ingestion of isolated ascorbic acid also depletes bodily stores of other parts of the C complex such as tyrosinase. Therefore, Dr. Lee felt it was not honest to use the name "vitamin C" for ascorbic acid. That term "should be reserved for the vitamin C COMPLEX." As recently as 1993, to differentiate articles sold as drugs from nutritional supplements, the US Pharmacopeia referred to ‘ascorbic acid' as a recognized drug name and ‘vitamin C' as a recognized food name.
When 1,000 mg of ascorbic acid is ingested, blood uric acid and oxalate levels rise. At doses of 2,000 to 10,000 mg, diarrhea is apt to be a problem. "Very high doses" (over 2,000 mg/day) of synthetic ascorbic acid can result in elevated plasma glucose (blood sugar). Reports indicate 1,000 to 3,000 mg of ascorbic acid daily moderately decreases basal cortisol (an adrenal hormone) levels. "More than 1,000 milligram doses are risky. The body will eliminate excess C [ascorbic acid], but not without side effects (unwanted effects)."
"It now looks like a combination of natural ascorbic acid and other vitamins, minerals, and plant chemicals - all naturally found together in plant foods - are the ticket to optimal health protection. In fact, many fruits and vegetables with their complex chemistries, are better antioxidants than single vitamins." Animal foods, too, can be good sources of vitamin C complex. Certified raw milk is one example. Heat sterilization (pasteurization) destroys the vitamins and proteins in milk. This means that whatever calcium there was in milk becomes unavailable to human digestion. In the early part of the 20th century, heat sterilization of milk became a major cause of death due to scurvy in infants.
Cornell researchers found that eating 100 grams of fresh apple (one small apple) with skin provided the total antioxidant activity equal to 1,500 mg ascorbic acid. The apple's ascorbic acid content (as a measurable part of the whole C complex) is about 12 mg. "What those findings show is that the combination of phytochemicals [plant components] plays a very important role in antioxidant and anti-cancer activity, and the real health benefits may come from a phytochemical mixture." Numbers do not measure true potency; function and effectiveness do.
Ascorbic acid in large doses is thought to "knock out a cold" if taken early enough in the process. Actually, it acts as an antihistamine, a drug, which interferes with some initial stages of the biochemistry of inflammation - the body's natural process to attempt tissue repair.
The late chemist, Linus Pauling, recommended huge doses of ascorbic acid - up to 18,000 mg a day, and even larger megadoses for people with diseases like cancer. Recent research clearly shows that the body will not absorb these amounts. Doses exceeding 120 to 200 mgs are excreted through the urine. And high doses routinely cause diarrhea, flatulence, loose stools, and sometimes urinary frequency and urgency - all obvious reactions. There may be deeper adverse biochemical effects as well. Dr. Arthur B. Robinson, Linus Pauling's assistant when Pauling performed his initial research on ascorbic acid, has long disagreed with Pauling's ideas about the "benefits" of mega-doses of ascorbic acid.
Recent research has demonstrated that synthetic ascorbic acid taken in as little 500 mg doses causes a roughening of the intima lining of the arteries leading to a plaque buildup which can eventually lead to a complete blockage of the artery causing a heart attack.
Apparently these two scientists had some major feuds, so some of their studies were never published - including animal studies showing that a normal diet with high doses of ascorbic acid promoted cancer in mice exposed to carcinogens. But mice whose diet consisted of large amounts of raw fruits and vegetables (containing high amounts of natural vitamin C complex) with the same exposure to carcinogens had significantly fewer cancers. Diet (food complexes) -- not an isolated chemical compound - was successful, effective, and functional. Synthetic ascorbic acid made things worse. Other Pauling research data suggested that massive doses of ascorbic acid were not always beneficial and could be harmful.
So Dr. Robinson has been and still is a proponent of obtaining vitamin C from foods, not ascorbic acid. "Pauling simply would not allow facts to interfere with his thesis."
An article in the conservative Journal of the American Dietetic Association estimates that 20% to 30% of the US population has "marginal vitamin C status." One fourth of newly admitted hospital patients are deficient. Even people with clinical scurvy are presenting in doctors' offices.
Low serum acerbate (ascorbic acid as a measurable part of the vitamin C complex) concentrations are associated with a greater risk of dying from cancer and from any cause. Patients with acute myocardial infarction (heart attack) have "substantially lower plasma vitamin C complex concentrations than do control subjects. The risk of stroke was 70% higher among people who consumed the least amount of vitamin C complex from fruits and vegetables as compared to those consuming the most. People who ate vegetables 6 to 7 days a week had a 58% lower risk of stroke than those who ate vegetables less than two days a week. Supplements were not addressed "because vitamin C complex consumption came only from fruits and vegetables." Blood levels of vitamin C complex were "inversely correlated with mortality from all causes." Again, the lowest blood levels of vitamin C complex were associated with the highest risk of death from any illness; the highest vitamin C complex levels were associated with the lowest risk of death from any cause. Higher blood levels of vitamin C complex were associated with lower risks of cardiovascular disease, ischemic heart disease, and cancer. It was calculated that a 50-gram increase (a little less than two ounces) in fruit and vegetable consumption could reduce risk of mortality from all causes by 20%. A little food has a big impact!
Vitamin C complex is one of "the most important of the vitamins," said Dr. Lee in 1940. But since it is easily oxidized, it disappears in storage of fruits and vegetables. Fresh meats contain "valuable amounts of vitamin C, but in cold storage it is completely oxidized." Raw milk is also a good source, but pasteurization and irradiation destroy the vitamin content. Very fresh fruits and vegetables or food concentrates are the best bet these days. ii
A CLOSER LOOK AT VITAMIN E
Almost 30% of US adults have clinically low blood levels of vitamin E complex, "which may put them at increased risk for heart disease and cancer," among other problems including disorders of the central nervous system, deterioration of the brain, and progression of Alzheimer's disease. Vitamin E deficiency "raises risks for chronic diseases" in which low dietary intake or low blood concentrations have been implicated. A low blood level of vitamin E complex is very predictive of heart disease - far more predictive than cholesterol or high blood pressure. In fact, blood cholesterol levels tend to rise alongside falling levels of vitamin E complex. Your chances of blood clots increase with decreasing levels of vitamin E complex. Furthermore, some scientists contend that the functions of vitamin E complex are underestimated if one considers only its anti-oxidative properties.
Although "vitamin E" is usually the term used to describe alpha-tocopherol - the tocopherol thought to have the highest biological activity and which is found plentifully in bodily tissues. However, vitamin E in foods and tissues always appears as a complex, a compound of multiple ingredients intricately woven together. Medical science acknowledges that there are at least a group of tocopherols and tocotrienols in vitamin E complex including four tocopherols (alpha, beta, delta, and gamma, known collectively as mixed tocopherols) and four corresponding isoforms of tocotrienols (alpha, beta, delta, gamma). All eight parts are antioxidants. In Nature they protect other functional portions of the vitamin E complex as well as contribute to its nutritional effectiveness.
Most attention has been focused on alpha-tocopherol, and most all "vitamin E" supplements on the market are merely alpha-tocopherol. Even "mixed tocopherols" are usually alpha-tocopherol with a tiny amount of the other three. Scientists are now "discovering" that gamma-tocopherol "possesses some unique properties" and is important in synergistic function with alpha-tocopherol. In fact, "supplementation with alpha tocopherol in the absence of gamma-tocopherol leads to a reduction of tissue and plasma levels of gamma-tocopherol." Dr. Lee warned years ago that taking supplements containing one particular fraction of a nutrient complex depletes bodily supplies of other components of that complex.
Recent research indicates that tocotrienols "may be more potent antioxidants" than tocopherols, with 40 to 60 times the antioxidant ability of tocopherols. They have a greater "recycling efficiency" under conditions of "oxidative stress" in the body. Tocotrienols also appear to have a more profound effect on cholesterol levels, have the ability to reduce plasma levels of apolipoprotein B and lipoprotein A, and have antithrombotic and antitumor effects. In other words, research attributes tocotrienols with benefits for cardiovascular disease, cancer, and neurological disease. "Tocotrienols magnify the protective effects of vitamin E [alpha tocopherol], making a complex mixture that is more effective than either E or tocotrienols alone." If these neglected fractions have specific biochemical uses and advantages, what of other associated factors in the vitamin E complex? The idea of extracting one tocopherol, one anything, or a few portions out of the whole interrelated complex denies the good reasons why Nature put all the factors together in the first place. In 2000 a new variant of vitamin E was found, alpha-tocomonoenol, which "outperforms" alpha-tocopherol as an antioxidant. What else will be discovered that has always been present in whole foods?
Furthermore, food complexes of vitamin E have far more than antioxidant effects. "Now we're talking about the physical importance of food," explains Tom Watkins, Ph.D., "not its chemical composition, but the importance of it in delivering a physical effect." The physiological effects of foods with small amounts of nutrient complexes are profound. Dr. Watkins uses the analogy of sprinkling salt on an icy stoop in winter. A small amount of salt will lead to the eventual melting of a large amount of ice.
In defining "vitamin E," it is now acknowledged that nutritives such as fatty acids, phospholipids, tannins, selenium, manganese, and others "are known to interact synergistically" with tocopherols and tocotrienols. Nature already puts these and other ingredients - known and unknown - together in foods. Would it not make sense to use these preformed ideal packages? Separating the contents essentially destroys most nutritional function. If the parts are subsequently put back together, they "don't work." They work only before they are taken apart, not after. A food concentrate is an organized mechanism that has a function. If the organization is disrupted, the function ceases. Dr. Lee liked to use the illustration of a watch. If a watch were smashed with a hammer and brought to a chemist for analysis, the chemical composition would be identical to an undamaged watch. But the smashed watch no longer functions.
Synthetic, manufactured alpha-tocopherol is poorly absorbed and inhibits the body's use of the functional, natural dietary sources. The designation "dl-tocopherol" indicates a synthetic form, the type used in many scientific studies. Tocopheryls (acetate or succinate) are tocopherols that have been converted to extend their shelf life (again, supplements meant to be sold, not ingested!) The "optically pure form" of alpha-tocopherol (commercially manufactured by isolating one compound from plant materials) is referred to as "natural vitamin E." Although better absorbed and able to be of limited nutritional use, it is still a chasm away from the whole, unaltered complex found in foods.
Studies indicate that food sources of vitamin E are far more beneficial than supplements of alpha-tocopherol. Fatty acids from fish have a beneficial effect on morbidity and mortality in patients with a recent heart attack, while daily use of 300 mgs of synthetic ‘vitamin E' had no such beneficial effect.
A clinical trial involving smokers given 50 mgs ‘vitamin E' found no effect for decreasing cardiovascular events. A significant decrease in non-fatal heart attacks but an increase in fatal ones was reported in a controlled trial when doses of 400 to 800 mgs of ‘vitamin E' were given to persons with confirmed coronary artery disease. A study reported in the New England Journal of Medicine in 2000, Heart Outcomes Prevention Evaluation (HOPE), "the best study done to date," showed that ‘vitamin E' (‘natural' alpha-tocopherol) failed to reduce the risk of heart disease or stroke. After an average of 4½ years, the vitamin-E takers were no less likely than the placebo takers to have a heart attack or stroke or to have died of cardiovascular disease. Nor did the two groups differ in the rates of unstable angina, congestive heart failure, complications of diabetes, cancer, or death due to any cause. However, several observational studies "have suggested" that high dietary intake of vitamin E complex may slow the development and progression of cancer, atherosclerosis, and other diseases.
A study on the effect of isolated alpha-tocopherol in young smokers found that the supplements protected LDL cholesterol from oxidation (premature breakdown), but had "few significant effects on the more physiologically relevant" neutrophil (white blood cell) function. This "cast doubt" on the ability of alpha-tocopherol supplementation to reduce coronary heart disease in smokers. Some large studies provided no support that alpha-tocopherol may reduce or prevent the development of early atherosclerosis. Recent clinical trials employing alpha-tocopherol have basically had mixed results indicating either some benefit (probably from protective effects for functional vitamin E components consumed in food or stored in the body), no effect, or adverse impacts. For example, a recent study indicated that dietary and supplemental ‘vitamin E' reduces the rate of cognitive decline in older people, and another study suggested that alpha-tocopherol supplements worsen and prolong respiratory ‘infections.' In the latter study, people taking alpha-tocopherol (with or without a multivitamin) were sick longer, experienced more symptoms, and were more likely to experience fever and activity restrictions than those who did not take a supplement.
Results from clinical trials using fractionated, often synthetic supplements, are quite different from "the relatively consistent benefits from vitamin E" seen in observational studies where the nutrient is primarily obtained from diet. Less lung cancer was found in smokers who had the highest dietary intake of vitamin E and beta-carotene, "a finding recently confirmed for vitamin E." Researchers found a connection between poor memory and low blood levels of vitamin E in an elderly population. Those who consumed the most vitamin E complex in their diets had the best memories. A low vitamin E complex intake was found to be a significant risk factor for atherosclerosis - "not related to vitamin supplements."
The natural form of alpha-tocopherol, said Dr. Lee, loses up to 99% of its potency - its effectiveness - when separated from its natural synergists. In fact, alpha-tocopherol or mixed tocopherols without synergists "ceases to be vitamin E." Pieces of nutrient complexes are not nutrients in their effects. And "high potency" fractions may actually reverse their natural, intended effects, performing opposite from the desired action. In an experimental trial back in 1945, animals deficient in vitamin E that were fed purified alpha-tocopherol died faster than deficient controls who received no vitamin at all. In the body, tocopherols, tocotrienols, and other antioxidants protect fats from becoming rancid, protect phospholipid nerve sheaths from being destroyed, guard the cellular membranes, and more -- all in addition to preserving oxidizable constituents of their natural complexes which are present in the system. Science is discovering what clinical experience has shown and what astute observers like Dr. Lee propounded over 60 years ago. Whole food works and works wonders. iii
Dr. Lee dared to think, to resist conforming to the current scientific status quo, to reverently respect the superior wisdom of Nature. More than a reformer, he was a revolutionary. He knew that alternative views could shake one out of complacency, provide fresh viewpoints, open up new possibilities, and ultimately benefit the condition of earth and its occupants. Scientific research is now confirming what Dr. Lee knew decades ago, "...that where nutrition is needed, where starvation really has brought about serious disorder," the use of drugs or drug-like substances (including isolated, synthetic supplements) where food is called for "is the height of scientific unsoundness, to say the least." iv
i B Halliwell, Lancet, 1 Apr 2000, 355(9210): 1179-80; A Mather, Vegetarian Times, Dec 2000, 280: 73-4; E Tomsits, et al, J Amer Coll Nutr, Apr 2000, 19(2): 237-241; BMJ, 2001, 323: 1145; Acres USA, Nov 1999, 29(11): 39; Health, Apr 2000, 14(3): 23; UC Berkeley Wellness Lttr, Jun 2001, 17(9): 4-5; Nutrition Week, 21 Apr 2000, 30(16): 3; M Morris, JAMA, 2002, 287: 3230-37; M Engelhart et al, JAMA, 2002, 287: 3223-29; J Whitaker, Health & Healing, June 2000, 10(6): 1-4; M Larkin, Lancet, 22 Apr 2000, 355(9213): 1433; M Traber, Am J Clin Nutr, May 2000, 71(5): 1029-30; Health News, May 2000, 6(5): 5; F Violi, et al, Lancet, 10 Aug 2002, 360(9331): 486; R Lee, Food Integrity, lecture April 1955: 42-43.
ii R Lee, Vitamins with their Natural Synergists, 1950: 5; R Lee, personal correspondence, 22 April, 1957; R Lee, Food Integrity, lecture April 1955: 37; E Ginter, Science, 16 Feb 1973; Ann Rev of Biochem, 1943: 381; R. Lee, Vitamins in Dentistry, lecture, Rochester, 10 Jan 1940; R Lee, Malnutrition Today, lecture, MA Osteopathic Soc Conven, Boston, Jan 1943; R Lee, Malnutrition as a Primary Cause of Disease, lecture, International Assoc of Liberal Physicians, NY, 23-24 Oct 1943: 5; R Lee, The Effect of Malnutrition on Tissue Degeneration, lecture, Amer Acad of Applied Nutrition, 17 Nov 1949: 4; T Valentine, True Health, Spring 2001: 6-13; W Douglass, Second Opinion, May 2001, 11(5): 3-4; D Lightsey, Lancet, 30 Jun 2001, 357(9274): 2135; Herbs for Health, Nov/Dec 1999, 4(5): 69; A Gaby, Townsend Lttr D&P, June 2000, 203: 122; S Padayatty, et al, CMAJ, 6 Feb 2001, 164(3): 353-55; C Clemetson, J Orthomolec Med, 3rd Q 1999, 14(3); B Halliwell, Trends in Biochemical Sciences, Jul 1999, 24: 255- 59; Acres USA, Oct 1999, 29(10): 35; Science News, 20 Nov 1999, 156(21): 323; Consumer Magazine's Digest, Oct 1999, 11(10): 2; R Stern, Sickbay Today, Oct 2000: 10-12; Stroke, Oct 2000, 31(10): 2287-94; K Khaw, Lancet, 3 Mar 2001, 357(9257): 657-63; S Padayatty, Am J Clin Nutr, May 2000, 71(5): 1027-28; C Loria et al, Am J Clin Nutr, Jul 2000, 72(7): 139-45; J Whitaker, Health & Healing, Jan 2000, 10(1): 5; CS Johnston, J Am Diet Assoc, Jul 1999, 99(7): 854-56; Nutr Week, 21 Jul 2000, 30(28): 7; V Srinivasan et al, Nutrition Today, Nov/Dec 1993, 28(6): 26-33; D Williams, Alternatives, Apr 2000, 8(10): 73-74; Altern Med Alert, Dec 2000, 3(12): Suppl; C Wheatley, Lancet, 21 Jun 1997, 350; J Simon et al, J Amer Coll Nutr, Jun 2001, 20(3): 255-63; Heart Protection Study Collaborative Group, Lancet, 6 Jul 2002, 360(9326): 23- 33.
iii E Ford & A Sowell, Amer J Epidem, Aug 1999, 150(3): 290- 300; A Theriault, et al, Clin Biochem, 1999, 32(5): 309-319; J Biolog Chem, Apr 2000, cited in True Health, Summer 2000: 19; D Williams, Alternatives, Suppl Res Update, 1st Ed, 2002: 3; Q Jiang, et al, Am J Clin Nutr, 2001, 74: 714-722; A Theriault, Clin Pearls News, Feb 2000, 10(2): 25; Science News, 15 Jan 2000, 157(3): 40; C Northrup, Health Wisdom for Women, Oct 2001, 8(10): 5-7; G Vatassery, et al, Am J Clin Nutr, Nov 1999, 70(5): 793-801; P Szapary & M Cirigliano, Altern Med Alert, Sept 2000, 3(9): 101-105; R Passwater, M Bierenbaum, & T Watkins, True Health, Winter 2000: 1-11; P Jaret, Health, Nov/Dec 2000: 129-136; Worst Pills Best Pills News, Oct 1999, 5(10): 79; S Yusuf, et al, NEJM, 20 Jan 2000, 342(3): 154-160; M Meydani & J Mayer, Nutr Rev, Sept 2000, 58(9): 278-281; J Blumberg, Nutr in Clin Care, Mar/Apr 2002, 5(2): 50-55; C Fuller, et al, J Amer Coll Nutr, Jun 2000, 19(3): 361-369; A Papas & E Vos, Am J Clin Nutr, Jun 2001, 73(6): 1113; Amer J Epidem, 1999, 150: 37-44; H Karpman, Intern Med Alert, 29 Apr 2002, 24(8): 60-61; Altern Med Alert, Jun 2001, 4(6): 71-72; M Steiner, Nutr Rev, Oct 1999, 57(10): 306- 9; W Douglass, Second Opin, Nov 2000, 10(11): 3-5; Health News, 15 Dec 1999, 5(15): 3 & Oct 2002, 8(10): 5; R Brigelius- Flohe, et al, Am J Clin Nutr, Oct 2002, 76(4): 703-16; A Iannuzzi, et al, Am J Clin Nutr, Sept 2002, 76(3): 582-7; H Huang, et al, Am J Clin Nutr, Sept 2002, 76(3): 549-55; R Lee, Food Integrity, lecture, Apr 1955: 21, 30; R. Lee, A Real High Potency Vitamin Product, lecture manual R. Murray, 1988: 52- 3; R Lee, The Vitamin Front in 1947, lecture, FL, Jun 1947: 1- 8; R Lee, The Direct Effect of Malnutrition on Tissue Degeneration, lecture, Amer Acad Appl Nutr, Seattle, 17 Nov 1949: 1-7.
iv Verbal quotation, Biochemical Nitty Gritty, June 1983.
NOTE: Most manuscripts for Royal Lee quotations can be found in Lectures of Royal Lee, Selene River Press, Ft Collins, CO.
Originally published as an issue of Nutrition News and Views, reproduced with permission by the author, Judith A. DeCava, CNC, LNC