Friday, February 26, 2010

Pete Zdanis' Vision, Passion and Mission

Pete Zdanis' Vision, Passion and Mission

"To provide world-class support to committed entrepreneurs in changing lives with USANA, the pre-eminent network marketing company which offers the highest-rated nutritional supplements in the world."

USANA has become much more than a business for Pete and Dora Zdanis. USANA has become their passion. They fully support Dr. Myron Wentz’s vision and USANA’s mission, and take pride in the fact that, for over 15 years, they have played a role in helping thousands of people reach their personal and financial goals and dreams with USANA, and continue to do so every day of every week of every year.

Here's some background on how they have arrived at this station in their lives......


Dr. Myron Wentz’ Vision:
“I dream of a world free from pain and suffering. I dream of a world free from disease. The USANA family will be the healthiest family on earth. Share my vision. Love life, and live it to its fullest in happiness and health.” - Dr. Myron Wentz, Founder and Chairman, USANA Health Sciences, microbiologist. Immunologist, philanthropist and author

USANA’s Mission:
“To develop and provide the highest quality, science-based health products, distributed internationally through network marketing, creating a rewarding financial opportunity for our independent Associates, shareholders, and employees.”

Pete & Dora Zdanis’  Mission and Passion:
"To provide world-class support to committed entrepreneurs in changing lives with USANA, the pre-eminent network marketing company which offers the highest-rated nutritional supplements in the world."


Pete Zdanis ( ) was born in Michigan City, Indiana and raised in New Buffalo, Michigan, in the very southwest corner of the Great Lake State. In high school, he was the president of the National Honor Society and was the Salutatorian of his 1967 graduating class.

He worked his way through college by pumping gas on the midnight shift at a Mobil Oil service station in East Lansing, Michigan. He graduated from college in 1971 with High Honors, and a Bachelor of Science Degree in Mathematics, Physics and Chemistry from Michigan State University. Pete had planned to teach math and science in high school. However, managers at Mobil Oil recognized Pete’s determination and work ethic as he worked long hours to pay for his education, and offered him an entry level position with Mobil.

After training with Mobil for a year in Chicago, Pete was assigned a territory as a Marketing Representative in Grand Rapids, Michigan. He was then transferred and promoted frequently to assignments in Detroit; Philadelphia; Toledo; Indianapolis; back to Philadelphia again; New York City; Los Angeles; Kansas City; Chicago; Washington, DC; and finally back to Philadelphia for a third time in 1991.

Pete was transferred around the country by Mobil a dozen times in twenty years. Each new position brought new and increased responsibilities. After beginning by managing a small sales territory, he eventually became responsible for such critical and diverse things as developing Mobil’s U.S. strategic planning, managing the company’s U.S. computer systems and data management operations, and directing Mobil’s worldwide credit operations.

It was during his third assignment in Philadelphia that he met fellow Mobil employee Dora Ferrer, and they married in November, 1993.

While Pete found his Mobil career to be rewarding, he was also becoming “burned out” by the demands of long hours, frequent travel, and having to produce increased results with fewer employees and resources lost due to cost-cutting. The company was “reorganizing and downsizing” almost every year, and each time Pete had to terminate many employees, some who had become friends of his over the years.

Pete was introduced to network marketing in 1989. He was intrigued by the concepts of leveraging his time and building residual income by helping other people do the same. He became involved with several different network marketing companies on a part time basis over the next several years. His goal was to supplement his and Dora’s income in the short term, with a long term goal of being able to replace their Mobil income and get out of the “corporate rat race”.

While Dora was not too sure about the validity of network marketing, she supported Pete’s efforts. Still working 60 and 70 hour weeks with Mobil, he worked his network marketing business on evenings and weekends and any other time he could find a spare moment. His results, however, were very disappointing. There always seemed to be one problem or another with the network marketing companies that Pete would choose to build a business with. There were either management problems, product problems, or the compensation plan just did not allow people to earn a fair return on their efforts.

After disappointing experiences with five different network marketing companies, Pete finally decided in September, 1994 that he could never succeed in the business, and decided to stop wasting his time and money in network marketing. He said that he felt like “roadkill on the network marketing highway”.

A few weeks later, someone Pete had met during his network marketing debacles asked him to take a look at USANA. Pete politely declined. Not only was he burned out in his corporate career, he was completely disillusioned by network marketing and wanted no part of it. He was frustrated with his current situation and prospects for the future, and just wanted to be left alone.

However, Pete’s friend was “pleasantly persistent”, and Pete finally agreed, as a favor to his friend, to take a look at USANA. Pete had absolutely no intention of getting involved in network marketing again, and figured that if he told his friend that he had read the material about USANA that his friend would then leave him alone and never ask him about USANA again.

However, as Pete read about USANA on that day in October, 1994, he became increasingly interested in what the then two year old company had to offer. Pete saw USANA’s proven products which offered a true value to the consumer, whether or not they chose to participate in the compensation plan. He saw the power of USANA’s binary compensation plan which allowed new people to start earning weekly commissions quickly, while also allowing associates to build their income to whatever level they desired over time. He also saw a well-managed company led by visionary scientist Dr. Myron Wentz, and supported by business leaders such as Dr. Denis Waitley, Robert Allen and many others.

Pete realized that he had finally found a network marketing company where all the “key ingredients” of product, compensation and management had come together in one place at one time. He figured that if he would ever realize his dream of building a full-time career in network marketing that USANA would be his vehicle to reach that dream. So, on October 28, 1994, with Dora’s somewhat reluctant blessing, Pete began their USANA career like everyone else, with three Business Centers and no one in their downline.

Over the next several months, Pete & Dora’s USANA business began to grow, slowly but surely. Their goal was to sponsor two or three associates every month and help them get started in building their USANA businesses. Their plan was working, and their USANA business and commission checks were growing. And, they were moving up the ranks, becoming USANA Silver Directors on March 24th, 1995.

Pete’s corporate career was going fairly well, too. Although the long hours and increasing workloads at Mobil continued, Pete continued to be on the list of managers who had jobs during the frequent waves of downsizing and cutbacks. In fact, Pete celebrated his 25th anniversary with Mobil the same month that he became a USANA Silver Director. Mobil threw a little anniversary party on Pete’s behalf and even gave him a gold (plated) watch!

Then things began to change quickly for Pete and Dora. On June 5th, 1995, Pete’s boss flew in from Mobil’s headquarters. At 9:00am that day, he thanked Pete for 25 years of service to Mobil, but regretted to tell him that Mobil was reorganizing yet again, and that this time there was no position available for Pete. He was “downsized” (fired). His boss also told Pete that he had ten minutes to remove his personal effects from his office, and that he could come back after business hours with a security guard if he realized that he had forgotten anything.

Immediately after the devastation and humiliation of losing his job after 25 years of service to the same company, Pete met Dora at a local restaurant. They let the events of the day soak in and talked about the future. Being the positive people that they are, Pete and Dora realized that as one door closes, another one opens. It wasn’t long before they decided that this was their golden opportunity to realize their dream of making USANA their full time career, and they haven’t looked back since that day in June of 1995.

Pete and Dora’s USANA business continues to grow steadily. They stuck with their plan of sponsoring two or three new associates every month and advanced to Gold Directors on September 1st, 1995, less than one year after they joined USANA. By working closely with all of their USANA team members, as they continue to do to this day, their business began to flourish as they advanced to Ruby Director, Emerald Director, Diamond Director and their current level of 1-Star Diamond Director.

Pete and Dora have been USANA “Top 20” income earners for the past thirteen years, and have been members of USANA’s fast-growing “Million Dollar Club” for the past nine years. They have been a member of USANA’s “Fortune 25” every year, and have been members of USANA’s Independent Distributor Council (IDC) for six years, serving as IDC Presidents for the 2003 – 2004 term, and Vice-Presidents for the 2007-2008 term.

USANA has become much more than a business for Pete and Dora. USANA has become their passion. They fully support Dr. Wentz’s vision and USANA’s mission, and take pride in the fact that they have played a role in helping thousands of people reach their personal and financial goals with USANA, and continue to do so every day.

Pete and Dora look forward to many more years of success in their USANA business, and are grateful that they how have a legacy to pass on to their loved ones. While they have achieved many milestones in USANA, Pete and Dora have no intention of “retiring” any time soon, and look forward to the opportunity to share their knowledge and training with all new members of their USANA team.

Pete has over 40 references which are available for your viewing at the following link:

© Zdanis USANA Power Team ®  - All Rights Reserved

This article may only be copied, shared, distributed or otherwise reproduced in its entirety, including this disclaimer and copyright authorization.

Thursday, February 25, 2010

The Seven Truths of Network Marketing

This article is over ten years old, but is just as valid as the day it was written. - Pete Zdanis

The Seven Truths Of Network Marketing
- Building your life of magnificence

by Michael S. Clouse

A wise man once defined success as a refined study of the obvious. How true. Most of what we need to know, say, and do to achieve mastery in Network Marketing could be easily taught—and understood—by a 12 year-old.

Why then are we making this business so difficult?

Let’s agree to start teaching the Seven Truths of Network Marketing to those who actually want to create their own destiny, and leave the rest of the world alone. After all, we’re involved in a great industry, with terrific people, offering unprecedented opportunity. And we should be proud to speak the truth...

1) Network Marketing is a business.

Networking is a unique form of enterprise, and you’ve got to understand the game you’re playing. Therefore, mentally consume every page of your distributor manual the day it arrives. Listen to your training tapes again, and again, and again. Like a song on the radio, you learn the music by hearing it one more time.

2) Freedom by the numbers.

Understand the numbers, and your compensation plan. Start by involving two or five people, whatever number of legs and leaders your plan dictates. By your fifth year, the commissions paid on your invested efforts could well equal a mid six-figure annual income. After that, the sky’s the limit.

3) Attend every live event.

The weekly presentation is part of the process. You need to be in attendance every week—to see the presentation again. Remember the music? You need the association, and the environment to showcase your company for your prospects. True, not everyone attending every meeting earns $10,000 a month. However, everyone earning $10,000 a month attends every meeting. Now that’s a refined study of the obvious.

4) Work only one company.

Leaders understand this truth, because no man or woman can serve two masters.

5) Have a compelling written “Why.”

Success in Network Marketing is 20% how to, and 80% why to... The best part is, if your reasons are strong enough, you’ll learn everything you need to know along your journey.

6) Invest in yourself first.

Some people are still trying to earn a 1999 wage, using a 1979 education. It can’t be done. If you want to earn more, you’ve got to learn more. Therefore, read all the books, attend all the classes, and learn everything you possibly can.

7) Decide in writing that you’ll be here a year from now.

Long-term written goals possess the power to pull you right to the top of your company. Put your dreams for your future on paper, and begin building your life of magnificence.

The great Winston Churchill once said, “The truth is incontrovertible. Malice may attack it and ignorance may deride it, but in the end, there it is.”

The Seven Truths.

Copyright 1999 by Michael S. Clouse. All international rights reserved.

Wednesday, February 24, 2010

Vitamin D Deficiency Associated with Cardiovascular Disease Prevalence

At a Glance: In a large sample of U.S. adults, new research indicates that vitamin D deficiency is associated with an increased prevalence of cardiovascular disease.

Read more about this study below.

Inadequate vitamin D levels are known to be associated with certain cardiovascular disease (CVD) risk factors, but until recently the association between vitamin D levels and the prevalence of CVD had not been comprehensively examined in the general U.S. population.

In a recent study published in Atherosclerosis, researchers examined data from the Third National Health and Nutrition Examination Survey (NHANES), a population-based sample of more than 16,000 U.S. adults.

In the total survey population, 1,308 subjects had some form of CVD. Using the standard definition of vitamin D deficiency (a serum level below 20 ng/mL), participants with CVD had a higher incidence of vitamin D deficiency (29.3%) than those without CVD (21.4%). After adjusting for age, gender, race/ethnicity, season of measurement, physical activity, body mass index, smoking status, hypertension, diabetes, elevated cholesterol, chronic kidney disease, and vitamin D use, the researchers showed that subjects deficient in vitamin D had a 20% increased risk of CVD.

The results of this analysis indicate a significant relationship between vitamin D deficiency and CVD prevalence in a large, highly representative sample of the U.S. adult population.

Atherosclerosis 2009 Jul; 205(1):255-60. 

USANA Health Sciences Essentials of Health

Wednesday, February 17, 2010



Excerpted from an article by: Dr. Stanley S. Bass. ND. D.C., PhC

Perhaps the greatest misunderstanding in the field of nutrition is the failure to understand and interpret the symptoms and
changes which follow the beginning of a better nutritional program. A remarkable thing happens when a person
IMPROVES the quality of the food he consumes. When the food you ingest is of a higher quality than the tissues from
which the body is made, the body DISCARDS the LOWER QUALITY TISSUES, to make room for the higher quality
materials to make HEALTHIER TISSUE.

During this process of regeneration, lasting about 10 days to several weeks, the emphasis is on breaking down and
eliminating lower quality tissue. The vibrant energy often found in the external parts of the body, the muscles and skin,
moves to vital internal organs and starts reconstruction. This movement of energy produces a feeling of less energy in the
muscles, which the mind interprets as weakness. At this time, more REST and SLEEP is often needed, and it's imperative
to AVOID STIMULANTS of any kind which will abort and defeat the regenerative process. Remember, the body isn't
getting weaker, it's simply using its energies in more important internal work rather than external work involving muscle
movements. With patience and diligence, a person will soon feel more energy than before.

By ingesting higher quality foods, the body begins a process called "retracing". The initial focus is on eliminating waste
and toxins deposited in the tissues. However, the process creates symptom that are often misinterpreted. For example, a
person who stops consuming coffee or chocolate may experience head-aches and a general letdown. The body begins
discarding TOXINS (caffeine or theobromin) by removing them from the tissues and transporting them through the
bloodstream. However, before toxins are passed through elimination, they register in our consciousness as pain. In other
words, a headache. These same toxins also stimulate the heart to beat more rapidly, thus producing the feeling of
exhilaration. The letdown is due to the slower action of the heart which produces a depressed mind state.

The SYMPTOMS experienced during "retracing" are part of the HEALING PROCESS! They are NOT DEFICIENCIES.
Do not treat them with stimulants or drugs. These symptoms are constructive, even though unpleasant at the moment.
Don’t try to cure the cure. The symptoms will vary according to the materials being discarded, the condition of the
organs involved in the elimination, and the amount of available energy.

They can include:
Skin Eruptions
Frequent Urination

The symptoms will be milder and pass more quickly if one gets more rest and sleep. Understand that the body becomes
healthier by eliminating wastes and toxins. Had they remained trapped in the tissues, eventually they would have brought
about illness and disease, thus causing greater pain and suffering.

The body is becoming healthier by eliminating TOXINS

Finally, don’t expect to improve your diet and feel better and better every day, until you reach perfection. The body is
cyclical in nature. Health returns in a series of gradually diminishing cycles, for example, you may begin eating better
and start feeling better. After some time, you experience a symptom such as nausea or diarrhea. After a day, you feel
even better than before and all goes well for a while. Then you suddenly develop a cold, the chills, and lose your
appetite. Without the use of drugs, you recover from these symptoms and suddenly you feel great. This well-being
continues for a time until you break out in a rash. The rash flares up, but finally disappears, and suddenly you feel better
than you’ve felt in years. As the body becomes pure, each reaction becomes milder and shorter in duration, followed by
longer and longer periods of feeling better than ever before, until finally you reach a level plateau of VIBRANT

Actually not usually. Usually it is a very good sign, a sign that your body is finally working properly and starting to eliminate built up toxins.

Tuesday, February 16, 2010

USANA Fact Sheet

USANA Corporate Information

Founded in 1992, USANA Health Sciences, Inc. (USANA) is a direct sales/network marketing company. Independent Associates market USANA’s scientifically-based nutritional, diet & energy, and personal care products.

Net sales for USANA in the year 2010 were $517.6 million USD.

USANA operates in fourteen markets worldwide: The United States, Canada, Australia, New Zealand, The United Kingdom, The Netherlands, Hong Kong, Japan, Taiwan, Korea, Singapore, Mexico, Malaysia, and The Philippines. The USANA worldwide corporate headquarters is located in Salt Lake City, UT, US. More information can be found at

USANA’s Mission Statement
“To develop and provide the highest quality, science-based health products, distributed internationally through network marketing, creating a rewarding financial opportunity for our Independent Associates, shareholders, and employees.”

USANA Health Sciences is publicly traded on the NASDAQ Stock Market® under the symbol "USNA." The company has been publicly traded since 1995 and has traded on the NASDAQ since July 1996.

USANA Health Sciences encompasses three product categories: Nutritionals, Diet & Energy, and Personal Care. More information can be found at by clicking on the “Products” tab in the upper left corner of the page.

Comprised of USANA’s Essentials and Optimizers, the high-quality Nutritionals are designed to provide the micronutrients (vitamins, minerals, antioxidants, and other compounds) your body needs for optimal, lifelong health by providing a complete and balanced spectrum of nutrients and antioxidants to help counteract poor nutrition and free-radical damage.*

Diet and Energy
USANA’s great-tasting drinks, meal replacements and snacks help you lose weight and maintain energy.

Personal Care
USANA's Sensé Beautiful Science patented self-preserving skin and personal care products provide the latest breakthroughs in the science of skin and personal care to cleanse, refine, and replenish your skin and hair at the cellular level.

Income Opportunity Potential- USDollars

$93,000 is the average yearly income for an established, full-time USANA Associate. $24,500 is the annual average of those who earned as little as one commission check each month. Total includes all earnings from the Compensation Plan, Leadership Bonus, Matching Bonus, contests, and incentives. Calculations based on earnings for fiscal year 2009.  Figures should not be considered as guarantees or projections of actual earnings, which result only from consistent, successful sales efforts. To be considered in a rank’s earnings, Associates must have earned checks at a median rank for at least 20 weeks. According to results from an in-house survey taken between 2004 and 2006, the primary reason 17% of USANA independent business owners join the company is to improve their financial future. 21% of that group earns a check at least once a month. Of those whose primary reason is to earn enough to replace a full-time income, 90% have been Associates for at least one year and 57% are full-time Gold Directors and above. The number of Gold Directors and above who have maxed at least 1 Business Center during the year equals less than 1% of all Associates. Those earning as little as one check a month equal approximately 3% of all Associates. If you include all 165,710 with the title of Associate, which includes Associates not actively building a business (acting as wholesale buyers), Associates who just joined, (as little as one day), and those who are just beginning to build their customer base, the average yearly income is still $616.71 with nearly one in three earning a check. To date, USANA has more than 140 Associates who are lifetime Million Dollar Club members.

USANA has been rated the #1 company in network marketing for ten straight years, and has received numerous awards and recognition for its scientific and business achievements over the years.

In addition to 199,000 Independent Associates in fourteen countries, USANA employs over 900 people worldwide, including approximately 600 people at the corporate offices in Salt Lake City, UT.

*These statements have not been evaluated by the Food and Drug Administration. These products are not intended to diagnose, treat, cure or prevent any disease. Keep out of reach of children. Consult your physician if you are pregnant, nursing, taking a prescription drug, or have a medical condition.

Higher Intakes of Fiber Help Prevent Weight Gain & Increases in Waist Circumference

Higher Intakes of Fiber Help Prevent Weight Gain & Increases in Waist Circumference

It is known that dietary fiber may play a role in obesity prevention. The role that different individual fiber sources play in weight change is less certain. In a recent paper published in the American Journal of Clinical Nutrition, researchers investigated the association of total dietary fiber, cereal fiber, and fruit and vegetable fiber with changes in weight and waist circumference.

The prospective cohort study included 89,432 European participants, aged 20–78 years, who were initially free of cancer, cardiovascular disease, and diabetes. Participants were followed for an average of 6.5 years. Adjustments were made for follow-up duration, dietary variables, and baseline anthropometric, demographic, and lifestyle factors.

Total fiber was inversely associated with weight and waist circumference change during the study period. For a 10 gram/day higher total fiber intake, there was an estimated 39 g/year weight loss and waist circumference decreased by 0.08 cm/year. A 10 gram/day fiber intake from cereals results in 77 g/year weight reduction and 0.10 cm/year reduction in waist circumference. Fruit and vegetable fiber was not associated with weight change but had a similar effect on waist circumference as total and cereal fiber intake.

Over a period of 6.5 years, weight gain and increases in waist circumference would be expected in typical adults. The findings of this research may support a beneficial role of higher intake of dietary fiber, especially cereal fiber, in prevention of weight and waist circumference gain.

Am J Clin Nutr Vol. 91, No. 2, 329-336, February 2010

USANA Essentials of Health

Wednesday, February 10, 2010

Goal Setting and Action Plans

- by Pete Zdanis

I spend a lot of time working with new people in my group helping them develop their goals and action plans for their USANA business.

I always ask them to make the initial effort to put their goals and plans in writing, and then share them with me for review and suggestions. The main reason I do this is because, unless they develop their goals themselves, they will never take ownership of them and will likely not take the necessary actions to reach the goals.

What I usually discover in the first draft I receive from new distributors is one of two extremes:

o Very general and vague - "I want to earn $1,000.00 per week in USANA."

o Extremely detailed and mind-numbing "business plans" which would require a Harvard MBA to understand.

The first example is far too general, and doesn't provide any detail on what must be done to achieve the goal. At the end of every day, there would be no way to measure if you made any progress toward your goal.

The second example is far too detailed, and usually overwhelms people and causes "paralysis by analysis". It would be impractical to review an elaborate business plan daily to measure progress.

What's the solution?:

Start with one or two high level goals with a specific target date, and then "work backward" to develop more specific action plans to achieve the goal(s).

For example:

Primary Goal:

"Become a Gold Director in 12 months."

Good. That's a specific goal with a defined time frame.

Now, let's break that down into smaller, manageable actions steps that are needed to achieve the goal.

For example, we know that the average Gold Director has personally sponsored 30 to 40 new Distributors.

So, let's define an action step, or secondary goal, to reach the primary goal:

"Personally sponsor three new Distributors per month".

OK. That will certainly get us to our primary goal, but - How do we sponsor three new Distributors per month?

Well, let's break it down into even smaller steps................

There are many, many different ways and methods to sponsor new distributors - warm market, classified ads, purchased leads, etc., etc. The various methods, combined with the individual Distributor's belief, confidence and experience level, make it difficult to determine specifically, at least initially, how many presentations a particular Distributor would have to make to sponsor one new Distributor

For the sake of this exercise, let simply, assume that they would sponsor one out of every ten people they make a presentation to. Note: By "presentation", I am referring to an H&F Meeting, a one-on-one H&F Presentation in person, an information pack sent by snail mail or e-mail, or a telephone presentation using the H&F Presentation, Fast Facts, etc. Therefore, we would need to make thirty presentations in one month in order to sponsor three new Distributors in a month.

So, our next level goal or action step would be:

"Make 30 presentations per month."

OK - Hang in there, we're almost done.............

Not everyone we talk to is interested in learning more about becoming involved in USANA. So, we're obviously going to need to contact more than 30 people in order to schedule 30 presentations. Again, the ratio of contacts to presentations varies widely based on many variables, similar to those listed above. But, for the sake of example, let's assume that half of the people we contact would be interested in learning more about USANA, i.e., would be willing to view / attend / listen to a presentation.

So, our next level goal or action step would be:

"Make 60 contacts per month." (Or an average of two per day)

NOW we have something to grab on to. We now know that, in order to become a Gold Director in one year, (Primary Goal) you would need to make an average of two contacts per day (Single Daily Action Plan – SDA).

Now, at the end of every day, you can look back at your activities for the day, ask yourself if you took needed action to reach your primary goal, provide an answer, and rate yourself:

o Zero Contacts - "F" - failed for the day.

o One Contact - "C" - did okay, but need to do better tomorrow.

o Two Contacts - "A" - achieved my goal, and am on track to reach my primary goal.

o More than two Contacts - "A+" - I may reach my primary goal faster than my target date.

CAUTION: Don't get all hung up about the numbers in the above examples. They are simply that - examples. As you gain in experience and knowledge, you may find that more than half of the people you contact would be willing to learn more about USANA, and that more than 10% of the presentations you make will result in a signup. In fact, I KNOW that will be the case.

Best of success!

Monday, February 8, 2010

Procrastination Doesn't Make Perfect by Denis Waitley

Procrastination Doesn't Make Perfect
- by Denis Waitley

Perfectionists are often great procrastinators. Having stalled until the last minutes, they tear into a project with dust flying and complaints about insufficient time. Perfectionist-procrastinators are masters of the excuse that short notice kept them from doing the quality job they could have done.

But that's hardly the only variety of procrastination - which is one of my own favorite hiding places when I try to blame external conditions instead of myself for some difficulty. Mine comes with a gnawing feeling of being fatigued, always behind. I try to tell myself that I'm taking it easy and gathering my energies for a big new push, but procrastination differs markedly from genuine relaxation - which is truly needed. And it saves me no time or energy. On the contrary, it drains both, leaving me with self-doubt on top of self-delusion.

We're all very busy. Every day we seem to have a giant to-do list of people to see, projects to complete, e-mails to read, e-mails to write. We have calls to answer and calls to make, then more calls to people with whom we keep playing voice-mail tag.

Henri Nouwen's classic book, Making All Things New, likens our lives to "overstuffed suitcases that are bursting at the seams."

Feeling there is forever far too much to do, we say we're really under the gun this week. But working hard or even heroically to solve a problem is little to our credit if we created the problem in the first place. When most people refer to themselves as being under the gun, they want to believe, or do believe, that the pressures and problems are not of their own making. In most cases, however, the gun appeared after failure to attend to business in good time. Instead of being proactive early, they procrastinated until the due date became a crisis deadline.

One of the best escapes from the prison of procrastination is to take even the smallest steps toward your goals. People usually procrastinate because of fear and lack of self-confidence and, ironically, become even more afraid when under the gun. There are many ways to experiment and test new ground without risking the whole ball game on one play.

Experience has shown that when people go after one big goal at once, they invariably fail. If you had to swallow a twelve-ounce steak all at once, you'd choke. You have to cut the steak into small pieces, eating one bite at a time. So it is with prioritizing. Proactive goal achievement means taking every project and cutting it up into bite-sized pieces. Each small task or requirement on the way to the ultimate goal becomes a mini-goal in itself. Using this method, the goal becomes manageable. When mini-mistakes are made, they are easy to correct. And with the achievement of each mini-goal, you receive reinforcement and motivation in the form of positive feedback. As basic as this sounds, much frustration and failure is caused when people try to "bite off more than they can chew" by taking on assignments with limited resources and impossible timeline expectations.

Two major fears that sire procrastination are fear of the unknown and fear of rejection or looking foolish. A third fear - of success - is often overlooked. Many people, even many executives, fear success because it carries added responsibility that can seem too heavy to bear, such as setting an example of excellence that calls for additional effort and willingness to take risks. Success, without adequate self-esteem or the belief that it is deserved, also can create feelings of guilt and the result is only temporary or fleeting high achievement. Playing it safe can seem more tempting than a need to step forward with determination to do it now and do it right.

Here are some ideas to help make you a victor over change rather than a victim of change:

1. Set your wake-up time a half hour earlier tomorrow and keep the clock at that setting. Use the extra time to think about the best way to spend your day.

2. Memorize and repeat this motto: "Action TNT: Today, not Tomorrow." Handle each piece of incoming mail only once. Answer your e-mail either early in the morning or after working hours. Block out specific times to initiate phone calls, personally take incoming calls, and to meet people in person.

3. When people tell you their problems, give solution-oriented feedback. Rather than taking on the problem as your own assignment, first, ask what's the next step they plan to take, or what they would like to see happen.

4. Finish what you start. Concentrate all your energy and intensity without distraction on successfully completing your current major project.

5. Be constructively helpful instead of unhelpfully critical. Single out someone or something to praise instead of participating in group griping, grudge collecting or pity parties.

6. Limit your television viewing or Internet surfing to mostly educational or otherwise enlightening programs. Watch no more than one hour of television per day or night, unless there is a special program you have been anticipating. The Internet has also become a great procrastinator's hideout for tension-relieving instead of goal-achieving activities.

7. Make a list of five necessary but unpleasant projects you've been putting off, with a completion date for each project. Immediate action on unpleasant projects reduces stress and tension. It is very difficult to be active and depressed at the same time.

8. Seek out and converse with a successful role model and mentor. Learning from others' successes and setbacks will inevitably improve production of any kind. Truly listen; really find out how your role models do it right.

9. Understand that fear, as an acronym, is False Evidence Appearing Real, and that luck could mean Laboring Under Correct Knowledge. The more information you have on any subject - especially case histories - the less likely you'll be to put off your decisions.

10. Accept problems as inevitable offshoots of change and progress. With the ever more rapid pace of change in society and business, you'll be overwhelmed unless you view change as normal and learn to look for its positive aspects - such as new opportunities and improvements - rather than bemoan the negative.

There is actually no such thing as a "future" decision; there are only present decisions that will affect the future. Procrastinators wait for just the right moment to decide.

If you wait for the prefect moment, you become a security-seeker who is running in place, unwittingly digging yourself deeper into your rut. If you wait for every objection to be overcome, you'll attempt nothing. Make your personal motto: "Stop stewing and start doing!"
This week, get out of your comfort zone and go from procrastinating to proactivating!

Denis Waitley

Wednesday, February 3, 2010

Higher Intakes of Fiber Help Prevent Weight Gain

Higher Intakes of Fiber Help Prevent Weight Gain

It is known that dietary fiber may play a role in obesity prevention. The role that different individual fiber sources play in weight change is less certain. In a recent paper published in the American Journal of Clinical Nutrition, researchers investigated the association of total dietary fiber, cereal fiber, and fruit and vegetable fiber with changes in weight and waist circumference.

The prospective cohort study included 89,432 European participants, aged 20–78 years, who were initially free of cancer, cardiovascular disease, and diabetes. Participants were followed for an average of 6.5 years. Adjustments were made for follow-up duration, dietary variables, and baseline anthropometric, demographic, and lifestyle factors.

Total fiber was inversely associated with weight and waist circumference change during the study period. For a 10 gram/day higher total fiber intake, there was an estimated 39 g/year weight loss and waist circumference decreased by 0.08 cm/year. A 10 gram/day fiber intake from cereals results in 77 g/year weight reduction and 0.10 cm/year reduction in waist circumference. Fruit and vegetable fiber was not associated with weight change but had a similar effect on waist circumference as total and cereal fiber intake.

Over a period of 6.5 years, weight gain and increases in waist circumference would be expected in typical adults. The findings of this research may support a beneficial role of higher intake of dietary fiber, especially cereal fiber, in prevention of weight and waist circumference gain.

Am J Clin Nutr Vol. 91, No. 2, 329-336, February 2010

Tuesday, February 2, 2010

New USANA Million Dollar Club Members!

Congratulations New Million Dollar Club Members!
USANA would like to congratulate and welcome its newest inductees into the Million Dollar Club: Emerald Director Takashi Kakino from Tokyo, Japan, Ruby Directors Tonja & Wade Hillebrant from Idaho, USA, and Ruby Director Elaine Lee from Missouri, USA.

Wednesday, January 27, was unforgettable as USANA greeted three more distributorships to this illustrious club! The inductees arrived at the USANA Home Office in a stretch limousine, and they were greeted by rousing the applause of USANA employees. They then met with a handpicked USANA management team to learn ways to continue building their successful businesses before enjoying lunch at one of Salt Lake City’s premier restaurants.

But that’s not all! The next day the new inductees received the royal treatment as they spent time doing activities they personally selected, including skiing in the beautiful Wasatch Mountains, getting a massage at the Grand America hotel, and shopping in Salt Lake’s boutiques.

Meet the New Members

Takashi Kakino, Tokyo, Japan
Emerald Director

From age 24, Takashi was looking for a way to accomplish his dreams. He tried another network marketing company but ended in failure. Then he found USANA. “I was determined to succeed in USANA to fulfill my dreams,” he states. “I was not about to give up.”

Though his USANA business brought many challenges, and there were days he did not see any progress at all, Takashi never gave up. “I have met a lot of fine people and have seized my health and financial freedom,” he states. “I now live in my dream house with a built-in garage where I can see my Ferrari from my living room. I thank Dr. Wentz as well as all USANA employees worldwide.”

In addition to being an Emerald Director and new Million Dollar Club member, Takashi was a Top Associate Enroller and a Top 25 Income Earner in Asia Pacific. He hopes to rank advance while continuing to promote Dr. Wentz’ vision.

Tonja & Wade Hillebrant, Idaho, USA
Ruby Directors

As a busy mother who was sick and tired of catching every bug, Tonja looked to USANA’s products for help. After seeing the results for herself, she wanted to share Dr. Wentz’ vision with everyone she met. “It has been an amazing ride since,” she states.

As Ruby Directors and new Million Dollar Club members, Tonja and Wade are grateful for what they’ve been able to achieve. “[Becoming a new Million Dollar Club member] represents the many people who have been helped by USANA’s products and business opportunity. In addition, we have built our dream home, traveled, and provided opportunities for our children that would not have been possible without our USANA business,” Wade states.

On January 20, they celebrated their “gotcha day,” the day they returned from Stavropol, Russia, with their new daughters. “We adopted two little princesses, Lyndee (Anna) and Kailtlyn (Sveta) now ages 10 and 12. USANA made it all possible.”

Elaine Lee, Missouri, USA
Ruby Director

With a stressful real estate career that demanded 18-hour days, Elaine was looking for a change. “The pager and cell phone were my boss,” she laughs. “Often at special family events, my job would demand my attention and departure rather than allowing me to enjoy my family. I wanted the freedom to enjoy the people I loved.”

When Elaine discovered USANA, she saw that there would be the ability to create a serious income. Today, her thriving USANA business gives her significant time and resources to spend on her family, friends, and church ministries. “This accomplishment represents a residual income that supports the dream I have for the years ahead,” Elaine states. “I can choose adventure. I can choose to be generous. I can choose to support church ministries with time and money. And I can choose to be good to my toddler and college-age grandchildren in the years ahead. Freedom of choice is a beautiful thing.”

In addition to being a Ruby Director and new Million Dollar Club member, Elaine was a Top Income Earner in 2005 and in the Fortune 100 in 2006 and 2007.

(From USANA Today)

Monday, February 1, 2010

The Case for Nutritional Supplements

The Case for Nutritional Supplements In Primary Prevention

by Tim Wood, Ph.D.
Executive Vice President, R&D
USANA Health Sciences, Inc.

Executive Summary

The value of nutritional supplements in promoting and protecting human health is intensely debated. Some argue that supplements provide a convenient and effective means for supplying the optimal intakes of essential nutrients that people need for good health. Others argue that there is no conclusive evidence that supplements provide any true health benefits at all. The latter argument has been bolstered over the past several years by a steady stream of negative research reports published in leading medical journals.

This paper examines the supplement debate and questions some of the recent evidence suggesting that nutritional supplements are ineffective and unsafe. It is argued that much of the current controversy and negativity surrounding nutritional supplements results from inappropriate use of a pharmaceutical, acute-care model in the clinical evaluation of nutritional products; products whose real value is in preventing rather than treating disease. As a result of this mismatch, nutritional supplements are often tested inappropriately, results of studies are interpreted less than objectively, and valid but non-clinical evidence of benefit is often discounted or ignored.

As a case in point, I focus on vitamin E supplements and their role in preventing heart disease. But the central tenets raised in this paper pertain to nutritional supplements in general, and to much broader issues surrounding the field of primary prevention as a whole. We now spend about $2.0 trillion dollars annually on healthcare in the US. Ninety-eight percent of this spending goes to the treatment of injuries and disease. And, the lion’s share goes to the treatment of chronic degenerative diseases (e.g. heart disease, cancer, and type 2 diabetes), the leading causes of premature death and disability in our society. Only 2% of our healthcare dollars are spent on primary prevention; measures designed to keep healthy people healthy. This despite the fact that most chronic degenerative diseases are highly (60-90%) preventable.

In this light, increased emphasis on primary prevention holds tremendous potential for improving the effectiveness of our healthcare system. Most Americans have the opportunity to add years of health to their lives by embracing prudent lifestyle strategies and habits over the long-term. Clearly, such strategies need to be broad-based, encompassing diet, nutrition, exercise, stress management, and the avoidance of harmful habits like smoking. And just as clearly, a program of responsible supplementation, designed to compliment healthy eating habits and provide the advanced levels of essential vitamins, minerals and antioxidants required for lifelong health, can play an important role in this endeavor. The science, when approached broadly with an open mind, is convincing on this point.


Tim Wood is Executive Vice President of Research and Development for USANA Health Sciences, Inc. He received his Ph.D. in the Biological Sciences from Yale University in 1980. He also holds an MBA from the Gore School of Business. Dr. Wood joined USANA Health Sciences in 1996 and has overseen the company’s Research and Development, Quality Assurance, and International Regulatory efforts since that time.


The value of nutritional supplements in promoting and protecting human health is intensely debated. Some argue that supplements provide a convenient and effective means for supplying, on a daily basis, the optimal intakes of essential nutrients that people need for good health. Others argue that there is no conclusive evidence that supplements provide any true health benefits at all. The latter argument has been bolstered over the past several years by a steady stream of negative research reports published in leading medical journals. Several such papers have concluded that antioxidants and B vitamin supplements are ineffective at reducing the risks of heart disease and cancer (Lee et al, 2006; Kirsh et al, 2006;Zoungas et al, 2006). Others have reported that calcium and vitamin D supplements provide at best incomplete protection against osteoporosis (c.f. Jackson et al, 2006). Still others have questioned the safety of nutritional supplements (c.f. Bjelakovic et al, 2004, Bairati et al, 2005; Miller et al, 2005). Each time such studies appear, newspaper headlines blare “Supplements Proven to Be Snake Oil” or “Vitamin E May Be Deadly”. Morning talk shows feature doctors and alternative practitioners who argue over the latest findings. Sadly, the public grows more confused about what to believe concerning the role of nutrition and nutritional supplements in health.

This paper examines the supplement debate and questions some of the recent evidence suggesting that nutritional supplements are ineffective and unsafe. I argue that much of the current controversy and negativity surrounding the benefits of nutritional supplements result from inappropriate use of a pharmaceutical, acute-care model in the clinical evaluation of nutritional products - products whose real value is in preventing rather than treating disease. It is further argued that while the case against supplements may be evidence-based, the relevance of much of that evidence is questionable.

Healthcare versus Disease Management

This year, Americans will spend $2 trillion on healthcare (Borger et al, 2006). This enormous sum represents about $7,000 in healthcare spending for every man, woman, and child in the US. It also equates to a spending rate of more than $60,000 per second…and that’s 24-7-365. How is this money being spent? Ninety-eight percent goes to the treatment of injuries and disease, and the lion’s share of this goes to the treatment of chronic degenerative diseases such as heart disease, cancer, type 2 diabetes, osteoporosis, Alzheimer’s disease, and the like. Today, these are the leading causes of premature death and disability in our society (CDC, 2002).

In comparison, only 2% of our healthcare dollars are spent on primary prevention - measures designed to keep healthy people healthy. This despite the fact that all of the chronic degenerative diseases listed above are highly preventable. It is estimated, for example, that 60-70% of the current cases of heart disease could have been prevented through improved nutrition, better exercise habits, avoidance of smoking, and the adoption of other healthy lifestyle habits (Koop, 2002). Similar statistics apply to the prevention of cancer, stroke, cataracts, osteoporosis, and macular degeneration (c.f. Michel, 2002; Rosenthal, 2002). Type 2 diabetes is thought to be 90% preventable, largely through improved nutrition and exercise (Hu et al, 2001).

This lopsided pattern in spending is a clear reflection of today’s dominant healthcare paradigm; one that focuses on disease treatment rather than disease prevention. Ours is a reactive as opposed to proactive healthcare system. We wait for people to develop chronic illnesses, and then we spend enormous amounts of money treating those illnesses. The alternative, a focus on primary prevention and an investment in keeping healthy people healthy, receives lip service, but is largely ignored in practice. Clearly our healthcare system is less about caring for health and more about managing disease.

It is also a system of high-tech, acute-care medicine based on the promise of powerful, fast acting drugs and surgeries that produce therapeutic results in hours, days or weeks. We spend tens of billions of dollars every year on medical research in a quest to develop ever more effective diagnostics, drugs, drug delivery systems, implants, and surgeries (Meeks, 2002). And we spend billions more on patenting these technologies. Why? Because our healthcare system is lucrative. It is no accident that we spend $2 trillion annually on healthcare in the US, that pharmaceutical companies rank among the most profitable in America, and that our healthcare costs are rising at near double-digit rates that surpass inflation and growth in our Gross Domestic Product (Polich, 2005; Borger et al, 2006).

To be sure, acute, treatment-based medicine is useful and effective in dealing with urgent medical conditions such as trauma, infection, or incipient heart attacks. However, our almost singular focus on reactive, acute-care medicine also carries serious limitations, costs and liabilities. This approach is not particularly effective in dealing with chronic degenerative diseases like heart disease, cancer and osteoporosis. After decades of research, we still have no reliable cures for these diseases. We can treat them and manage them, but we cannot cure them. Moreover, this approach is expensive, both in dollars spent and in years of health lost to premature death and disability. Chronic diseases rob far too many Americans of their health, independence, and quality of life far too early (Michaud et al, 2001). Finally, acutely acting medicines and surgeries have many undesirable side effects. Every year, prescription drugs - taken as prescribed - injure more than 1.5 million Americans so severely that they require hospitalization. One hundred thousand others are killed by prescription drugs, making such medicines a leading cause of death in the United States (Lazarou et al, 1998).

A Vital Role for Primary Prevention

Is there a better way? I would argue that rebalancing our healthcare system to include a larger emphasis on primary prevention is an essential step. I would further argue that we can act now. We know enough today about the principles of primary prevention, and about the basics of a healthy lifestyle (nutrition, exercise, stress management, avoidance of smoking, etc) to implement significant improvements without delay. And I would argue that nutritional supplementation can play a vital role in this arena.

The research is clear. Diet and nutrition play key roles in supporting good health (WHO, 2003). It is equally clear that Americans, as a whole suffer from generally poor nutritional habits (Frazao, 1999). As a nation we are overfed and undernourished. Two thirds of American adults are overweight or obese (Flegal et al, 2002; Hedley et al, 2004), and high percentages of us are chronically deficient for one or more of the essential vitamins, minerals and antioxidants (FASEB, 1995).

Some would argue that this problem lies in poor diet alone; that all we need to do is eat better. Clearly, a healthy well balanced diet is an absolute foundation for any program of optimal nutrition. But is a healthy diet enough? Can we obtain “optimal levels” of the essential vitamins, minerals, and antioxidants on a routine basis from diet alone? Many, including myself, argue “no”; that optimal intakes of the essential nutrients, intakes required to optimize health and minimize the risk of chronic diseases, are significantly higher than the amounts that can be obtained routinely from food (and significantly higher than the current RDA’s). In my view, optimal nutrition is best achieved through a combination of a healthy well balanced diet plus a responsible program of nutritional supplementation. In my view, a healthy diet and nutritional supplements are not mutually exclusive. This is not an “either-or” proposition. It is an “and” proposition.

Is there substantial scientific evidence to support this notion? Yes. There are hundreds of scientific studies showing that regular and responsible use of nutritional supplements can benefit people’s health both in the short- and long-terms (Dickinson, 1998). Have all supplement studies shown positive benefits, and are all the findings consistent? No. As with any body of exploratory research, negative findings and inconsistent results appear in the mix. But when the science is reviewed in full, the evidence for defined benefits is convincing. There are scores of studies supporting the role of calcium and vitamin D supplementation for promoting strong, mineral-rich bones and reducing the risk and progression of osteoporosis (c.f. Chevalley et al, 1994; Dawson-Hughes et al, 1997; Chapuy et al, 1994; Recker et al, 1996; Larsen et al, 2004). There are scores of studies supporting the use of B vitamin supplements for reducing the risks of some birth defects and lowering some markers of heart disease (c.f. MRC Vitamin Study Research Group, 1991; Berry et al, 1999; Czeizel and Dudas, 1992; Lobo et al, 1999; Woodside et al, 1998; Bronstrup et al, 1998; Schnyder et al, 2002). In addition, numerous studies link antioxidant supplementation to reduced incidence of cataracts, heart disease, and some cancers (Jacques et al, 1997; Mares-Perlman et al, 2000; AREDS Research Group, 2001; Stampfer et al, 1993; Stephens et al, 1996; Clark et al, 1998; Meyer et al, 2005). Fish oil supplements have been shown to support improved cardiovascular health and neural development (GISSI-Prevenzione Investigators, 1999; Bucher et al, 2002; Studer et al, 2005; Carlson et al, 1993; Birch et al, 2000). And the list goes on.

Why then, is the role of nutritional supplementation in healthcare so hotly debated? Clearly, this is a complex issue, but I believe that much of this debate stems from a fundamental incompatibility between our current healthcare paradigm (acute, disease-focused medicine) and the basic tenets of primary prevention. Moreover, current approaches to medical research, geared largely toward the evaluation of acute, fast-acting medicines and surgeries, are in most cases inappropriate for the study of long-term primary preventive measures like nutritional supplementation. As a result, nutritional supplements are often tested inappropriately, results of studies are interpreted less than objectively, and valid but non-clinical evidence of benefit is often discounted or ignored.

Conventional Medicine Looks at Vitamin E: A Case in Point

These challenges are perhaps most evident in the scientific literature concerning vitamin E supplements and heart disease. In the early 1990’s, a large body of scientific evidence pointed to oxidative stress as a disease process in the onset and progression of atherosclerosis. This same research suggested in various ways that antioxidants like vitamin E might be important in preventing this disorder. Numerous epidemiological (population based) studies, many involving tens of thousands of subjects, concluded with consistency that people who consumed high amounts of vitamin E through diet and supplements were at 30-50% lower risk for heart attacks or death due to heart disease relative to those people who consumed minimal amounts of vitamin E (Stampfer et al, 1993; Rimm et al, 1993; Losonczy et al, 1996; Kushi et al, 1996; Meyer et al, 1996). Typically, the levels of vitamin E that were protective totaled hundreds of International Units per day, many times higher than the Recommended dietary Allowance (RDA).

A. An Early Clinical Evaluation

To further test this protective effect, clinical research on vitamin E supplementation and heart disease was undertaken at several centers. In January 2000, results from one of the first such studies were published in the New England Journal of Medicine (Yusuf et al, 2000). The Heart Outcomes Prevention Evaluation (HOPE) involved over 9,500 subjects 55 years of age or older who were at high risk for cardiovascular events because they had advanced cardiovascular disease, diabetes, or similar risk factors. Over half, in fact, had had a previous heart attack. Half the subjects in the trial were assigned at random to take 400 IU daily of natural-source vitamin E. The remainder were given placebo capsules. Average follow-up was 4.5 years, during which time, subjects were monitored for primary and secondary cardiovascular events such as nonfatal heart attacks, stroke, angina, and death.

Results of the HOPE study showed that, after 4.5 years, there were no significant differences in the numbers of heart attacks, strokes, reports of angina, or deaths due to heart disease between the treatment and placebo groups. The authors of the paper correctly and appropriately concluded that “in patients at high risk [emphasis added] for cardiovascular events, treatment with vitamin E for 4.5 years has no apparent effect on cardiovascular outcomes”.

Unfortunately, while the conclusions reached by the authors were appropriate, much of the editorializing in the medical and popular press was not. Instead, headlines and sound bites touted the results of the HOPE study as conclusive proof that vitamin E supplements provided no benefits for cardiovascular health. Others declared the findings as “the last nail in the coffin for vitamin E”.

HOPE is only one of several clinical trials to have evaluated the efficacy of vitamin E in preventing cardiovascular events in high-risk groups. While two such trials showed significant benefit (Stephens et al, 1996; Boaz et al, 2000), the majority, like the HOPE study, produced disappointing results (GISSI-Prevenzione Investigators, 1999; Collaborative Group of the PPP, 2001). Does this mean that vitamin E is ineffective as a preventive agent? In answering this question, two important issues need to be addressed.

First, the standard model for clinical research requires testing one remedy (one drug) at a time, so that the true, isolated effect of that drug can be identified and measured. This is good science. However, it is not necessarily appropriate in the field of preventive nutrition.

Humans require a full range of some 25-plus essential vitamins, minerals, and antioxidants, in proper amounts and balances, to support good health. This is because vitamins and minerals work in teams to support, for example, robust energy metabolism and protein synthesis. Similarly, antioxidants work most effectively in groups and networks (Packer and Obermuller-Jevic, 2002), each playing a unique role in channeling and quenching the chain-like series of oxidative reactions that can result from a single oxidative event. As such, high-doses of a single nutrient represent an incomplete and inappropriate approach to boosting overall antioxidant protection. This would be analogous to testing the hypothesis that broccoli has cancer-preventive properties by putting people on an all- broccoli diet. It’s not likely to work, and it carries the risk of creating nutrient imbalances, unwanted side effects, and experimental artifacts.

Second, an important distinction needs to be drawn between primary and secondary prevention. Primary prevention involves keeping healthy people healthy. It is about preventing the development of disorders like heart disease in the first place. Secondary prevention is about preventing further progression of a disease that people already have (CDC, 1992). Moreover, because chronic diseases like heart disease and osteoporosis develop over a lifetime, primary prevention needs to be viewed as a lifelong (decades long) undertaking. It is not something that is accomplished over a year or a few years. Within this context, the HOPE study was clearly a secondary prevention trial. It had nothing to do with primary prevention. Study subjects were selected because they already had advanced heart disease. Consequently, attributing the findings of this study to the general (healthy) public is inappropriate.

Is it possible for something to be an effective primary preventive agent without being an effective secondary preventive agent? I believe so. Dentists tell us to floss our teeth to prevent tooth decay and avoid the need for root canal surgery. If you were to select a group of people with advanced tooth decay, many who had chronic tooth aches, and divided them into two groups, telling one to floss regularly and the other to refrain from flossing, what do you think would happen? Would the flossing group experience significantly fewer tooth aches, fewer tooth extractions and fewer root canal surgeries in the short-term? Probably not; the flossing came too late in the day to change the course of existing disease.

A similar situation may exist with respect to vitamin E and heart disease. It is very possible that vitamin E, acting as an antioxidant over the long-term, may help to prevent atherosclerosis. Epidemiological research certainly supports this notion. However, vitamin E may be ineffective in preventing the rupture of existing atherosclerotic plaques (thus triggering a heart attack, stroke, or cardiovascular death). The HOPE trial and similar clinical studies support this notion. As such, vitamin E supplementation may be an effective long-term measure for the primary prevention of heart disease, while being an ineffective short-term secondary prevention measure or cure (Lewis, 2004). Clearly this hypothesis deserves attention, and the following study put it to the test.

B. Vitamin E and the Primary Prevention of Heart Disease

In 2005, the results of a clinical trial on vitamin E supplementation for primary prevention of heart disease and cancer were published in the Journal of the American Medical Association (Lee et al, 2005). This randomized placebo-controlled study involved almost 40,000 women at least 45 years of age who had no history of heart disease or cancer. Half of the women were assigned to the vitamin E treatment (600 IU natural-source vitamin E every other day). Half were assigned to placebo. Average follow-up was just over 10 years. As such, this trial differed from the HOPE study in that it was a true primary prevention trial. Moreover, it lasted a full decade, an improvement over HOPE’s 4.5 year duration.

Results of the study indicated that vitamin E had no effect on cancer incidence or cancer mortality. However, there were notable benefits for cardiovascular health. Overall, vitamin E use showed a protective trend toward reducing the risk of total major cardiovascular events among all women in the study. While individual impacts on heart attacks and stroke were nil, there was a statistically significant 24% reduction in cardiovascular deaths among women in the vitamin E group. And importantly, when the data for women at least 65 years old were examined separately, there was a significant 26% reduction in major cardiovascular events, which included a 34% reduction in nonfatal heart attacks and a 49% reduction in cardiovascular death. These are very significant protective effects, and they are particularly relevant because women tend to suffer from heart disease in their senior years following menopause (Mosca et al, 1997). As such, if vitamin E were to have an effect, it would likely be most pronounced in this age group.

Despite these findings, the conclusions reported in the abstract of the study were as follows.

“The data from this large trial indicated that 600 IU of natural-source vitamin E taken every other day provided no overall benefit for major cardiovascular events or cancer, did not affect total mortality, and decreased cardiovascular mortality in healthy women. These data do not support recommending vitamin E supplementation for cardiovascular disease or cancer prevention among healthy women.”

This despite the fact that vitamin E supplements reduced cardiovascular deaths by 24% across all women and by 49% among women 65 years or older. Why was this benefit largely ignored? Because cardiovascular death, while measured in the study, was not a specified clinical parameter – in other words, because the study was not specifically designed to report on this benefit. So instead the authors concluded there was “no overall benefit” and that the results of the study “[did] not support recommending vitamin E supplementation for healthy women.”

These conclusions appear less than objective, and they beg the question of bias against nutritional supplements, or primary prevention, or both in the medical community. Would it not have been more appropriate to conclude that vitamin E had an apparent primary preventive effect against heart disease in women, and that the benefits were most significant in senior women…the group at highest risk for suffering a major cardiovascular event? I will return to this point later.

C. The Safety of Vitamin E is Questioned

In January 2005, a research article entitled “Meta-Analysis: High-Dosage Vitamin E Supplementation May Increase All-Cause Mortality” was published in the Annals of Internal Medicine, a respected medical journal (Miller et al, 2005). This study called the safety of vitamin E supplements into question. It was conducted by scientists at Johns Hopkins Medical Institutions who pooled the results of 19 clinical trials involving vitamin E supplementation at doses of 16 to 2,000 IU per day. In total, the 19 trials included almost 136,000 subjects. In none of the individual trials was a statistically significant increase in mortality observed from vitamin E supplementation. But when the 19 trials were examined together, there were weak but apparent trends towards decreased mortality in subjects taking low doses of vitamin E (< 400 IU/d) and increased mortality in subjects taking high doses of vitamin E ( 400 IU/d). The overall conclusion of the statistical analysis was that high-dose vitamin E may increase the risk of all-cause mortality by about 5%, and therefore, should be avoided. Could the results be real? Yes, it is possible. At high doses, some essential nutrients can produce imbalances and adverse effects (Hathcock, 1997a). Nevertheless, three important points argue against the conclusions of this study. First, the toxicology and safety of vitamin E have been extensively reviewed, and experts agree that tolerable upper intakes are on the order of 1000 mg per day (about 1500 IU per day) (Hathcock, 1997b, Food and Nutrition Board, Hathcock et al, 2005). Second, several large epidemiological studies that identified and followed groups of people consuming high doses of vitamin E (>400 IU/d) over the long-term, did not show increased risk of mortality. In fact they generally showed a reduced risk of dying relative to those people consuming the least amounts of vitamin E (Stampfer et al, 1993; Rimm et al 1993; Losonczy et al, 1996; Meyer et al, 1996; Kushi 1999).

Third, while it is possible that high-dose vitamin E could have adverse effects for certain groups, the Johns Hopkins study did not provide conclusive evidence of harm. The study suffered from several important weaknesses. As noted by the authors themselves, all of the studies included in the meta-analysis were conducted on subjects who were chronically ill. They included patients with heart disease, cancer, Alzheimer’s disease, type 2 diabetes, or related disorders. In short, the subjects were at high risk for dying to begin with. In addition, many of the studies included in the analysis were small, containing several hundred as opposed to several thousand subjects. And in fact, the smaller studies were the ones that typically showed the larger deviations from normal mortality rates. Given these issues, the authors concluded that “the generalizability of the findings to healthy adults is uncertain”.

Moreover, a third and critical weakness of the analysis was largely overlooked. In all, the authors identified 36 studies involving vitamin E supplementation that fit the primary criteria for review. Of these, 19 were included in the final meta-analysis, five were excluded because mortality data was not available or was insufficiently reported, and 12 studies were excluded because not enough people died in them. This latter exclusion is suspect. The authors suggest that mortality data was available, but close to zero in both the vitamin E and control treatments. I would argue that this is not a sufficient and rational reason for excluding the studies from the analysis. And given the weak nature of the trends as reported in the paper, it is highly likely that no effect of vitamin E on all-cause mortality would have been seen had the 12 additional studies been included in the meta-analysis. As such, I believe that the results and conclusions of the study are seriously flawed and biased. I would be less critical if the title of the paper had been “High-Dosage Vitamin E Supplementation May Increase All-Cause Mortality in Very Ill Subjects at High Risk for Dying”; and if the conclusion had been that high dose vitamin E should be used cautiously by chronically ill people in that high risk group. But these distinctions were not evident in the paper or the press.

The Need for a Broader Healthcare Perspective

Our current approach to healthcare, with its almost singular focus on reactive acute-care medicine, presents challenges for the study and implementation of long-term primary preventive healthcare measures, including nutritional supplementation. As the cases discussed above illustrate, nutritional supplements are often tested inappropriately, results of studies are interpreted less than objectively, and valid but non-clinical evidence of benefit is often ignored or discounted.

Do these studies constitute bad science? Clearly, some of the methodologies are flawed. The criteria for exclusion of studies from the Johns Hopkins meta-analysis are questionable, and they likely biased the results and conclusions of this research. However, the real challenge is not so much one of poor science as it is one of inappropriate approach and trial design. The majority of studies on the health benefits of nutritional supplements have tested supplements as though they were acute-acting therapeutic agents expected to provide dramatic health benefits over the short-term in acutely ill people. This is a fundamentally flawed outlook.

The principal value of nutritional supplementation lies in primary prevention; that is, in approaches to keeping healthy people healthy. Importantly, primary prevention is also a lifelong undertaking. We suffer heart attacks and hip fractures as seniors, but the roots of heart disease and the beginnings of osteoporosis are evident in childhood and adolescence. As such, the prevention of these diseases needs to begin in childhood and progress lifelong. The timeframes of primary prevention are measured in decades and lifetimes, not in hours, days, months, or years.

Such long timeframes are beyond the purview of acute-care medicine, in part because they pose significant operational challenges for clinical research. How does one manage a double blind, placebo-controlled clinical trial, the gold standard of medical science, over a period of decades? Epidemiological studies more easily embrace long timeframes, and as such are useful in studying preventive measures. However, they also tend to be less well controlled and less precise. This troubles many in mainstream medicine who then discount or disregard epidemiological science altogether. Does this constitute tunnel vision? I believe it does. Our understanding of the link between a balanced diet and long-term health is largely based on epidemiology. Our understanding of the link between smoking and lung cancer is largely based on epidemiology. In short, good epidemiological research constitutes sound science and should not be discounted or ignored (Kushi, 1999; Potischman and Weed, 1999). It was a mistake in 1964 when the American Medical Association refused to endorse the Surgeon General’s Report on Smoking (the AMA was the last public health organization to do so), claiming that the research was inconclusive (Weiner, 1996). And it is a mistake today to overlook epidemiology in assessing the role of nutritional supplements in preventive healthcare. In short, advances in primary prevention will require healthcare scientists to review and give serious consideration to a broad body of scientific evidence that extends well beyond the clinical trial paradigm.

It will also require a more open-minded and objective interpretation of results. The finding that vitamin E supplementation, over a 10 years period, reduced cardiovascular deaths by 24% in women over 45 years of age, and by 49% in women over 65 years of age (Lee et al, 2005) may have been disappointing to those steeped in acute care medicine (although I don’t understand why). But these are significant and positive findings within the context of primary prevention. In short, vitamin E worked. Why then did the authors conclude that it “provided no overall benefit for major cardiovascular events” and refrain from recommending vitamin E supplementation for the primary prevention of heart disease? And why did the popular press lead their coverage of this study with headlines stating “Vitamin E Gets and ‘F’”? Simply put, the findings did not fit the paradigm.

Poor reporting and bias in the press is easy to understand. Most journalists are not trained scientists, statisticians, or healthcare professionals. As such, they are not qualified to interpret medical studies objectively and competently. Moreover, Job One at major news organizations involves selling more newspapers and capturing more viewers, and they accomplish this by crafting controversial headlines and scary sound bites. If you want the masses to listen, frighten them. Unfortunately, the delivery of objective and complete information appears to be a distant Job Two.

This is an unfortunate situation, in that many Americans rely on the popular press for their health information. As such, the sensational and controversial coverage given to nutrition news has generated confusion, doubt, and skepticism in the public’s mind, turning many against the diet and health message (Patterson et al, 2001).

Why would medical professionals have a negative bias against nutritional supplements? Several reasons come to mind. Most doctors receive no more than a few hours of nutritional training during their medical education. They know little about nutrition and the important role it plays in human health. Second, many express concerns that their patients might use supplements as an excuse to eat poorly. This concern has proved to be unfounded. Surveys show that supplement users tend to be health-conscious and to follow generally healthy habits. Third, many doctors have a low opinion of the nutritional supplement industry - and rightfully so. Too many supplement companies sell substandard products that fail to meet pharmaceutical standards for potency, purity, and efficacy. Too many companies fail to pay sufficient attention to safety. And too many companies make false and outrageous health claims for their products. Clearly this industry needs an overhaul to win the respect and confidence of doctors and the general public. But just as clearly, there are very reputable supplement companies in business today; companies that have adopted pharmaceutical standards for product quality, safety and efficacy; company’s that deserve the public’s trust.

These issues aside, I believe that the most significant barrier to the open consideration of supplement use in mainstream healthcare is the closed mind. Primary prevention, the focus of keeping healthy people healthy, lies outside the acute-care paradigm, and so it is ignored. Some in the mainstream pay lip service to prevention, but few base their practices or research careers on it. And sadly, because primary prevention is “alien”, it is often derided as “ineffective”, “too slow”, “unreliable”, “clinically unproven”, and “only partially effective”.

Unfortunately, these attitudes carry over to nutritional supplements. As tools of primary prevention, nutritional supplements also lie outside the acute care paradigm. When they are evaluated within that paradigm for short-term treatment / curative benefits, one or two nutrients at a time, on chronically ill people, they often fail. These failures, in turn, are judged as evidence that supplements have no benefit whatsoever.

Clearly it’s time to challenge these notions and views. Change may begin at the grass roots level, as rising healthcare costs threaten to close the doors of access to good medical care. Today, too many Americans literally can’t afford to get sick. Our alternative is primary prevention. We can choose to take charge of our health by adopting prudent lifestyle strategies and habits for staying healthy long-term. Nutritional supplementation can play an important role in this endeavor. The science, when approached broadly with an open mind, is convincing on this point. As components of healthy living, nutritional supplements can help people add years of health to their lives.


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