Studies of the value of supplemental nutrition keep producing conflicting conclusions.

Some evidence reviews question the value of daily multivitamins, while others find definite benefits.

For example, see Are Multivitamins Worse than Worthless? and Vitamin Studies Paint a More Positive Prevention Picture.

And research continues to find benefits from specific supplemental nutrients — as well as widespread nutrient deficiencies along Americans.

Why can’t scientists come to a clear conclusion? There are three probable reasons.

First, most studies are epidemiological in nature, and therefore cannot prove a cause-effect relationship between a supplemental nutrient and health outcomes.

Second, few clinical trials that test the effects of dietary supplements last long enough to reveal possible long-term benefits.

Third, most clinical studies are designed to test the effects of one supplemental vitamin or mineral — which doesn’t capture the benefits of ensuring optimal intakes of multiple nutrients, including ones not currently considered “essential”.

Finally, evidence reviews concerning the potential benefits of supplemental nutrition focus on prevention of specific diseases or deficiencies, rather than broad “anti-aging” effects.

These shortcomings of the current approach explain why professor Bruce Ames, PhD — one of the world’s most published and honored biochemists — thinks we need to view the value of micronutrients in a very different way.

(To learn more about this pioneering, widely praised researcher, see “Who is Bruce Ames?” at the end of this article.)

Dr. Ames’ work has been focused on lengthening people’s “health spans”. Your lifespan is how many years you live, while your health span is how long you live in good health — which may matter as much or more to many people.

Let’s delve into his theory about the long-term effects of micronutrients —the vitamins and minerals officially deemed essential, plus other, more obscure compounds — and list the ones he identifies.

Health span and the triage theory of micronutrients
Dr. Ames argues that nutrition science overlooks the fact that most vitamins and minerals are required by dozens to hundreds of different enzymes within our cells.

Accordingly, the same nutrients we need to survive and maintain basic bodily functions — such as vitamin D, omega-3 fatty acids, and magnesium — are also critical components of enzymes required for our bodies’ long-term health.

Those long-term maintenance tasks include repairing DNA damage and preventing cellular damage inflicted by excess amounts of free radicals, both of which promote chronic health conditions such as cardiovascular disease, dementia, autoimmune disorders, and cancer.

(Excesses of free radicals are typically caused by poor diets, pollution, alcohol/drug abuse, and sedentary lifestyles, and can damage DNA.)

When the body is faced with shortages of key nutrients, it must “ration” them, enabling enzymes critical to our immediate survival and reproductive capacity to keep functioning at the expense of longer-term physiological needs.

Dr. Ames’ team has published substantial evidence that such trade-offs can be seen in people with chronic, low-level deficiencies in vitamin K and selenium, which are key components of 16 and 25 different enzymes, respectively.

Published studies from the Ames lab suggest that, when forced to ration scarce vitamin K for its critical role in blood clotting, the body produces fewer enzymes required for keeping arteries clear, which has been linked to higher rates of mortality from cardiovascular disease.

Ames calls this theoretical framework “triage theory,” echoing a concept used by military and hospital health professionals to prioritize patients for treatment according to the seriousness of their illness or injury.

As Ames wrote, “The prevention of the degenerative diseases of aging is a different science than curing disease: it will involve expertise in metabolism, nutrition, biochemistry and genetic regulatory elements and polymorphisms.”

(We’ve covered development of triage theory since Dr. Ames first proposed it: see Selenium Seen as Key Anti-Aging AllyMagnesium Shortage Speeds Aging of America, and Seafood Mineral May Deter Diabetes.

Dr. Ames also makes an important socio-economic point: “This approach is critical for lowering medical costs. It has been estimated that the E.U. would save about $4 billion from osteoporosis alone by using vitamin D and calcium supplementation.”

The 40+ nutrients critical to long-term health maintenance
Dr. Ames argues that most American diets are deficient in micronutrients that promote longevity and curb the risk of chronic conditions such as heart disease, cancer, and neurodegeneration (e.g., dementia).

However, the research cited in Dr. Ames’ new review shows that almost three out of four (70%) Americans are deficient in one or more key nutrients.

Most are not so deficient as to put their immediate health at risk from diseases such as rickets or scurvy, but Ames notes that even minor vitamin deficiencies could impact long-term health.

Dr. Ames brought the implications of his findings back to basics: “Diet is very important for our long-term health and this theoretical framework just reinforces that you should try to do what your mother told you: eat your veggies, eat your fruit, give up sugary soft drinks and [nutritionally] empty carbohydrates.”

His evidence review summarizes more than a decade of research in his laboratory at Children’s Hospital Oakland Research Institute (CHORI), which is affiliated with the University of California, San Francisco (UCSF).

Dr. Ames’ new paper encompasses a detailed survey of evidence published by other scientists and does not depend on his own research.

In brief, Dr. Ames concludes that healthy aging can be extended by consuming optimal levels of 30 essential vitamins and essential minerals, and that these nutrients — along with 11 others not currently considered essential — constitute a class of “longevity vitamins” that can extend a person’s “health span”.

In addition to the nine essential amino acids, these include:

  • Vitamins — vitamin A, B vitamins*, vitamin C, choline, vitamin D, vitamin E**, and vitamin K
  • Omega-3 fatty acids — DHA and EPA, which are found only in seafood and supplements.
  • Minerals/elements — calcium, chloride, chromium, cobalt, copper, iodine, iron, manganese, magnesium, molybdenum, phosphorus, potassium, selenium, sodium, sulfur, and zinc.

*B1 (thiamin), B2 (riboflavin), B3 (niacin), B5 (pantothenate), B6 (e.g., pyridoxine), B12 (cobalamins), biotin, and folate (folic acid is the synthetic form in supplements and fortified foods).
**Vitamin E is a complex of tocopheryl and tocotrienol compounds. Although tocopherols are more commonly used in supplements, tocotrienols are highly valuable but often overlooked.

Importantly, Dr. Ames calls for classifying the amino acid taurine as a conditional vitamin, and for classifying it and 10 other compounds as “longevity vitamins”:

  • Ergothioneine — An antioxidant found in mushrooms.
  • PQQ — A metabolite produced by bacteria in the human gut.
  • Queuine — A metabolite produced by bacteria in the human gut.
  • Carotenoids: Lutein, zeaxanthin, lycopene, alpha and beta-carotene, beta-cryptoxanthin, and the marine carotenoid astaxanthin.

To learn more about ergothioneine — and other valuable nutrients in fungi — see Newly Discovered Magic in Mushrooms.

Like CoQ10, PQQ is a co-enzyme whose antioxidant capacity helps defend against mitochondrial decay and dysfunction.

Queuine is the most obscure micronutrient in Dr. Ames' list, and as a French-American team wrote, “[Queuine is] an important but under-recognized micronutrient for plants, animals, and fungi … [making it] a micronutrient or even a vitamin.” (Zallot R et al. 2014)

Likewise, as Irish researchers said, “Micronutrients from the diet and gut microbiota are essential to human health and wellbeing. Arguably, among the most intriguing and enigmatic of these micronutrients is queuine …”. (Fergus C et al. 2015)

The Irish team noted that yogurt and milk contain “appreciable amounts of queuine and are likely to be sufficient to meet physiological requirements”.

Food remains the best source of most of the nutrients in Dr. Ames list, but you can’t easily obtain enough of all the micronutrients in it unless your diet includes foods across the spectrum, from meats and fish to fruits, vegetables, dairy, and mushrooms.

Supplements appear to be the only good sources of PQQ and astaxanthin. Although astaxanthin occurs in the flesh of wild salmon — and accounts for its red/orange color — the amounts (measured in micrograms) are probably too small to make much difference.

Krill oil supplements contain about 10 times more astaxanthin per dose, but only astaxanthin supplements provide the milligram doses clinically shown to enhance various aspects of human health.

Importance of diet to optimal health
Dr. Ames suspects many more longevity vitamins may remain to be discovered.

That’s because — unlike so-called “essential” micronutrients such as vitamin C, that were originally identified because we quickly become sick without them — the damage caused by shortages of these micronutrients is, by nature, an insidious and slow process into old age.

In other words, the identification of “longevity vitamins” requires very long-term observation, which is difficult and costly.

Ames, who has published more than 500 scientific papers in a career spanning nearly seven decades, ranks his triage theory among his most important work. “This may be a theoretical paper, but I hope it can add a few years to everyone’s lives.”

Who is Bruce Ames?
Bruce Ames is probably best known for devising the “Ames test” during the 1970s — a laboratory method still used today that is designed to rapidly predict a chemical’s potential to cause cancer.

He’s currently a Senior Scientist at Children's Hospital Oakland Research Institute (CHORI), director of its Nutrition & Metabolism Center, and a University of California, Berkeley Professor Emeritus of Biochemistry and Molecular Biology.

Dr. Ames is also a member of the National Academy of Sciences, a past board member of the National Cancer Institute, and has been awarded — among many other honors — the U.S. National Medal of Science, the American Society for Microbiology Lifetime Achievement Award, and the Gold Medal Award of the American Institute of Chemists.

Awards and prestigious posts don’t guarantee a scientist’s infallibility — for example, Nobel Prize winning chemist Linus Pauling made unsupported claims for vitamin C — but they indicate the degree to which his or her colleagues respect their work and judgment.


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