US citizens spent nearly US$50 billion on vitamin and dietary supplements in 2021 – “all for nothing,” according to researchers from Northwest Medicine. A study published in JAMA suggests that the evidence for supplements to have a preventive effect on cardiovascular diseases is “insufficient.”
“Patients always ask, ‘What supplements should I be taking?’ They’re wasting money and focus thinking there has to be a magic set of pills that will keep them healthy when we should all be following the evidence-based practices of eating healthy and exercising,” says Dr. Jeffrey Linder, chief of general internal medicine in the department of medicine at Northwestern University Feinberg School of Medicine.
Nonetheless, the Council for Responsible Nutrition (CRN) hit back saying numerous studies provide evidence for the benefits of taking multivitamins, as they fill significant nutrition gaps among the US population.
“Under-consumption of calcium, potassium, dietary fiber, and vitamin D is of public health concern for the general US population because low intakes are associated with numerous health concerns,” says Andrea Wong, senior VP in scientific and regulatory affairs, CRN.
Multivitamins: all hype?
The appeal of supplements is “obvious,” as vitamins should have anti-inflammatory and antioxidative effects, decreasing the risk of cancer and cardiovascular disease. The same prevention comes from eating fruit, according to the researchers.
“Eating fruits and vegetables is associated with decreased cardiovascular disease and cancer risk. It is reasonable to think key vitamins and minerals could be extracted from fruits and vegetables, packaged into a pill, and save people the trouble and expense of maintaining a balanced diet,” notes the study.
“But whole fruits and vegetables contain a mixture of vitamins, phytochemicals, fiber and other nutrients that probably act synergistically to deliver health benefits. Micronutrients in isolation may act differently in the body than when naturally packaged with a host of other dietary components.”
Wong however, argues a recent cocoa supplement and multivitamin outcomes study (COSMOS) is among the growing evidence that multivitamins help delay cognitive decline in older people.
“Additionally, results of a large-scale, placebo-controlled trial showed an 8% reduction in overall cancer risk in older male physicians who took a multivitamin,” says Andrea Wong, senior VP in scientific and regulatory affairs, CRN.
“The apparent limited evidence should not be misinterpreted as the absence of benefit.”
Health is not accessible to all
Dr. Jenny Jia, co-author, JAMA editorial, highlights the issue of achieving a healthy lifestyle for all. Low-income families don’t always access nutritious, healthy food or exercise facilities.
Due to rising food prices, parents have previously reported the increased use of supplements to provide their children with the right amount of nutrition. In an experiment, low-income families were provided food and increased accessibility, leading to healthier diets among children.
“The task force is not saying ‘don’t take multivitamins,’ but there’s this idea that if these were good for you, we’d know by now,” Linder said.
Vitamin D and calcium have been shown to prevent bone fractures in the elderly. Therefore, individuals with vitamin deficiencies are still recommended to take supplements, even by researchers in the newly published study.
The same goes for pregnant women, as previous studies have shown that most women in the US have poor health before conceiving. “In addition to discussing vitamin supplementation, working with patients to optimize cardiovascular health before pregnancy is an important component of prenatal care,” says Dr. Natalie Cameron, instructor of general internal medicine, Feinberg.
