By Bob Aronson
The National Institutes of Health (NIH) says Americans have been taking multivitamin/mineral (MVM) supplements since the early 1940s, when the first such products became available. MVMs are still popular dietary supplements and, according to estimates, more than one-third of all Americans take them. MVMs account for almost one-fifth of all purchases of dietary supplements.
“You have to get your vitamins.” I’ve heard that phrase since I was a child, but why? What are Vitamins and are vitamin pills or supplements the same as the vitamins found naturally in what we eat and in sunshine? Vitamins are not all the same. There can be a huge difference between those that are naturally contained in our food and the sometimes “smelly” things that come in a bottle from your Pharmacy.
Over the past several years there have been a number of news reports about vitamins. Some experts support their use, some say the supplements are worthless and others say they can actually cause harm. What’s true? All of the above! We’ll try to shed some light on the subject so let’s start with their importance to our health.
Vitamin deficiencies lead to a wide range of problems spanning from anorexia to obesity, organ malfunction, confusion, depression and fatigue. We need vitamins. The question that must be answered is; how do you know which ones? We’ll provide an answer.
Tough question when you consider the fact that the NIH says, “No standard or regulatory definition is available for an MVM supplement—such as what nutrients it must contain and at what levels. Therefore, the term can refer to products of widely varied compositions and characteristics. These products go by various names, including multis, multiples, and MVMs. Manufacturers determine the types and levels of vitamins, minerals, and other ingredients in their MVMs. As a result, many types of MVMs are available in the marketplace.”
It is entirely possible that there are no standards because the vitamin industry is huge and can afford heavy lobbying to ensure that they remain free of government regulation. The NIH says that sales of all dietary supplements in the United States totaled an estimated $30.0 billion in 2011. This amount included $12.4 billion for all vitamin- and mineral-containing supplements, of which $5.2 billion was for MVMs. If the government set standards, every single manufacturer would have to reformulate their products to meet them. Doing so would be costly so there is no wonder that the industry would rather not rock their very profitable boat.
Whether your vitamins are hurting you is another story. What people are not aware of is that all vitamins are not created equal, and most are actually synthetic and the synthetic vitamins are rarely like the real thing.
The type of vitamins that benefit us most is murky but there are some. However, a healthy diet should provide most of the nutrients our bodies need. Sometimes, though, supplements can help. The problem is, which ones? How do you know what to buy?
For the most part, medical science has made it clear that most vitamin supplements are either useless or cause harm and we’ll elaborate on those claims shortly. First, though, you ought to know what’s good for you and what seems to work for some conditions.
This article in Smithsonian.com lists five supplements that can be helpful. http://www.smithsonianmag.com/science-nature/five-vitamins-and-supplements-are-actually-worth-taking-180949735/#VsZOfYrBAkvtVYvY.99
Of all the “classic” vitamins—the vital organic compounds discovered between 1913 and 1941 and termed vitamin A, B, C, etc.—vitamin D is by far the most beneficial to take in supplement form. Researchers found that adults who took vitamin D supplements daily lived longer than those who didn’t.
Other research has found that in kids, taking vitamin D supplements can reduce the chance of catching the flu, and that in older adults, it can improve bone health and reduce the incidence of fractures.
A mounting pile of research is showing how crucial the trillions of bacterial cells that live inside us are in regulating our health, and how harmful it can be to suddenly wipe them out with an antibiotic. Thus, it shouldn’t come as a huge surprise that if you do go through a course of antibiotics, taking a probiotic (either a supplement or a food naturally rich in bacteria, such as yogurt) to replace the bacteria colonies in your gut is a good idea.
In 2012, a meta-analysis of 82 randomized controlled trials found that use of probiotics significantly reduced the incidence of diarrhea after a course of antibiotics.
All the same, probiotics aren’t a digestive cure-all: they haven’t been found to be effective in treating irritable bowel syndrome, among other chronic ailments. Like most other supplements that are actually effective, they’re useful in very specific circumstances, but it’s not necessary to continually take them on a daily basis.
Vitamin C might not do anything to prevent or treat the common cold, but the other widely-used cold supplement, zinc, is actually worth taking. A mineral that’s involved in many different aspects of your cellular metabolism, zinc appears to interfere with the replication of rhinoviruses, the microbes that cause the common cold.
This has been borne out in a number of studies
Also known as vitamin B3, niacin is talked up as a cure for all sorts of conditions (including high cholesterol, Alzheimer’s, diabetes and headaches) but in most of these cases, a prescription-strength dose of niacin has been needed to show a clear result.
At over-the-counter strength, niacin supplements have only been proven to be effective in helping one group of people: those who have heart disease. A 2010 review found that taking the supplement daily reduced the chance of a stroke or heart attack in people with heart disease, thereby reducing their overall risk of death due to a cardiac
Garlic, of course, is a pungent herb. It also turns out to be an effective treatment for high blood pressure when taken as a concentrated supplement.
A 2008 meta-analysis of 11 randomized controlled trials (in which similar groups of participants were given either a garlic supplement or placebo, and the results were compared) found that, on the whole, taking garlic daily reduced blood pressure, with the most significant results coming in adults who had high blood pressure at the start of the trials.
On the other hand, there have also been claims that garlic supplements can prevent cancer, but the evidence is mixed.
Vitamin Supplements are unnecessary and may cause harm.
In December of last year, the Annals of Internal Medicine reported that, “Not only are the pills mostly unnecessary, but they could actually do harm those taking them. We believe that the case is closed—supplementing the diet of well-nourished adults with (most) mineral or vitamin supplements has no clear benefit and might even be harmful. These vitamins should not be used for chronic disease prevention. Enough is enough.” http://www.cbsnews.com/news/multivitamin-researchers-say-case-is-closed-supplements-dont-boost-health/
Based on three studies examining multivitamins’ links to cancer prevention, heart health, and cognitive function, the research is a blow to the multi-billion dollar industry that produces them and to the millions of Americans who religiously shell out their dollars for false hope.
The doubts about vitamin supplements are not new. In his 2013 book Do You Believe in Magic, Dr. Paul Offit pointed to a handful of major studies over the past five years that showed vitamins have made people less healthy. “In 2008, a review of all existing studies involving more than 230,000 people who did or did not receive supplemental antioxidants found that vitamins increased the risk of cancer and heart disease.”
Last year, researchers published new findings from the Women’s Health Initiative, a long-term study of more than 160,000 midlife women. The data showed that multivitamin-takers are no healthier than those who don’t pop the pills, at least when it comes to the big diseases—cancer, heart disease, stroke. “Even women with poor diets weren’t helped by taking a multivitamin,” says study author Marian Neuhouser, PhD, in the cancer prevention program at the Fred Hutchinson Cancer Research Center, in Seattle.
That said, there is one group that probably ought to keep taking a multi-vitamin: women of reproductive age. The supplement is insurance in case of pregnancy. A woman who gets adequate amounts of the B vitamin folate is much less likely to have a baby with a birth defect affecting the spinal cord.
The problem is that many vitamin and mineral supplements are manufactured synthetically. Some estimates place the amount at 90 percent and higher and while they are made to mimic natural vitamins they are not the same. Natural vitamins come directly from plants and animals, they are not produced in a lab and — most synthetic vitamins lack co-factors associated with naturally-occurring vitamins because they have been “isolated.”
Isolated vitamins can’t always be used by the body, and are either stored or excreted. Most synthetic vitamins don’t have the necessary trace minerals either and must use the body’s own mineral reserves which can then cause mineral deficiencies.
Most synthetic supplements contain chemicals that do not occur in nature. The history of the human race is such that our bodies have grown accustomed to consuming the food we grow and gather naturally, from the earth, not food that is synthesized in a lab.
What Vitamin and Mineral Supplements Can and Can’t Do
Reviewed By Elizabeth Ward, MS, RD
Experts say there is definitely a place for vitamin or mineral supplements in our diets, but their primary function is to fill in small nutrient gaps. They are “supplements” intended to add to your diet, not take the place of real food or a healthy meal plan.
WebMD takes a closer look at what vitamin and mineral supplements can and cannot do for your health.
Food First, Then Supplements
“They can plug nutrition gaps in your diet, but it is short-sighted to think your vitamin or mineral is the ticket to good health — the big power is on the plate, not in a pill,” explains Roberta Anding, MS, RD, a spokesperson for the American Dietetic Association and director of sports nutrition at Texas Children’s Hospital in Houston.
It is always better to get your nutrients from food, agrees registered dietitian Karen Ansel. “Food contains thousands of phytochemicals, fiber, and more that work together to promote good health that cannot be duplicated with a pill or a cocktail of supplements.”
What Can Vitamin and Mineral Supplements Do for Your Health?
When the food on the plate falls short and doesn’t include essential nutrients like calcium, potassium, vitamin D, and vitamin B12, some of the nutrients many Americans don’t get enough of, a supplement can help take up the nutritional slack. Vitamin and mineral supplements can help prevent deficiencies that can contribute to chronic conditions.
Numerous studies have shown the health benefits and effectiveness of supplementing missing nutrients in the diet. A National Institutes of Health (NIH) study found increased bone density and reduced fractures in postmenopausal women who took calcium and vitamin D.
Beyond filling in gaps, other studies have demonstrated that supplemental vitamins and minerals can be advantageous. However, the exact benefits are still unclear as researchers continue to unravel the potential health benefits of vitamins and supplements.
Web MD offers these tips to guide your vitamin and mineral selection:
- Think nutritious food first, and then supplement the gaps. Start by filling your grocery cart with a variety of nourishing, nutrient-rich foods. Use the federal government’s My Plate nutrition guide to help make sure your meals and snacks include all the parts of a healthy meal.
- Take stock of your diet habits. Evaluate what is missing in your diet. Are there entire food groups you avoid? Is iceberg lettuce the only vegetable you eat? If so, learn about the key nutrients in the missing food groups, and choose a supplement to help meet those needs. As an example, it makes sense for anyone who does not or is not able to get the recommended three servings of dairy every day to take a calcium and vitamin D supplement for these shortfall nutrients.
- When in doubt, a daily multivitamin is a safer bet than a cocktail of individual supplements that can exceed the safe upper limits of the recommended intake for any nutrient. Choose a multivitamin that provides 100% or less of the Daily Value (DV) as a backup to plug the small nutrient holes in your diet.
- Are you a fast food junkie? If your diet pretty much consists of sweetened and other low-nutrient drinks, fries, and burgers, then supplements are not the answer. A healthy diet makeover is in order. Consult a registered dietitian.
- Respect the limits. Supplements can fill in where your diet leaves off, but they can also build up and potentially cause toxicities if you take more than 100% of the DV.
- Most adults and children don’t get enough calcium, vitamin D, or potassium according to the 2010 Dietary Guidelines. Potassium-rich foods, including fruits, vegetables, dairy, and meat are the best ways to fill in potassium gaps. Choose an individual or a multivitamin supplement that contains these calcium and vitamin D as a safeguard.
- The best way to judge any supplement or medication is by reviewing clinical trials. There aren’t a lot of them done on vitamins, but those that have been conducted are quite revealing. The NIH concluded that most supplements not only don’t work as intended, they actually make things worse. They examined the efficacy of 13 vitamins and 15 essential minerals as reported in long-term, randomized clinical trials and there were some positive results like:
- A combination of calcium and vitamin D was shown to increase bone mineral density and reduce fracture risk in postmenopausal women.
- There was some evidence that selenium reduces risk of certain cancers.
- Vitamin E maydecrease cardiovascular deaths in women and prostate cancer deaths in male smokers.
- Vitamin D showed some cardiovascular benefit.
Those few positives are overwhelmed by the negative findings.
- Trials of niacin (B3), folate, riboflavin (B2), and vitamins B6 and B12 showed no positive effect on chronic disease occurrence in the general population
- There was no evidence to recommend beta-carotene and some evidence that it may cause harm in smokers.
- High-dose vitamin E supplementation increased the risk of death from all causes.
So what’s the bottom line? Our research indicates that most medical authorities pretty much dismiss the usefulness of most vitamin supplements. Most revealing, though, and also dangerous is the fact that there are no standards for vitamin supplements. The companies that make them can each have their own formulations and there is no approval process so the consumer may be at great risk. Buyer beware. Don’t believe the advertising. If you are determined to take these supplements, though, google them and look for clinical trials. If there are none, don’t buy. If there are, read them carefully. For the most part the best advice is, save your money because most of us don’t have a clue as to what we are buying.
Bob Aronson of Bob’s Newheart is a 2007 heart transplant recipient, the founder of Facebook’s nearly 4,000 member Organ Transplant
Initiative (OTI) and the author of most of these donation/transplantation blogs. You may comment in the space provided or email your thoughts to me at firstname.lastname@example.org. And – please spread the word about the immediate need for more organ donors. There is nothing you can do that is of greater importance. If you convince one person to be an organ and tissue donor you may save or positively affect over 60 lives. Some of those lives may be people you know and love.