Journal Recommends 'None-A-Day' Multivitamins

by , Dec 17, 2013, 7:49 AM
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An editorial accompanying two original studies and one review of existing research published yesterday in the Annals of Internal Medicine seeks to put the kibosh on the marketing, sale and use of multivitamins once and for all with the prescriptive headline: “Enough Is Enough: Stop Wasting Money on Vitamin and Mineral Supplements.”

“People over time and particularly people in the United States have been led to believe that vitamin and mineral supplements will make them healthier, and they're looking for a magic pill," Dr. Cynthia Mulrow, senior deputy editor and co-writer of the editorial, tells Reuters’ Genevra Pittman. 

Such a pill doesn't exist, Mulrow maintains. But not for want of trying. Sales of all dietary supplements in the U.S. were about $30 billion in 2011. This included $12.4 billion for all vitamin- and mineral-containing supplements, of which $5.2 billion was for multivitamins, according to a fact sheet compiled by the Office of Dietary Supplements at the National Institutes of Health.

“Despite sobering evidence of no benefit or possible harm, use of multivitamin supplements increased among U.S. adults from 30% between 1988 to 1994 to 39% between 2003 and 2006, while overall use of dietary supplements increased from 42% to 53%,” the editorial in the journal of the American College of Physicians points out before stating that research has found “no substantial health benefits” from the use of multivitamins. 

“The message is simple: Most supplements do not prevent chronic disease or death, their use is not justified, and they should be avoided,” the editorial asserts.

Industry trade groups begged to differ vehemently with the recommendation while stopping far short of claiming vitamins and supplements will increase life span or prevent chronic disease.

“It's no secret that many consumers in this country don't get the recommended nutrients from their diet alone, and multivitamin and mineral supplements are an affordable alternative,” John Shaw, executive director of the Natural Products Association, tells Jeanne Whalen in the Wall Street Journal.

“While those in the ivory tower may say that people just need to eat their sardines and salads, in the real world there are nutrient gaps," Douglas “Duffy” MacKay, VP, scientific and regulatory affairs at the Council for Responsible Nutrition tells Kim Painter in USA Today.

“We would not suggest that vitamin supplements are a panacea for preventing chronic disease, but we hope the authors would agree that there is an appropriate place for supplements,” CRN president and CEO Steve Mister says in a statement. “Given that government research repeatedly demonstrates that the typical consumer diet is falling short on critical nutrients, vitamin supplements are an appropriate option to meet those needs.”

One study published in the Annals of Internal Medicine found “in male physicians aged 65 years or older, long-term use of a daily multivitamin did not provide cognitive benefits.” 

Another study concludes: “High-dose oral multivitamins and multiminerals did not statistically significantly reduce cardiovascular events in patients after [myocardial infarction] who received standard medications. However, this conclusion is tempered by the non-adherence rate.” 

And a review of existing studies found “limited evidence supports any benefit from vitamin and mineral supplementation for the prevention of cancer or CVD. Two trials found a small, borderline-significant benefit from multivitamin supplements on cancer in men only and no effect on CVD.”

Web MD’s Brenda Goodman delves into the research a bit more here

Francine Grodstein, a professor of medicine at Harvard University and Brigham and Women's Hospital in Boston who led the study involving male physicians, told the WSJ’s Whalen that “she wasn't ready to write off vitamins to the same extent as the editorial writers. Longer studies or trials in less highly educated populations with poorer diets could yield different results, she said.”

If all this sounds somewhat familiar, that may be because it is. 

The Cochrane Collaboration, which publishes reviews of medical evidence, has also concluded that taking vitamins does not extend life,” blogs Roni Caryn Rabin in the New York Times. “An updated review of the evidence by the United States Preventive Services Task Force, published online on Nov. 12, likewise concluded that there was limited evidence that vitamin and mineral supplementation could prevent cancer or cardiovascular disease.”

So, what to do? 

“People … should be active, should not (overeat), should avoid excessive alcohol and should not be spending money on these pills, these vitamins and minerals,” Dr. Mulrow tells Reuters’ Pittman.

If you haven’t heard that one before, give us 10 pushups. If you have, you should be good for 20.

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