Making Sense of Vitamins without losing Cents!

The frequent reporting in the media about benefits (or lack of) of vitamin supplementation congers up the old adage “dammed if you and dammed if you don’t.” Recent reporting on results of long term studies (Women’s Health Initiative http://www.nhlbi.nih.gov/whi/cad.htm and the Physicians’ Health Study II http://phs.bwh.harvard.edu/phs2.htm) indicated that ingesting multivitamin pills (except for Vitamin D) were generally not beneficial to most people. It’s the food that one eats that is most important in obtaining and absorbing nutrients.

The first vitamin to be synthesized was vitamin C (1933-34). For those interested in its history, check this Wikipedia site (http://en.wikipedia.org/wiki/Vitamin_C) or a scientifically accurate nutrition textbook. Throughout the remaining years of the twentieth century, other vitamins were discovered and synthesized. Today, the market is glutted with various combinations and various dosages advertised to “treat” or “prevent” a wide a variety of health conditions. About half of all Americans daily take a multivitamin supplement. Is there a beneficial return on this investment of over 20$ billion a year? Does vitamin supplementation make one healthier or enhance one’s health status? The proof is in the pudding, so to speak. Several schools of medicine and public health (e.g., Northwestern University’s Feinberg School of Medicine, Harvard Medical School, Brigham and Women’s Hospital in Boston, Harvard School of Public Health, and Yale School of Public Health--http://opa.yale.edu/news/article.aspx?id=1820) have published reports that show no benefit, and some show harm.

Vitamin D. Research studies are concluding that people need more Vit D, unless they live in a sun- soaked environment and frequent the outdoors soaking in the sun rays. The federal Agency for Health- Care Research and Quality (AHRQ--http://www.ahrq.gov/clinic/tp/vitadtp.htm) reviewed a large number of studies looking at reduction of factures and bone loss as a result of increased calcium and D intake.

Benefit was primarily in female nursing-home residents. Currently Vit D is being promoted as the “cure-all” for nearly every disease (e.g., cancer, heart disease, Alzheimer’s, diabetes, multiple sclerosis). This vitamin is important and people in the northwest seem to be deficient. But, keep in mind that no one nutrient is the “cure-all”! Doses of 800-1,000 IU from fortified foods and supplements are recommended. Vitamin D3 may be more potent than D2.

Researchers involved with the Women’s Health Initiative, observing 161,808 women for eight years, could find no link between those taking multivitamins and a lower risk of cancer, heart disease, and stroke; nor did they find any link between multivitamin use and total mortality. “These results were similar to Harvard's Nurses' Health Study, in which researchers found no significant health advantage to taking multivitamins, except for a slightly lower risk for colon cancer in women taking multivitamins for more than 15 years.” A slight increased risk for fatal non-Hodgkin's lymphoma was found with multivitamin users.

The National Institutes of Health sponsored a conference in 2006 to evaluate the evidence for multivitamin use in relation to chronic disease. They concluded that there was not sufficient evidence to recommend taking vitamins for chronic disease prevention. They also said there was insufficient evidence to suggest that taking multivitamins increased health risks.

The American Cancer Society's guidelines on nutrition and cancer prevention do not recommend taking multivitamins. Researchers at the Memorial Sloan-Kettering Cancer Center in New York warned that vitamin C seems to protect not just healthy cells but cancer cells, too. This means that C supplementation reduces the effectiveness of cancer therapy (http://well.blogs.nytimes.com/2008/10/01/vitamin-c-may- interfere-with-cancer-treatment). The Nurses’ Health Study showed that women taking multivitamins with vitamin A were getting too much vitamin A and showed a significant increased risk for osteoporosis.

The Physicians' Health Study demonstrated that individual vitamin E and vitamin C supplements did not reduce the risk of major cardiovascular events (Brigham and Women's Hospital and the Harvard School of Public Health). Several reports in recent years have challenged the notion that megadoses of vitamins are good. A Johns Hopkins School of Medicine review of 19 vitamin E clinical trials of more than 135,000 people showed high doses of vitamin E (greater than 400 IUs) increased a person’s risk of dying during the study period by 4%. Taking vitamin E with other vitamins and minerals resulted in a 6 percent higher risk of dying. Another study of daily vitamin E showed vitamin E takers had a 13 percent higher risk for heart failure.

Studies consistently show that ingesting multivitamins is not an effective strategy for improving one’s health. Eating healthfully gives significant advantage over multivitamins. “A healthful diet means eating more fruits and vegetables; limiting animal fats, cholesterol, and sugar-laden and refined foods; and eating more whole-grain breads, unrefined cereals, nuts, and legumes. If you want better nutrition, put your money in these proven effective dietary methods (Archives of Internal Medicine. 2009;169(3):294-304).

Who may need multivitamins? Older adults may need vitamin B-12 supplements because they absorb less of this vitamin. People with problems absorbing nutrients such as those with celiac disease which can cause the villi in the intestinal tract to disappear, resulting in absorption problems, may need extra vitamins. Strict vegetarians often are quite low in B-12. One study showed vegans to have such low levels that they showed signs of brain atrophy. Supplements of vitamin C (500 mg), E (400 IU), beta- carotene (15 mg), zinc oxide (80 mg), and copper (2mg) may slow the progression in people with early or moderate macular degeneration. People who are heavy alcohol drinkers, or smokers, or are on very low calorie-restricted diets are recommended to take vitamin supplements.

Concluding remark: Healthy people who eat enough calories from a varied diet do not benefit from multivitamin supplements. Save your cents for fun activities! Calories provide energy for the body, not vitamins!

For an updated explanation of the food pyramid for older adults, check out this site from Tufts University: http://nutrition.tufts.edu/1174562918285/Nutrition-Page-nl2w_1203674431946.html