Written by Hammer Nutrition’s Steve Born:
A recent editorial published in the Annals of Internal Medicine has mainstream media in a frenzy once again. When there’s a no-punches-pulled headline of “Enough is Enough: Stop Wasting Money on Vitamin and Mineral Supplements,” and a doctor involved in the editorial is quoted stating, “Most supplements do not prevent chronic disease or death, their use is not justified, and they should be avoided,” you can bet it’s going to garner front page coverage.
But that’s exactly where the problem lies. The blunt anti-vitamin/mineral stance taken in this editorial is based primarily on the analysis of two recent studies, and on the premise “that most supplements do not prevent chronic disease or death.” That’s exactly right, supplements are not meant to do that; they’re not a “cure all” for diseases. Instead, the nutrients in vitamin/mineral supplements help bridge the gap between what our diets supply nutrient-wise and what we should really be obtaining for optimal health.
We believe that this editorial, with its broad-stroke condemnation of vitamins, presents a distinctly one-sided and inaccurate viewpoint, one that doesn’t bother to take into account the established benefits of vitamins, minerals, and other nutrients. As a result, we consider this editorial to be a disservice to all individuals desiring to make educated decisions in their goal of enjoying optimal health. When you review some of the flaws about the studies involved, we believe you’ll agree that the sensible use of vitamin/mineral supplements is not a waste of money at all.
What you didn’t hear in the news
There are significant issues in the studies that didn’t get mentioned in any of the news media’s articles. One of the studies involved about 6,000 male doctors 65 years and older and analyzed the effects of vitamin supplementation on cognitive function. At the end of the study, researchers concluded that there was no difference between those who took vitamins and those who took a placebo. Here are the primary problems associated with this study:
1) The multivitamin used contained extremely low and inadequate amounts of nutrients, such as a mere 60 mg of vitamin C, 50 mg of vitamin E (a poorly absorbed, synthetic vitamin E at that), and 25 mcg of vitamin B12. With such minimal amounts, significant health benefits cannot realistically be expected. Even the researchers took note of that, stating that the “doses of vitamins may be too low.” Still, in spite of the fact that low-potency vitamins were used, after 2.5 years of supplementation, cognitive function was improved as compared to placebo. However, the difference wasn’t statistically significant, which is perhaps why it wasn’t mentioned in any of the news reports.
2) The standards in terms of adherence were far too relaxed. Study subjects who took the multivitamin just three-quarters of the time were deemed to have properly adhered to the study protocol. Think about that . . . even if they only took the multivitamin 3 out of 4 weeks—missing a full 7 days monthly— that was acceptable in terms of being adherent. How can any reliable conclusions about supplement efficacy, or lack thereof, be formed when a portion of the study subjects are only using the product a portion of the time?
Additionally, instead of requiring participants to provide specific documentation with any frequency, returning any unused product so that its contents can be counted to see how much was actually taken, or other more reliable methods to accurately measure compliance, the participants were simply asked to recall from memory how frequently they used the multivitamin supplement. Compared to the aforementioned methods, a recollection-based-only approach in acquiring data is a less reliable way to truly quantify study participants’ adherence to a study protocol.
A second study involved over 1,700 subjects with an average age of 65 who had suffered a heart attack. The objective was to “assess whether oral multivitamins reduce cardiovascular events and are safe.” Study participants were given either a multivitamin or a placebo, and were monitored for nearly 4.5 years for “cardiovascular events” such as a recurrent heart attack or stroke. At the completion of this time period it was concluded that, “High-dose oral multivitamins and multiminerals did not statistically significantly reduce cardiovascular events in patients after MI [Myocardial Infarction] who received standard medications. However, this conclusion is tempered by the nonadherence rate.”
Take special notice of that last sentence because it brings to light a serious flaw in the study–a whopping 46% of the study subjects did not adhere to the vitamin supplementation regimen! How can any logical and definitive conclusions be made when nearly half of the study subjects don’t follow the protocol? Yet it is the very conclusions of this study that are partially responsible for the blanket statement that, “Most supplements do not prevent chronic disease or death, their use is not justified, and they should be avoided.”
Additionally, there were more diabetics in the multivitamin group than in the group receiving the placebo. Considering that diabetes is one of the major risk factors for cardiovascular disease, it’s logical to assume that those who had a higher rate of diabetes at baseline would be at a higher risk of experiencing a “cardiovascular event.” When the playing field isn’t level, so to speak, it can bias the results, which it may very well have done in this particular study.
Lastly, take note of the study conclusions: “High-dose oral multivitamins and multiminerals did not statistically significantly reduce cardiovascular events…” The reason this is true is because a 25% reduction in cardiovascular risk was required to conclude that multivitamins provide effective cardiovascular benefits. As one nutritional scientist remarked, “… the investigators constructed the study so as to ignore anything short of miraculous cardiovascular risk reduction, so the conclusion drawn questions multivitamin benefits.”
We do not believe that optimal health comes solely from a bottle of vitamins; it takes a multi-faceted approach to maximize one’s health. Regular exercise, the best possible diet, stress management, and other factors need to be employed as well. And while we adamantly do not believe that taking a handful of supplements ever takes the place of the consumption of the highest quality diet possible, we remain convinced that supplementation is a necessity for three primary reasons:
- A growing body of research shows that food alone does not supply all of the micronutrients we need to prevent deficiency, let alone achieve optimal health.[1, 2]
- Even if we could obtain all the nutrients we need from our diet, most people do not consume a healthy diet, eating highly processed foods instead
- Numerous studies have shown that the soil crops are now grown in has become depleted in nutrients, resulting in less nutritious produce. Additionally, much of what we eat comes from foods grown far away, picked when unripe, and then sent packing. Nutritional content is thus further depleted.
- A USDA report  shows that a sizeable portion of the American population has inadequate intakes of numerous vitamins and minerals. This report is over a decade old, so it’s logical to suggest that an even greater percentage of Americans may not be getting sufficient amounts of nutrients from their diet.
Alarmist headlines and stories that demonize the use of supplements isn’t anything new. However, we do not believe that this recent editorial, with its overly generalized and blunt stance to “stop wasting money on vitamin and mineral supplements,” provides anywhere near sufficient evidence to merit such a recommendation. Now that you have both sides of the story, we think you’ll agree.
The Council for Responsible Nutrition (CRN) provides more alternate points of view on this particular topic at crnusa.org/AIMresponses13.html. We highly recommend reading their statements and watching the short videos.