Print Digg

Article

Multivitamins Play Important Role in Overall Health

Friday, February 20, 2009


The press continues to create sensationalized headlines about multivitamins possibly being a waste of money. This is curious since U.S. government data suggests that less than 15% of our citizens actually consume five fruits and vegetables a day (the new recommendation is 9-13 a day), and 65% of the U.S. population is now overweight or obese, mostly from over-consumption of empty-calorie foods.  

Below is a statement from Andrew Shao, PhD, vice president, scientific and regulatory affairs, The Council for Responsible Nutrition, in response to the publication of a study, “Multivitamin Use and Risk of Cancer and Cardiovascular Disease in the Women’s Health Initiative Cohorts,” published in the most recent Archives of Internal Medicine.

“Multivitamins, like all other dietary supplements, are meant to be used as part of an overall healthy lifestyle; they are not intended to be magic bullets that will assure the prevention of chronic diseases, like cancer. As the authors themselves point out in this study, people who use multivitamins are likely to be healthier and engage in many healthy habits, including being more physically active, having a higher fruit and vegetable intake, consuming lower amounts of fat, and are less likely to smoke. In other words, the key to good health is a commitment to an overall wellness approach and that includes daily use of a multivitamin.

"It’s important to point out that consumers, as well as healthcare professionals, cite that the number one reason that they take supplements is for overall health and wellness benefits. According to the 2007 ‘Life…supplemented’ Healthcare Professionals Impact Study, almost half of physicians and nurses who take supplements most often do so for ‘overall health/wellness benefits,’ while 41 percent of physicians and 62 percent of nurses who recommend supplements most often do so for the same reason. In addition, almost three quarters of physicians (72 percent) and more than three quarters of nurses (88 percent) say it is a good idea for patients to take a multivitamin. This point is further supported by the 2008 CRN Consumer Survey on Dietary Supplements, which found that 59 percent of supplement users take supplements for ‘overall health and wellness benefits’ and 42 percent of users take them ‘to fill nutrient gaps in my diet.’

"From a practical standpoint, this study does not change the fact that the majority of consumers could benefit from taking an affordable multivitamin, particularly as the majority of Americans fail to consume the recommended amounts of a variety of essential nutrients established by the Institute of Medicine. It is better to meet these recommendations than not, and consistently taking a multivitamin over the long-term could help fill these nutrient gaps and may help consumers lead healthier lives.

"Finally, the article demonstrates a lack of understanding about the regulation of dietary supplements. The Dietary Supplement Health and Education Act (DSHEA), the law under which dietary supplements are regulated, provides additional enforcement authority for the Food and Drug Administration (FDA), including the authorization for Good Manufacturing Practices (GMPs) that are specific to dietary supplements and are more stringent than those required for conventional foods. Manufacturers of dietary supplements must report to the FDA any serious adverse event reports they receive, a requirement for prescription and over-the-counter drugs, but not conventional foods.

"Further, there is a strong body of evidence supporting the benefit of many supplemental nutrients. In fact, there are many nutrients for which the evidence base is so robust that the FDA has approved health claims (for example, calcium and vitamin D to reduce the risk of osteoporosis; folic acid to reduce the risk of neural tube birth defects; plant sterols and stanols to reduce the risk of coronary heart disease) or qualified health claims (such as omega-3 fatty acids to reduce the risk of coronary heart disease). Supplemental nutrients are only one part of an overall healthy lifestyle that helps maintain health and avoid chronic disease.”

Ellen Troyer, MT MA
Biosyntrx Chief Research Officer
Voting member – Council for Responsible Nutrition

PEARL

It's important to understand that there are empty-calorie diets and poorly-designed multiples, and there are nutrient-dense diets and well-designed full-spectrum multiples.  
 
A careful read through the Archives of Internal Medicine study lets us know that the investigators did not collect data on the form of the micronutrients (synthetic or natural, chealated or not, alpha tocopherol or mixed tochopherols or tocotrienols as the Vitamin E source, as an example). Nor did the study clearly identify average amounts or variety of micronutrients and antioxidants included in the multiples.  Nor did the study identify if the multiples were biochemically-balanced, given today's knowledge-base on the subject of balance and absorption rate.   
 
Did the multiples simply include the RDA of nutrients that have established recommended daily amounts (the amount necessary to sustain human life, rather than optimal health)? The study also did not clearly identify if the amounts dramatically exceeded the safe upper limits (UL) established by the Food & Nutrition Board at the Institute of Medicine. 
 
Again, it's important to understand that multiple-vitamin formulas are  not all the same.  
 
The Archives of Internal Medicine multivitamin study lead investigator, Marian Neuhouser, PhD, also suggests that women take vitamins despite the availability of a diverse and affordable food supply.  Unfortunately, the truth is that the readily affordable food supply is primarily high- calorie, overly-processed, and micronutrient deficient.  

References

Multivitamin use and risk of cancer and cardiovascular disease in the Women's Health Initiative cohorts. Neuhouser ML, Wasserteil-Smoller S, et al. Arch Intern Med. 2009 Feb 9;169(3):294-304 [abstract]