The Multivitamin Controversy
You probably saw the recent headlines telling you that “the experts” have concluded that multivitamins are a waste of money. The article (Gualler et al., Annals of Internal Medicine, 159: 850-851, 2013) that generated all of the headlines was an editorial, which means it was an opinion piece, not a scientific study. It represented the opinion of five very prominent doctors, but it was, at the end of the day, just their opinion.
At the time I pointed out fallacies of their arguments in a “Health Tips From the Professor” article (MultiVitamins-waste-money?). But, what do I know? I have only published 114 papers in peer reviewed journals and two book chapters on nutrition.
It turns out that I’m not the only expert who feels this way. Five very prominent experts recently published rebuttals concluding that the authors of the original editorial ignored “decades of nutrition research and diet monitoring of the U.S. population to reach this misleading conclusion” (Frei et al, Annals of Internal Medicine, 160: 807-809, 2014).
Before I share what these experts said, I should probably share their qualifications:
Balz Frei, PhD
- Distinguished Professor of Biochemistry & Biophysics & Director of the Linus Pauling Institute, Oregon State University
- 203 publications
Bruce N. Ames, PhD
- Director of the Nutrition & Metabolism Center, Children’s Hospital Oakland Research Institute
- 540 publication
Jeffrey B. Blumberg, PhD
- Professor, Freidman School of Nutrition Science and Policy and Director of the Antioxidants Research Laboratory at the Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University
- >300 publications
Walter C. Willet, MD, DrPH
- Chair of the Department of Nutrition, Harvard School of Public Health
- 1,422 publications
Thomas R. Friberg, MD, MS
- Professor of Ophthamology and Director of the Medical & Surgical Retinal Division of the University of Pittsburg School of Medicine
- Principle investigator for the AREDS and AREDS II clinical studies.
- 134 publications
As you can see, these are not just your run of the mill scientists. They are the top experts in the field.
Are multivitamins a waste of money?
What did these experts say?
1. They started by pointing out that few people in the United States follow the USDA dietary guidelines, and “consequently, most people in the United States even in cities like Raleigh, Durham, and Chapel Hill are not well nourished”. Specifically:
- 93% of U.S. adults don’t get enough vitamins D & E from their diet.
- 71% of U.S. adults don’t get enough vitamin K from their diet.
- 61% of U.S. adults don’t get enough magnesium from their diet.
- 50% of U.S. adults don’t get enough calcium and vitamin A from their diet.
2. They also pointed out that adequate intake of micronutrients is essential for normal body function and to support good health. Specifically:
- Vitamins A, D, iron and zinc are required for normal immune function
- Folic acid is required for neurological development. For example, “A multivitamin supplying folic acid dramatically decreases the risk of neural tube defects and is recommended for women of childbearing age.”
- The AREDS and AREDS II studies have established the value of supplementation in preventing vision loss due to age-related macular degeneration.
3. They pointed out that largest (15,000 male physicians) and longest (13 years) randomized, placebo controlled trial of a multivitamin (the Physician’s Health Study II) showed a:
- 8% reduction in cancer incidence and a 12% reduction in cancer deaths
- 9% reduction in cataract formation
4. Finally, they pointed out that the claims that supplement use might actually increase mortality were overemphasized. Specifically:
- The claims that high dose vitamin E increase mortality have been refuted by subsequent studies. I have discussed that in detail in my eBook, “The Myths of the Naysayers” (available for free to all subscribers of “Health Tips From the Professor”).
- Only 1.1% of the U.S. population consumes more than the recommended upper limit for vitamin A (10,000 IU/day).
- The only warning that actually holds up is that smokers should avoid high dose beta-carotene.
- More importantly, all of those concerns involved high dose individual supplements. There is no evidence for any risk from taking a daily multivitamin.
In summary, the experts concluded: “Taking a daily multivitamin and mineral supplement not only helps fill known nutritional gaps in the diet of most persons in the United States (thereby ensuring normal body function and supporting good health), but may have the added benefit of helping to reduce the risk for chronic disease.”
1) Are multivitamins are a waste of money? No. That was simply the opinion of one group of experts. Other experts have come to the exact opposite conclusion.
2) Of course, it was only the negative opinion that made the headlines. Somehow the opinion that multivitamins are valuable for most Americans never got the attention of the press.
3) According to the experts mentioned in this article, multivitamins play an important role in filling well documented nutrition gaps in the U.S. population, assuring normal body function and helping preserve good health. There is evidence that they may have a modest role in reducing the risk for chronic diseases, and there is no evidence that multivitamin supplements increase the risk of mortality.
4) Of course, you shouldn’t expect miracles from your multivitamin. It’s not going to help you leap tall buildings in a single bound. Your multivitamin should just be one small part of your holistic health program of diet, exercise, weight control and supplementation.
These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.