Experts still cannot agree about vitamin and mineral supplements. Many health professionals maintain that they are a total waste of money and could be dangerous. Others say that vitamin insurance is essential for good health. Back in 2002 we wrote that “the vitamin wars are over.” We were sorely mistaken. The controversy over vitamin supplementation has only become more intense with time.
The Vitamin Wars Persist
Since the mid-20th century, health professionals have disagreed about the value of taking vitamins and minerals. One group, often personified by Nobel Prize winner Linus Pauling, advocates for supplements. The other group maintains that people get all the nutrients they need from their food and that pills are a waste of time and money.
On June 19, 2002, the Journal of the American Medical Association published a recommendation:
“that all adults take one multivitamin daily”
This was based on evidence that suboptimal vitamin intake puts people at risk for chronic diseases.
Doctor Is Adamant: Vitamins Pills Are Worthless:
That did not put the issue to rest, however. The vitamin wars continued, with some experts arguing as did “Orac” commenting on ScienceBlogs in 2013:
“I remember during medical school that more than one of my faculty used to have a regularly repeated crack that the only thing that taking vitamin supplements could do for you was to produce expensive pee. My first year in medical school was nearly thirty years ago now; so it’s been a long time. During the nearly three decades since I first entered medical school, I have yet to see any evidence to persuade me otherwise. If you eat a well-rounded diet, you don’t need vitamin supplementation.”
The Latest Review from Cardiology:
This reaction from health professionals is not uncommon. A recent review of studies examining vitamin supplements to prevent heart disease found that only folate or B-complex vitamins with folic acid slightly lowered the risk for cardiovascular disease or stroke (Journal of the American College of Cardiology, June 5, 2018). This meta-analysis of prior studies did not show that multivitamins, beta-carotene, calcium, selenium or vitamins C or D prevent heart disease.
Television commentators, including doctors, were quick to dismiss the value of vitamins. Headlines announced that the vitamin wars were over: vitamin and mineral supplements are useless.
What Is a Well-Balanced Diet?
If Americans generally ate a well-balanced diet, that would pretty much finish the argument. But we don’t.
Nutrition Action recently noted that:
“half the population gets less magnesium than experts recommend”
(Nutrition Action, June 2018)
That’s because rich sources of magnesium such as pumpkin seeds, black-eyed peas, tempeh, soy beans, sunflower seeds, flaxseeds, wheat germ, prickly pear, spinach, Swiss chard and quinoa are not staples of the American diet.
Who Needs Extra Nutrients?
Even experts who think most people should not take supplements admit that there are many Americans who need them, however. Women who are pregnant, patients with celiac disease, vegans and people who have had bariatric surgery likely need supplements.
Tens of millions of people take medications that deplete the body of essential nutrients. PPI-type acid-suppressing medications and diabetes drugs containing metformin can lower vitamin B12 levels. Blood pressure pills containing diuretics could lead to suboptimal amounts of potassium, magnesium and zinc.
Vitamins and Cancer:
We find it truly astonishing that the vitamin skeptics always ignore one of the best and longest studies of vitamins ever conducted. The Physicians’ Health Study II was a “large-scale, randomized, double-blind, placebo controlled trial” involving nearly 15,000 male doctors. In other words, this was a gold-standard study.
The results:
“Compared with placebo, men taking a daily multivitamin had a statistically significant reduction in the incidence of total cancer (multivitamin and placebo groups, 17.0 and 18.3 events, respectively, per 1000 person-years…”
“Conclusion: In this large prevention trial of male physicians, daily multivitamin supplementation modestly but significantly reduced the risk of total cancer.”
If this were an expensive drug we suspect that many physicians would be prescribing it with enthusiasm. Even a modest reduction in cancer is important.
Vitamin D vs. Cancer:
There has been considerable evidence over the decades that low levels of vitamin D are associated with an increased risk of various cancers. The latest evidence was published in the Journal of the National Cancer Institute (June 14, 2018).
NPR summarized the results:
“‘For both men and women, deficient levels of vitamin D were associated with a 30 percent increased risk of colorectal cancer,’ says Marji McCullough, a nutritional epidemiologist with the American Cancer Society and study co-author. People who had higher circulating blood levels of vitamin D, above the range deemed ‘sufficient,’ had a 22 percent lower risk, she says.
“The study pooled findings from 17 previous studies that included 12,813 adults in the U.S., Europe and Asia. Those studies collectively looked at 5,706 people with colorectal cancer and 7,107 people of a similar age and race who didn’t have cancer.”
In their own words the researchers state:
“Higher circulating 25(OH)D was related to a statistically significant, substantially lower colorectal cancer risk in women and non–statistically significant lower risk in men. Optimal 25(OH)D concentrations for colorectal cancer risk reduction, 75-100 nmol/L, appear higher than current IOM [Institute of Medicine] recommendations.”
People’s Pharmacy Perspective on the Vitamin Wars:
We do not understand why health professionals continue to fight the vitamin wars. What is it about nutritional supplements that makes so many physicians cringe? Tens of millions of Americans are deficient in both vitamins and minerals. Many of these deficiencies are triggered by commonly prescribed medications. Here is a link to our free Guide to Drug and Nutrient Interactions.
If you would like to learn more about medicines that interfere with nutrient levels, we recommend the book, Fortify Your Life: Your Guide to Vitamins, Minerals, and More, by Dr. Tieraona Low Dog. It is published by National Geographic Books.
You may also be interested in our recent interviews with Dr. Low Dog and Dr. JoAnn Manson. They offer differing perspectives on the value of vitamin and mineral supplements and who can benefit. It is Show 1124. Here is a link.
Share your own thoughts about vitamin and mineral supplements below in the comment section.
Joe Graedon is a pharmacologist. Teresa Graedon holds a doctorate in medical anthropology and is a nutrition expert. Their syndicated radio show can be heard on public radio. In their column, Joe and Teresa Graedon answer letters from readers.
