Multivitamins Don't Work!
"Multivitamins don't work."
I'm sure you saw it... Online, on TV... It was everywhere! For about 48 hours... New research has shown that long term use of multivitamins doesn't provide the health benefits we once thought. We've already ranted on the topic so we were going to let it go. Then, however, we read the comments from consumers on different websites and the rage crept back in. This month, we’ll take a few of those lovely comments and dissect them to get to the truth.
The Annals of Internal Medicine went on a bit of a tear and published multiple studies (here, here, and here) and an editorial stating, quite plainly, that the use of multivitamins for “optimal health” is fruitless.
CRAZINESS, I know! Being one of our patients you're probably used to us saying something similar. For us, it was a usual day, apart from a few Facebook questions, phone calls, or emails about it. I'd imagine that once the public got wind of this travesty - that multivitamins aren't doing anything yet they're widely used and promoted - there would be hell to pay!
Nope. Maybe people had too much food at Thanksgiving to care. Nothing changed. Status quo.
Why? Probably because of the seemingly back and forth nature of medical research. "Eat butter." "Don't eat eggs!" "Meat will kill you." "Calories matter." "Calories don't matter." We understand better than anyone how confusing this is to our patients. Yes, at times medical advice seems like a roller coaster ride. We'd place the blame on the scientific media and the emphasis they place on certain studies to attract readers than "conflicting" research.
Maybe people are really entrenched in their ways. Maybe the marketing and propaganda from the vitamin industry works. Maybe we're just a bit skeptical of the establishment these days.
Most of the comments on the sites were definitely skeptical - almost to a fault. Many were similar to this one below, tying the new data to the problems of our health system and of course Obamacare (Thanks Obama!):
Comment 1: "Big deal. This story about vitamins being no good comes out every 3 or 4 years. No one believes the state-run media, we know they lie for Big Pharma and Big Advertisers."
This made us LOL, especially since the comment was posted on a site known for spreading propaganda (rhymes with Box Shoes). Patients of ours know that in fact, Big Pharma and Big Supplement are one in the same. They know vitamin manufacturers and their talking heads in the media are the first to bend the truth in their favor. If this study was, in fact, a shill, it probably would have shown a benefit for multivitamins, since that’s where the money is ($28 billion dollar industry!), right?
That was the only politically based comment we pulled. They were so many and they were killing us but we wanted to stick to the health portion of the debate... Know that, in these studies, the only bias was from the editorial. The author was passionate about traditional, proven therapies over unproven, unregulated alternative medicine.
Comment 2: "I don't care if my multivitamins 'do not prevent chronic disease or death.' I know I don't take dailies because of a chronic disease, I take them because I know my sparse college diet doesn't always get me 100% of everything, especially B vitamins. "
This is the biggest misconception we want everyone to understand. Let's slowly walk through this logic because it is important.
We eat to feed the extremely complicated machine that is our body. Quite simply, this ensures all the reactions happen efficiently, we have the energy we need to live our lives, and all the waste products are taken away appropriately. We've learned over decades of nutrition science (which is constantly changing as with any medical field) that not eating appropriately will lead to disease and early death. Not supplying your body with the key nutrients, it seems, causes major medical events that result in death via cancer, heart attacks, strokes, etc.
So what do we do to prevent dying if we cannot get those key nutrients all the time? It was theorized that we can use multivitamins to "fill in the gaps" of our diet. We thought eating an OK or even a poor diet but supplementing with key vitamins would be the same as eating a good diet for our health. Remember, we eat well not only for right now, but for the long haul to prevent us from dying from a major, preventable medical death.
The collection of data has proved, quite definitively, that that theory is incorrect. Using traditional, isolated, synthetic chemicals does not give any long-term health benefit. There is also no evidence of short-term benefits of multivitamins – in large studies, they don’t make anyone “feel better” or healthier in the short term either.
Therefore, using a traditional, synthetic multivitamin in place of good nutrition or to "fill in the gaps" is an incorrect thought.
Isolated, synthetic multivitamins should be reserved for patients that have “clear evidence of micro-nutrient deficiencies.” In the case of almost all people who use them, there is no deficiency.
Comment 3: "Where I live, people simply cannot get enough Vitamin D six months of the year … Supplementing vitamin D is considered essential here -- in fact, our government just DOUBLED the recommended daily amount. Many people are seriously deficient."
There's a big distinction between supplements that have proven benefit on their own and multivitamins.
Multivitamins have always had an ambiguous use. Vitamin D, on the other hand, has been shown beneficial by itself. The amount of individual vitamins in a multivitamin is very low compared to studied doses. Vitamin D in a multi is usually around 400 IU a day; the new recommendations are between 600 and 800 IU, and many prescribers use approximately 1000 – 2000 IU in their patients to treat deficiency.
The study didn't prove that vitamins don't work, it showed that multivitamins most likely don't work to "fill in the nutritional gaps" and prevent illness from poor diet.
Comment 4: "Our food these days is so processed; we don't get many actual nutrients out of it. Vitamins, however, only provide benefit if they're naturally derived. The body doesn't know what to do with chemicals, so it usually flushes them out with the rest of the garbage."
Which goes with...
"I take vitamins to get nutrients because GMO foods are less nutritious. "
This is a biggie and we've already typed a bunch about natural vs synthetic isolates and how they really aren't different a majority of the time. There's been evidence to show nutritional values don't change between organic and non-organic products. That data isn't as complete yet for GMO, but I'm sure we're not going to see too varied of results than we'd expect. Still, we don’t know 100% and this isn’t the place to argue it.
That being said, let’s say this notion is true. It's similar to the other commenter discussing poor diet; using isolated multivitamins does not make up for less nutrition - whether from poor diet choices or "less nutritious foods."
So what can we do?
First, understand that our mantra of "Food First" has been validated once again by these new studies. It's absolutely crucial to have a balanced diet and avoid isolated vitamins to "fill in the gaps". We can help you design that diet and achieve food goals, especially with New Year's Resolutions just hours away...
We do stress the use of true whole food supplements. Our theory is that when done correctly, the nutritional components of food can be almost entirely retained if turned into a pill. If most of the "stuff" - proteins, anti-oxidants, co-factors, co-enzymes, and fiber - can be saved, then just maybe the long-term health benefits may be saved as well. Full disclosure, there is no 100%, definitive scientific data to back this up either. It, too, is a theory.
If you are concerned about nutrition levels it is best to avoid synthetic vitamin isolates and use real food first and foremost. Eat your veggies and your apple a day. Don't rely entirely on supplements, whole food or not.
Just trying to keep it real,
Neal Smoller, PharmD
Owner, Pharmacist, Big Mouth