Overall, the study results were largely inconclusive against disease prevention.
Stop wasting money on multivitamins is the message of an Annals of Internal Medicine (AIM) editorial that made mainstream news earlier this week. The journal’s December 17, 2013, issue (vol. 159, no. 12) featured not only the editorial but also three studies on multivitamins, each showing inconclusive or negative results on whether multivitamins can help to prevent the occurrence or progression of chronic disease. In the media, dietary supplements association the Council for Responsible Nutrition (CRN; Washington, DC) responded to the AIM stories, pointing out that multivitamins do have benefit-among them, helping to fill nutrient gaps.
Penned by five doctors, the editorial titled “Enough Is Enough: Stop Wasting Money on Vitamin and Mineral Supplements” came out swinging against vitamin and mineral supplements.
“The message is simple: Most supplements do not prevent chronic disease or death, their use is not justified, and they should be avoided. This message is especially true for the general population with no clear evidence of micronutrient deficiencies…”
But many Americans do not get all the nutrients they need, which is where multivitamins can help, CRN said.
“The editorial demonstrates a close-minded, one-sided approach that attempts to dismiss even the proven benefits of vitamins and minerals,” said Steve Mister, CRN’s president and CEO, in a press statement. “We would not suggest that vitamin supplements are a panacea for preventing chronic disease, but we hope the authors would agree that there is an appropriate place for supplements. Given that government research repeatedly demonstrates that the typical consumer diet is falling short on critical nutrients, vitamin supplements are an appropriate option to meet those needs.”
As far as the three studies published in the AIM issue, the first, a systematic review (Fortmann et al.), looked at past studies on single, paired, or multivitamin supplements and whether or not these were shown to prevent cardiovascular disease (CVD) or cancer. The conclusion: there was not strong enough evidence either way. The authors also noted that the drug-model studies may not be an appropriate design for nutrient studies. (The U.S. Preventive Services Task Force used this Fortmann et al. review as the basis for its recent draft recommendation on multivitamins, which likewise concluded that evidence is insufficient on whether or not multivitamins show benefit for cancer or CVD. CRN sent its comments to USPSTF.)
The second AIM study (Grodstein et al.) looked at the effect of multivitamins on cognitive decline. This study was part of the Physicians’ Health Study II. Researchers found no significantly different effects between the multivitamin and placebo groups; however, they noted that the subjects may have been too well nourished for the effects of the multivitamin to be apparent. They advised that future studies in less-well-nourished populations are needed. (Some positive effects of multivitamins were also seen: a reduced risk of cancer and cataracts.)
The third AIM study (Lamas et al.) concluded that high-dose multivitamins did not help prevent occurrence of secondary cardiovascular events such as strokes or myocardial infarction in those who had already experienced a primary cardiovascular event. However, that study had a high rate of noncompliance among subjects, which impacted results.
Overall, the study results were largely inconclusive against disease prevention-but CRN noted that there is still a benefit to taking multivitamins.
“While people should not expect that multivitamins in isolation can prevent disease, the fact that an affordable and convenient addition of a multivitamin to your daily health regimen may provide benefits on top of filling nutrient gaps makes it a smart choice in combination with other healthy habits,” said Duffy MacKay, ND, CRN’s vice president, scientific and regulatory affairs, in a press statement responding to the Grodstein et al. Physicians’ Health Study II study.
Nutritional Outlook asked CRN whether these AIM stories are likely to impact multivitamin usage/sales.
“It’s still too early to tell what kind of long-term impact, if any, this will have on the market," says Judy Blatman, CRN's senior vice president, communications. "But, we know consumers take vitamins for overall health and wellness and to fill nutrition gaps and that they’re savvy enough to understand you don’t take a multivitamin as a panacea for serious disease.”