By Dr. Mercola
About one-third of Americans take multivitamin and mineral supplements, and this rises to more than 40 percent among older Americans.1 Despite their popularity, there's been quite a bit of debate about whether or not they're truly useful.
In 2013, researchers at the Kaiser Permanente Center for Health Research went as far as to say that vitamin supplements are probably useless when it comes to preventing heart disease and/or cancer.2
That study was heavily criticized, in part because it reviewed studies containing doses of vitamins that were in some cases lower than the upper tolerable limit. In many cases, this is not high enough to have a therapeutic effect.
Likewise, the studies may have included synthetic forms of vitamins rather than whole-food forms, which can also impact their performance. If you happened to catch wind of this study, you'll know it was presented as the "last word" on vitamins… but it's far from it.
The latest research has once again shown that multivitamins do have a place in health, including heart health.
Multivitamin-Mineral Use May Benefit Heart Health
A study of nearly 9,000 adults followed the participants for nearly two decades to see whether or not multivitamin usage played a role in heart health. Among women, but not men, taking multivitamin-mineral supplements for at least three years was associated with a 35 percent lower risk of dying from heart disease.3
It doesn't prove cause-and-effect, and people who take multivitamins often tend to lead healthier lifestyles overall that could account for the heart benefits. Still, the researchers accounted for many other heart risk factors, such as weight, blood pressure, blood sugar control, education, and alcohol use, and the association still remained.
It's interesting to note that only those taking multivitamin mineral supplements experienced the benefit, and they had to take them for three years or more. This suggests the minerals may be of crucial importance, and also that it's not a quick fix or a cure-all by any means.
Dietary supplements are intended to be just that… a supplement to a healthy lifestyle. It cannot take the place of healthy eating, but it can support it.
According to the National Center for Complementary and Integrative Health (NCCIH), "Most individuals can get all of the vitamins and minerals necessary through a healthy eating pattern of nutrient-dense foods."4
The problem with this, however, is that many people are not eating nutrient-dense foods, either by choice or consequence. Some of the top sources of calories in the US come from grain-based desserts (cakes, cookies, and doughnuts), soda, bread, pizza, and alcohol…
Multivitamins Can Fill Nutritional Gaps
Among those with a poor diet, multivitamins may have a place. Again, they are not a substitute for good food, but they do help to fill in nutritional gaps. As reported by members of the Council for Responsible Nutrition (CRN) in the Natural Medicine Journal:5
"Government research shows that Americans have frank nutrient gaps. In fact, recent data show that a large portion of Americans fall below the estimated average requirement (EAR) for certain nutrients, specifically vitamins A, C, D, and E and magnesium and calcium, even when nutrient intake from diet, fortified foods, and supplements is considered.
Intake of some nutrients is low enough to be a public health concern. These include potassium, dietary fiber, calcium, and vitamin D, along with iron, folate, and vitamin B12 for specific population groups.6
From a clinical standpoint, MVMM [multivitamins and multiminerals] supplementation provides a safe way to correct these nutrient shortfalls while working with individuals to improve dietary intake of nutrients."
NCCIH also states, "Taking a MVM increases overall nutrient intake and helps some people get the recommended amounts of vitamins and minerals when they cannot or do not obtain them from food alone."6
The Global Alliance for Improved Nutrition (GAIN), which is a group of governments, business and organizations working to reduce malnutrition, also recently announced that adding micronutrients like vitamin A, zinc and iron to children’s food, as well as to the diets of poor mothers, is a simple way to provide key nutrients that children need to grow and thrive.7
19 Studies Show Multivitamin Supplements May Reduce Heart Disease, Cancer
Getting back to supplements' role in disease prevention, there is sound evidence that they help (although manufacturers can't state that on the label). Dr. Andrew Saul has over 35 years of experience in natural health education.
In the above interview, he discusses the safety of vitamin supplements, particularly in comparison to prescription drugs.
Meanwhile, Dr. Saul has compiled 19 studies that show strong correlations between vitamin use and reduced risk of heart disease and cancer. Below is a handful. For the full list, please see Dr. Saul's article.
- JAMA 2012: Multivitamin supplements were found to reduce cancer risk by eight percent.9
- International Journal of Cancer 2011: A mere 10 ng/ml increase in serum vitamin D levels was associated with a 15 percent reduction in colorectal cancer incidence and 11 percent reduction in breast cancer incidence.10
- American Heart Journal 2011: Each 20 micromole/liter (µmol/L) increase in plasma vitamin C was associated with a nine percent reduction in heart failure mortality. According to Dr. Saul, if everyone were to take 500 mg of vitamin C per day—the dose required to reach a healthy level of 80 µmol/L—an estimated 216,000 lives could be spared each year.11
- International Journal of Cancer 2011: This study found that gamma-tocotrienol, a cofactor found in natural vitamin E preparations, decreases prostate tumor formation by a respectable 75 percent.12
- International Journal of Cancer 2008: Here, 300 IUs of vitamin E per day reduced lung cancer risk by 61 percent.
Strategic Supplementation Could Save the US $11 Billion a Year in Healthcare Costs
As noted by CRN, about 75 percent of US health care expenditures are spent on preventable diseases… but only 3 percent of these expenditures are invested in disease-prevention programs.
In a report titled "Smart Prevention—Health Care Cost Savings Resulting from the Targeted Use of Dietary Supplements," CRN found that supplementation at preventive intake levels could save the US health care system more than $11 BILLION each year.13
The report suggests that certain high-risk populations over the age of 55, in particular, may benefit from the strategic use of dietary supplements, noting:
"Targeted dietary supplementation regimens are recommended as a means to help control rising societal health care costs, and as a means for high-risk individuals to minimize the chance of having to deal with potentially costly events and to invest in increased quality of life."
Some of the diseases that may benefit include heart disease, diabetes-related heart disease, age-related eye diseases and osteoporosis. Some of the most striking findings included:
|Animal-Based Omega-3: Nearly $4 billion in coronary heart disease (CHD)-related savings could occur from 2013-2020 if the target population used omega-3 supplements at preventive intake levels.
||B Vitamins: More than 808,000 CHD-related medical events could be avoided if the target population used folic acid, B6, and B12.
|Phytosterols: More than $4 billion a year in avoidable hospital utilization costs could be saved if adults 55 and over with CHD used phytosterol dietary supplements.
||Psyllium Dietary Fiber: An annual savings of more than $4 billion a year is realizable if the target population used preventive intake levels of psyllium fiber.
|Lutein and Zeaxanthin: Nearly $4 billion a year in avoidable health care costs could be saved if those aged 55 and over diagnosed with age-related eye diseases used lutein and zeaxanthin.
||Magnesium: Nearly $7 billion in avoidable hospital costs could be saved from 2013-2020 if the target population used magnesium supplements.
In 2002, the Journal of the American Medical Association (JAMA) actually reversed its long-standing anti-vitamin stance with the publication of two scientific reviews that were based on 30 years' worth of scientific papers looking at vitamins in relation to chronic diseases. Both of these reviews ended up recommending daily multivitamin supplementation for all adults, based on the accumulated evidence.14 That was 13 years ago, and the evidence supporting the use of dietary supplements has only gotten stronger since then.
Did You Know Dietary Supplements Are Regulated by the FDA?
Pro-pharmaceutical spokesmen like Dr. Paul Offit and US Senator Dick Durbin have repeatedly stated that dietary supplements are unregulated and need stricter oversight due to the hazards they pose to your health. This is patently false, and you only have to look at the very first sentence on the Food and Drug Administration's (FDA) website to settle that dispute.15 There, it plainly states:
"FDA regulates both finished dietary supplement products and dietary ingredients. FDA regulates dietary supplements under a different set of regulations than those covering 'conventional' foods and drug products. Under the Dietary Supplement Health and Education Act of 1994 (DSHEA):
- The manufacturer of a dietary supplement or dietary ingredient is responsible for ensuring that the product is safe before it is marketed.
- FDA is responsible for taking action against any unsafe dietary supplement product after it reaches the market."
Back in the early 1990s, the FDA threatened the availability of dietary supplements to the point that consumers staged a massive revolt, which resulted in the Dietary Supplement Health and Education Act of 1994 (DSHEA). The law specifically protects your access to dietary supplements by classifying them as foods, not food additives or drugs, and it grandfathered in dietary supplements that were already in use as of 1994. Only novel ingredients introduced after October 15, 1994 are required to seek FDA approval, but the FDA can, and has, shut down supplement makers that do not meet these regulations.
Dietary Supplements Have a Superb Safety Record
There is a well-orchestrated campaign underway to take away your rights and access to vitamins and supplements, often under the guise of safety. Yet, dietary supplements are safe.
In 2013, there were no deaths from vitamins in the US.16 Not from multivitamins, mineral supplements, vitamin C, vitamin D, vitamin E, B vitamins, etc. None whatsoever. As Dr. Saul reported:
“Well over half of the U.S. population takes daily nutritional supplements. If each of those people took only one single tablet daily, that makes about 170,000,000 individual doses per day, for a total of well over 60 billion doses annually. Since many people take far more than just one single vitamin tablet, actual consumption is considerably higher, and the safety of vitamin supplements is all the more remarkable.”
The March 2013 GAO Dietary Supplements report also showed how incredibly safe supplements are—particularly when compared to drugs and vaccines.18 Since 2008, the supplement industry has been required to report adverse events to the FDA's adverse effects reporting (AER) system, pursuant to the 2006 Act. Consider the following statistics comparing dietary supplement AERs with drug AERs from the 2013 GAO report2 for the year 2008:
- 1,080 dietary supplement AERs were reported to FDA
- 526,527 prescription drug AERs were reported
- 26,517 vaccine AERs were reported
When you do the math, there were 488 times as many adverse events reported from prescription drugs as from dietary supplements. In all, the number of AERs is miniscule compared to the hundreds of millions of supplement servings consumed each year. Meanwhile, an estimated 106,000 hospitalized patients die each year from drugs that, by medical standards, are properly prescribed and administered, and two million more suffer serious side effects. This does not include deaths and side effects from medical errors. How does the safety of supplements compare?
- In 2001, 84.6 percent of all substances implicated in fatal poisonings were pharmaceutical drugs, according to that year's American Association of Poison Control Centers (AAPCC) report. This compares with 0.8 percent for all dietary supplements combined, even including substances such as dinitrophenol, a dangerous (and illegal) substance banned in 1938, as well as the central nervous system stimulant Ma Huang (Ephedra).
- According to CDC mortality data for 2005, prescription drugs killed more than 33,500 people that year, second only to car accidents.19 That same year, the American Association of Poison Control Centers20 reported 27 deaths that were associated with dietary supplements (one of which was reportedly due to Ephedra; the herbal supplement banned the year before for being too dangerous. In 2005, low-dose Ephedra was also subsequently banned).
- In 2011, it was reported that there are more than 487 times more adverse event reports for FDA-approved prescription drugs than there are for supplements, and 409 times more serious events for drugs than supplements.21
Why All Young Men and Women Might Want to Consider a Multivitamin Supplement
Many of the studies mentioned have focused on the benefits of supplementation in older populations, but younger generations stand to benefit as well. The group that most requires these vitamins are women of child-bearing age. While it is important for women already pregnant to take a high-quality multivitamin, the latest studies show men's health at time of conception may also be critical to delivering a healthy child.
Fifty percent of pregnancies are not planned, so it is absolutely critical we educate our youth about the importance of multivitamins. This age group is typically not the most interested in obtaining proper nutrition, and I feel it is absolutely critical for the future generations that all young men and women consider a high-quality multivitamin. When selecting a high-quality dietary supplement, be sure it is as close as possible to its natural (whole food) form and follows industry standards for quality assurance including ISO 9001, ISO 17025, and Good Manufacturing Processes (GMP) certifications.
Remember, if you are interested in optimizing your health, your BEST solution is to choose the highest quality foods possible, and eat a wide variety of whole organic foods. You can use my free nutrition plan and work your way up to the advanced stage. Once you have addressed your diet and are looking for further improvement, odds are you might benefit from some supplements, such as animal-based omega-3 supplement and a probiotic, for example. There are many others you could then consider depending on your specific circumstances, including a high-quality multivitamin, additional antioxidant support and others.