Multi vitamins: cure-all or insurance policy?

If you’re taking a multiple vitamin, why are you doing it?  To prevent heart disease?  If so, the long-running Physicians’ Health Study has some mixed news: multiple vitamins may slightly reduce cancer risk, but they don’t prevent heart disease.

Vitamins were originally discovered when medical researchers realized that animals fed purified diets grew poorly and were very unhealthy compared to animals that ate whole food.  One hundred years ago, the word “vitamine” was coined by Casimir Funk, who researched beriberi.  He realized that brown rice prevented the disease, while milled white rice did not.  He theorized that brown rice contained some unidentified substance – a “vitamine” – that was essential to health.  Nutrition was born.

The misconception that vitamins cure diseases other than deficiency diseases is rather new, and so far not supported by any evidence.  So it’s not surprising that multiple vitamins don’t prevent heart disease, which is linked to genetics and numerous lifestyle factors like exercise, fat intake, obesity and smoking.

There’s another complication with judging health benefits of multiple vitamin use: the general health habits of the user.  People who take vitamins tend to have better habits in general: lower weight, healthier diet, more exercise and less smoking.  Vitamins are just one piece of the puzzle.  Did the vitamins cause the healthy habits?  Not likely.  Could vitamins cancel out bad habits?  Very unlikely.

This study has received some criticism from vitamin advocates.  Focusing on white male physicians, who already tend to have healthier lifestyles, may have skewed potential results from the get go.  A multiple vitamin wasn’t likely to add dramatically to their health.  Steve Mister, President of the Council for Responsible Nutrition added

“we shouldn’t expect vitamins to perform miracles.”

If you’re going to take a multiple vitamin, to add to your already healthy lifestyle (right?), keep these tips in mind:

  1. Vitamins are not drugs.  They do not cure diseases.
  2. Vitamin supplements are not regulated like prescription drugs are.  There is no government testing to make sure supplements contain what the label says.  Buy reputable products.
  3. There is no standard formula for “multiple vitamin”.  The formulas can vary wildly from one to another.  The best choices contain about 100% of the RDA for a large number of vitamins and minerals for the target population.
  4. Beware formulas that try to impress you with big numbers, such as 2000% of the RDA for one or two vitamins.  Would your car run better if you dumped 1000 gallons of oil over the engine?
  5. Remember: they’re supplements, not replacements.  A healthy diet will provide nutrients.  Remember, Casimir Funk discovered that brown rice fixed B1 deficiency.

Finally, In my professional opinion, the formulas for many of the multiples aimed at children are either incomplete or contain weirdly low and/or excessive amounts of some nutrients.  Other experts agree with me.  A study on multiple intake in a large group of children showed nutrient intakes ranging from inadequate to excessive.  What’s true for adults is true for children: vitamins do not replace a healthy diet.

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