Surprise! Multiple vitamins don’t cure disease

OLYMPUS DIGITAL CAMERAThere was big news in the medical community recently: drug company GlaxoSmithKline will stop paying doctors to do speaking engagements.  Meaning, no more docs paid to shill promote the company’s drugs.  Someone realized this practice looks very suspicious — blatant PR disguised as research.  Other drug companies may follow suit.

Why does this have to do with nutrition?  Doctors are trained to use drugs to fix diseases.  They tend to trust what their colleagues say about drugs.  Recent studies, done by doctors — one done on doctors — claim that multiple vitamins are a complete waste of money because they don’t work like drugs to fix heart disease or dementia symptoms.  Conclusion: don’t bother taking multiple vitamin supplements.  Here is a direct quote from the cardiologist who led the study (WSJ subscription may be required):

 “If you’re a healthy person trying to stay healthy, the money is in stopping smoking, exercising, losing weight” and taking any prescriptions for hypertension or cholesterol. — Dr. Gervasio Lamas, Columbia University.

In other words, according to the esteemed Dr. Lamas, prescription drugs are the key to health, not supplements.   Repeating that: prescription drugs are more important than nutrition.

There are so many things wrong with these studies it’s hard to know where to begin.  They both start with a false premise: nutrients should work like drugs and cure established disease.  If they don’t cure disease, they’re worthless, except to prevent extreme deficiency diseases.

In fact many of these doctors cite deficiency diseases as the only reason to take vitamins.  Research on vitamin deficiencies were mostly done 50+ years ago, on healthy young men, fed weird diets that were devoid of one vitamin or another.  The problem with that kind of thinking is that drastic deficiencies of one vitamin are very hard to recreate in the real world.  Back then, the researchers thought this kind of diet manipulation was fascinating.  But at this point, we should understand that suboptimal nutrition can have it’s own will effects.  Unfortunately research on that is hard to pin down, so no one bothers doing it.

The doctors are also fond of proclaiming that a balanced diet would theoretically provide all the nutrients one needs.  True, but according to all the diet surveys available, only about 1% of Americans follow balanced diet guidelines, eating requisite amounts of fruits and vegetables and dairy foods.  Even vegans and vegetarians can eat unbalanced diets, lacking in numerous nutrients.  I know this from counseling vegans and vegetarians with poor diets.

Then there’s the nutrient-as-drug myth.  In one study, 50+ year old men who had had a heart attack were given multiple vitamins.  Surprise!  They weren’t cured.  A simple multiple vitamin is never going to fix years of poor lifestyle and diet choices that lead to heart disease.  Heart disease has myriad contributing factors.  Diet is a big one, and the effects or poor diet build over years of neglect.  Reversing that means switching to better diet choices and sticking with them permanently.

In the other study, 65+ year old male physicians were given a multiple vitamin and assessed to see effects on cognitive function.  There was no effect apparently.  But who thought there should be?  The ill effects of poor diet and nutrition on brain function start decades before symptoms show up in old age.  And multiple vitamins are the only issue.  Omega-3 fatty acids are critical to brain function and structure, and multiple vitamins don’t contain those.

Another major problem with study design: it was done on doctors.  So we’re talking about a wealthy upper middle class population, able to afford to eat good food, and already more health conscious than the average person.  Let’s do this study on a group of average obese people who sit all day and eat a highly processed, high sugar, high fat diet devoid of vegetables and fruits.

It’s almost as if these studies were deliberately designed to make multiple vitamins look useless.  But no one would do that.  Would they?  Remember what Dr. Lamas said: it’s important to take prescription drugs.

What to do?  Multiple vitamins typically include RDI doses of known vitamins and varying doses of many minerals.  You can get similar vitamins in some breakfast cereals.  And of course, you get vitamins and minerals from food.  Food groups have different concentrations of vitamins and minerals, which is why it’s a good idea to eat a variety of foods.  But plenty of people do not do that, especially when it comes to vegetables and fruit.  Plenty of people do not eat whole grains.   Plenty of people live on processed foods and junk food, with high fat and sugar intakes.

My main issue with supplements are the weird mega-dose and single-nutrient products, from vitamin C to E to random amino acids to sketchy chemicals that aren’t known to be nutrients in the first place, but sure sound scientific.  I don’t recommend those to my clients.

If you have heat disease or hypertension or diabetes or are trying to prevent cognitive decline, don’t expect a multiple vitamin to cure you, while you continue to eat a junky diet.  Nutrients are absolutely essential to keep your body and metabolism running smoothly.  They are not drugs.  They will never work like drugs.  Nutrition experts know that; apparently some doctors don’t.

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