The Scientific Activist

This isn’t really anything new, but Emily Anthes has a nice summary in Slate today of what we currently know about the effectiveness of nutritional supplements–namely that they don’t consistently show any clear benefits except in a few very specific situations:

Vitamins–with their promise to bridge the gap between the nutrients our bodies need and those they get–have always seemed reassuringly simple: Just pop a multivitamin and let your body soak in those extra nutrients. But not any longer. During the past few years, study after study has raised doubts about what, if any, good vitamins actually do a body. They could even pose some real medical risks.

…

In fact, the reports littering the ODS site seem to converge upon the same point: There is some good news for supplements, but it’s extremely limited. The 2006 NIH panel, for instance, concluded that postmenopausal women should probably take calcium and vitamin D to safeguard their bones; that pregnant women should keep taking folate; and that adults with age-related macular degeneration, an eye disease, should take a combination of antioxidants and zinc. But beyond that, the panel’s strongest recommendation was that scientists conduct further research on the risks and benefits of vitamins. For every study that turns up disconcerting vitamin side effects, there seem to be two more that conclude that we simply don’t know enough yet about supplements to make evidence-based recommendations.

Until we do, we should stop treating supplements like health candy and more like prescription meds, to be used only when there’s a demonstrated need. Doctors should create individualized regimes, tailored to a particular patient’s deficiencies. As for the rest of us, we can put the pills back on the shelf and save our cash for one of those martinis.

So common is the incorrect conventional wisdom on this topic that I too, like so many others, once upon a time regularly took a daily multivitamin. But, I stopped a few years ago, and I’d suggest the same to you… unless you enjoy throwing your money away. If you’re not totally convinced, or if you’d like to read more in depth on the subject, I’d encourage you to take a look at Ben Goldacre‘s book Bad Science, which covers the topic in his characteristicly thorough but quite enjoyable manner. The book still hasn’t been published in the US, but you can find it online.

Comments

#1 CLS
January 6, 2010

Vitamin D is a drug (Schedule III Controlled Substance) and has nothing whatsoever in common with any other supplement or vitamin. In terms of long term (and for that matter short term) human health NOTHING is more important than maintaining an activated vitamin D serum level of at least 50 ng/ml- year round- for the rest of your life. In 5 years the whole planet will be supplementing D3 and disease rates will fall by at least half within a further 5 years. Again- look up the facts- cast away the vitmain of the month B.S.- and recognize D3 is the tangible essence of the sun- in our bodies. It is up there with oxygen and water and a lot more potent in fighting disease then anyone uninformed imagines. Look it up: Vitamin D Council or Vitamin D3 World. Be sure there is something soft to land on when you fall out of your chair…no foolin’!
#2 Jeff
January 7, 2010

Emily Anthes seems to be unaware of the research concerning substances like vitamin D or Omega 3 fatty acids. William Faloon has written a compelling editorial about vitamin D. Of the many studies showing benefit from Omega 3s are those which demonstrate how important DHA can be for early brain development.
#3 romunov
January 7, 2010

Got any papers on this?
#4 Nick Anthis
January 7, 2010

I’m not sure if you’re asking me or the other commenters for papers, romunov, but if you’re looking for references online, I’d encourage you to check out the NIH report from 2006 and the NIH’s Dietary Supplements Fact Sheets, both of which are fully referenced.

The particular DHA study that Jeff mentions appears legit, although it only concerns infants. In terms of vitamin D, our bodies will synthesize a sufficient amount in response to exposure to sunlight (only a relatively limited amount of exposure is required), plus many foods are already fortified with vitamin D, so additional supplements are not necessary for adults.
#5 Nick Anthis
January 7, 2010

I should also note that the Slate article also references the original peer-reviewed literature well, so you can also check out the studies linked to there.
#6 stripey_cat
January 7, 2010

Nick Anthis: I believe GPs in the UK are starting to see rickets cases again; predominantly in non-white populations, with a bias towards women who wear Muslim dress (ie towards darker women many of whom show little exposed skin). Similarly, white women who don’t tan or participate in outdoor sports or activities may also be at risk, although are more likely to be eating dairy products. However, the latter isn’t being studied (although it will become a more significant demographic as more people worry about cancer risks of sun exposure). Of course this only applies to vitamin D, but as someone who doesn’t eat much milk and covers up in the sun because of a family history of skin cancers, I’ve been advised to take Calcium/D supplements.
#7 Nick Anthis
January 7, 2010

The American Academy of Pediatrics does recommend vitamin D supplementation for infants and children in some cases:

To prevent rickets and vitamin D deficiency in healthy infants, children, and adolescents, a vitamin D intake of at least 400 IU/day is recommended. To meet this intake requirement, we make the following suggestions:

1. Breastfed and partially breastfed infants should be supplemented with 400 IU/day of vitamin D beginning in the first few days of life. Supplementation should be continued unless the infant is weaned to at least 1 L/day or 1 qt/day of vitamin D–fortified formula or whole milk. Whole milk should not be used until after 12 months of age. In those children between 12 months and 2 years of age for whom overweight or obesity is a concern or who have a family history of obesity, dyslipidemia, or cardiovascular disease, the use of reduced-fat milk would be appropriate.

2. All nonbreastfed infants, as well as older children who are ingesting <1000 mL/day of vitamin D–fortified formula or milk, should receive a vitamin D supplement of 400 IU/day. Other dietary sources of vitamin D, such as fortified foods, may be included in the daily intake of each child.

3. Adolescents who do not obtain 400 IU of vitamin D per day through vitamin D–fortified milk (100 IU per 8-oz serving) and vitamin D–fortified foods (such as fortified cereals and eggs [yolks]) should receive a vitamin D supplement of 400 IU/day.

4. On the basis of the available evidence, serum 25-OH-D concentrations in infants and children should be ≥50 nmol/L (20 ng/mL).

5. Children with increased risk of vitamin D deficiency, such as those with chronic fat malabsorption and those chronically taking antiseizure medications, may continue to be vitamin D deficient despite an intake of 400 IU/day. Higher doses of vitamin D supplementation may be necessary to achieve normal vitamin D status in these children, and this status should be determined with laboratory tests (eg, for serum 25-OH-D and PTH concentrations and measures of bone-mineral status). If a vitamin D supplement is prescribed, 25-OH-D levels should be repeated at 3-month intervals until normal levels have been achieved. PTH and bone-mineral status should be monitored every 6 months until they have normalized.

6. Pediatricians and other health care professionals should strive to make vitamin D supplements readily available to all children within their community, especially for those children most at risk.
#8 Jeff
January 7, 2010

The American diet is highly deficient in Omega 3 fatty acids – supplementation is a virtual necessity. There are several studies showing Omega 3s can benefit those with cardiovascular issues. Here are two more recent studies:

1. Fish Oil Helps Menopausal Depression

2. A new study funded by the Centers for Disease Control found that in 2005 84,000 Americans died because they didn’t have enough omega 3 fatty acids in their diet.
#9 kelly
January 13, 2010

Thanks for this.

When you isolate vitamins from enzymes, minerals and other essential nutrients like Omega-3 fatty acids, the results often turn up differently. It’s through vitamin research results has turned up different things. This is “research flaw”!

Also vitamins prevents free radical damage n prevents mutation of cells – The Society for Free Radical Research (ASEAN)

Vitamin B (lots of it in excess of the Daily Recommended Dosage) a mental patient regain her sanity – Gerson Institute.

Yep, multivitamins don’t work if they are synthetic and been through poor processing eg. repetitive heat-treatment. But they are badly needed in modern times by us humans partially due to pollution of air, water, stress, etc…and we don’t eat enough fibre.
#10 Alex
January 22, 2010

Nice article, though I think the suggestion of creating individually tailored vitamin profiles is not feasible in the near term. I tend to agree that the best source of vitamins is from the food you eat, but don’t see supplementation is a bad thing. What this study does not acknowledge is that effect size for a lot of the drugs (especially anti-depressants) is horrifyingly small. I was just privy to some new research on omega-3′s and depression (double blind/placebo), bad news – no effect for omega-3s. “Good news”, there was no “effect” from Welbutrin or Paxil either. Pharmacological data are often a bit weak, and since people obviously do respond to certain drugs (re: antidepressants), we should be careful to not toss out the baby as it were.
#11 Melvin Sherwood
August 22, 2010

You’re a total moron, and a dangerous one at that. You’d like nothing better than to impose your rigid elitist doctrinaire small-minded idiocy on the whole planet, I’m sure. Over the last twenty-five years I’ve seen thousands of people restored to excellent health through the use of vitamins, minerals and herbs. I’ve seen terminal cancer patients rid their bodies of tumors using the right supplements. And you, you young and ignorant pipsqeak sit there pontificating as if you had any actual knowledge of the subject. Why don’t you focus on the 100s of thousands who die every year from adverse reactions to perscription medications instead of worrying about vitamins, which in 2008, not a single soul in the US died from? God save us from the likes of you!
#12 Nicolas Martin
August 27, 2010

Sadly, as Melvin shows, multivitamins do not improve bad manners.
#13 vitamins
September 29, 2010

Hmmmm, I was shocked reading the title. My effort on drinking those are useless? nahhh, hard to be true . vitamins
#14 Pilot
January 20, 2011

I have never really been into taking vitamins, but as I started getting older, I wanted to take care of my healthy and keep myself going. Since I am a super healthy guy, I have to make sure I get all of my supplements, and sometimes that can be hard just from food. I found dr max powers multvitamins on sale and they sound easy and safe to use. I have had a bad experience with some vitamin brands because they will upset my stomach, be a bad form to take or not show results.

I take one in the morning with breakfast and it has really seemed to help me stay healthy and have more energy. I like that they are all natural and not made with gelatin, and they contain both calcium and iron which I need. A bottle is reasonably priced and is a balanced formula that keeps me going and healthy.
#15 Alan
February 5, 2011

If Melvin has actually seen thousands of people “restored to good health” on vitamins- thousands, mind you- then it would seem likely he is in some way involved in the vitamin business.
#16 GERRIT
February 28, 2011

you are a idiot
#17 James morison
March 11, 2011

Multivitamins don’t work if you don’t take it under medical observation unless you are very confident about deficiency of vitamin. There are many types of vitamins, so out of these which vitamin you require is very hard to tell.
#18 Nick
April 21, 2011

Vitamin D is a schedule 3 controlled substance? Is that so? Where did you learn about the Controlled Substances Act from, a crackerjack box?
#19 japanjot
May 10, 2011

I think the best place to buy supplements, whey protein powders, protein shakes and other nutritional products online is http://www.madeinhealth.com . They have good service, low prices and products are genuine.. It’s cool. Also try http://www.supplementindia.in
#20 Dave
October 13, 2011

I find most multivitamin studies to be done on most poor vitamins, like One-A-Day. If you look on the back of those, you’ll find they have like, 3-5 different vitamins that are fortified in almost every food we eat. If you get a multivitamin/mineral, make sure to at least look at the back to check it’s vitamin/mineral profile.
#21 Repent and return to YAHUSHA!
December 24, 2011

Nutrient Supplements, including the Natural sourced are: weak: not properly absorbed\assimilated. Heathy whole Fiber( & nutrient) rich foods, block and prevent the absorption\assimilation of ‘odd’ substances like Pharmaceuticals & out-of-tact nutrients. Where as – well package nutrients (in their whole food form) are absorbed\assimilated to their fullest potential. so as to say for a hypothetical example: 1000mg calcium(citrate) supplement ingested, 100mg are absorbed\assimilated; 200mg calcium 8oz raw milk, 165mg absorbed\assimilated. Ain’t nothing like the real thing.
#22 semyon llendon
February 11, 2012

I don’t believe many of you even understand how your small intestine, processes vitamins and minerals by themselves. And vitamin D are you kidding me, I mean if you live in alaska and its dark 20 hours out of the day maybe, but if you live anywhere else in the country give it up. Get off your lazy bum and go outside and enjoy the sun. If you want to get better nutrition start eating right, not eating whatever crap you can get your hands on and then taking vitamins to cover what you missed. Melvin, Read The China Project you’ll find some great and interesting things in that book that have nothing to do with vitamins but food its self. Heck vegetable based protein actually stops cancer in their research because of the different amino acid combination.
Case and point….Vitamins are their MOStly for profit…like i said some actually do need them. though in small doses