MONDAY'S MED: THE DOCTOR IS IN! (12/30/2013) - The Flap Over Multivitamins

We've all heard on the news and read articles lately about new medical research that is debunking the benefits of multivitamins.  The story that has sparked the recent debate is an editorial in the December 17, 2013, Annals of Internal Medicine*. The conclusions and recommendations by the editorial's authors were based on reviews of three articles in the medical journal related to research on the efficacy of multivitamins.  In all 3 articles, large populations of participants were studies (thousands) over multiple trails and years.  Several key points were raised in  the editorial:

"Most supplements do not prevent chronic disease or death, their use is not justified, and they should be avoided".
"...Supplementing the diet of well-nourished adults with (most) mineral or vitamin supplements has no clear benefit and might even be harmful". 
"... β-carotene, vitamin E, and possibly high doses of vitamin A supplements are harmful. Other antioxidants, folic acid and B vitamins, and multivitamin and mineral supplements are ineffective for preventing mortality or morbidity due to major chronic diseases."  The effects of over-supplementing - particularly with antioxidants - were further magnified by a December 17, 2013, CNN interview by Anderson Cooper with Dr. Sanjay Gupta and Dr. Travis Stork of "The Doctors" TV show.

Of course, those in the multivitamin and supplement industry do not agree with this editorial, nor the findings of the medical research report in the journal.  An industry executive, John Shaw of the Natural Products Association, noted in the Wall Street Journal article's "Multivitamins Found to Have Little Benefit"  that "... many consumers don't the recommended nutrients from their diets only, and multivitamins and mineral supplements are an affordable alternative."  But this statement is not surprisingly, because this is a huge - in effect - multi-billion dollar industry:  a January 2013 National Institute of Health report found that in 2011 US sales of multivitamin and mineral supplements was $5.2 BILLION!  The Centers for Disease Control and Prevention reported in April 2011 (cited in CNN Health News) that more than 50% of Americans were taking dietary supplements - including multivitamins, minerals and herbs.

While the authors of the Annals of Internal Medicine editorial closed the door on any further clinical study on the preventive health benefits of vitamin A, beta-carotene, vitamin E, and other antioxidants, the debate over the benefits of vitamin D remains open.  This was noted in particular for deficient populations, such as the elderly. The authors noted that there were mixed results from studies on using vitamin D supplementation for fall prevention so additional investigation to clarify its proper dosing is warranted.  However, the authors noted further that the "current widespread use [of vitamin D} is not on solid evidence that benefits outweigh harms".

In the final analysis, most experts are agreeing that multivitamins have no medical benefit.  However, that may be some instances in which individuals may be deficient in a specific vitamin, and as Drs. Gupta and Stork noted in their CNN interview,  so individuals should consult and follow their doctors' advice.
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*NOTE - Because the Annals of Internal Medicine article is targeted at the medical community, it may be difficult to read and follow for the layperson.  I found a very good article on the WebMD site that is written for the layperson to understand and enjoy - check it out: Experts: Don't Waste Your Money on Multivitamins