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It might not be worth taking vitamins if you want to prevent chronic disease. That’s the message in an an editorial today in the Annals of Internal Medicine.
The editorial is a sweeping analysis of studies that focus on multivitamins. The authors looked at three studies that included hundreds of thousands of patients.
They determined that vitamins had “no clear evidence of beneficial effect” on the occurrence or progression of chronic disease, and in some cases could be harmful. For instance, smokers who took only beta carotene supplements increased their risk of lung cancer.
Dr. Lawrence Appel was one of the authors of the editorial and joins Here & Now’s Robin Young to discuss it.
On the studies’ focus on people with healthy diets
“These are the people that supplement manufactures are targeting. They are often people who are eating well and get enough nutrients. I mean, there are populations in the world, many in less developed countries, where vitamin supplements are important, really important. But not in the United States, Canada, other places where diets are basically okay, at least in terms of micronutrients. It’s not saying that our diets are perfect, you know, our diets can be improved, but the approach is not to take a pill.”
Are there no benefits to vitamins?
“Very equivocal. There have been studies that examine quality of life, and there really is not any evidence that it is any better than placebo. Evidence that supplements can improve joint function or symptoms is very weak too. So there really is not a compelling database for people to take these supplements, many of which can be expensive and divert people from doing what they really should do … [such as] being physical active. Take the money they use on supplements and spend it on a pair of sneakers, or gym club, or eating better foods.”
On some people’s belief that vitamins work
“The problem is we’re dealing with a product that has a mystique — how can vitamins not be beneficial? The term vitamin almost connotes value. So we’re taking on firmly held beliefs, but it’s held on shaky scientific evidence.”
ROBIN YOUNG, HOST:
From NPR and WBUR Boston, I'm Robin Young. It's HERE AND NOW.
And the FDA has confirmed what a lot of people suspected: Bacterial soap isn't any better at killing bacteria than regular soap. In fact, it's worse because long-term use can cause bacterial resistance and hormonal side effects. And the agency is now going to require manufacturers to prove the benefits of their antibacterial products. So there's that.
And there is more ammunition in the war over vitamins. An editorial out today in the Annals of Internal Medicine looked at three studies and concluded: case closed. Vitamins have no clear benefit for people who eat well. And they shouldn't be used for chronic disease prevention. The editorial ends with the words enough is enough. Dr. Lawrence Appel is professor of medicine and epidemiology at the Bloomberg School of Public Health at John Hopkins University and one of the authors of the editorial. Wow, Dr. Appel, pretty emphatic.
DR. LAWRENCE APPEL: We were just restating what these studies found, but it's not just these studies. I mean there's been really a long line of sort of disappointing results from trials. These statements have been made before by other people, but we just happened to have the opportunity to write an editorial and comment on it.
YOUNG: Well, the first study that you looked at out of the three was a meta-analysis of 27 studies. So there's, you know, tons of work here. But it sounds like these studies were looking specifically at the effect of vitamins on mortality, whether they can prevent stroke or a heart attack. And the conclusions were, they couldn't?
APPEL: Yes. They found that there was no benefit from taking multivitamins, you know, at least in populations such as those residing in the United States.
YOUNG: Well, that's what critics are responding to. There are people who have come forward to say, well, but you looked at people who were well-nourished. What about people don't have good diets?
APPEL: Yeah. But these are the people that supplement manufacturers are targeting. They're often people who are eating well and get enough nutrients. I mean there are populations in the world - many in less developed countries - where vitamin supplements, you know, are important - really important, but not in the United States, Canada, other places where diets are basically OK, at least in terms of micronutrients. It's not saying that the diets are perfect. You know, our diets can be improved, but the approach is not to take a pill.
YOUNG: Well, what about the other reasons people take vitamins, not necessarily to prevent death but to make them feel better while they're living, to, you know, lubricate the joints or make your skin better. Are there no benefits to vitamins?
APPEL: Very equivocal. I mean, there have been studies that have examined quality of life. There really is not any, you know, evidence that it's any better than, you know, placebo - evidence that supplements can improve joint function or symptoms is very weak too. So there really is not a compelling database for people to take these supplements, many of which, you know, can be expensive and divert people from doing what they really should do.
YOUNG: Which is?
APPEL: Being physically active, take the money that they use on supplements and spend it on a pair of sneakers or a gym club or eating better foods.
YOUNG: Well, this is a huge multibillion-dollar industry. What are you hearing?
APPEL: Well, I've heard from people, individuals who expressed their own opinion that they perceive some benefit. The problem is that we're dealing with, you know, a product that has a mystique or a, you know, how could vitamins not be beneficial? The term vitamin almost connotes value. We're taking on firmly held beliefs, but it's based on shaky scientific evidence.
YOUNG: You mean the beliefs are?
YOUNG: Dr. Lawrence Appel, professor of medicine at the Bloomberg School of Public Health at John Hopkins, also a co-author of an editorial in the Annals of Internal Medicine that looked at several studies and concluded taking vitamins to prevent chronic disease is not worth it. Dr. Appel, thank you.
APPEL: A pleasure to be on your program.
YOUNG: So Dr. Appel told us he's going into the witness protection program now. We, however, welcome your thoughts. Go to hereandnow.org. Love to hear what you think about this. You're listening to HERE AND NOW. Transcript provided by NPR, Copyright NPR.
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