The Case Against Vitamins
by Sara Parr, MS, RD, LDN
Do I need a vitamin and mineral supplement?
This may be a question that you have asked yourself before. Between television ads, magazines and the Internet, promises to make you healthier are everywhere.
These marketing efforts are not wasted, as many individuals come to my office with a bagful of over-the-counter supplements, some quite expensive. Is this money wasted? Are they helpful? Could they be harmful?
The first question you need to ask is: "Am I eating a wide variety from all five of the major food groups (fruits, vegetables, grains, dairy, and protein foods such as meat, poultry, dry beans, eggs, and nuts)? Or do I eat the same things everyday, frequently skip meals or miss out on one or more food groups daily?"
The Truth: Most people don't need supplements
Despite all the hype, the truth is that most people really do not need to take vitamin or mineral supplements. Vitamins and minerals are essential for our daily health. They are necessary for specific metabolic reactions within the body and for normal growth and repair. However, since vitamins and minerals exist naturally in foods and are supplied in sufficient quantities through a well-balanced diet, "vitamin pills," especially high dose supplements, are not really necessary for most individuals. The main U.S. authority on nutritional recommendations - The Food and Nutrition Board of the National Academy of Sciences - has concluded that vitamins in pill form serve no purpose for the average American.
Unfortunately, too many people use vitamin and mineral supplements to treat themselves for suspected diseases. It is not unusual for patients to be taking five or more over-the-counter supplements with the mistaken belief that they are improving their health. In most cases, that is money wasted. The person who benefits the most is the manufacturer of the supplement. Severe vitamin and mineral deficiencies are very rare in this country. There is no evidence to indicate that supplements, taken on a routine basis, will improve the health of most individuals.
Vitamins do not contain energy
Some people take vitamin and mineral supplements believing that they will supply an energy boost. Energy comes from the calories in our food. Because these supplements are essentially calorie-free, they do NOT provide energy. Also, be cautious about more expensive "natural" vitamin supplements currently being promoted by some manufacturers who claim that "natural" nutrients are somehow more effective than man-made products. The truth is that all vitamins are specific chemical compounds and have the same composition and effect on the body, whether they are produced synthetically or extracted from natural sources.
Are supplements actually dangerous?
Many good scientific studies have shown that getting vitamins through a balanced diet containing fruits and vegetables is safe and has many positive effects on our health. Years ago, it made sense that through chemical isolation and synthesis, vitamins could be packaged in even higher doses and taken in pill form to make us even healthier. Unfortunately, it has not worked out that way. There is something about the way Mother Nature packages vitamins in our food that we haven't figured out yet when we go to package them in pill form. In pill form, vitamins may not be helpful and, in some circumstances, may even be harmful.
Although manufacturers are restricted from claiming that using their products improve health, surveys show that many people take supplements for purposes such as treating colds, preventing heart disease and cancer, or alleviating depression. According to other survey data, the majority of consumers believe these products to be either reasonably or completely safe. Unfortunately, long-term scientific studies have not shown the benefit of such supplements and sometimes have shown them to be harmful. Here are a few examples:
Vitamin E
In 2005, several major long-term studies of vitamin E capsules and prevention of heart disease were inconclusive or showed no benefit. In fact, some suggested harm. The Wellness Letter from the University of California-Berkely (which first discovered vitamin E in 1922) now no longer recommends vitamin E supplements because of data showing no benefit. Studies at John's Hopkins actually showed a 6% greater risk of dying when taking more than 400 I.U. of vitamin E daily. The Journal of Clinical Oncology reported a higher risk of chemotherapy failures when combined with vitamin E pills.
Beta-Carotene
Beta-Carotene turns into vitamin A inside our bodies. Beta-Carotene in fruits and vegetables has long been shown to help prevent some cancers. However, in a 1994 study in Finland, smokers who took capsules containing 20 mg of Beta-Carotene daily had a 18% higher risk of lung cancer. In 1996, a study of vitamin E and Beta-Carotene in smokers was stopped when the combined therapy showed a 28% risk of lung cancer and a 26% higher risk of dying from heart disease.
Vitamin C
Foods containing vitamin C have been shown to improve health. For the past thirty years, millions of Americans have believed that taking high doses of vitamin C in pill form may also be beneficial. Although initial studies by Nobel Prize winner Linus Pauling did show a benefit in preventing symptoms of a cold, subsequent follow-up studies have been disappointing. A comprehensive review of 23 clinical studies in 2005 failed to show a signifiant benefit of high dose vitamin C in cold prevention or duration - except in extreme circumstances such as soldiers exposed to extreme cold and stress. For the average American, high dose vitamin C seems to possess no significant benefit. It may be harmful in pill form. In 2004, cancer researchers found a 6% higher death rate from some cancer in individuals taking supplements which contained high dose vitamin C.
Certain vitamins and minerals, if taken in excess, may cause problems. It is well established that serious toxicity symptoms may appear because of excessive intake of the fat-soluble vitamins A and D. Vitamins A, D, E and K in excess are stored in the liver. Because they are stored, they are not needed every day in our diet. Excessive ingestion of minerals may also be toxic. Taking large amounts of one nutrient can interfere with the function of others. Some vitamins are excreted from the body when they are present in excess. Water-soluble vitamins like the B vitamins and vitamin C are not stored, so we need a continuous supply. Because of the dangers associated with some vitamins and minerals when they are taken in excess, the Food and Drug Administration recommends that high potency vitamins should be taken only with the advice of a physician.
Many misleading claims out there
No supplement has been proven to cure diseases such as cancer, diabetes, heart disease or digestive problems. If it sounds too good to be true, it probably is. Be cautious of supplements that promise quick and dramatic results.
The FDA suggests these precautions:
- Be wary of unfounded medical claims for dietary supplements, and be sure to tell healthcare providers about all supplements you take, including concentrations and amounts.
- Children, adolescents, older or chronically ill people, and women who are pregnant or breast-feeding should not use high-potency supplements or those used for medicinal purposes unless they have responsible medical supervision.
Who really benefits?
Supplements may help those diagnosed with severe vitamin and mineral deficiencies, people on low-calorie weight loss diets, gastric bypass patients, or very strict vegetarians who cannot achieve a balanced food intake. Smokers appear to need more Vitamin C than non-smokers do because smoking apparently speeds up the metabolism of this vitamin. Also, elderly persons, alcohol abusers and chronic users of certain medications may benefit from supplements. Post-menopausal women, women who are pregnant or lactating, and individuals with certain digestive disorders such as pancreatic insufficiency, celiac disease or Crohn's disease may need supplements including extra calcium and vitamin D. Persons with specific nutritional problems should seek advice from a physician or dietitian, rather than self-prescribe vitamin or mineral supplements.
You can take this online quiz from the American Dietetic Association to see if you need a daily supplement:
Eat a variety of foods instead
We need to obtain a balance of nutrients, including vitamins and minerals by eating a wide variety of foods from the basic food groups. This is important because our present knowledge of the body's nutritional needs is incomplete. Vitamin and mineral supplements contain only those nutrients that have been identified, synthesized, and researched. A number of essential nutrients exist for which minimum requirements have not yet been established. There may also be important nutrients that have not yet been discovered. A diet consisting of nutrient-rich foods provides the benefit from nutrients and other factors such as dietary fiber. Your diet is more likely to to be balanced and healthful if you eat a variety of foods, rather than rely on vitamin and mineral supplenents.
Vitamin D and Calcium
One exception to the supplement debate might be vitamin D and calcium. There is very little vitamin D in our diet other than some fortified milk products. Vitamin D is mostly made when direct sunlight hits our skin. However, most of us now work indoors and spend very little time in direct sunlight. Add that fact to the current fear of skin cancer and the liberal use of sunscreen and you can see why many people may have a mild vitamin D deficiency. Your doctor can do a simple blood test to see if your vitamin D level is normal or low. It is hard for most individuals to obtain enough vitamin D and calcium from diet alone. In that instance, a daily low supplement of 800 mg vitamin D combined with a calcium supplement daily would not be harmful.
MyPyramid.gov
Below is some helpful information about how to eat healthier from the U.S. Department of Agriculture website - www.mypyramid.gov:
Grains
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Eat at least 3 oz of whole grains daily. Look for the word "whole" before the grain name on the list of ingredients. Substitute whole wheat bread for white bread and brown rice for white rice. Start the day with a whole grain cereal. Choose a whole grain snack such as popcorn, whole wheat crackers, or whole grain baked tortilla chips. Snack on ready-to-eat whole grain cereals such as toasted oat cereal. A slice of bread, 1 cup of cold cereal, 1/2 cup of cooked rice, cooked pasta, or cooked cereal counts as one ounce from the grains group.
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Vegetables
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Plan some meals around a vegetable main dish such as soup or a vegetable stir fry. Eat more green and orange vegetables. Add dried beans and peas to your menu. Shred carrots or zucchini into meatloaf casseroles, homemade bread and muffins. Include fresh, frozen and canned chopped vegetables in pasta sauce or lasagna. Buy vegetables that are in season. They will cost less and will likely be at their peak flavor. In general, one cup of raw or cooked vegetables or vegetable juice, or two cups of leafy greens counts as 1 cup from the vegetable group.
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Fruits
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Choose a variety of fresh, frozen, or canned fruit. Go easy on the fruit juices. Top off a bowl of cereal with some berries. Snack on dried fruit at work. Keep some of them in your desk. Keep a bowl of fresh fruit on the table, counter, or in the refrigerator. Mix fresh, frozen or canned fruit to make a salad for dinner. In general, 1 cup of fruit or 100% fruit juice, or 1/2 cup of dried fruit counts as 1 cup of the fruit group.
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Milk
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Go low-fat or fat-free when you choose milk products such as milk, yogurt and cheese. If you can't consume milk choose lactose-free milk or other sources of calcium such as calcium fortified orange juice, or rice. Yogurt is low in lactose. Include milk as a beverage at meals. Add fat-free or low-fat milk instead of water to oatmeal or hot cereals. Top cut-up fruit with flavored low-fat yogurt for a quick dessert. Try shredded low-fat cheese as a topping for casseroles or vegetables. In general, a cup of milk or yogurt, 1 1/2 oz of natural cheese, or 2 ounces of processed cheese count as 1 cup from the milk group.
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Meat & Beans
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Remember to vary your protein routine - choose more fish, beans, peas, nuts, and seeds in your diet and less red meat. Trim away all the visible fat from meats and poultry before cooking. Choose cooked dried beans or peas as a main part of a dish or part of a meal more often. Broil, grill, roast, or poach meat, poultry, or fish instead of frying. Drain off any fat that appears during cooking. In general, 1 ounce of meat, poultry, fish, 1/4 cup of cooked beans, 1 egg, 1 tbsp of peanut butter, or 1/2 oz of nuts, or seeds counts as one ounce from the meat and bean group.
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Oils
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Use oils sparingly. Stick with liquid oils and avoid solid oils such as Crisco, lard, solid stick margarine, and excessive butter. Avoid transfatty acid. Use olive or canola oils. Check the Nutrition Facts label to find margarines with 0 grams of trans fat. Oils from plant sources (vegetable and nut oils) do not contain any cholesterol. In fact, no foods from plant sources contain cholesterol. A few plant oils, however, including coconut oil and palm kernel oil, are high in saturated fats.
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If you decide to take a daily multivitamin
While it is probably unnecessary to take vitamin and mineral supplements, there is probably no harm in taking a single multivitamin capsule daily. Most contain 100% or more of the recommended daily allowances of particular nutrients. Choose one that offers no more than 100% of the daily value for those nutrients.
Summary
Vitamins and mineral supplements are not worthless. Many studies do show that vitamins and minerals in our food actually prevent disease. Supplements in pill form just do not benefit our bodies in the same way that Mother Nature's vitamins and minerals do. The bottom line, if in doubt about your daily intake of vitamins and minerals, you should concentrate on selecting, buying, and eating nutrient-rich foods.
You might be interested in the USDA website, USDA MyPyramid.gov where you can determine what diet is best for you - customized to your age, sex, weight, and level of physical activity. Check it out...
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