vitamins

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Why Julie Dropped Her Multi: Tufts Experts Debate Multi-Vitamins

vitamins

I trust Julie Flaherty. She used to be my colleague back in our New York Times days, and never was there a more stalwart or accurate reporter. “Yes!” I said, when I saw that, in her current role as editor of Tufts Nutrition magazine, she had put together a roundtable discussion on the science of multi-vitamins, and posed its experts the widespread question: I’m a fairly healthy adult with a pretty good diet. My doctor said to take a multi-vitamin. Should I?

I stopped taking multi-vitamins more than a year ago because more and more data seemed to suggest they did little or no good, and might even do a bit of harm. But I confess to unease about that decision; doctors keep routinely recommending them, and the silver-haired people in the TV ads look so healthy and happy…I’ll take my cue from Julie, I decided.

The discussion begins with a contrast between two Tufts professors and nutrition researchers, Jeffrey Blumberg and Alice H. Lichtenstein.

Blumberg: I feel there is no harm in taking a multivitamin, and doing so will help fill in the gaps. More than half the American population isn’t consuming the amounts of fruits, vegetables and whole grains that we recommend to help them meet their needs for vitamins and minerals.

Lichtenstein: Your physician’s recommendation is not consistent with current clinical guidelines. There was a very extensive systematic review sponsored by the federal government that was done by the Johns Hopkins Evidence-Based Practice Center that showed no benefit to the general population from a multivitamin.

It’s a rich discussion, worth reading all of, but here are my takeaways: We already get many vitamins from fortified foods. We should think about vitamins in a more individualized way: Which particular ones am I lacking? And mainly, we need to eat better, not expect vitamins to fill in any nutritional gaps. Here’s a memorable quote from nutrition researcher Johanna Dwyer, a professor at Tufts School of Medicine:

Indiscriminate vitamin use is sort of like the use of holy water in the Middle Ages: People thought if you sprinkled it on things, it would ward off all evil. People who take supplements would probably be offended by that, but sometimes if you look at their reasons, they are not more sophisticated than beliefs in the Middle Ages.

Oof. I asked Julie what effect this discussion had on her own multivitamin practices. She emailed: Continue reading

Shun Multivitamins? They Won’t Kill You, But Walk To Farmstand Instead

Recent studies raise concerns about vitamin supplements

Recent studies raise concerns about vitamin supplements

I used to pop a multivitamin every day. You’re just supposed to, right? Then I started paying closer attention to the research, and I dropped them from my morning routine.

My neck gets tired from watching the good-for-you-bad-for-you vitamin pendulum; here’s the kind of thing I mean, from October:

Last we heard — last fall, actually — a study of more than 38,000 older women in Iowa brought disturbing news to the millions who take daily vitamins. It found, as NPR reported: “Use of many common supplements — iron, in particular — appeared to increase the risk of dying, and only calcium supplements appeared to reduce mortality risk. The increased risk amounted to a few percentage points in most instances.”

Now comes a somewhat countervailing study: The Journal of the American Medical Association reports that in 15,000 older men, multivitamins do confer apparent benefit, reducing the total risk of cancer by 8 percent.

So what’s the bottom line? Dr. Paul Offit, best known for his vaccine research, took an outspoken stance in The New York Times this weekend, and it has been on the most-emailed list since. Headlined “Don’t take your vitamins,” it says in part:

Nutrition experts argue that people need only the recommended daily allowance — the amount of vitamins found in a routine diet. Vitamin manufacturers argue that a regular diet doesn’t contain enough vitamins, and that more is better. Most people assume that, at the very least, excess vitamins can’t do any harm. It turns out, however, that scientists have known for years that large quantities of supplemental vitamins can be quite harmful indeed.

Offit offers a lucid explanation of how large doses of antioxidants could become too much of a good thing. Uh oh. I contacted Dr. Pieter Cohen, a general internist at Cambridge Health Alliance who researches dietary supplements, for a reality check. Our conversation, edited:

So why is this Paul Offit piece so emailed? What is it telling us that we want others to know?

He’s recommending not to take multivitamins, and we so often hear: Since we can’t eat every day out of our personal gardens, we should make up for it by taking a multivitamin with a nice bucolic image on the label.

But, I think [Paul Offit] overstates the case and is alarmist: He’s saying multivitamins are dangerous and avoid them –

Or is he talking about megavitamins?

Since the editors have titled it “Don’t take your vitamins,” and we generally take multivitamins which are not megavitamins, this would imply to me, ‘Don’t take multivitamins because they are dangerous.’

That’s false. There’s a ton of data: Over 175,000 people have been carefully studied while taking multivitamins, and what the huge database is telling me is that taking your multivitamin won’t kill you. That’s why the headline is misleading, because in fact we know that for the great majority of people, taking multivitamins is not going to kill them. Continue reading

After The Multivitamin Study Comes Multimedia Ad Campaign

Yesterday, many major news outlets covered the story of an 11-year study of multivitamins that suggested men who take them have a slightly reduced risk of developing cancer.

The vitamins’ effect on cancer was “modest — an 8% reduction in the risk of total cancer,” said the study’s co-author, Dr. Howard Sesso, an associate professor of medicine at Brigham and Women’s Hospital. But he said the findings were important  “given how little we know about the prevention of cancer in general.”

But perhaps even more striking than the vitamins’ modest health benefit was what happened today: a decidedly un-modest advertising campaign on television and in newspapers touting the multivitamins used in the study — Centrum Silver, owned by drug giant Pfizer.

(Just to be clear on the study’s financing, it was “supported by grants from the National Institutes of Health and an investigator-initiated grant from BASF Corporation. Study agents and packaging were provided by BASF Corporation and Pfizer, formerly Wyeth, American Home Products, and Lederle, and study packaging was provided by DSM Nutritional Products, Inc., formerly Roche Vitamins”).

A full-page ad in The New York Times claims the multivitamins used in a clinical trial are the “most studied.”

There was a full page ad in The New York Times promoting the vitamins as: “Most doctor recommended; Most preferred; Most studied.” Interestingly, the ad doesn’t mention any reduced cancer risk, but maybe in this age of tainted drugs, “most studied” is an even more reassuring claim.

And here’s what CommonHealth’s co-host Carey Goldberg confronted during her morning workout:

I was on the elliptical at my gym at a little after 8 this morning, looking up at the array of a half dozen television screens, and was amazed to see ads for Centrum Silver on three televisions at once, apparently all three major networks, touting the vitamins as not just most recommended by doctors but “most studied.” It surely is “most studied” after a trial of 15,000 men over more than a decade, but I felt like a total tool for writing about that trial yesterday.

Indeed, as soon as the study was released, the promoting kicked in. For instance, here’s part of Pfizer’s cheerleading press release on the vitamins and offers of myriad company executives to interview about the results: Continue reading

10 Points About Vitamin D From A Prime Proponent

From: The Journal of D-I-Y Medical Research (which I just made up).
Number of subjects: 1.
Intervention: 2,000 units of Vitamin D per day over one month, after I heard a primary care doctor attest that since he’d started taking more Vitamin D, his aches and pains of middle age had largely disappeared.
Outcome: Subject (yours truly) no longer has to walk stiffly down the stairs in the mornings like a toddler, planting both feet onto each stair before moving on to the next one. Foot and ankle pain mostly gone.
Conclusions: None. You can’t conclude anything from a study with an “n” of 1. But the results were intriguing enough to make me attend a lecture today by Dr. Michael Holick, director of the Vitamin D, Skin and Bone Research Laboratory at Boston University. It was titled, “The Solution For Good Health: Rx Vitamin D.”

For context, Dr. Holick is clearly a controversial figure. He tends to be hated by some dermatologists because he advocates (moderate, carefully calibrated) sun exposure. He discloses an array of financial ties with various companies — as well as NIH support — and has written two books on Vitamin D, the latest called “The Vitamin D Solution.”

But he is not a fringe figure. He remains a professor of medicine, physiology and biophysics at B.U., and he led the Endocrine Society team that issued new practice guidelines on Vitamin D this summer. (They recommended more than a 2010 Institute of Medicine report, which had tripled the recommended levels.)

Here in Boston, our bodies make virtually no Vitamin D from November to February no matter how long we stay outside.

I must confess, I had Linus Pauling on my mind when I went to see Dr. Holick speak. For all Pauling’s Nobel-winning chemistry brilliance, time appears to have proven him wrong on his great enthusiasm for Vitamin C.

But lately, time seems to be on Dr. Holick’s side. Evidence of a broad array of health benefits — and lack of harm — from appropriate doses of Vitamin D has been accumulating, and more studies are in the works. I quake when I pass along recommendations of a vitamin that can have toxic effects if overdone — and the dangers are very real, as the Wall Street Journal’s Health Blog reported here. But here are two recent positive signs: Continue reading

Nestle On Vitamins: Belief Or Science-Based Interpretations (Both Are True)

Recent studies raise concerns about vitamin supplements

Here’s nutrition expert Marion Nestle’s take on recent news that certain vitamin supplements are potentially harmful for older women and men.

In her blog, Nestle explains two approaches to understanding vitamin supplements — one based on beliefs and the other on science. (Interestingly, she says both are viable.) She writes:

Supplements are a good example of how scientists can interpret research in different ways, depending on point of view….

For example, on the need for supplements, a belief-based approach rests on:

–Diets do not always follow dietary recommendations.
–Foods grown on depleted soils lack essential nutrients.
–Pollution and stressful living conditions increase nutrient requirements.
–Cooking destroys essential nutrients.
–Nutrient-related physiological functions decline with age.

A science-based approach considers:

–Food is sufficient to meet nutrient needs.
–Foods provide nutrients and other valuable substances not present in supplements.
–People who take supplements are better educated and wealthier: they are healthier whether or not they take supplements.

The statements in both approaches are true.