Are you wasting your money on supplements? Most likely, experts say
Vitamin, mineral and
multivitamin supplements aren't likely to protect you from cancer, heart
disease or overall mortality, the US Preventive Services Task Force
said in updated guidelines released Tuesday in the journal
JAMA.
Since its last recommendation in 2014, the task force reviewed 84
studies testing vitamins in almost 700,000 people, including 52 new studies on
the topic.
Yet the conclusion
remained the same as that of 2014: If you are a healthy, nonpregnant adult,
there is "insufficient evidence" of any benefits to extending one's
life in taking vitamin E, vitamin D, calcium, vitamin A, beta carotene, vitamin
B3, vitamin B6, vitamin C and selenium.
However, there is
enough evidence to recommend against the use of beta carotene
supplements, which the body turns into vitamin A, to prevent cardiovascular
disease or cancer "because of a possible increased risk of mortality, cardiovascular
mortality, and lung cancer," the task force said.
Nor should people
take vitamin E "because it probably has no net benefit in reducing
mortality, cardiovascular disease, or cancer," the task force said.
"Lifestyle
counselling to prevent chronic diseases in patients should continue to focus on
evidence-based approaches, including balanced diets that are high in fruits and
vegetables and physical activity," said Dr Jeffrey Linder, chief of
general internal medicine at Northwestern University's Feinberg School of
Medicine in Chicago, in an accompanying editorial.
Take, for example,
the Mediterranean diet. Eating the Mediterranean way, which focuses on a
plant-based diet, physical activity and social engagement, can reduce the risk
for high cholesterol, dementia, memory loss, depression and breast cancer, numerous studies found.
Meals from the sunny
Mediterranean region have also been linked to weight loss, stronger bones, a healthier heart and longer life.
Another
evidence-based intervention: is the DASH diet, which stands for "dietary
approaches to stop hypertension." The diet successfully reduces high blood
pressure, studies have shown. Both the Mediterranean and DASH diets avoid
processed foods and focus on fruits, vegetables, beans, lentils, whole grains,
nuts and seeds.
"Rather than
focusing money, time, and attention on supplements, it would be better to emphasize
lower-risk, higher-benefit activities ... following a healthful diet, getting
exercise, maintaining a healthy weight, and avoiding smoking," Linder and
his colleagues wrote.
Yet despite the
consistent message from the scientific community, "more than half of
American adults take dietary supplements," spending an estimated $50
billion (About Ksh 5.9 trillion) in 2021, according to Linder and his colleagues.
Why would we spend
so much money on pills with so little evidence to support their benefits?
"According to
population surveys, people take vitamins either to stay healthy, feel more
energetic, or gain peace of mind. These evidence-defying beliefs are bolstered
by clever marketing campaigns," said behavioural scientist Dr Peter Ubel,
in an accompanying editorial published in JAMA Internal Medicine.
Then, once people see
vitamins as being "good and healthy," another behaviour called
"dose insensitivity" takes hold: If a little is good, more must be
better, said Ubel, who is a professor of business, public policy and
medicine at Duke University's Fuqua School of Business in Durham, North
Carolina. Add to that human bias toward anything labelled "natural" or
"botanical" and the likelihood of purchasing vitamins and minerals
marketed in that manner rises, he said.
"Advertising
agencies recognize this bias," Ubel added. "Now, people can make up
for the lack of fruits and veggies in their diets by ingesting daily
supplements."
CNN reached out to
the Council for Responsible Nutrition, a trade organization for the supplement
industry, and received this response:
"The apparent
limited evidence should not be misinterpreted as the absence of evidence,"
said Andrea Wong, senior vice president for scientific and regulatory affairs
for the council. "Numerous research studies support the use of
multivitamins by most Americans for a range of benefits."
Some populations
need supplements
There are some
populations who do need certain vitamins. Pregnant women should take a daily
supplement containing 0.4 to 0.8 milligrams (400 to 800 micrograms) of folic
acid to prevent neural tube birth defects, according to a separate recommendation from the task force.
People with limited
access to healthy food choices or who have certain medical conditions or anyone
over the age of 65 may need to focus on adding specific micronutrients to
their diet, experts say.
Some seniors may
need additional supplementation of vitamin B12 and B6 as
absorption of those vitamins from food fades as we age. Because the elderly
often get less sun than younger ages, they may need additional vitamin D, but
levels should be checked by a doctor, as too much D can be harmful.
Many postmenopausal
women take supplements to reduce fractures, but in 2018 the task force found
vitamin D combined with calcium had no effect on the incidence of fractures in
postmenopausal women.
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