• Shall We Slam The Door On Multivitamins Once And For All?

    Posted January 6, 2014: by Bill Sardi

    That’s what an editorial in the Annals of Internal Medicine said.  After citing flawed study after flawed study where multivitamins were found to be ineffective at reducing death rates or mental decline with advancing age, and even citing published studies to say multivitamins are harmful and even kill people, these experts from the most prestigious medical centers in the world said: “we believe the case is closed – supplementing the diet of well-nourished adults with (most) mineral or vitamin supplements has no clear benefit and might even be harmful.  These vitamins should not be used for chronic disease prevention.  Enough is enough.”

    Case closed?

    Hardly.

    The catch: “well nourished.”

    All present studies are flawed

    Representatives of the Linus Pauling Institute at Oregon State University responded to these efforts to throw multivitamins into the closet and throw away the key by saying most published vitamin studies are flawed.  They explained, until controlled studies obtain blood levels of nutrients before and at the completion of the study, it cannot be said vitamin pills are ineffective.  Because of problems with vitamin absorption and transport, which are rampant among older adults, the most frequent users of these vita-pills, it cannot be said they are ineffective.

    Also these studies lump data from thousands of people altogether when there may be hidden subgroups of people who are truly nutrient deficient and may benefit from dietary supplementation.  None of the studies cited in the Annals of Internal Medicine did that.  The primary study multivitamin study group cited was comprised of well- nourished physicians.

    Not instructive

    Furthermore, none of these large group studies provide meaningful instruction to individuals.  They may serve to help determine levels of nutrients needed for food fortifications in large populations, but for an individual with a true nutrient deficiency, any conclusions from these studies would not apply.

    What about morbidity?

    Additionally, the studies cited by these researchers largely dealt with mortality (death) rates, not with morbidity (presence or rate of disease).

    There is a stark difference between the “lock the door and throw away the keys” position of these so-called experts and what the U.S. Department of Agriculture (USDA) publishes regarding the percentage of Americans whose intake of essential vitamins and minerals is “inadequate.”

    For example, USDA says 54% of Americans have inadequate intake of vitamin A, 42% of vitamin C, 86% for vitamin E, 18% for vitamin B1, 40% for vitamin B9 (folic acid), 57% for magnesium, 29% for zinc.  Apparently multivitamins help to reduce hidden vitamin deficiency diseases like scurvy (vitamin C), beri beri (vitamin B1), pernicious anemia (vitamin B12) that are pervasive in the population.

    Why vitamin pills may not always work

    In 1990 Dr. Wayne R. Bidlack of the University of Southern California published a report (Geriatric Nutrition, Raven Press, 1990) showing that elderly subjects remain vitamin deficient even though they were taking dietary supplements.  After supplementation up to 33% were niacin (vitamin B3) deficient, up to 39% pyridoxine (B6) deficient, up to 18% were B12 deficient, and up to 13% deficient in folic acid and water pills (vitamin B1, zinc, magnesium, potassium).  Malabsorption due to lack of stomach acid is a primary reason.

    Also, the dose of the vitamin supplements may have been too low to normalize these nutrient levels.

    How can multivitamins work when most are taking vitamin-robbing drugs?

    Yet these MD/PhD experts never think to advise their patients to supplement their diet because they are taking these nutrient-robbing medicines.

    It is also odd that this group of elite doctors, who slammed the door on multivitamins, frequently prescribe drugs to their patients that induce nutrient deficiencies, such as metformin (vitamin B12), ACE inhibitors for high blood pressure (zinc), statin cholesterol-lowering drugs and beta blockers (coenzyme Q10), steroidal anti-inflammatory drugs (vitamins C &D), blood thinners (vitamin K), estrogen replacement (magnesium and folic acid).

    What about the study that said otherwise?

    Another oddity is that four months prior to the door-slamming report published in the Annals of Internal Medicine, a landmark study, the Third National Nutrition Examination Survey involving 16,008 individuals, measured the blood levels of antioxidant vitamins over a 14-year period.  Researchers report individuals with the highest blood concentration of vitamins C and E experience d -45% and -29% risk for death compared to individuals with the lowest blood levels.  Supplement users had a clear reduction in their risk for death but four months later the news media chose to widely air a slanted negative story instead with no balanced reporting, which would have included the prior report.

    Conflicts of interest not disclosed

    Also of interest, the conflict of interest disclosures for the five authors of the Annals of Internal Medicine report were not available for direct viewing and the website where there disclosures were posted was not operable.  Many journals today now publish this statement: “all members of the writing group are required to complete and submit a Disclosure Questionnaire showing all such relationships that might be perceived as real or potential conflicts of interest.”  But their actual affiliations with commercial interests are not disclosed.

    Multivitamins formulated for healthy, not aged or sickly adults

    Also, there is concern that the most widely sold multivitamin, Centrum, the very multivitamin selected for the major study, made and marketed by a major pharmaceutical company, offers baby-doses of essential nutrients that aren’t sufficient for smokers, diabetics, physically or mentally stressed individuals, and most prescription drug users, thus gaming the population so that a certain level of disease is assured that will be inappropriately addressed by their own drugs.  There are obvious conflicts of interest here.

    And Centrum, the multivitamin being assailed in the Annals of Internal Medicine report, is proud to brag at its website that “because of Centrum’s quality, it was the only multivitamin used in the Physicians’ Health Study II.”  Centrum grabs the bragging rights despite the null outcome of the study.  Don’t you just love these guys?

    Doctor recommended

    Another interesting finding is that 23% of the patients who take multivitamins say their decision to take them was based upon advice from their doctor.  So now what?  Are these consumers supposed to ignore their doctors’ recommendation?

    A good diet will do.  Really?

    Marian Neuhouser, of the Fred Hutchinson Cancer Research Center in Seattle, quoted at WebMD, a website that offers information to doctors, said “a multivitamins might cost $20 a month.  Why not spend that on more fresh produce?” she asked.  But Dr. Neuhauser failed to mention that the National Cancer Institute’s own 5-A-DAY plant food diet abysmally failed to reduce mortality rates.  Most of the authorities commenting on whether to continue to take multivitamins have some conflict of interest in the matter.

    You get what you pay for

    The Office of Dietary Supplements at the National Institutes of Health reports sales of multivitamins were $5.2 billion in 2011.  Out of a population of ~310 million, only about 33% of Americans take a multivitamin, about $16.70 per person per year (that amounts to $1.39 per month!).  It is obvious many Americans may be buying multivitamins at some time throughout the year, but two-thirds never buy or consume them and the other third doesn’t take them very often.  You can’t benefit from a vitamin pill you don’t take.  ©2014 Bill Sardi, Knowledge of Health, Inc.

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