Enough is Enough: An Editorial on Supplements

I'd missed this journal editorial from last month on the topic of the current scientific consensus on the utility (or rather lack of utility) of dietary supplements. The evidence presently strongly favors the view that for people who have no vitamin deficiencies adding more dietary supplements does nothing or may even harm long term health - such as when dietary antioxidants block the hormetic processes necessary to benefit from exercise. The supplement industry is somewhat louder than the scientific community, however.

Reviews and guidelines that have appraised the role of vitamin and mineral supplements in primary or secondary prevention of chronic disease have consistently found null results or possible harms. Evidence involving tens of thousands of people randomly assigned in many clinical trials shows that β-carotene, vitamin E, and possibly high doses of vitamin A supplements increase mortality and that other antioxidants, folic acid and B vitamins, and multivitamin supplements have no clear benefit.

The large body of accumulated evidence has important public health and clinical implications. Evidence is sufficient to advise against routine supplementation, and we should translate null and negative findings into action. The message is simple: Most supplements do not prevent chronic disease or death, their use is not justified, and they should be avoided. This message is especially true for the general population with no clear evidence of micronutrient deficiencies, who represent most supplement users in the United States and in other countries.

The evidence also has implications for research. Antioxidants, folic acid, and B vitamins are harmful or ineffective for chronic disease prevention, and further large prevention trials are no longer justified. Vitamin D supplementation, however, is an open area of investigation, particularly in deficient persons. Clinical trials have been equivocal and sometimes contradictory.

With respect to multivitamins, [studies] and previous trials indicate no substantial health benefit. This evidence, combined with biological considerations, suggests that any effect, either beneficial or harmful, is probably small. As we learned from voluminous trial data on vitamin E, however, clinical trials are not well-suited to identify very small effects, and future trials of multivitamins for chronic disease prevention in well-nourished populations are likely to be futile. Although available evidence does not rule out small benefits or harms or large benefits or harms in a small subgroup of the population, we believe that 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.

Link: http://dx.doi.org/10.7326/0003-4819-159-12-201312170-00011


Anti-vitamin people are exactly like anti-vaccine people. These people need to be charged with murder and jailed.

You have to be pretty thoroughly brainwashed to think that taking vitamin tablets (strangely they only count tablets not fruit and vegetables) is a bad idea. But that's political correctness for you. No grounding in common sense.

Super cheap and easy preventative medicine like vitamins should be compulsory and provided by the government to everyone. It won't make people live to 200 (that will require things the body can't naturally do), but it will help people live to 80.

Posted by: Carl at January 8th, 2014 1:58 PM

What this guy wrote about supplements is highly uninformed. Go to lef.org for some real science. Go to coenzyme-a.com & read Defining Cellular Aging & The Structural & Biochemical Functions of Coenzyme A & then reflect on what this guy doesn't know.

Posted by: Pat McCormick at January 8th, 2014 2:36 PM

I have to say, that since taking supplements, my immune system seems to be better, I don't get sick nearly as often as I used to. I think my skin looks better and there are some other improvements in my overall health that I attribute to taking supplements. Perhaps they will not extend my life but they certainly have improved the quality of my life.

Posted by: Mark at January 8th, 2014 5:46 PM

Enough IS enough, since supplements taken to excess have been reported to cause problems. However, we have found that taking advised dosages of some supplements such as the Vitamin B group, Vit C, probiotics, minerals Ca, Mg, Selenium and Zinc, and also supplementary Folic Acid make a daily difference. Many of the above are indicators our doctor uses in blood tests, certain levels of which indicate 'good health'. We feel our immune systems are strengthened, since we heal quickly from infections, and repel colds and such like contagious diseases common in the population at large. We notice a difference when we stop the supplements. That said, we also think it is important to eat a 'balanced diet', whatever we conceive that to be from our extensive reading, and exercising every day improves mood, mobility and health, whatever your age. We do not generally agree with the article.

Posted by: LILIAN HAYBALL at January 14th, 2014 11:44 AM
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