Multivitamins' 'benefits' are all in your head: study
medicalxpress.com
medicalxpress.com
I can't trust a society (or medical/scientific community) that can only express health as the lack of critical illness to make me optimally "healthy" (operation and expression).
To illustrate the point for many diseases/issues they are progressions and spectrum -- like Osteoporosis -- such that sure maybe the humble multivitamin (and minerals?) didn't cure it for life, but maybe it made it more manageable in the final 10-15 yrs?
More vitamin doesn't mean better health. Water soluble vitamins saturate in your body, and the excess is excreted in urine. Fat soluble vitamins, however, build up, and taking more than you need may lead to various kinds of poisoning (particularly A, D, B3 and B6 [3]).
Generally speaking if you're not eating 100% of your meals at McDonalds, you're getting all the vitamins you need from your diet and more vitamins is at best neutral and at absolute worst fatal.
Here's a study from 2011 that shows no decrease in all cause mortality, no decrease in cancer risk [1]. Here's one that shows all cause mortality was 5% higher in multivitamin takers [2].
[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3105257/
> The Centers for Disease Control and Prevention found that nearly 10% of all Americans have a nutritional deficiency.
And what about very low, but non-deficient levels?
It very much depends how the study is designed: in this case they do not measure quality of life or disease progression, but clinical outcome. That is what OP was alluding to: if you are going to only look at clinical outcome and completely tar "effectiveness" with that, then that is a very one-sided view of health and well-being.
Osteoporose patients are at increased risk of vitamin K deficiency. Just because multivitamins are not effective at taking us to Mars, are you really going to recommend patients to spend their vitamin money on fresh fruits?
The analysis needs to come from the other direction: take one vitamin, and prove it does something. Don't load people up with 20 vitamins and hope. Here's a great breakdown of the state of common supplements and whether they do anything at all that I found here, actually, a while back [1]
I put the onus on you: tell me why I should be putting this into my body. Explain what benefit it would provide me. Rather than saying "well, if you have low but not deficient levels of some vitamins supplementation may do something" -- that's not how medical science works :) I mean, eating lots of things may do something, but the burden of proof is higher.
[1] https://informationisbeautiful.net/visualizations/snake-oil-...
For me it is proof enough that my wise mother told me take my vitamins, but more scientific: you have a vector of essential vitamins and minerals. There are thresholds for deficiency. There are optimal levels. Aim for optimal levels, and do not overdo it. Supplements can help with that, and easier and cheaper than a diet which includes all necessities. Low levels are suboptimal for you. Makes sense?
That's not proof of anything.
> There are thresholds for deficiency. There are optimal levels.
And there are levels that cause toxicity.
> Supplements can help with that.
[citation needed] which is kind of the point of this article.
> ...and easier and cheaper than a diet which includes all necessities. Low levels are suboptimal for you. Makes sense?
Unless your diet already has you covered, in which case it's strictly harder and more expensive.
Again, you should look for evidence of improvement, that's what the scientific process is all about. I encourage you to embrace the scientific process and take a data driven approach to whether ingesting something is going to help, harm, or have no impact on you at all, instead of just listening to your mom. My mom is a saint, but she's not right about everything.
Worse yet, because multivitamins like all nutritional supplements are not regulated by the FDA, they can range from totally ineffective to half decent, but you have no way of really knowing. The most common magnesium supplement I've found on Amazon is only 19% bioavailable [1] as compared to a best-in-class 90%. Where does your multivitamin rank? That's just one specific example.
And they find no harm of normal use, but warn against dangerous toxicity effects of overdosing.
Sources are what count. She shares many.
You need a source attached to agree with an argument that a vlog is not a rebuttal of a paper?
>Sources are what count. She shares many.
Sources are a dime a dozen. Bad/happy/fradulent papers also have tons of sources, and even peer reviewers don't ever bother to check them...
That many people have no idea what they are purchasing is a separate matter.
As if the headline alone should give the full breakdown/
So much for confirmation bias...
Hmmm... this seems fishy. I'm not going to read any further.
Peanut gallery: That seems a bit presumptuous. Confirmation bias much?
This argument and the other regarding protein powders not being "real food" stands beyond reason to me. If you're eating vitamins or protein in food or in a pill, what would the difference be? Are smoothies, soups or other processed foods not food?
I take a multivitamin and magnesium supplement, although I take them at the same time as my breakfast (as stated on the label). Logically this makes sense to me, as the contents will be absorbed and digested along with other food stuffs rather than just flushed through the body.
The only way I could imagine multi-vitamins useless and ineffective is if the the vitamins themselves are structurally different and indigestible?
Yes. It is what they are bound to and how they are prepared. The idea of "micronutrients" popped up during the mass production of food post-war--(think of all those cereals that were fortified, fortified because all the nutrients had been stripped out during manufacture!)--and went out of vogue in the 70's. This was the idea that you could reduce food (like a steak) to just a bunch of chemicals, eat those chemicals, and have the same outcome as eating a steak. We've learned a lot more. (That's a crass way to describe it, but close enough.)
I am treating bone loss and I take a prescription Vitamin D because the kind found in OTC single- or multivitamins are not biologically available due to their (inexpensive) preparations.
I have a prescription for it. Still prefer daily pill.
For instance, in magnesium supplementation, all sorts of different formations exist -- and they're not particularly well studied. Some of them are pretty much totally ineffective. Here's a good study demonstrating the variability in terms of bioavailability of magnesium from different formulations -- ranging from 0% to 100% of the magnesium contained in the pill actually accessible to the body. [1]
For instance, Nature's Bounty comes out bottom of the pack, pretty much totally useless (19% bioavailable) [2], whereas Magnerot Classic [3] seems to be best in class (90% bioavailable)
[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6683096/
[2] https://www.amazon.com/Natures-Bounty-Magnesium-Supplement-V...
[3] https://www.woerwagpharma.de/de/produkte/produkt/magnerot-cl...
Of course, that argument is valid only if the supplement would actually fix the prevalent deficiency, as you refer in your example about vitamin D.
> This argument and the other regarding protein powders not being "real food" stands beyond reason to me. If you're eating vitamins or protein in food or in a pill, what would the difference be? Are smoothies or soups not food?
Nutrition studies are quite difficult to perform, and the biology of digestion is not well understood. Certainly different foods eaten in different ways are absorbed by your body differently. Your smoothie example is a good one: fibrous vegetables travel farther through the gut* and their nutrients are absorbed differently than when the fibres are chopped up so that they travel through the lower intestine faster.
> ...The only way I could imagine they're useless is if the the vitamins themselves are structurally different and indigestible?
Likewise an iron supplement alone (or just iron from a piece of meat) will not raise iron levels as much as when taken with lemon juice or, yes, vitamin C.
You can measure this effect for yourself by measuring glucose rise when eating various foods: a raw apple, for example, vs the same mass of apple sauce vs the same mass of apple juice.
* of course it all makes its way the same distance from mouth to anus! I mean arriving intact, or less processed, in the lower intestine and spending a longer time there.
I'm not a doctor so maybe my views are overly simplistic? Seems like a good insurance policy to me more than anything else. I still strive to eat a healthy diet, but why not cover all bases?
Just to be pedantic for a moment, but you'd want to compare same calories (isocaloric), rather than mass per se
And because your body only needs a certain amount, and doesn't benefit from an excess. Water soluble vitamins saturate and the rest is excreted in urine, fat soluble ones build up, potentially to the point of toxicity.
If you already get a sufficient amount from your diet as the overwhelming majority of Americans do, it's just a money sink.
Whether you reach the requirements or not doesn't affect your health, then it's not "required".
There are many diseases related to micronutrient deficiencies, that isn’t being questioned.
The problem at hand is at what levels measurable outcomes disappear.
People who take multivitamins probably have different feelings about health than people who don't.
That doesn't mean the multivitamin caused that.
Curious if there would be a concrete suggestion to replace the $5/month on vitamins.
Full disclosure: I started taking a multivitamin recently, on the basis of it seems like it can't hurt, and who knows, maybe it could help for corona.
Maybe fish oil and/or another Omega-3 source like flax seed.
Rabbit hole is deep on that stuff. Improving Vitamin Absorption is another step. Some with oil, some water, etc.
I've never seen concrete evidence that it does anything. Wikipedia also seems to say it's all ambiguous, with studies flip flopping as much as coffee and wine health studies.
Fish oil and the other ones parent mentioned are all part of my daily routine. I went from 7/10 pain level to 2/10. Those all get mentioned a lot in various help support groups.
- effective for preterm birth
- promising for colorectal cancer
- inconclusive for cardiovascular disease, low sperm count, depression, psychosis, cystic fibrosis
- slightly beneficial for cancer symptoms
- has no effect on diabetes, Crohn's disease, asthma, alzheimers
- harmful: increases the risk of prostate cancer
Regarding coffee, there is strong evidence that consumption of black coffee reduces the risk of cardiovascular disease -- a massive meta-analysis of 36 studies covering 1.28 million people and 36500 cases of cardiovascular disease showed a nonlinear association with minimal CVD risk at 3-5 cups per day [2].
[1] https://informationisbeautiful.net/visualizations/snake-oil-...
[2] https://www.ahajournals.org/doi/full/10.1161/circulationaha....
And that's the misconception.
Things like Vitamin C are no problem. Your body takes what it needs, stores a bunch, and easily excretes the excess.
Things like Vitamin D, however, aren't so benign. Excessive Vitamin D has knock on effects with Calcium. Also, Vitamin D tends to accumulate in fat, so if you store up too much, it can take weeks to bring down.
Just because something is a "Vitamin" doesn't make it harmless.
And, this is before we even start considering things like supplements which have who knows what in them.
Would be nice To be able to quickly check blood levels
I think a better idea than taking an all-in-one is taking only what your body needs. If have a stable diet and you know what you're really putting in your mouth, it shouldn't be difficult to know what supplements are good for you.
I take vitamins B, C, D and K and magnesium and zinc. I have never left better than now. I don't need coffee anymore to have energy throughout the day, I just feel good.
Working the opposite direction,
https://www.cureus.com/articles/7343-a-review-on-the-role-of...
is a survey paper covering 14 recent observational studies of the effect of Vit D on Asthma and 12 of the studies showed actual improved results for folks with asthma.
Its not a numbers game; google and the AAFA imply about 7 percent of adults have asthma related condition, and 7% of 5K would be about 350 people in the study likely had asthma. The survey paper had studies with up to, for example "616 children diagnosed with asthma in Costa Rica" so the numbers are similar.
I just find it interesting that if you ask random untrained people how, for example, vit D affects their asthma you get no result, but if a professional scientific study is run there is a statistically significant difference in outcome.
Source. Was functionally blind much of the day for a couple years.
This is probably the point where the asinine line of reasoning in this article derails and hits bottom.
Vitamins and minerals are not for "health", but for body function.
Deficiency in a vitamin or mineral is not necessarily going to show up as a documented physical or mental illness in your someone's medical history.
If vitamin supplements don't do anything (the benefit is all in the mind), then it must mean that if we take a group of people who are under conditions that will cause them to develop scurvy, and we give half of them a vitamin C supplement, keeping the other half as a control group, then that supplemented group will develop scurvy, indistinguishably from the control group.
Supplementing with vitamins or minerals in which one is not deficient is a waste of money, and could cause a harmful excess, depending on the specific substance. But "everyone" knows that. And, yes, people use supplements without obtaining evidence that they are deficient.
* Vitamin D (for certain races, and for people with a mostly sedentary lifestyle in countries where exposure to sunlight is low)
* B12 (vegans)
Disclaimer: I am not a medical professional.
[1] http://www.informationisbeautiful.net/play/snake-oil-supplem...
Stuff is life altering, if you need it.
50% reduction in migraines, sharp drop in aches and pains. Supper my groups are full of success stories.
I’ve had multiple Neurologist recommend it as a starting point.
If your feeling fine to begin with. It’s probably not going to do a thing.
Ok, that's not how science works.
> Stuff is life altering, if you need it.
And if so, it'll show up in a study.
> 50% reduction in migraines, sharp drop in aches and pains. Supper my groups are full of success stories.
That's great, and it's supported by... wait for it... studies [1] "Magnesium's role in migraine pathogenesis is well-described, with deficiencies known to promote cortical spreading depression, alter nociceptive processing and neurotransmitter release, and encourage the hyperaggregation of platelets, all major elements of migraine development."
If you have a defined deficiency, then a specific vitamin may be helpful. If there's nothing wrong with you, then it's at best neutral, and at worst harmful -- and expensive.
We need to take a science-forward approach to this stuff.
[edit] To be clear: you didn't mention specifically what you were using magnesium for, and the parent post was implying that there were vitamins or minerals that it wasn't worth checking whether you had the deficiency before taking. As such I looked into the role of magnesium in general wellness which is not supported by data. Had you mentioned that it was for a specific condition, I would have researched it before making my implication, so my bad there.
But vitamins do physically help when you are deficient. Your energy levels and immune system improves.
And "all in your head" is nothing to scoff at when the Placebo effect has been measured to help shorten disease by 7%.
Sure. But the vast majority of people are not deficient. 86% of Americans take vitamins or supplements of some sort. 21% have been diagnosed with kind of vitamin deficiency. And the vast majority of those could, to your point, eat more lettuce. [1]
"Most people have no need to take vitamins and are wasting their money on supplements that are unlikely to improve their health and may actually harm it." [1]
If you aren't deficient, you may end up with an excess of fat soluble vitamins (A, D) which may actually poison you.
[1] https://osteopathic.org/2019/01/16/poll-finds-86-of-american...
If you take the prescribed one pill a day, how are you going to form overdose? Talking about excess I hear the medical professional disdain for vitamins in that. Understandably, because they get those people who take extreme doses of over the counter stuff in their visiting hours. But that's no risk to use as an argument against vitamin supplementation for regular use. Multivitamins would be banned if regular use caused overdose.
Further, "if you take the prescribed one pill a day, how are you going to form overdose?" -- vitamin and mineral supplements are not regulated by the FDA, and vary widely by brand and batch and so on.
FDA recommends 700IU for an average adult. The first bottle of multivitamin I found, "Sundown Multivitamin Gummies" has 800IU, which is additive with your diet. 4000IU is the upper limit (and 60,000IU per day has been shown to cause toxicity) I've seen people chow down on those gummies because they're tasty. Not likely to hit, though.
The first Vitamin D supplement (Forest Leaf D3) I found is a once-weekly 50,000IU hum-dinger that provides on average double the safe upper limit.
Lastly, if folks at the poverty line are taking these sometimes expensive, often unnecessary supplements, could that money be better spent on other things?