Vitamins and Supplements: Do They Work?
The picture is mixed, but thumbs up for vitamin D and fish oil
Clarified on 12/10/08: An earlier version of this article stated that Harvard Men's Health Watch newsletter editor Harvey Simon says his concerns about multivitamins have recently eased. They have eased somewhat for breast cancer but not prostate cancer.
Before making claims about any nutrient, "we need to step back and look at the basic biology and chemistry," says Cynthia Thomson, associate professor in the University of Arizona department of nutritional sciences. As Lichtenstein notes, perhaps we're assuming that a particular nutrient in a carrot, say, is key when really it's one of a thousand substances that are all working together. Researchers are still studying whether supplemental antioxidants might slow the progression of age-related macular degeneration and perhaps prevent noise-related hearing loss. But "no doctor would recommend them for the prevention of cancer, of cardiovascular disease, or of dementia," says Simon.
What about you? Nutritional profiles are not all the same. Recommended intake varies by age, gender, and even race. And genetic differences mean everyone utilizes or responds to vitamins differently, says K. Simon Yeung, a research pharmacist in the Integrative Medicine Service at Memorial Sloan-Kettering Cancer Center. Eating preferences, such as a low-fat or vegetarian diet, will alter the mix of nutrients taken in. Moreover, lab tests that analyze the nutrients in your system and indicate which ones might need boosting or trimming are, with a few exceptions, not readily available and not often performed. "You can get your cholesterol checked, but not your niacin levels," says Thomson. However, keeping tabs on your dining habits for a few days at MyPyramidTracker, a U.S. Department of Agriculture tool, will give you a sense of whether you're on the right course.
Lichtenstein worries that supplements give Americans license to continue their unhealthful ways so long as they pop a pill after the steak and hot fudge sundae. Diet is still the best source of nutrients. Adding supplements—or fruits and veggies, for that matter—to a high-calorie diet is not going to work magic. Good health begins with physical activity and a balanced diet that is heavy on fruits, veggies, whole grains, "good" fats, and fish and light on red meat, "bad" fats, and processed food—and not too high in calories. "Nature," says the ACS's Lichtenfeld, "is probably better than our manufacturers."
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