The headlines that appeared would make me go to my doc with questions were I you (and my or your doc may have not read the fine print) … or maybe I'd just say to myself, "I don't need these and stop 'em". And whenever new studies in this area appear, especially headline-making studies, I review 'em in detail to see if my recommendations should change. I need to be responsive to the data, but that requires the work of reading the studies and the fine print in the studies.
So I wanted you to know what the fine print said so you were not misled. And so you didn't throw those babies – your multivitamins, your vitamin D3 and four other supplements I'll elaborate on in future blog posts – out with the bathwater.
What the fine print said were that all those people in these studies had normal nutrition and had no vitamin deficiencies, were not potentially or actually pregnant and weren't tested for quality-of-life issues like eyesight. And the news media ignored the significant 8 percent reduction in non-prostate cancers for men over 50, significant 18 percent reduction in non-prostate cancers for men over 70 and the non-significant (because they didn't study enough people) 11 percent reduction in cardiovascular events and deaths (of a high-dose vitamin regimen compared with a low-dose one – yes, everyone in that study received vitamin supplementation).
Yes, the studies had that in the fine print. The editorial noted some of this, but left out the importance of vitamins to eyesight and to preventing 40 percent of autism, 60 percent of childhood cancers (up to age 6) and over 80 percent of congenital defects; it also left out that the cardiovascular study was of a high dose versus a low dose of some vitamins and minerals to prevent deficiency. But you can't blame the editorial writers for not caring about children or for "minor oversights" like cancer and cardiovascular deaths if the study were done right (with enough people).
The editorial writers were (I hope) probably thinking about their patients, and they may not see many women who are, or are trying to get, pregnant. But women between 12 and 50 are an important group that needs to consider half a multivitamin twice a day. Since 50 percent of all pregnancies in North America are unplanned, and since you need that prenatal multi (it has DHA – the omega-3 fat that is active in brain and eyes – in addition to a multi) three months prior to pregnancy (per the best study we have) to prevent 40 percent of autism, maybe all women between puberty and menopause (12 and 50 or so) should be excluded from their recommendations to stop wasting money on vitamins.
[Read: The New Pregnancy Nutrition Rules.]
So, maybe, should those men who don't want to battle cancer, or those of us over age 50 who care about preventing the early stages of age-related macular degeneration or fading eye acuity. Or what about the fact that in working and non-working populations not taking supplements, over 60 percent test as having one or more vitamin deficiencies (and in the heart-attack study, all patients were given some vitamins and minerals to prevent deficiencies). But rather than just refute those overlooked issues, lets talk about why I do what I do and what data supports that.
What did these studies say: One metastudy conducted for the U.S. Preventive Services Task Force looked at 27 supplement studies involving more than 400,000 people. It found no benefit for longevity, cancer prevention or heart health in people without nutrient deficiencies. (More than 60 percent of the tested population in almost all other studies have one or more vitamin or mineral deficiency.)
The second followed 5,947 guys for 12 years and found that multivitamins didn't sharpen thinking or memory in men who ate healthy diets.
The third tracked more than 1,700 heart-attack survivors, all were given some vitamins and minerals to prevent deficiencies and, again, found only an 11 percent non-significant (because it wasn't a big enough study, and plenty of people – on the placebo side too – dropped out of that study) heart-health benefits for those who took the complete and higher dose than anyone I know would recommend multivitamin. All three studies appeared in the same issue of the Annals of Internal Medicine.
We want you to know that these studies really found that if you eat well almost all the time, take enough vitamins to prevent deficiencies or only take your vitamins some of the time, you won't get a benefit. The studies also showed no harm from taking multivitamins.
My take: You still will benefit from taking half a daily multivitamin containing important nutrients at levels close to their recommended daily allowance twice a day if you are potentially going to become, or are, pregnant, or as an insurance policy against an inadequate diet in people over 50 or if you care about your eyesight (add 900 milligrams of DHA plus 10 milligrams of lutein and 2 milligrams of zeaxanthin a day – more on that in the next blog or two in this series).
Men and postmenopausal women: Only take multis without iron. Finally, no mega-vitamins, please! There was plenty of data prior to this saying those don't have a benefit in relatively typical people without specific diseases.
At least 60 percent of people need that insurance policy against a less-than-perfect diet based on deficiencies found in typical populations. And if you take a diuretic, an acid-blocking proton pump inhibitor (PPI), the diabetes drug metformin or use sea salt as your primary salt, you are likely to develop a vitamin or mineral deficiency, too.
So I think half a multi twice a day is a great, inexpensive insurance policy against an imperfect diet. If you think an 18 percent reduction in cancer rates is worth it when you hit age 70, then you should too. And certainly all women who are possibly going to be pregnant, should.
As to the other 5 supplements or OTC meds I take and recommend to my patients when benefits exceed risks, one of our last blog posts on this U.S. News & World Report site discussed the benefits and risks of taking two baby aspirins a day.
Aspirin is one of the six supplements or OTC meds that I take and routinely recommend to those of my patients when the benefits exceed the risks, and in the next blog, we'll expand more on the data supporting vitamin D3 (1000 IU a day), DHA (600 milligrams a day under age 50, 900 milligrams after age 50) and maybe calcium with magnesium and another odd omega.
In the future I'll also give the evidence why some specific foods (like walnuts, avocados, cruciferous veggies and extra virgin olive oil) should be enjoyed by you regularly. But I've overstayed the alloted space for this blog.
Hungry for more? Write to firstname.lastname@example.org with your questions, concerns and feedback.
An esteemed authority on health and wellness, Michael F. Roizen, MD, chairs the Wellness Institute at Cleveland Clinic, the first such position at any major healthcare institution, where he actively coaches patients. He is a former editor of six medical journals and has published more than 175 peer-reviewed scientific papers. Board-certified in internal medicine and anesthesiology, Roizen co-founded with Mehmet Oz YouBeauty, a media company focused on helping women lead healthier, more beautiful lives, and RealAge. His RealAge series of books as well as his "YOU" series, written with Oz, are worldwide bestsellers, with four No. 1 bestsellers in the U.S. and No. 1 bestsellers in at least five other countries. Roizen and Oz write a daily syndicated column tha appears in over 130 newspapers. Roizen has appeared regularly on Oprah, Today, 20/20 and Good Morning America and has a two-hour, 33-station radio show. He is 67 calendar years of age but his RealAge is 48.7 He routinely tweets the week's top medical stories @DrMike Roizen.