When it comes to protecting health, vitamins and supplements have had a rough time of it in the past few years, with studies failing to find that many of them shield against cancer and heart disease or extend life. It appears that while isolating a specific nutrient and adding it to the diet in the form of a pill or capsule is great for dealing with diseases of deficiency, such as scurvy (caused by lack of vitamin C), the same approach isn't so helpful in addressing chronic diseases. So some manufacturers are trying to come closer to putting the likely source of fruits' and vegetables' power—the complex interplay of all their vitamins, minerals, and phytochemicals—in a capsule, as "whole food" vitamins and minerals.
Everyone involved agrees that getting nutrients by eating whole foods is best and that it's probably going to be tough to consolidate all the benefits of a blueberry in a single pill. But manufacturers of whole-food vitamins say that unlike conventional supplements, their products serve up the nutrients in something closer to their food context, in the presence of other substances that make them more effective and in a form that's better absorbed by the body. This goes beyond the distinction between synthetic and natural vitamins, which hinges on the source of the individual nutrient. (The Center for Science in the Public Interest says that picking a vitamin purely because it's labeled "natural" is not generally worth it, with one exception: Vitamin E seems to be better absorbed by the body when its given in its natural form than in a synthetic.)
But the whole-food vitamins are different. Supplement maker New Chapter, for example, takes isolated nutrients and cultures them in a medium (soy, for example) with probiotic organisms. The end result, says naturopathic physician Taryn Forrelli, the company's director of medical education, is the transformation of individual nutrients into "the kind of complex compounds you'd find in food." The idea, she says, is that those compounds are more easily recognized and absorbed by the body. A similar process is used by Garden of Life, which markets a line of "food-created" vitamins and minerals under the Vitamin Code brand. Founder and chairman Jordan Rubin says the end result is a complex that includes not just a "naked, isolated nutrien," but the cofactors, both known and unknown, that make it effective in the body.
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It's an intriguing premise, says John LaPuma, an internist and author of, most recently, ChefMD's Big Book of Culinary Medicine: A Food Lover's Road Map to Losing Weight, Preventing Disease, and Getting Really Healthy. He does believe in the notion that vitamin C consumed in an orange is quite different from a pill. "It interacts with the other compounds that are in oranges and gives benefits that we don't even know about," he says. So at some intuitive level, whole-food vitamins sound like something "closer to the idea of what supplements are supposed to be—supplements to a good diet that resemble or are actually food."
What's lacking, though, is evidence. Forrelli points out some studies suggesting that New Chapter's products are more bioavailable than their conventionally produced counterparts and in some cases have more antioxidant activity. But the question of how the products, or any whole-food supplements, ultimately affect people's health is unanswered. (New Chapter has hired a former M.D. Anderson Cancer Center researcher as chief science officer in part to help figure out how to test the products' efficacy.) Rubin says that there isn't proof that his products are better than the conventional kind but that people do seem to find them gentler on the stomach.
Some patients do find that benefit, says Mary Beth Augustine, a registered dietitian and senior integrative nutritionist for Beth Israel Continuum Center for Health and Healing in New York. Lacking any evidence about how they stack up against conventional supplements or placebo, though, she says that at this point, "it's a matter of preference." And that preference can have a cost; whole-food vitamins and minerals are significantly pricier than the conventional kind. On vitaminshoppe.com, Vitamin Code's multivitamin for men recently was selling for a discounted $30 (list price $40) for 120 capsules. But at a recommended dose of four capsules a day, that's about $1 per day. New Chapter's men's multi, selling at a discounted $36 (list price $60) for a 90-day supply, is about 40 cents per day. Over on cvs.com, though, Centrum's conventional men's multi was selling for a discounted $9 (list price $12) for a 100-day supply, or about 9 cents per day.
And of course, even if you believe in the philosophy behind the products, you have to go back to the question of which—if any--vitamin and mineral supplements you should take at all, given the recent evidence. Though calcium, vitamin D, and fish oil supplements for certain groups of people (for example, calcium for women who don't get enough from food) get a thumbs-up from experts, the data on individual antioxidant supplements are less clear. Researchers are still looking at them for some conditions, but recent studies have many doctors backing away from the notion that they're beneficial for the prevention of cancer, cardiovascular disease, and dementia. Even multis—which many doctors and nutritionists say are an inexpensive insurance policy against the nutritional gaps in your diet—weren't found to extend life in postmenopausal women in a study published last year.
Augustine says she breaks down supplement use into two regimens: long-term maintenance (for general health) and treatment (to address a specific ailment). Both, she says, should be designed in consultation with a physician or nutritionist; consumers should know exactly what they're taking, where it comes from, what the mechanism of action is, and whether it's safe and effective. The best idea, of course, is to plan on getting your nutrients from the diet we've come to think of as healthful: a variety of fruits, vegetables, forms of lean protein, whole grains, and "good" fats. "The take-home message is: Eat food," says LaPuma.