Christopher Labos: Vitamin myths are hard to dispel

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Surprisingly, negative studies on the vitamins don’t seem to hurt sales, which amount to billions of dollars worldwide.

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Many people view vitamins as an inexpensive and risk-free way to prevent disease. But just as the Holy Roman Empire was neither holy, nor Roman, nor an empire, vitamins aren’t cheap or risk-free, and they don’t actually prevent disease. In fact, they can make things worse.

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Last week, the U.S. Preventive Services Task Force released its recommendations know if vitamins, minerals and nutritional supplements should be taken to prevent cardiovascular disease and cancer. Just as it did in 2014 when it last reviewed the evidence, it explicitly recommends against taking beta-carotene or vitamin E, and says there is not enough evidence to support the use of other vitamins.

In short, vitamins don’t work. Indeed, beta-carotene increases the risk of cancer and vitamin E the risk of hemorrhagic stroke.

So why do people keep taking them?

Surprisingly, negative studies on vitamins do not seem to hurt sales, which amount to billions of dollars worldwide. When asked, most people say they take vitamins to improve their health, but, ironically, when you look at the data from the National Health and Nutrition Examination Survey people who take vitamins are more likely to be healthy initially. They smoke less, exercise more and have lower obesity rates. Also, when you investigation people about their vitamin intake, you reveal surprisingly contradictory beliefs. Nearly 90% of respondents agree or strongly agree that vitamins can help people meet their nutritional needs. But 80% also agree or strongly agree that vitamins should not replace an unhealthy diet, and 75% agree or strongly agree that vitamins are not meant to cure disease.

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When you explore people’s perceptions, they immediately recognize that vitamins do not cure disease and yet simultaneously view them as health enhancing.

Some people have valid medical reasons for taking vitamins; vitamin deficiencies happen. But vitamin deficiencies are extremely rare.

This leaves many people taking vitamins for reasons that are not medically justifiable. A investigation Italian students found that those who took supplements did not take them because they feared they were not getting enough vitamin D, iron, or omega-3s. The most frequently cited reason was to improve athletic performance, although there are little evidence to support this idea.

This belief system is incredibly difficult to dislodge. The editorial accompanying the USPSTF recommendations explains why this may be the case. Some fairly successful marketing continues to convince the public that vitamin supplementation has value, when this is largely not the case. Vitamins are considered natural, and people who abhor “Big Pharma” and take medications happily take a vitamin supplement while blissfully unaware that prescription drugs and vitamins are often made by the same company. Moreover, people often prefer to do “something” even when that something is against their self-interest. Statistically, a soccer goalie best strategy is to stay in the center of the net during a penalty. And yet, Guardians feel compelled to dive one way or the other because in this context, inaction is unacceptable. The term has a name: action bias. It’s what compels some of us to honk our horns in traffic when we know it will have little effect.

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Humorous examples aside, the problem with our fascination with vitamins is that only a quarter of people who take vitamins would stop taking them if advised to do so by public health. While it’s understandable to want to take charge of your health, there are better and cheaper things you can do. Quit smoking, exercise regularly, eat lots of fruits or vegetables, avoid junk food and you will significantly reduce your risk of cancer and heart disease. Just take vitamins, and you won’t.

Christopher Labos is a Montreal physician and co-host of the Body of Evidence podcast.

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