New Study Says There Is Insufficient Evidence to Recommend Common Vitamins

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In a previous column, I discussed the limited effectiveness of the $14 billion that Americans spend each year on cold and flu supplements. The bottom line was that we could get the vast majority of our immune-boosting vitamins from a healthy, diverse diet, good sleep hygiene, stress control, and early morning sunlight. morning.

Now comes a JAMA’s massive meta-analysis of 84 studies on vitamins and supplements. The aim of this review was to assess the benefits (or harms) of vitamins and minerals in healthy non-pregnant adults in preventing cardiovascular disease and cancer. This review looked at beta-carotene (a precursor to vitamin A), vitamin D, and vitamin E. Here’s what the researchers found:

  • Beta-carotene: supplementation associated with increased risk of lung cancer and cardiovascular mortality.
  • Vitamins D and E: Not associated with an increased or decreased risk of all-cause mortality, cardiovascular disease, or cancer. In short, no advantage.

Based on these findings, the US Task Force on Preventive Services 1) advises against the use of beta-carotene or vitamin E supplements for the prevention of cardiovascular disease or cancer and 2) states that it does not There is insufficient evidence to rate the benefits or harms of multivitamins or other single or paired nutritional supplements for the prevention of cardiovascular disease or cancer.

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That’s a pretty definitive statement considering Americans spent $50 billion on multivitamins and supplements in 2021.

Conventional wisdom in medicine holds that multivitamins or nutritional supplements still have a role in certain populations such as the elderly, pregnant women, or special dieters. But there is a lack of consistent, definitive evidence for the proven benefits of multivitamins in any of these populations. At the individual level, a better approach remains to identify the specific nutrient deficiency and address it with specific fortified foods or diet.

For example, we continue to recommend that pregnant women take a prenatal vitamin, but the quality of evidence is not very high that this supplementation reduces the risk of a fetus being small for gestational age or developing tube defects. neural. It is more likely that the folic acid present in the prenatal vitamin is the main player in the healthy development of the fetus. Thus, it may make more sense for pregnant women to take only folic acid or to eat more grain products fortified with folic acid.

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In that sense, I think this study provides a good opportunity to examine how a healthy and varied diet can provide some of the most important vitamins and minerals. Here are a few of my favorites:

Vitamin D is essential not only for bone health and immunity, but also for mood and a healthy circadian rhythm. The best natural source of natural vitamin D is sunlight, which converts the precursor molecules in our skin into the active form of vitamin D that we benefit from. The best time of day to consume vitamin D is in the morning sun. Doing this right after waking up establishes a healthy circadian rhythm for the day and also helps you avoid the more harmful UVA and UVB rays that are present from the early afternoon.

Fatty fish like tuna and salmon are rich in vitamin D. Egg yolks and mushrooms also contain solid amounts of vitamin D. Note that the recommended daily intake of vitamin D is 400-800 IU/day – however, most adults need around 1000-2000 IU. of vitamin D3 per day depending on the amount of sunlight they receive and where they live. I get a sufficient amount of sunlight and take 2000 IU a few times a week.

Magnesium is important for blood pressure control and blood sugar control. It is a key cofactor for over 300 enzymes that regulate protein synthesis and nerve function. Magnesium is necessary for the synthesis and activation of vitamin D, so if you lack dietary magnesium, it doesn’t matter how much vitamin D you supplement.

Unfortunately, our Western diet of refined grains and processed foods is a poor source of magnesium. An adequate amount of magnesium can be obtained from dark green leafy vegetables, almonds, legumes like black beans, and whole grains.

omega-3 fatty acids form a key part of the structure of every cell we have. It is an “essential” fat, which means that the body cannot generate its own and we must obtain it through food. These essential fatty acids are a major component of our brain, eye retina, skin and nails. They participate in the transmission of signals between cells and are a source of energy. While a A 2012 meta-analysis found that the protective effects of fish oil on the heart were not as strong as we once thought, there is probably a benefit in people at high risk for cardiovascular disease.

Mackerel, salmon, and cod liver oil have some of the highest levels of omega-3s.

There are a total of eight essential B vitamins. Primarily, they work by converting energy sources from carbohydrates, fats, and proteins into energy. Fifteen percent of the population are deficient in vitamin B12, for example, especially those who follow a vegan or vegetarian diet. Those with digestive disorders or who have had gastrointestinal surgery could also be at high risk for vitamin B deficiency.

Top sources of the B vitamin complex include chicken, organ meats, eggs, seeds, nuts, and fortified cereals and grains.

In most healthy adults, essential vitamins and minerals can be obtained from a well-balanced diet and daily early morning sunlight. Supplementation may only be necessary in people who cannot get enough sunlight or who are elderly or have high-risk conditions that make it difficult to consume vitamins from food alone.

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Michael Daignault, MD, is a Los Angeles board-certified emergency physician. He studied global health at Georgetown University and holds a medical degree from Ben Gurion University. He completed his emergency medicine residency at Lincoln Medical Center in the South Bronx. He is also a former United States Peace Corps volunteer. Find him on Instagram @dr.daignault

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