{"id":1053,"date":"2014-07-03T18:10:25","date_gmt":"2014-07-04T01:10:25","guid":{"rendered":"http:\/\/blogs.oregonstate.edu\/linuspaulinginstitute\/?p=1053"},"modified":"2016-05-16T17:17:16","modified_gmt":"2016-05-17T00:17:16","slug":"following-evidence-multivitamins-revisited","status":"publish","type":"post","link":"https:\/\/dev.blogs.oregonstate.edu\/linuspaulinginstitute\/2014\/07\/03\/following-evidence-multivitamins-revisited\/","title":{"rendered":"Following the Evidence: Multivitamins Revisited"},"content":{"rendered":"

\"multivitamin<\/a>
\nAre\u00a0multivitamin supplements useless? Does\u00a0the science all point to these pills\u00a0being\u00a0a complete waste of money and time?<\/p>\n

This is simply not true, and you should know why.<\/p>\n

In a letter<\/a> in Annals of Internal Medicine<\/i>, nutrition experts from the Linus Pauling Institute at Oregon State University, the Children\u2019s Hospital Oakland Research Institute, Tufts University, and the Harvard School of Public Health gather scientific evidence to show that the conclusions to stop your multivitamins are just plain wrong\u00a0(Guallar et al., \u201cEnough Is Enough<\/i><\/a>\u201d).<\/p>\n

First, be aware that\u00a0multivitamins are not miracles<\/a>. They can’t cure every disease, nor are they designed to do so. However, they are intended to supplement a diet that may not be reach recommended levels of all vitamins and minerals.<\/p>\n

And this is not an usual – national surveys<\/a>\u00a0say that\u00a0many American adults do not meet vitamin and mineral intake recommendations from diet alone: at least 90% don’t get enough\u00a0vitamins D and E, 60% a low in magnesium, and about 50% are lacking enough\u00a0vitamin A and calcium. Taking a daily multivitamin helps to fill many<\/a> of these nutritional gaps effectively, safely, and at low cost<\/a>.\"Multivitamins\"<\/p>\n

But this campaign against\u00a0multivitamin supplements has recently taken on\u00a0a new life. Where did it start? Three recent publications has set new\u00a0fuel for this most recent fire. But do these articles really<\/em> condemn multivitamins as useless?<\/p>\n

The first article, conducted by the U.S. Preventive Services Task Force<\/a>, gathered data from vitamin studies involving more than 400,000 people. To quote the article directly: \u201cTwo large trials [with 27,658 individuals] reported lower cancer incidence in men taking a multivitamin for more than 10 years.\u201d Although there appeared to be no overall effects on cardiovascular disease, there is no reason to discount these cancer results out of hand.<\/p>\n

The second article was conducted as part of the Physicians Health Study<\/a> (PHS II), which examined the effect of a daily multivitamin\/mineral supplement on cognitive function in male physicians. The main conclusion of this study was that there were no significant cognitive health benefits in people over the age of 65 taking a multivitamin\/mineral compared to those who took a placebo pill. However, as explained in the PHS II report, the subjects of this trial had a decent diet and\u00a0were highly-educated men, so the\u00a0benefits on cognition were not expected based on previous studies using multivitamins.<\/p>\n

Nonetheless, previously published data from PHS II (the same study group<\/i>) showed other benefits from\u00a0multivitamins, including reduced risks of cancer<\/a> and \u00a0cataracts<\/a>. So following a conclusion that these cognitive data provide \u201cno benefit\u201d of multivitamin use is clearly not examining all the evidence.<\/p>\n

\"woman<\/a><\/p>\n

The third study was a little unusual: it used\u00a0a high-dose multivitamin\/mineral supplement to prevent a\u00a0recurrent cardiovascular event<\/a>\u00a0in people\u00a0who already had\u00a0a heart attack. The main conclusion of this study was that there was no benefit or harm of the multivitamin regimen.<\/p>\n

However, a closer look at the data showed that people taking high-dose multivitamins showed fewer cardiovascular events (such as stroke, heart attack, etc.) versus the placebo group at every time point<\/i> after the first year of the study<\/i>. But the results never reached statistical significance, so an overall conclusion about the multivitamins could not be made.<\/p>\n

Several limitations plagued this study’s conclusions. First, it was primarily designed to test the effect of chelation therapy with vitamin therapy<\/a> on cardiovascular events and not just focused on multivitamins. The individuals in this study were low in number , on multiple prescription medications, and approximately 30% of them had diabetes. Additionally, almost half left the study before its conclusion!<\/p>\n

Furthermore, this supplement was not a typical multivitamin: it contained more than the daily value (%DV) of 15 of vitamins and minerals, but\u00a0contained other non-essential compounds (like citrus bioflavonoids).<\/p>\n

\"Fruits<\/a><\/p>\n

Despite all of this, there was a result from this study that is not often discussed: of the individuals who did not take drugs to lower their cholesterol (statins),\u00a0<\/i>the multivitamin regiment showed a significantly lower rate for cardiovascular events versus those who took\u00a0a placebo. In other words, the use of statins \u2013 while certainly of benefit to individuals who have had a heart attack \u2013 may have hidden\u00a0the cardiovascular benefits of the multivitamin therapy.<\/p>\n

If anything, the conclusions of this study should not suggest that multivitamins are \u201cuseless,\u201d but are instead deserving of further investigation, especially in individuals who cannot take statins because of allergy or other side effects.<\/p>\n

If we go beyond these three articles, the benefits of taking multivitamins are multifold: they supply micronutrients to those in more critical need, such as older adults, people who have poor access to fresh fruit and vegetables (and children who refuse to eat them), people who are obese, women who are pregnant or planning on becoming pregnant, and some people who are ill or injured.<\/p>\n

\"Heart<\/p>\n

The fact of the matter is that multivitamin\/mineral supplements are designed to supply the body with micronutrients that allow for its proper function \u2013 they are designed to keep us in good health<\/a>. Any evidence that these supplements may also help decrease chronic disease risk, like in the PHS II study with respect to cancer and cataract, should be worthy of further, better designed multivitamin trials.
\nThe Linus Pauling Institute and others<\/a> have stated that research methods need to improve<\/a> in order to realize the benefits of vitamin and mineral interventions for chronic disease prevention. However, until they do, we will continue to examine the totality of the evidence from supplementation studies. At the LPI, we base our recommendations for healthy living<\/a> on the up-to-date scientific evidence.<\/p>\n

Eating a healthy diet<\/a> and taking your multivitamin<\/a>\u00a0is still a good idea — and we encourage you to ignore all the sensational headlines that tell you otherwise.<\/p>\n","protected":false},"excerpt":{"rendered":"

Are\u00a0multivitamin supplements useless? Does\u00a0the science all point to these pills\u00a0being\u00a0a complete waste of money and time? This is simply not true, and you should know why.<\/p>\n","protected":false},"author":5337,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"jetpack_post_was_ever_published":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2}},"categories":[582791],"tags":[160036,44258,165491],"class_list":["post-1053","post","type-post","status-publish","format-standard","hentry","category-lpi-take","tag-multivitamins","tag-recommendations","tag-vitamins"],"jetpack_publicize_connections":[],"jetpack_featured_media_url":"","jetpack_sharing_enabled":true,"jetpack-related-posts":[{"id":905,"url":"https:\/\/dev.blogs.oregonstate.edu\/linuspaulinginstitute\/2013\/12\/18\/multivitamins-miracles-important\/","url_meta":{"origin":1053,"position":0},"title":"Multivitamins are not miracles… but they are important.","author":"Alexander Michels, PhD","date":"December 18, 2013","format":false,"excerpt":"Should you stop taking multivitamin supplements as they have no apparent health benefit and may potentially be harmful? The Linus Pauling Institutes that reading headlines may bring you to the wrong conclusions as they\u00a0ignore the totality of the evidence from decades of nutrition research. Vitamins and minerals are needed by\u2026","rel":"","context":"In "LPI Take"","block_context":{"text":"LPI Take","link":"https:\/\/dev.blogs.oregonstate.edu\/linuspaulinginstitute\/category\/lpi-take\/"},"img":{"alt_text":"Multivitamins","src":"https:\/\/i0.wp.com\/blogs.oregonstate.edu\/linuspaulinginstitute\/files\/2013\/12\/Multivitamins.png?resize=350%2C200","width":350,"height":200},"classes":[]},{"id":955,"url":"https:\/\/dev.blogs.oregonstate.edu\/linuspaulinginstitute\/2014\/03\/04\/taking-multivitamins-still-good-idea\/","url_meta":{"origin":1053,"position":1},"title":"Taking multivitamins – still a good idea.","author":"Alexander Michels, PhD","date":"March 4, 2014","format":false,"excerpt":"A recent\u00a0report from the US Preventive Services Task Force in the Annals of Internal Medicine focused on the use of vitamin, mineral, or multivitamin supplements.\u00a0Their conclusions are that the current evidence is insufficient to assess the benefits and harms of these\u00a0supplements with respect to prevention of cardiovascular disease and cancer.\u2026","rel":"","context":"In "Ask the Expert"","block_context":{"text":"Ask the Expert","link":"https:\/\/dev.blogs.oregonstate.edu\/linuspaulinginstitute\/category\/ask-the-expert\/"},"img":{"alt_text":"Multivitamins","src":"https:\/\/i0.wp.com\/blogs.oregonstate.edu\/linuspaulinginstitute\/files\/2014\/03\/Multivitamins2.png?resize=350%2C200","width":350,"height":200},"classes":[]},{"id":647,"url":"https:\/\/dev.blogs.oregonstate.edu\/linuspaulinginstitute\/2014\/01\/14\/keep-taking-your-vitamins\/","url_meta":{"origin":1053,"position":2},"title":"Keep Taking Your Vitamins","author":"freib","date":"January 14, 2014","format":false,"excerpt":"An article by Paul Offit titled \u201cThe Vitamin Myth: Why We Think We Need Supplements\u201d\u00a0has been part of the media blitz surrounding so-called negative claims of vitamin and mineral supplements. The Linus Pauling Institute at Oregon State University has a different point of view - one that is based on\u2026","rel":"","context":"In "LPI Take"","block_context":{"text":"LPI Take","link":"https:\/\/dev.blogs.oregonstate.edu\/linuspaulinginstitute\/category\/lpi-take\/"},"img":{"alt_text":"multivitamins","src":"https:\/\/i0.wp.com\/blogs.oregonstate.edu\/linuspaulinginstitute\/files\/2014\/01\/multivitamins-300x140.jpg?resize=350%2C200","width":350,"height":200},"classes":[]},{"id":1545,"url":"https:\/\/dev.blogs.oregonstate.edu\/linuspaulinginstitute\/2016\/03\/31\/nutrition-facts-label\/","url_meta":{"origin":1053,"position":3},"title":"Why the Nutrition Facts Label Can Lead You Astray","author":"Alexander Michels, PhD","date":"March 31, 2016","format":false,"excerpt":"On the back of every cereal box, frozen dinner, condiment bottle, and any other packaged food, you will find the Nutrition Facts label. Introduced by the Food and Drug Administration over 25 years ago, the purpose of this labeling system is to help consumers make more informed food choices. Thus\u2026","rel":"","context":"In "Healthy Living Tips"","block_context":{"text":"Healthy Living Tips","link":"https:\/\/dev.blogs.oregonstate.edu\/linuspaulinginstitute\/category\/healthy-living-tips\/"},"img":{"alt_text":"FDA Nutrition Facts Label 2006","src":"https:\/\/i0.wp.com\/blogs.oregonstate.edu\/linuspaulinginstitute\/files\/2016\/03\/FDA_Nutrition_Facts_Label_2006-522x1024.jpg?resize=350%2C200","width":350,"height":200},"classes":[]},{"id":1186,"url":"https:\/\/dev.blogs.oregonstate.edu\/linuspaulinginstitute\/2015\/04\/08\/everyone-needs-vitamin-e\/","url_meta":{"origin":1053,"position":4},"title":"Remember: You Need Vitamin E","author":"Alexander Michels, PhD","date":"April 8, 2015","format":false,"excerpt":"Clinical trials involving vitamin E supplementation have been mixed\u00a0\u2013 some showed benefits, while others did not.\u00a0Some trials even\u00a0reported negative\u00a0outcomes associated with taking vitamin E. Is it time to\u00a0ditch your vitamin E supplement? Perhaps - but find out why first. Although it wasn't the first trial to show negative effects of\u2026","rel":"","context":"In "Feature Stories"","block_context":{"text":"Feature Stories","link":"https:\/\/dev.blogs.oregonstate.edu\/linuspaulinginstitute\/category\/feature-stories\/"},"img":{"alt_text":"vitamin E pills","src":"https:\/\/i0.wp.com\/blogs.oregonstate.edu\/linuspaulinginstitute\/files\/2014\/10\/vitamin-E.jpg?resize=350%2C200","width":350,"height":200},"classes":[]},{"id":1828,"url":"https:\/\/dev.blogs.oregonstate.edu\/linuspaulinginstitute\/2016\/08\/05\/tell-us-think-possibly-win-thank-gift\/","url_meta":{"origin":1053,"position":5},"title":"Tell Us What You Think (And Possibly Win a Thank-You Gift!)","author":"Anne Glausser","date":"August 5, 2016","format":false,"excerpt":"Please help us improve our efforts in public outreach at the Linus Pauling Institute by taking this short online survey.","rel":"","context":"In "LPI Take"","block_context":{"text":"LPI Take","link":"https:\/\/dev.blogs.oregonstate.edu\/linuspaulinginstitute\/category\/lpi-take\/"},"img":{"alt_text":"online_survey_icon_or_logo1","src":"https:\/\/i0.wp.com\/blogs.oregonstate.edu\/linuspaulinginstitute\/files\/2016\/08\/online_survey_icon_or_logo1-300x212.png?resize=350%2C200","width":350,"height":200},"classes":[]}],"_links":{"self":[{"href":"https:\/\/dev.blogs.oregonstate.edu\/linuspaulinginstitute\/wp-json\/wp\/v2\/posts\/1053","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/dev.blogs.oregonstate.edu\/linuspaulinginstitute\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/dev.blogs.oregonstate.edu\/linuspaulinginstitute\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/dev.blogs.oregonstate.edu\/linuspaulinginstitute\/wp-json\/wp\/v2\/users\/5337"}],"replies":[{"embeddable":true,"href":"https:\/\/dev.blogs.oregonstate.edu\/linuspaulinginstitute\/wp-json\/wp\/v2\/comments?post=1053"}],"version-history":[{"count":24,"href":"https:\/\/dev.blogs.oregonstate.edu\/linuspaulinginstitute\/wp-json\/wp\/v2\/posts\/1053\/revisions"}],"predecessor-version":[{"id":1684,"href":"https:\/\/dev.blogs.oregonstate.edu\/linuspaulinginstitute\/wp-json\/wp\/v2\/posts\/1053\/revisions\/1684"}],"wp:attachment":[{"href":"https:\/\/dev.blogs.oregonstate.edu\/linuspaulinginstitute\/wp-json\/wp\/v2\/media?parent=1053"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/dev.blogs.oregonstate.edu\/linuspaulinginstitute\/wp-json\/wp\/v2\/categories?post=1053"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/dev.blogs.oregonstate.edu\/linuspaulinginstitute\/wp-json\/wp\/v2\/tags?post=1053"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}