The choice about multivitamins from Nutrition Investigator Roc

RESPONSE TO: The Case Against Multivitamins Grows Stronger by NANCY SHUTE  December 17, 201312:37 PM
Several have inquired about this story that multivitamins have no benefit. Below are three key sentences from the story:
1) One review found no benefit in preventing early death, heart disease or cancer. 2) Another found that taking multivitamins did nothing to stave off cognitive decline with aging. 3) A third found that high-dose multivitamins didn’t help people who had had one heart attack avoid another.

And here is what the 3 articles actually stated [with my comments in brackets]:
1) “The analysis included only primary prevention studies in adults without known nutritional deficiencies. Studies were conducted in older individuals and included various supplements and doses under the set upper tolerable limits. Duration of most studies was less than 10 years… Two large trials (n = 27 658) reported lower cancer incidence in men taking a multivitamin for more than 10 years [But duration of most studies was less than 10 years!]”
2) “Patients: 5947 male physicians aged 65 years or older. Limitation: Doses of vitamins may be too low or the population may be too well-nourished to benefit from a multivitamin.” [In other words, people who are very knowledgable about nutrition and can afford an excellent diet do not benefit from a multivitamin.  In fact, those with an excellent diet may suffer from a multivitamin because then they receive twice the Daily Requirement of many nutrients, which is hazardous!] 3) “Patients: 1708 patients aged 50 years or older who had myocardial infarction (MI) at least 6 weeks earlier and had serum creatinine levels of 176.8 µmol/L (2.0 mg/dL) or less. Limitation: There was considerable nonadherence and withdrawal, limiting the ability to draw firm conclusions (particularly about safety).Conclusion: High-dose oral multivitamins and multiminerals did not statistically significantly reduce cardiovascular events in patients after MI who received standard medications. However, this conclusion is tempered by the nonadherence rate. .. Patients received vitamins for a median of 31 months (IQR, 13 to 59 months) in the vitamin group and 35 months (IQR, 13 to 60 months) in the placebo group  [In other words,  in 3 years where many of 850 people did not take a multivitamin, they could not detect a significant difference.]

Nutrition investigator conclusion: This is a great example of media hype.  The news sentences are brief and catchy, but tell little about the actual research.  For well educated and nourished people like doctors, I think multivitamins may be hazardous.  But most people are not so fortunate.  I take a multivitamin on days when I have not had time to eat lots of salad and fruit, but that’s only about once a week.  But distinguished experts Walter Willett and Bruce Ames endorse multivitamins for everyone, and it is the rare person who eats a healthy, vegetarian or no fours diet. For those who eat poorly, a multivitamin is nice insurance.

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Professor, Biochemistry, Beloit College
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