Board Certification: Internal Medicine – Cardiovascular Diseases
Are you horrified of prescription medications? Do you live in morbid fear of taking a…….STATIN for your cholesterol? Yet stuffed in your medicine cabinet or strewed across your kitchen countertops are bottles and jars of supplements, herbal concoctions, and vitamins that you spend upwards of several hundred dollars on per month. Now think for a moment whether or not there is any sound scientific evidence regarding the use of these agents to reduce serious diseases like cancer, stroke, heart attack and heart failure. I am here to tell you that these purported health aids and disease fighters do not do what they are advertised to do. The science behind this conclusion far exceeds the evidence to support the manufacturer and retailers who make and sell these “products” claims.
Almost 50% of the U.S. population takes vitamin and mineral supplements daily to the tune of 23 billion dollars spent. Yes that was billion with a B! Many take these products not even knowing why, while others do it with the belief that decreasing inflammation in the body will help reduce the incidence of chronic illness. There has been some basic scientific work in the past that seemed to support this hypothesis. Larger studies that were performed to investigate the preliminary work did not support those early findings. In 2003 the U.S. Preventive Services Task Force concluded that there was insufficient scientific evidence either for or against the use of vitamin, minerals or supplements in the prevention of chronic disease. In an effort to clarify their equivocal recommendation, the U.S. Preventive Services Task Force has continued the study of this controversial topic.
Stephen P. Fortmann, MD and his investigators from the Kaiser Permanente Center for Health Research in Portland Oregon reviewed 26 studies that had been performed since the previous review. After thorough analysis of the 26 studies, they whittled it down to 5 studies looking at 100-944 participants. In November 2013, their findings were published in the Annals of Internal Medicine: Vitamin and Mineral Supplements in the Primary Prevention of Cardiovascular Disease and Cancer: An Updated Systematic Evidence Review for the U.S. Preventive Services Task Force. The studies reviewed looked at individual micronutrients, pairs and complex combinations. They looked at outcomes of primary prevention of cardiovascular disease (this means prevention of a first event like stroke or heart attack) and cancer. The populations studied were healthy adults without deficient diets taking “less-than-toxic” doses of the supplements. Their conclusion after combing through 8 years of clinical studies and thoughtful analysis of the final 5:
“Limited evidence supports any benefit from vitamin and mineral supplementation for the prevention of cancer or CVD. Two trials found a small, borderline-significant benefit from multivitamin supplements on cancer in men only and no effect on CVD.”
The lack of a benefit was seen in studies of single nutrients as well as multivitamins. Two of the multivitamin trials demonstrated an equivocal or borderline reduction in cancer, but only in male subjects. The authors do comment that there are limitations to the study given the trials reviewed tested different combinations of micronutrients in varying amounts in differing populations of healthy participants.
What does this research mean to you, the “community-dwelling, healthy population without a diet deficient in vitamins and supplements?” Well considering we are very similar to the populations studied, it means that you almost certainly do not need to take any extra vitamins, minerals or supplements. You do need to eat a diet rich in green vegetables and fruit featuring lean meats, fish with less amounts of dairy and carbohydrate rich foods (white foods). You also need to exercise several days per week for 30-45 minutes, vigorously. If you really want to take a supplement and you are over 50 years old, then take a simple multi-vitamin daily. Otherwise there is not a clear scientifically supported reason to take additional vitamins, minerals or supplements. I always tell my patients…. “Taking all these supplements does benefit someone… the guy who sold it to you.”
The information provided is for general interest only and should not be misconstrued as a diagnosis, prognosis or treatment recommendation. This information does not in any way constitute the practice of medicine, or any other health care profession. Readers are directed to consult their health care provider regarding their specific health situation. Marque Medical is not liable for any action taken by a reader based upon this information.