Taking the Spin Out of the Multiple Vitamin Controversy

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CBS News recently reported that "the case is closed," multivitamins offer no health benefits and "might even be harmful." Yet drawing a conclusion from a single study, that was only looking at a single specific outcome, simply cannot be used to justify such a conclusion. But, before discussing any possible "health benefits" from taking vitamins and minerals, lets go back to the thinking behind making and taking them in the first place.

The main idea behind taking a multiple vitamin-mineral (MVM) is to provide a daily intake of vitamins and minerals that one should be getting from their diet but typically are not. It is not news that the standard American diet rarely contains the amount of nutrients needed to provide the best state of health and vitality. This is one of the main driving forces behind the intake of MVMs and organic foods. People want to ensure that their bodies have the nutrients needed daily so that they function better. MVMs are typically designed to keep one from becoming depleted in any of the important nutrients, instead of being made for disease prevention. Personally, in 35 years of practice I have NEVER given MVMs with the hope of preventing chronic disease. I have recommended them to all my patients, and have taken (and still consume them) daily as part of my "foundation of health." Yet, in the Physicians Health Study, they were assessed for the ability to prevent chronic diseases. This, in itself, appears to be a design for a failure.

Fortunately two previously published studies looked at the basic health and wellness of those taking MVMs, which is the type of outcome I would expect for anyone taking them. One study looked at the effect of 16 weeks of taking a multiple vitamin, or placebo, on 138 young health adults. Those taking the supplement showed a statistically significant improvement in stress, physical fatigue. To be statistically significant means that there is less than a 5 percent change that the effect occurred by chance. In other words, it is 95 percent certain that taking the MVMs caused this outcome. Another study followed 50 older men (between the ages of 50 and 69) who took an MVM for only eight weeks. While I would not have expected anyone to notice any improvement in such a short time, it was found that those taking the MVM had significant improvements (over placebo) in: depression, anxiety, stress, alertness and daily function. The alertness and improved daily function I would have expected, but I had never considered a MVM to be a preventive measure, or a treatment for depression or anxiety. Both of these studies show that daily MVM use helps one function better on a daily basis. But, these studies did not look at disease outcome. For this we have to start with the Physicians Health Study articles, one of which began led to the CBS report that was quoted earlier.

The recent media blitz about the lack of benefit of daily use of MVMs was unleashed after the publication of the most recent installment of over 14,000 physicians who took Centrum Silver daily for approximately 11 years. This last article reported on the effect of supplementation on their cognitive function and found that those taking the MVM for 11 years had no better mental function than those who didn't. But, this is only the latest installment of this long-term trial, it is not a review of the total benefit (or lack thereof) of MVMs throughout the study. To gain a broader perspective we need to look at the three previous papers from this study that reported on the effect of Centrum Silver on eye health, heart disease and cancer.

The researchers reported in these other articles that the physicians taking the MVMs were benefited by:

• A 40 percent drop in the risk of dying from a heart attack . Who wouldn't want a 40 percent greater likelihood of surviving a heart attack? Interestingly, this benefit was not mentioned in the abstract, but was clearly evident upon reading the article.

A 27 percent lower risk of developing cancer for those physicians who previously had cancer, and a 12 percent reduction in cancer incidence in those with no previous history.

The articles measuring the potential benefits of MVMs on heart disease and cancer were both published in the Journal of the American Medical Association. The cancer benefits found in this large physicians study were consistent with several other studies on MVMs and cancer. One study looked a group of almost 8,000 women with invasive breast cancer. Those women who took MVMs regularly had a 30 percent lower mortality rate than those who had not been taking regular supplements. A study of close to 13,000 French adults revealed that men who took low-dose MVMs daily for 7.5 years had a 31 percent lower cancer incidence and a 37 percent lower overall death rate. The researchers then followed the group for another five years after they stopped the MVM to see if the benefits persisted. They found that after stopping the daily supplement the benefits of preventing cancer incidence and overall mortality were lost. In another study a group of close to 24,000 Europeans were followed for an average of 11 years to see if MVMs had any benefit on chronic illnesses. The researchers reported that the participants who were taking MVMs before entering the study, and who continued throughout the study, had a 48 percent lower risk of developing cancer and a 42 percent lower risk of dying (from any cause). Yes, those numbers are correct, those consistently taking a MVM for years cut their risk of developing cancer by half! And, finally, a study was done on persons with terminal small cell lung cancer to see if MVMs made any difference in outcome. It turned out that those taking supplements lived longer (a 37 percent reduction in death rate).

To summarize, those people who take a daily MVM experience less stress, have more energy, less depression and anxiety, lower rates of cancer, better cancer outcomes for those who do get cancer and lower mortality rates. So, how can a major news agency get something so easy to track down with a computer and PubMed get this important information so wrong? Hopefully, given time they will start to get it right, but in order to live long enough to see it happen you better start taking your MVM.