Are MultiVitamins a Waste of Money?

Written by Dr. Steve Chaney on . Posted in Nutritiion

The Multivitamin Controversy You Never Heard About

Author: Dr. Stephen Chaney

money-waste Are multivitamins a waste of money?  You probably saw the recent headlines telling you that “the experts” have concluded that multivitamins are a waste of money. The article (Gualler et al., Annals of Internal Medicine, 159: 850-851, 2013) that generated all of the headlines was an editorial, which means it was an opinion piece, not a scientific study. It represented the opinion of five very prominent doctors, but it was, at the end of the day, just their opinion.

At the time I pointed out fallacies of their arguments in a “Health Tips From the Professor” article (MultiVitamins-Waste Money?). But, what do I know? I have only published 114 papers in peer reviewed journals and two book chapters on nutrition.

It turns out that I’m not the only expert who feels this way. Five very prominent experts recently published rebuttals concluding that the authors of the original editorial ignored “decades of nutrition research and diet monitoring of the U.S. population to reach this misleading conclusion” (Frei et al, Annals of Internal Medicine, 160: 807-809, 2014).

Who Are These Experts?

Before I share what these experts said, I should probably share their qualifications:

Balz Frei, PhD

  • Distinguished Professor of Biochemistry & Biophysics & Director of the Linus Pauling Institute, Oregon State University
  • 203 publications

Bruce N. Ames, PhD

  • Director of the Nutrition & Metabolism Center, Children’s Hospital Oakland Research Institute
  • 540 publications

Jeffrey B. Blumberg, PhD

  • Professor, Freidman School of Nutrition Science and Policy and Director of the Antioxidants Research Laboratory at the Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University
  • >300 publications

Walter C. Willet, MD, DrPH

  • Chair of the Department of Nutrition, Harvard School of Public Health
  • 1,422 publications

Thomas R. Friberg, MD, MS

  • Professor of Ophthamology and Director of the Medical & Surgical Retinal Division of the University of Pittsburg School of Medicine
  • Principle investigator for the AREDS and AREDS II clinical studies.
  • 134 publications

As you can see, these are not just your run of the mill scientists. They are the top experts in the field.

 

Are You Wasting Your Money On Multivitamins?

Are multivitamins a waste of money?   What did these experts say?

  1. They started by pointing out that few people in the United States follow the USDA dietary guidelines, and “consequently, most people in the United States even in cities like Raleigh, Durham, and Chapel Hill are not well nourished”. Specifically:
  • 93% of U.S. adults don’t get enough vitamins D & E from their diet.
  • 71% of U.S. adults don’t get enough vitamin K from their diet.
  • 61% of U.S. adults don’t get enough magnesium from their diet.
  • 50% of U.S. adults don’t get enough calcium and vitamin A from their diet.
  1. They also pointed out that adequate intake of micronutrients is essential for normal body function and to support good health. Specifically:
  • Vitamins A, D, iron and zinc are required for normal immune function
  • Folic acid is required for neurological development. For example, “A multivitamin supplying folic acid dramatically decreases the risk of neural tube defects and is recommended for women of childbearing age.”
  • The AREDS and AREDS II studies have established the value of supplementation in preventing vision loss due to age-related macular degeneration.
  1. They pointed out that largest (15,000 male physicians) and longest (13 years) randomized, placebo controlled trial of a multivitamin (the Physician’s Health Study II) showed a:
  • 8% reduction in cancer incidence and a 12% reduction in cancer deaths
  • 9% reduction in cataract formation
  1. Finally, they pointed out that the claims that supplement use might actually increase mortality were overemphasized. Specifically:
  • The claims that high dose vitamin E increase mortality have been refuted by subsequent studies. I have discussed that in detail in my eBook, “The Myths of the Naysayers” (available for free to all subscribers of “Health Tips From the Professor”).
  • Only 1.1% of the U.S. population consumes more than the recommended upper limit for vitamin A (10,000 IU/day).
  • The only warning that actually holds up is that smokers should avoid high dose beta-carotene.
  • More importantly, all of those concerns involved high dose individual supplements. There is no evidence for any risk from taking a daily multivitamin.

In summary, the experts concluded: “Taking a daily multivitamin and mineral supplement not only helps fill known nutritional gaps in the diet of most persons in the United States (thereby ensuring normal body function and supporting good health), but may have the added benefit of helping to reduce the risk for chronic disease.”

 

The Bottom Line

1)     Are multivitamins are a waste of money?  No.  That was simply the opinion of one group of experts. Other experts have come to the exact opposite conclusion.

2)     Of course, it was only the negative opinion that made the headlines. Somehow the opinion that multivitamins are valuable for most Americans never got the attention of the press.

3)     According to the experts mentioned in this article, multivitamins play an important role in filling well documented nutrition gaps in the U.S. population, assuring normal body function and helping preserve good health. There is evidence that they may have a modest role in reducing the risk for chronic diseases, and there is no evidence that multivitamin supplements increase the risk of mortality.

4)     Of course, you shouldn’t expect miracles from your multivitamin. It’s not going to help you leap tall buildings in a single bound. Your multivitamin should just be one small part of your holistic health program of diet, exercise, weight control and supplementation.

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

 

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Comments (7)

  • RUTH BIEBER

    |

    DR. CHANEY….LOVE YOUR INFORMATIVE EMAILS…..VERY HELPFUL.
    JUST READ THE LATEST ONE…”ARE YOU WASTING YOUR MONEY ON MULTIVITAMINS?”
    PLEASE LOOK AT THE SENTENCE THAT READS, “AS YOU CAN SEE, THESE ARE JUST YOUR RUN OF THE MILL SCIENTISTS”……..I BELIEVE IT SHOULD READ, ” THESE ARE NOT JUST YOUR RUN OF THE MILL SCIENTISTS”………

    Ruth Bieber

    Reply

    • Dr. Steve Chaney

      |

      Dear Ruth,

      You are absolutely correct. I did correct that sentence in this post, but it slipped past me in the email you received. Sorry.

      Dr. Chaney

      Reply

  • sharry zacharia

    |

    Like to know waht brand of Vitamins are good source.

    Reply

    • Dr. Steve Chaney

      |

      Dear Sharry,

      I personally use Shaklee vitamins because of their scientific integrity and quality controls. If you were forwarded my newsletter from a Shaklee representative, I recommend that you contact them for more information. If not, I will be happy to recommend soneone who will give you good service.

      Dr. Chaney

      Reply

  • chelia mcfowler

    |

    I am glad that this issue refuted the past statements about supplements. If they really look at it it is impossible to eat all the nutrients in a meal, that’s why it call a supplement. Thank you doctir.

    Reply

  • Celeste Edwards

    |

    Where can I find a copy of “The Myth of the Naysayers”, Part 1.
    Thank You
    PS I love your very informative emails.

    Reply

    • Dr. Steve Chaney

      |

      Dear Celeste,

      It will be coming late this year.

      Dr. Chaney

      Reply

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Latest Article

Does Protein Supplement Timing Matter?

Posted May 15, 2018 by Dr. Steve Chaney

How Do You Gain Muscle Mass & Lose Fat Mass?

Author: Dr. Stephen Chaney

 

protein supplement timingMost of what you read about protein supplements on the internet is wrong. That is because most published studies on protein supplements:

  • Are very small
  • Are not double blinded.
    • Both the subjects and the investigators knew who got the protein supplement.
  • Are done by individual companies with their product.
    • You have no idea which ingredients are in their product are responsible for the effects they report.
    • You have no idea how their product compares with other protein products.
    • There is no standardization with respect to the amount or type of protein or the addition of non-protein ingredients.

Because of these limitations there is a lot of misleading information on the benefits of protein supplements timing and maximal benefit. Let’s start by looking at why people use protein supplements. Let’s also look at what is generally accepted as true with respect to the best supplement timing.

There are 4 major reasons people consume protein supplements:

  • Enhance the muscle gain associated with resistance training: In this case, protein supplements are customarily consumed concurrently with the workout.
  • Preserve muscle and accelerate fat loss while on a weight loss diet: In this case, protein supplements are customarily consumed with meals or as meal replacements.
  • Provide a healthier protein source. In this case, protein supplements are customarily consumed with meals in place of meat protein.
  • Prevent muscle loss associated with aging or illness. There is no customary pattern associated with this use of protein supplements.

How good are the data supporting the customary timing of protein supplementation? The answer is: Not very good. The timing is based on a collection of weak studies which do not always agree with each other.

The current study  (J.L. Hudson et al, Nutrition Reviews, 76: 461-468, 2018 ) was designed to fill this void in our knowledge. It is a meta-analysis that compares all reasonably good studies that have looked at the effect of protein supplement timing on weight gain or loss, lean muscle mass gain, fat loss, and the ratio of lean muscle mass to fat mass.

How Was The Study Done?

The authors started by doing a literature search of all studies that met the following criteria:

  • The study was a randomized control trial with parallel design. This means that study contained a control group. It does not mean that the investigators or subjects were blinded with respect to which subjects used a protein supplement and which did not.
  • The subjects were engaged in resistance training.
  • The study lasted 6 weeks or longer.
  • Reliable methods were used to measure body composition (lean muscle mass and fat mass).
  • The subjects were healthy and at least 19 years old.
  • There was no restriction on the food the subjects consumed.

The authors started with 2074 published studies and ended up with 34 that met all their criteria. They then separated the studies into two groups – those in which the protein supplements were used with meals and those in which the protein supplements were used between meals.

Both groups were diverse.

  • Group 1 included subjects who consumed their protein supplement with their meal and those who consumed their protein supplement as a meal replacement.
  • Group 2 included subjects who consumed their protein supplement concurrent with exercise (usually immediately after exercise) and those who consumed their protein supplement at a fixed time of day not associated with exercise.

Does Protein Supplement Timing Matter?

 

protein supplement timing workoutsBecause the individual studies were very diverse in the way they were designed, the authors could not calculate a reliable estimate of how much lean muscle mass was increased or fat mass was decreased. Instead, they calculated the percentage of studies showing an increase in lean muscle mass or a decrease in fat mass.

When the authors compared protein supplements consumed with meals versus protein supplements consumed between meals:

  • Weight gain was observed in 56% of the studies of protein supplementation with meals compared to 72% of the studies of protein supplementation between meals. In other words, protein supplements consumed with meals were less likely to lead to weight gain than protein supplements consumed between meals.
  • An increase in lean muscle mass was observed in 94% of the studies of protein supplementation with meals compared to 90% of the studies of protein supplementation between meals. In other words, timing of protein supplementation did not matter with respect to increase in muscle mass.
  • A loss of fat mass was observed in 87% of the studies of protein supplementation with meals compared to 59% of the studies of protein supplementation between meals. In other words, protein supplements consumed with meals were more likely to lead to loss of fat mass.
  • An increase in the ratio of lean muscle mass to fat mass was observed in 100% of the studies of protein supplementation with meals compared to 87% of the studies of protein supplementation between meals. In short, protein supplements consumed with meals were slightly more likely to lead to an increase in the ratio of lean muscle mass to fat mass.

The following seem to suggest protein supplement timing matters:

The authors pointed out that their findings were consistent with previous studies showing that when protein supplements are consumed with a meal they displace some of the calories that otherwise would have been consumed. Simply put, people naturally compensate by eating less of other foods.

In contrast, the authors stated that previous studies have shown that when foods, especially liquid foods, are consumed as snacks (between meals), people are less likely to compensate by reducing the calories consumed in the next meal.

The others concluded: “Concurrently with resistance training, consuming protein supplements with meals, rather than between meals, may more effectively promote weight control and reduce fat mass without influencing improvements in lean [muscle] mass.”

What Are The Limitations Of The Study?

Meta-analyses such as this one, are only as good as the studies included in the meta-analysis. Unfortunately, most sports nutrition studies are very weak studies. Thus, this meta-analysis is a perfect example of the “Garbage In: Garbage Out (GI:GO)” phenomenon.

For example, let’s start by looking at what the term “protein supplement” meant.

  • Because the studies were done by individual companies with their product, the protein supplements in this meta-analysis:
    • Included whey, casein, soy, bovine colostrum, rice or combinations of protein sources.
    • Were isolates, concentrates, or hydrolysates.
    • Contained various additions like creatine, amino acids, and carbohydrate.
  • As I discuss in my book, Slaying the Food Myths, previous studies have shown that optimal protein and leucine levels are needed to maximize the increase in muscle mass and decrease in fat mass associated with resistance exercise. However, neither protein nor leucine levels were standardized in the protein supplements included in this meta-analysis.
  • Previous studies have shown that protein supplements that have little effect on blood sugar levels (have a low glycemic index) are more likely to curb appetite. However, glycemic index was not standardized for the protein supplements included in this meta-analysis.

protein supplement timing workout peopleIn short, the conclusions of this study might be true for some protein supplements, but not for others. We have no way of knowing.

We also need to consider the composition of the two groups.

  • Protein supplements used as meal replacements are more likely to decrease weight and fat mass than protein supplements consumed with meals. Yet, both were included in group 1.
  • Some studies suggest that protein supplements consumed concurrent with resistance exercise are more likely to increase muscle mass than protein supplements consumed another time of day. Yet, both are included in group 2. We also have no idea whether the meals with protein supplements in group 1 were consumed shortly after exercise or at an entirely different time of day.

This was the most glaring weakness of the study because it was completely avoidable. The authors could have grouped the studies into categories that made more sense.

In other words, there are multiple weaknesses that limit the predictive power of this study.

What Can We Learn From This Study?

Despite its many limitations, this study does remind us that protein supplements do have calories. This is of relatively little importance for people whose primary goal is to increase lean muscle mass.

However, most of us are using protein supplements to lose weight or to increase our lean mass to fat mass ratio. Simply put, we are either trying to lean out (shape up) or lose weight. And, we want to lose that weight primarily by getting rid of excess fat. For us, calories do matter. With that in mind:

  • If we are consuming a protein supplement immediately after exercise or between meals we probably should make a conscious effort to reduce our daily caloric intake elsewhere in our diet.
  • Alternatively, we could consume the protein supplement with a meal, but time the meal so it occurs shortly after exercise.

 

The Bottom Line:

 

A recent study looked at the optimal timing of protein supplements consumed by subjects who were engaged in resistance exercise. Specifically, the study compared protein supplements consumed with meals versus protein supplements consumed between meals on weight, lean muscle mass, fat mass, and the ratio of lean muscle mass to fat mass. The study reported:

  • Protein supplements consumed with meals were less likely to lead to weight gain than protein supplements consumed between meals.
  • Timing of protein supplementation did not matter with respect to increase in muscle mass.
  • Protein supplements consumed with meals were more likely to lead to loss of fat mass.
  • Protein supplements consumed with meals were slightly more likely to lead to an increase in the ratio of lean mass to fat mass.

The authors pointed out that their findings were consistent with previous studies showing that when a protein supplement was consumed with a meal it displaces some of the calories that would have been otherwise consumed. Simply put, people naturally compensate by eating less of other foods.

In contrast, the authors said that previous studies have shown that when foods, especially liquid foods, are consumed as snacks (between meals), people are less likely to compensate by reducing the calories consumed in the next meal.

As discussed in the article above, the study has major weaknesses. However, despite its many weaknesses, this study does remind us that protein supplements do have calories. This is of relatively little importance for people whose primary goal is to increase lean muscle mass.

However, for those of us who are using protein supplements to lose weight or to increase our lean mass to fat mass ratio, calories do matter.  With that in mind:

  • If we are consuming a protein supplement immediately after exercise or between meals we probably should make a conscious effort to reduce our daily caloric intake elsewhere in our diet.
  • Alternatively, we could consume the protein supplement with a meal, but time the meal so it occurs shortly after exercise.

For more details, read the article above:

 

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

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