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

Should You Avoid Sugar Completely?

Posted October 24, 2017 by Dr. Steve Chaney

Is It The Sugar, Or Is It The Food?

Author: Dr. Stephen Chaney

 

Should we avoid sugar completely?  Almost every expert agrees that Americans should cut down on the amount of sugar we are consuming. However, for some people this has become a “sugar phobia”. They have sworn that “sugar shall never touch their lips”. Not only do they avoid sugar sweetened sodas and junk food, but they also have become avid label readers. They scour the label of every food they see and reject foods they find any form of sugar listed as an ingredient. Is this degree of sugar avoidance justified?

 

Should We Avoid Sugar to Keep it From Killing Us?

 

Let me add some perspective:

  • If you just take studies about the dangers of sugar at face value, sugar does, indeed, look dangerous. Excess sugar consumption is associated with increased risk of obesity, diabetes, and heart disease. However, when you look a little closer, you find that most of these studies have been done by looking at the correlation of each of these conditions with sugar sweetened beverage consumption (sodas and fruit juices).

A few studies have looked at the correlation of obesity and disease with total “added sugar” consumption. However, 71.6% of added sugar in the American diet comes from sugar sweetened beverages and junk food. None of the studies have looked at the sugar from healthy foods like fruits, vegetables, and whole grains. That’s because there is ample evidence that these foods decrease the risk of obesity, diabetes, and heart disease.

  • For example, if apples had a nutrition label, it would list 16 grams of sugar in a medium 80 calorie apple, which corresponds to about 80% of the calories in that apple. The sugar in an apple is about the same proportion of fructose and glucose found in high fructose corn syrup. Apples are not unique. The nutrition label would read about the same on most other fruits. Does that mean you should avoid sugar from all fruits? I think not.

Avoid Sugar or Avoid Certain Foods

 

avoid sugar from junk foodsThe obvious question is: “Why are the same sugars, in about the same amounts, unhealthy in sodas and healthy in fruits?” Let’s go back to those studies I just mentioned—the ones that are often used to vilify sugars. They are all association studies, the association of sugar intake with obesity and various diseases.

The weakness of association studies is the association could be with something else that is tightly correlated with the variable (sugar intake) that you are measuring. Could it be the food that is the problem, not the sugar?

If we look at healthy foods (fruits, vegetables, whole grains) they are chock full of vitamins, minerals, phytonutrients, fiber, and (sometimes) protein. Fiber and protein slow the absorption of sugar into the bloodstream. As a result, blood sugar levels rise slowly and are sustained at relatively low levels for a substantial period of time.

In sodas there is nothing to slow the absorption of blood sugar. You get rapid rise in blood sugar followed by an equally rapid fall. The same is true of junk foods consisting primarily of sugar, refined flour and/or fat.  Avoid sugar from those types of foods.

Another consideration is something called caloric density. Here is a simple analogy. I used to explain the concept of caloric density to medical students in my teaching days. There are about the same number of calories in a 2-ounce candy bar and a pound of apples (around 278 in the 2-ounce candy bar and 237 in a pound of apples). You can eat a 2-ounce candy bar and still be hungry. If you eat a pound of apples you are done for a while. In this example, the 2-ounce candy bar had a high caloric density (a lot of calories in a small package). Perhaps a more familiar terminology would be the candy bar was just empty calories.

Are Sodas and Junk Foods Killing Us?

avoid sugar from candyPutting all that together, you can start to understand why the foods the sugars are in are more important than the sugars themselves. When you consume sugars in the form of sugar sweetened beverages or sugary junk foods, your appetite increases. We don’t know for sure whether it is the intense sweetness of those foods, the rapid increase and fall in blood sugar, or the high caloric density (lots of calories ina small package) that makes us hungrier. It doesn’t matter. We crave more food, and it isn’t usually fruits, vegetables, and complex carbohydrates we crave. It’s more junk. That sets in motion a predictable sequence of events.

  • We overeat. Those excess calories are stored as fat and we become obese. [Note: The low carb enthusiasts will tell you our fat stores come from carbohydrates alone. That is incorrect. All excess calories, whether from protein, fat, or carbohydrate, are stored as fat.]
  • It’s not just the fat you can see (belly fat) that is the problem. Some of that fat builds up in our liver and muscles. This sets up an unfortunate sequence of metabolic events.
  • The fat stores release inflammatory cytokines into our bloodstream. That causes inflammation. Inflammation increases the risk of many diseases including heart disease and cancer.
  • The fat stores also cause our cells to become resistant to insulin. That reduces the ability of our cells to take up glucose, which leads to hyperglycemia and type 2 diabetes. [Note: The low carb enthusiasts will tell you carbohydrates cause type 2 diabetes. That is also incorrect. It is our fat stores that cause insulin resistance and type 2 diabetes. Our fat stores come from all excess calories, not just excess calories from carbohydrates.]
  • Insulin resistance also causes the liver to overproduce cholesterol and triglycerides and pump them into the bloodstream. That increases the risk of heart disease.
  • Sugar sweetened beverages and sugary junk foods also displace healthier foods from our diet. That leads to potential nutrient shortfalls that can increase our risk of many diseases.

However, none of this has to happen. The one thing that every successful diet has in common is the elimination of sodas, junk foods, fast foods and convenience foods. You should avoid sugar from those foods as much as possible. Once you eliminate those from your diet,you significantly enhance your chances of being at a healthy weight and being healthy long term.

 

What About Protein Supplements And Similar Foods?

Of course, the dilemma is what you, as an intrepid label reader, should do about protein supplements, meal replacement bars, or snack bars. They are supposed to be healthy, but the label lists one or more sugars. Even worse, the sugar content is higher than your favorite health guru recommends.  So, should you avoid sugar from supplements and the like?

In this case, a more useful concept is glycemic index, which is a measure of the effect of the food on your blood sugar levels. Healthy foods like apples may have a high sugar content, but they havea low glycemic index.

avoid sugar and consume protein to slow absorbptionThe same is true for the protein supplements and bars you are considering. Rather than looking at the sugar content, you should be looking for the term “low glycemic” on the label. That means there is enough fiber and protein in the food to slow the absorption of sugar into the bloodstream and stabilize your blood sugar levels.

What Does This Mean For You?

Don’t misunderstand me. I am not advocating for unlimited consumption of sugar. We should work on ways to avoid sugar or reduce the amount of sugar in our diet. On the other hand, we don’t need to become so strict that we and our family need to eat foods that taste like cardboard. We also don’t want to replace natural sugars with artificial sweeteners. I have warned about the dangers of artificial sweeteners previously.

We can go a long way towards reducing sugar by just eliminating sodas, other sugar sweetened beverages, junk foods, fast foods, convenience foods, and pastries from our diet. When considering fast foods and convenience foods, we should check the label for hidden sugar. For example, some Starbucks drinks are mostly sugar. When considering foods that are supposed to be healthy, we should look for the term “low glycemic” on the label.

So we don’t have to avoid sugar completely, but we should reduce sugar from sugar sweetened beverages and junk food.

 

The Bottom Line

 

We need to keep warnings about the dangers of sugar in perspective:

  • The studies showing that sugar consumption leads to obesity, diabetes, and heart disease have all been done with sodas and junk foods.
  • Many fruits have just as much sugar as a soda. They also contain about the same proportion of fructose and glucose as high fructose corn syrup. Yet we know fruits are good for us.
  • Diets rich in fruits, vegetables and whole grains decrease our risk of obesity, diabetes, and heart disease.
  • That is because the sugar in whole foods is generally present along with fiber and protein, which slows the absorption of sugar and prevents the blood sugar spikes we get with sodas and junk foods.
  • In the case of prepared foods like protein supplements, you should look for “low glycemic” on the label rather than sugar content. Low glycemic means that there is enough fiber and protein in the product to slow the absorption of sugar and prevent blood sugar spikes.
  • Don’t misunderstand me. I am not advocating for unlimited consumption of sugar. We should all work on ways to avoid sugar from junk foods or to reduce the amount of sugar in our diet. On the other hand, we don’t need to become so strict that we and our family need to eat foods that taste like cardboard. We also don’t want to replace natural sugars with artificial sweeteners.
  • We can go a long way towards reducing sugar by just eliminating sodas, other sugar sweetened beverages, junk foods, fast foods, convenience foods, and pastries from our diet. When considering fast foods and convenience foods, we should check the label for hidden sugar. When considering foods that are supposed to be healthy, we should look for the term “low glycemic” on the label.

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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