Multivitamins: The Case For Taking One A Day
In an ideal world, we'd all be eating copious amounts of nutrient-dense foods such as fruits and vegetables — and getting all the essential vitamins and nutrients our bodies need for optimal health.
But, as a nation, we're far from that healthful eating ideal.
According to the Centers for Disease Control and Prevention, Americans, on average, only eat about one fruit and one or two vegetables on a typical day. This helps explain why millions of people fall short of the recommended intakes of some vitamins and minerals.
For instance, more than 1 in 3 children and teens (ages 9 to 18) don't meet recommended intakes for calcium and vitamin D, according to a study in The Journal of Pediatrics.
So, how might people with less-than-stellar diets plug the gaps of good nutrition?
Fortification efforts, such as the Food and Drug Administration's requirement that folic acid be added to many cereals and breads, have paid off. As this CDC infographic points out, folate levels in women increased by 50 percent between 1993 and 2006. This is critical, since folate helps prevent birth defects.
Another option? Taking a daily multivitamin with minerals may be helpful.
A study published in the American Journal of Clinical Nutrition found that supplements helped adults meet the recommended intake of certain minerals, such as calcium and magnesium in men and women, as well as iron for women.
Another study found that in children and teenagers (ages 9 to 18), "taking supplements added nutrients (for example, magnesium, phosphorus, and vitamins A, C, and E) for which intakes would have been inadequate from food alone," according to study author Regan Bailey of the National Institutes of Health.
So, given the case that vitamins may be a good way to avoid nutritional inadequacies, why do they get a bad rap?
About a year ago, as we reported, the U.S. Preventive Services Task Force concluded that there was insufficient evidence to recommend for or against the use of multivitamins for prevention of cancer and heart disease.
Some medical experts have also weighed in, concluding that vitamins and supplements are a waste of money. Researchers also point to evidence that taking more than the recommended levels can be harmful.
As our colleagues at Shots have pointed out, studies have found that multivitamins show no benefit in preventing early death.
What's more, one of the largest studies ever conducted to evaluate multivitamin use, the Physicians' Health Study II, determined that, at least in men, taking a multivitamin did not reduce the risk of death from heart disease.
But the evidence is decidedly mixed. For instance, that same study found a small reduction in cancers and cataracts associated with multivitamin use.
And just this month, a study published in the Journal of Nutrition found that women who took a multivitamin with minerals for three years or longer had a lower risk of death from heart disease. Interestingly, the benefit was not seen in men.
So when it comes to preventing serious diseases, the jury is still out on whether taking multivitamin supplements may be beneficial.
But when it comes to plugging nutritional gaps in our diet, some researchers say a multivitamin is a good bet. Jeffrey Blumberg, a senior nutrition scientist at Tufts University, is among them.
"I'm not saying it's an excuse not to eat healthy," Blumberg told us. But given how many people aren't eating well, "it's a very prudent thing for many people to choose to take a multivitamin" he says.
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Transcript
RENEE MONTAGNE, HOST:
When it comes to promoting good health, a lot of us turn to multivitamins. More than 1 in 3 American adults, to be precise, are in the habit of taking a daily vitamin, even though we hear mixed messages on whether those little capsules really do any good. A new study sheds light on the potential benefits. NPR's food and health correspondent Allison Aubrey joined us to talk about it. Good morning.
ALLISON AUBREY, BYLINE: Hi there, Renee.
MONTAGNE: This study evaluated, I gather, the effect of taking multivitamins over a very long period of time. What did the researchers find?
AUBREY: So the new study's published in the "Journal Of Nutrition." It's really trying to get at whether taking a multivitamin might help cut the risk of death from heart disease. Now, as you might imagine, many factors influence the risk of disease - right? - everything from your diet, your exercise habits, whether you smoke. So to try to figure out the effect of any one factor is tough. But to try and disentangle this, researchers back in the early 1990s began studying a group of about 9,000 adults, all of whom were in their 40s or older. And the researchers went into the people's homes, interviewed them about a whole range of health habits, asked about diets, smoking. They also asked about multivitamin use and what they have found, 20 years later, is that women who'd been in the habit of taking a daily multivitamin with minerals for three years or longer had a lower risk of dying from heart disease. Interestingly, they did not see this benefit in men.
MONTAGNE: And what might explain the difference between men and women?
AUBREY: Well, it's unclear. And in fact, this is not the first study to show multivitamins don't lower the risk of death from heart disease in men. A large study of physicians came to the same conclusion. And so it's possible that for unknown reasons, women may benefit where men don't. But it's also possible that women who take multivitamins are more proactive in their health. So maybe what's being captured here is the result of healthy living, not just the result of taking a multivitamin. It's hard to suss out.
MONTAGNE: If researchers are not certain that multivitamins help cut the risk of heart disease, are there other reasons to take one?
AUBREY: Well, the answer to that question really depends on who you ask. On one hand, the U.S. Preventive Services Task Force - that's a panel of health experts that make evidence-based recommendations - says that there's insufficient evidence on vitamins. And some doctors say, hey, you know, it's a waste of money. There's evidence that taking more than the recommended amounts can be harmful. But what's clear is that this is still a very active area of research. The physicians' health study I mentioned, though it found no heart disease benefit, did find that multivitamin use was associated with reduced cancers and cataracts. So researchers are planning a follow-up study. And I'd say, in a way, the jury's still out.
MONTAGNE: What about overall health? Is there a case to be made that a multivitamin, say, might give us nutrients we miss out on if we don't eat enough fruits and vegetables?
AUBREY: Yes, I think there is a case to be made. In fact, I spoke to Jeffrey Blumberg at Tufts University. He's a senior scientist at the nutrition school there. And he says the argument in favor of taking a multivitamin is that it's a way to sort of plug the nutritional gaps in our diets. I mean, to put this in context, at a time when the government's official dietary advice is that we should all be filling half of our plates with fruits and vegetables, CDC data shows that on average, Americans only eat about one fruit and one vegetable a day. As a result, Blumberg points out, many Americans don't meet target intakes for vitamins. So his view is this.
JEFFREY BLUMBERG: Everybody should eat better. But if you're not, it's a very prudent thing for most people to choose to take a multivitamin.
AUBREY: And I'd say the bottom line is even if you are taking a multivitamin, you should still be trying to eat better as well.
MONTAGNE: All right. Allison, thanks.
AUBREY: Thank you, Renee.
MONTAGNE: NPR's food and health correspondent Allison Aubrey. Transcript provided by NPR, Copyright NPR.
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