Is There Really Any Benefit to Multivitamins?
Half of all American adults—including 70 percent of those age 65 and older—take a multivitamin or another vitamin or mineral supplement regularly. The total price tag exceeds $12 billion per year—money that Johns Hopkins nutrition experts say might be better spent on nutrient-packed foods like fruit, vegetables, whole grains and low-fat dairy products.
In an editorial in the journal Annals of Internal Medicine titled “Enough Is Enough: Stop Wasting Money on Vitamin and Mineral Supplements,” Johns Hopkins researchers reviewed evidence about supplements, including three very recent studies:
- An analysis of research involving 450,000 people, which found that multivitamins did not reduce risk for heart disease or cancer.
- A study that tracked the mental functioning and multivitamin use of 5,947 men for 12 years found that multivitamins did not reduce risk for mental declines such as memory loss or slowed-down thinking.
- A study of 1,708 heart attack survivors who took a high-dose multivitamin or placebo for up to 55 months. Rates of later heart attacks, heart surgeries and deaths were similar in the two groups.
Healthy Food Instead of Supplements
“I don’t take any supplements routinely,” says Larry Appel, M.D., director of the Johns Hopkins Welch Center for Prevention, Epidemiology and Clinical Research. “I try to eat three healthy meals a day to get the vitamins, minerals and other nutrients I need.” How he does it:
- Plenty of produce. “I aim for two or more servings of fruits or vegetables at every meal,” he says. “I enjoy salads and have one for lunch or dinner several times a week.”
- Low-fat dairy and whole grains. “Low-fat or fat-free milk and yogurt provide calcium, magnesium, potassium and other nutrients,” he says. “I have cereal with milk for breakfast a few times a week. And I have yogurt sometimes too.”
- Protein. “At home we usually have fish or chicken for dinner. I am not a vegetarian; rather, I eat minimal meat,” Appel says. Some fish, such as salmon, are a good source of healthful omega-3 fatty acids.
The Vitamin Verdict
The researchers concluded that multivitamins don’t reduce the risk for heart disease, cancer, cognitive decline (such as memory loss and slowed-down thinking) or an early death. They also noted that in prior studies, vitamin E and beta-carotene supplements appear to be harmful, especially at high doses.
“Pills are not a shortcut to better health and the prevention of chronic diseases,” says Larry Appel, M.D., director of the Johns Hopkins Welch Center for Prevention, Epidemiology and Clinical Research. “Other nutrition recommendations have much stronger evidence of benefits—eating a healthy diet, maintaining a healthy weight, and reducing the amount of saturated fat, trans fat, sodium and sugar you eat.”
The exception is supplemental folic acid for women of child-bearing potential, Appel says. “Folic acid prevents neural tube defects in babies when women take it before and during early pregnancy. That’s why multivitamins are recommended for young women.” The Centers for Disease Control and Prevention recommends that all women of reproductive age get 400 micrograms of folic acid daily. The amount of iron in a multivitamin may also be beneficial for women of child-bearing potential, Appel adds.
“I don’t recommend other supplements,” Appel says. “If you follow a healthy diet, you can get all of the vitamins and minerals you need from food.”
Whole grains: Grains such as whole wheat, brown rice and barley still have their fiber-rich outer shell, called the bran, and inner germ. It provides vitamins, minerals and good fats. Choosing whole grain side dishes, cereals, breads and more may lower the risk for heart disease, type 2 diabetes and cancer and improve digestion, too.
Saturated fat: A type of fat found in abundance in butter, whole milk, ice cream, full-fat cheese, fatty meats, poultry skin, and palm and coconut oils. Saturated fat raises levels of heart-threatening LDL cholesterol in your bloodstream. It can also interfere with your body’s ability to absorb blood sugar easily. Limiting saturated fat can help control your risk for heart disease.
Omega-3 fatty acids (oh-may-ga three fah-tee a-sids): Healthy polyunsaturated fats that the body uses to build brain-cell membranes. They’re considered essential fats because our body needs them but can’t make them on its own; we must take them in through food or supplements. A diet rich in omega-3s—found in fatty fish, like salmon, tuna and mackerel, as well as in walnuts, flaxseed and canola oil—and low in saturated fats may help protect against heart disease, stroke, cancer and inflammatory bowel disease.