Multivitamins aren’t Drugs but they are Supplements
Headlines might have you believe vitamin supplements are a wasted investment. How can efforts to achieve recommended nutrient intakes be so distorted? The Dietary Reference Intakes (DRIs) are nutrient reference values set the by Institute of Medicine of The National Academies. They are intended to serve as a guide for good nutrition.
The second fact is people using multivitamin supplements are more likely to meet the DRI.
The third misfortune is that most dietary supplement interventions have been conducted without consideration of nutrient status. Time and time again, volunteers for RCTs do not reflect the general public in terms of diet, physical activity or health.
The fourth fact: Because of the millions of dollars spent recruiting and executing these RCTs and researchers are recognized for publishing scientific articles, cohorts tend to be leveraged long after the RCT is terminated. Such an approach may make sense for a group who were exposed to a chemical, i.e. hormone replacement therapy or who smoked and quit. It makes little sense for nutrition where everyone continues to eat and have some level of nutrient status.
Fifth, researchers choose to study other nutrient-disease interactions that were not part of the original RCT design. In other words, researchers use (abuse?) the data to examine hypothetical relationships. Unintended, unplanned relationships. As an example, the Selenium and Vitamin E Cancer Prevention Trial (SELECT) recruited men with prostate cancer. Vitamin E and selenium were administered as treatments for 7-12 years. Cancer incidence was the primary outcome. Researchers are retrospectively assessing another outcome, e.g. cataracts, in a cancer-prone population. Again, without any assessment of nutrient status. The inference is that vitamin E supplementation isn’t beneficial even though a meta-analysis of prostate cancer intervention trials found each 5.8 µmol/L increase in blood α-tocopherol concentrations was associated with a 21% decrease in prostate cancer risk.
Nutrients are not drugs. Nutrients don’t prevent or mitigate disease. Nutrients are essential for life. DRIs have been established for nutrients. Most people do not consume the DRIs recommended for their age and sex. Using a multivitamin supplement can help them safely meet recommended intakes. What more is there to be said?
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Cui R, Liu Z-Q, Xu Q. Blood α-tocopherol, γ-tocopherol levels and risk of prostate cancer: A meta-analysis of prospective studies. 2014 PloS ONE doi: 10.1371/journal.pone.0093044
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