Food, Supplementation, USPTSF and Health
Nutrition and exercise are fundamental to good health. The combination increase longevity when we avoid unhealthy risky behaviors, e.g. smoking and alcohol abuse. Malnutrition most often jeopardizes health via excess weight gain or inadequate intakes of essential nutrients. Eating less and exercising more will help manage obesity. Dietary choices can overcome nutrient inadequacy if one has access to these foods, financial resources to acquire, and will to prepare and consume.
Many people use multivitamin supplements to insure nutrient adequacy. Their goal is to help improve or maintain overall health. After all, essential nutrients prevent deficiency diseases. Nutrients are not drugs. Nutrients are required for life; they do not mitigate, treat, or prevent chronic disease. It shouldn’t be newsworthy to be informed that single or paired nutrients or multivitamins do not affect risk of cardiovascular disease or cancer. The US Preventive Services Task Force may have found the evidence insufficient to assess the benefits of supplements to prevent cancer but there is promise; possibly because so many Americans fail to meet their nutritional requirements from food alone (Fulgoni et al, 2011).
The Task Force singles out vitamin E and beta-carotene. With respect to vitamin E, they say they cannot identify a benefit of supplementation or any evidence of harm. With vitamin E intakes from food well below recommendations for most Americans, the conservative agenda against vitamin E is unclear. Admittedly, high intakes of beta-carotene have been found to increase risk of lung cancer in smokers but the effects of beta-carotene on cancer incidence dissipate post-intervention. Shouldn’t the recommendation be against smoking? Or more specifically for smokers to not supplement with beta-carotene? Even when drugs are being evaluated with the intent of preventing cancer, there are few certainties. Established drugs, i.e. tamoxifen for breast cancer, are not without risk or suitable for everyone. One size does not fit all.
As the Council for Responsible Nutrition stated, “There are real reasons why people should take vitamins and why so many doctors recommend them.” It is because of inadequate nutrient intakes from foods. Choosing to supplement your diet is the right choice for many people; otherwise your nutritional intake may be in jeopardy (Fulgoni et al, 2011). We just need to remember balance and moderation , ie Tolerable Upper Limit, when choosing a product.
Vitamin, Mineral, and Multivitamin Supplements for the Primary Prevention of Cardiovascular Disease and Cancer: U.S. Preventive Services Task Force Recommendation Statement. February 2014.
Bailey RL, Gahche JJ, Miller PE, Thomas PR, Dwyer JT. Why US adults use dietary supplements. 2013 JAMA Intern Med doi:10.1001/jamainternmed.2013.2299
Fulgoni III VL, Keast DR, Bailey RL, Dwyer J. Foods, fortificants, and supplements: Where do Americans get their nutrients? 2011 J Nutr doi:10.3945/jn.111.142257
Gaziano JM, Sesso HD, Christen WB, Bubes V, Smith P, MacFadyen J, Manson JE, Glynn RJ, Buring JE. Multivitamins in the prevention of cancer in men: the Physicians’Health Study II randomized controlled trial. 2012 JAMA doi: 10.1001/jama.2012.14641