As I have pointed out in a previous post, there is no reason to take multivitamins or any individual vitamin or supplement to prevent cardiovascular disease.
The U.S. Preventive Services Task Force (USPSTF) has just updated its 2003 recommendation on vitamin supplementation to prevent cardiovascular disease and cancer and published this analysis in the April 15, 2014 Annals of Internal Medicine issue.
Their recommendations agree with mine and those of the American Heart Association, the American Cancer Society and the Academy of Nutrition and Dietetics.
After analyzing all available studies they found insufficient evidence to support
the use of multivitamins to prevent cardiovascular disease or cancer
the use of single or paired nutrients (except β-carotene or vitamin E) for the prevention of cardiovascular disease or cancer (including Vitamins A, C, D, E, folic acid, selenium and beta-carotene)
About half the country is taking these worthless vitamins, supplements and multivitamins and spending 28 billion dollars per year on them.
This money would be much better spent on gym memberships or on the purchase of real, unprocessed food which contains all the vitamins and nutrients you need.
As I pointed out in an earlier blog , individual vitamins and multivitamins have been proven over and over to have no benefit for heart disease.
A recent series of articles in the Annals of Internal Medicine summarized in this accompanying editorial, confirms this and further shows that multivitamins have no benefit on preventing cognitive decline with aging.
The U.S. Preventive Services Task Force reviewed all studies on multivitamins, single and paired vitamins and concluded that there was no benefit of taking these on overall mortality, cardiovascular mortality or cancer.
Hopefully this series of articles will start the decline of the multibillion dollar Vitamins and Supplement industry in the U.S.
For my patients, I recommend a healthy diet that includes, fruits, vegetables, and fish which will provide all the micronutrients and vitamins they need. There is no evidence that you can substitute taking industry-processed micronutrients or fish-oil and expect the benefits to be the same
Many of my patients take a multivitamin supplement and a lot take individual vitamins or supplements. When they ask me if I think they are worthwhile I invariably say no, not from a cardiovascular standpoint. If they ask me if they should take the vitamin/supplement I usually respond that there is no evidence of harm and they should take it if some other reputable (not a chiropractor or naturopath) physician has advised it for a particular reason.
Data from the Center for Disease Control has shown that use of dietary supplements has increased progressively over the last decade . The graph below shows that despite evidence of no benefit , about a third of Americans continue to take a multivitamin/multimineral (defined as having 3 or more components)
It bears emphasizing-there is no evidence any multivitamin or vitamin improves your heart health or lowers your risk of heart disease or stroke!
This has been proven over and over again in multiple trials in which a vitamin with proposed healthy antioxidant properties (say Vitamine E or C) or anti-inflammatory properties (say homocysteine) has gone up against placebo. The vitamin is no better than placebo.
Apparently, the message that these chemicals are beneficial from the vitamin/nutraceutical/supplement industry is so persuasive and pervasive that my patients will continue to pay for and take their chosen vitamin or multivitamin despite my advice. The patients most likely to persist in taking the useless pills have a suspicion of doctors, the pharmaceutical industry and are convinced that “natural” methods (totally unproven by any scientific techniques) are superior to medically approved methods for disease prevention.
Nail In The Coffin for Multivitamins
The latest nail in the coffin for vitamins in the prevention of cardiovascular disease was published by Sesso et al in JAMA late last year .
This study reported data from the large, long term Physicians’ Health Study II which was started in 1997 and ended in 2011. Over 14 thousand male physicians over the age of fifty were entered into the study. On a random basis half of them took a multivitamin and half took a placebo (thus the study was randomized and placebo-controlled). Neither the patients nor their doctors knew who was taking what (thus double blind).
The study investigators measured who had what is termed in cardiology research a major adverse cardiovascular event, known as MACE. A MACE would in this case would be a stroke, a heart attack or death from cardiovascular disease.
The results of this really well done, large, controlled trial show absolutely no benefit of multivitamins in reducing any cardiovascular outcome. Those taking multivitamins were just as likely as those taking a placebo to have heart attacks, strokes or to die from any cause.
In the interest of full disclosure an earlier publication from this same study also in JAMA showed a very slight , barely significant lowering of risk of cancer by multivitamin use. However, the significance of these findings, given multiple other negative studies , lack of any mortality benefit, and any specific cancer effect has been widely questioned. An accompanying editorial , I think, best summarizes the weakness of the study and the authors, very clearly do not recommend multivitamin usage for preventing cancer.