New medical indications indicate that the market is booming as Americans seek good health in pills.
After years of study and growing into a multi-billion dollar industry, there is still no conclusive evidence that vitamin supplements help patients ward off heart disease and cancer.
The US Task Force on Preventive Services (USPSTF), an independent panel of national experts, updated its recommendation on the effectiveness of multivitamins in preventing cardiovascular disease and cancer in healthy, non-pregnant adults.
The result: insufficient evidence, according to the recommendation statementa evidence report And one editorial all published on June 21 in JAMA. Northwestern University Feinberg School of Medicine has also published a Press release on the discoveries.
What works best? Healthy eating and exercise.
“Patients ask all the time, ‘What supplements should I take?’ They waste money and get carried away thinking there must be some magic set of pills that will keep them healthy when we should all be following the evidence-based practices of healthy eating and exercising Jeffrey A. Linder, MD, MPH, FACP, chief of general internal medicine in the department of medicine at Northwestern University Feinberg School of Medicine, said in the press release.
More than half of American adults take dietary supplements to improve or maintain their overall health. In 2021, Americans spent nearly $50 billion on dietary supplements, an industry that spent about $900 million on marketing, Linder and co-authors Jenny Jia, MD, MSc and Natalie Cameron, MD, said in the ‘editorial.
“The appeal of supplements is obvious,” the editorial said. “In theory, vitamins and minerals have antioxidant and anti-inflammatory effects that should decrease the development of cardiovascular diseases and cancers. Fruit and vegetable consumption is associated with a reduced risk of cardiovascular disease and cancer. It’s reasonable to think that essential vitamins and minerals could be extracted from fruits and vegetables, packaged into a pill, and people could avoid the difficulty and expense of maintaining a balanced diet.
However, whole fruits and vegetables contain a mix of vitamins, phytochemicals, fiber, and other nutrients that likely work synergistically to provide health benefits. Isolated micronutrients may act differently in the body than when naturally packaged with other food components, the authors said.
Supplements “are relatively unregulated” and must carry disclaimers stating that they “have not been evaluated by the Food and Drug Administration” and are “not intended to diagnose, treat, cure or prevent disease,” the editorial said.
Necessary healthy lifestyle
Most people view supplements as benign preventatives, but focusing on supplements can be a potentially dangerous distraction, the authors said.
Healthy eating can be a challenge when America’s industrialized food system doesn’t prioritize health, said Jia, a general internal medicine instructor and a medical northwest physician who studies chronic disease prevention in families. low income through lifestyle interventions.
“Eating a healthy diet and exercising more is easier said than done, especially among low-income Americans,” Jia said in the press release. “Healthy eating is expensive and people can’t always afford to find environments to exercise — maybe it’s dangerous outside or they can’t afford to exercise. afford a facility. So what can we do to try to make things easier and help make healthier decisions?
The latest recommendations update guidance from 2014 and are based on a review of 84 studies since then.
The USPSTF recommends:
- Against taking beta-carotene supplements due to increased risk of lung cancer
- Against taking vitamin E supplements as it has no clear benefit in reducing mortality, cardiovascular disease or cancer
The results do not apply to adults with known nutritional deficiencies, and Linder noted that calcium and vitamin D have been shown to be effective in preventing fractures and possibly falls in older people.
Patients who are pregnant or trying to become pregnant should take folic acid and iron supplements for health effects.
“Pregnant women should keep in mind that these guidelines do not apply to them,” Cameron, a physician with Northwestern Medicine, said in the press release. “Certain vitamins, such as folic acid, are essential for pregnant women to support healthy fetal development. The most common way to meet these needs is to take a prenatal vitamin. More data is needed to understand how a Specific vitamin supplementation may alter the risk of adverse pregnancy outcomes and cardiovascular complications during pregnancy.