The vitamin pills you think will do your body good aren't actually doing very much to keep you healthy, doctors want to remind you.
More than half of Americans, or 52 percent, report using at least one dietary supplement, but supplements aren’t a substitute for a healthy diet and provide little if any benefit for healthy adults, notes a Viewpoint article published in JAMA this week.
The commentary aims to separate facts from fiction, said Dr. JoAnn E. Manson, the lead author, chief of preventive medicine at Brigham and Women's Hospital and professor of medicine at Harvard Medical School.
“People are bombarded by the marketing for dietary supplements and they may not be fully aware of the lack of evidence for efficacy,” Manson told TODAY.
“[We want] to really encourage people to try to get these vitamins, minerals and other micronutrients from foods, from a healthy diet, because that’s where they’re best absorbed and you get an array of nutrients in biologically optimal ratios.”
While routine use of multivitamins and other supplements isn’t recommended for the general population, people in certain life stages or “high risk” groups can benefit from them, the article notes.
Here are some of the recommendations:
Focus on a healthy diet, rather than supplements
“A healthful, well-balanced diet that includes whole grains and whole foods will provide sufficient vitamins and minerals for the vast majority of the population,” Manson said.
“You have to be aware that vitamin supplements are not a substitute for fruits and vegetables. You’re talking about foods that have a very complex array of beneficial macronutrients and micronutrients, so it’s not the same.”
Avoid highly-processed products because processing will strip many foods of vitamins, minerals and fiber.
Multivitamins can fill in some gaps
Multivitamin and multimineral supplements are not recommended for generally healthy adults, the report notes. But if you’re concerned your diet is inadequate — perhaps because you don’t eat enough fruits and vegetables — and you’re not in a position to improve it, a multivitamin could fill in some of the gaps, Manson said.
“It is a reasonable form of insurance,” she noted.
People in certain life stages can benefit from supplements:
Pregnant women: Folic acid to prevent birth defects. “Synthetic folic acid actually is better absorbed than the dietary folate, so it’s important during pregnancy and during pre-conception planning to take folic acid and the prenatal vitamins,” Manson said.
Infants and children: For breastfed infants, vitamin D until weaning, and iron from age 4 to 6 months.
Middle-aged and older adults: Some may benefit from supplemental vitamin B12, vitamin D, and/or calcium.
People with certain medical conditions can also benefit:
Conditions that interfere with nutrient absorption or metabolism — including bariatric surgery, pernicious anemia, Crohn’s disease and osteoporosis — may require patients to take supplements.
Beware of “mega” doses of supplements
It was once believed that taking high doses of nutrients such as beta carotene, folic acid, vitamin E or selenium would be beneficial, but clinical trials discovered they may have harmful effects instead, including increased mortality, cancer, and hemorrhagic stroke, the paper notes.
“So we shouldn’t make the assumption that high-dose supplementation is free of risk,” Manson said.
“Now, with something like multivitamins, you’re talking about small to moderate doses, doses that are generally within the recommended dietary allowance, so the risks should be very minimal, if any.”