The Vitamin Debate

by Wendy Kagan and illustrations by Annie Internicola, December 29, 2011

If you’re like most Americans, you have one or more vials of vitamin or mineral supplements in your medicine cabinet. You’ve been lured by the health claims, hopeful studies, and pop folklore surrounding these nutritional powerhouses—from vitamin C for colds to biotin for thinning hair. You’re tired? Could be low iron. Looking to combat the ravages of aging? Bring on the vitamin E.  Your doctor is pushing a multivitamin on you, and a message in your Inbox makes you feel like an idiot for not downing Omega-3 soft gels daily. Yet for every silver-bullet declaration, it seems there’s a study out there to turn the research on its head and reveal yesterday’s cure as today’s snake oil—just one more reason that, as the outspoken Harvard scientist Victor Herbert said 20 years ago, Americans have the most expensive urine on Earth.

When it comes to vitamin supplements, the messages are mixed, and even the most objective nutrition experts seem to lock heads in disagreement. Two papers published in the fall of last year—an Iowa Women’s Health study that signaled a slight increase in mortality (yes, increase) among older women who took multivitamins, and a select trial that linked vitamin E supplementation with a higher risk of prostate cancer in men—found pundits questioning the effectiveness and even the safety of some vitamin supplements. To complicate matters, some experts expressed doubt over the soundness of the multivitamin study. Through it all, and undeterred by a sluggish economy, the industry remains robust. Americans spent $28 billion on vitamins and other supplements in 2010, a 4.4 percent increase from the previous year, according to Nutrition Business Journal, a trade publication. In 2011 the GNC brand reported a 15.5 percent increase in annual revenue, and stock in the company was up. Many Americans, particularly the well-educated and affluent, have enough vitties in their possession to power a small army.

What works and what’s trash? Which vitamin supplements do our bodies really need, and what simply gets flushed down the toilet? Just before writing this article, I dutifully purchased some doctor-recommended B-complex capsules. But after reading about a few studies and talking to my first expert—Marion Nestle, professor of nutrition, food studies, and public health at New York University—I left the vial unopened with its receipt in my car, a kind of vitamin purgatory. The act felt rebellious. But before I was going to swallow that oversized pill and its hefty price tag, I wanted some answers.

SUPPLEMENTARY OR SUPERFLUOUS
Nestle (who bears no relation to the chocolate-bar maker and global brand) has been a vitamin naysayer for years. In her books and Food Politics blog (foodpolitics.com), she has stated that food is better than supplements because the range of nutrients is greater and better balanced. You’ll be hard pressed to find a nutrition expert who disagrees with that. Yet Nestle departs from the pack by going one step further: She discourages vitamin use as a preventive measure to safeguard health. Nestle tells me via e-mail, “People who are vitamin or mineral deficient or who eat vegan diets need supplements and benefit from them.” But for the rest of us, she’d rather we didn’t swallow any horse pills. Asked about the multivitamin and vitamin E studies from fall 2011, Nestle says flatly, “They confirm the results of a whole series of studies during the past few years: Vitamin supplements do not make people healthier.”

To hammer yet another nail in the supplement coffin, Nestle points out that the industry is poorly regulated. As a result many supplements don’t actually offer the dosage reflected on the bottle; many also contain a range of “fillers” of no use to the body, as well as heavy metals that could very well cause harm. But don’t go blaming the FDA. Their hands are tied thanks to the Dietary Supplement Health and Education Act, passed by Congress in 1994. For Nestle, this is yet another reason to look to food as, in most cases, the only source of trustworthy vitamins and minerals. She has also stated—somewhat controversially—that even with ubiquitous fast foods and unhealthy eating habits, it’s hard for most Americans to achieve a true vitamin deficiency. Yet she offers one caveat: “Supplements make people feel better. Is this a placebo effect? Maybe, but feeling better has benefits on its own.”  The placebo effect doesn’t seem like a compelling enough reason to release my vitamins from their purgatory in my car. Onward to the next expert.