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Multivitamins: Victim of a Truth Deficiency?

Neil E. Levin

A recent article in the New York Times attacks multiple vitamins, warning of the dangers of overdosing. I can't help but wonder if this is really about anti-vitamin activists counter-attacking against last year's article in the Journal of the American Medical Association (JAMA) that advocated the use of multiple vitamins by most of our population. Looking at the reports of the American Association of Poison Control Centers, vitamin overdoses are rare, with typically no deaths resulting in a typical year. 

The reporter asserts that "researchers say that vitamin supplements cannot correct for a poor diet, that multivitamins have not been shown to prevent any disease and that it is easy to reach high enough doses of certain vitamins and minerals to actually increase the risk of disease. No longer, the experts say, are they concerned about vitamin deficits. Those are almost unheard of today, even with the population eating less than ideal diets and skimping on fruits and vegetables. Instead, the concern is with the dangers of vitamin excess."

Wow. Do these researchers read their medical journals and see all of the research on the benefits of vitamin use?

Dr. Thomas A. Barringer of Carolinas Medical Center in Charlotte, North Carolina reports that his studies show that multiple vitamins benefit our diabetic population. He states that "any population at risk of having marginally inadequate nutrition, such as the elderly in general, might also benefit." Dr Barringer adds: "all obese people might benefit." He pointed out that supplements are safe and relatively inexpensive, so taking a daily multivitamin is "a reasonable option" for people who are overweight, who have any type of diabetes, who may not receive adequate nutrition or whose immune system is weak. (March 4th 2003 Annals of Internal Medicine)

The World Health Organization reported March 14, 2002 that scurvy, caused by vitamin C deficiency, and night blindness, caused by vitamin A deficiency, are both being detected in certain parts of Afghanistan. All vitamins, by definition, will prevent deficiency diseases... In addition, sub-optimal levels of nutrients (including Vitamins C, B-12, B-6 and folic acid) are now considered factors in the development of cardiovascular disease. The use of antioxidant nutrients is a promising lead in research to combat chronic inflammation, which seems to increase our risk of getting arthritis, Alzheimer's Disease, Parkinson's Disease and cancer. The pre-diabetic condition known as Metabolic Syndrome, or Syndrome X, responds well to both dietary changes and increases of nutrients by supplementation of vitamins and co-factors. Contrary to popular myth, these disorders are not caused by deficiencies of pharmaceutical drugs or surgery.

According to nutrition classes given at the University of California (Davis), common causes of vitamin deficiencies include: monotonous diets (lacking a variety of foods/nutrients), disturbances of absorption (pancreatic insufficiency), biliary obstructions of the liver and gall bladder, alcohol, enteropathies (celiac sprue or food sensitivities), lack of gastric derived factors (intrinsic factor, of importance in B-12 absorption), antagonists (antibiotics, tannins, caffeic acid, alcohol), metabolic conditions and specific pathologies: pregnancy, diabetes, and pernicious anemia (caused by a lack of Vitamin B-12). Also, people with low levels of B12 or folic acid may have a higher risk of developing Alzheimer's disease (Neurology, May 8, 2001).

The Merck Manual of Geriatrics, a standard medical text, states that "Mild vitamin deficiencies are very common among elderly persons (particularly frail and institutionalized elderly) and are associated with cognitive impairment, poor wound healing, anemia, and an increased propensity for developing infections. Trace mineral deficiencies are associated with immune system dysfunction and many other disorders....A diet that includes at least five or six daily servings of fruits and vegetables usually contains sufficient vitamins (as well as other healthful phytochemicals available only in food). However, a less healthful diet probably requires daily supplementation. There is also evidence that a multivitamin supplement improves immune status in healthy elderly persons."

According to Professor Gladys Block at the University of California-Berkeley, "Only 9% of the (U.S.) population eats the recommended five servings of fruit and vegetables daily."

Another issue is the variation of nutrient content based on growing, storage and handling practices. Dr. Michael Colgan (Ph.D.) tested oranges that had been picked that same day, and their average vitamin C content was 180 mg. He then tested oranges from the same grower which had been in storage at a local supermarket. They looked and tasted the same, but the vitamin C content had dropped to zero. Meanwhile, the nutrient content of standard foods has changed dramatically in the past hundred years, due to soil depletion of trace elements, a change in the varieties of plants grown, and longer storage times. Scientists and physicians would be smart to not trust that the standard nutrient content tables provide accurate information on actual vitamin and mineral content of modern foods.

The standard fortification of foods is inadequate to replace the many more nutrients removed by food processing. Both the forms and the variety of nutrients in "enriched" flours are quite inferior to what was in the original whole grains. Combine this erosion of nutrients with the poor diets eaten by many of us, and you'll know why the Standard American Diet is known to many of us in the nutrition field by its initials (SAD).

JAMA (the Journal of the American Medical Association) published a Scientific Review of articles about vitamins in relation to chronic disease in June 2002. The authors reviewed all known articles published in English (from 1966 through January 2002) for the most clinically important information. Their conclusions: "Some groups of patients are at higher risk for vitamin deficiency and suboptimal vitamin status. Many physicians may be unaware of common food sources of vitamins or unsure which vitamins they should recommend for their patients.

Vitamin excess is possible with supplementation, particularly for fat-soluble vitamins. Inadequate intake of several vitamins has been linked to chronic diseases, including coronary heart disease, cancer, and osteoporosis... suboptimal intake of some vitamins, above levels causing classic vitamin deficiency, is a risk factor for chronic diseases and common in the general population, especially the elderly. Suboptimal folic acid levels, along with suboptimal levels of vitamins B6 and B12, are a risk factor for cardiovascular disease, neural tube defects, and colon and breast cancer; low levels of vitamin D contribute to osteopenia and fractures; and low levels of the antioxidant vitamins (vitamins A, E, and C) may increase risk for several chronic diseases. Most people do not consume an optimal amount of all vitamins by diet alone. Pending strong evidence of effectiveness from randomized trials, it appears prudent for all adults to take vitamin supplements."

Health Disclaimer. Content provided by NOW Foods. Copyright ©2006-2018. Published with permission. Neil E. Levin CCCN, DANLA is a certified clinical nutritionist and is a professional member of the International & American Associations of Clinical Nutritionists.