Vitamin devotees should shift their loyalty to lifestyle changes, experts say
Vitamin supplements, a multi-billion-dollar industry, are a layperson’s favorite prescription. Tired? Take an iron supplement. Sad? Classic vitamin D deficiency. But a recent paper related to cardiovascular health, published July 9 in Annals of Internal Medicine, put this loyalty to the test. Surprise, surprise: vitamin supplements had little impact on heart conditions, including heart disease, and lifespan as a whole. According to Dr. Erin D. Michos, associate professor of medicine in cardiology at Johns Hopkins School of Medicine and one of the paper’s co-authors, the paper was catalyzed in part by the growing popularity of the supplement industry.
“An estimated 1 out of 2 Americans are taking some kind of supplement or vitamin,” Michos said. “For the vast majority of vitamins, we did not find any benefit, either in reduction in death or cardiovascular health.”
While vitamin devotees might feel betrayed, medical professionals are less surprised. The paper reviewed collective evidence from separate randomized clinical trials to analyze the benefit of dietary intervention and supplementation in cardiovascular conditions. Dr. Jeffrey Linder, chief of internal medicine and geriatrics at Northwestern Medicine, wasn’t surprised by the results, which corroborated and combined years of prior research while putting a spotlight on cardiovascular health.
“This new study confirms what we’ve been thinking all along: that there are very few, if any, supplements or vitamins that people should take as long as you’re eating a healthy diet,” Linder said. “Every time scientists have compared taking a supplement of something versus getting it through food, getting it through food wins every time.” Food, Linder said, contains both minerals and vitamins that the body is “built and designed to absorb.”
Dr. Mark Rabbat, a Loyola Medicine cardiologist, said that he would only prescribe a supplement to patients with established vitamin deficiencies who may derive benefits, but this is not the majority. Still, patients crave what Rabbat called “that magic pill,” and their desire for an easy fix makes them putty in the hands of a supplement industry that claims to have it in spades. Vitamins are considered food supplements and are not regulated by the Food and Drug Administration, and Rabbat said they’re often vague in labeling as a result – claiming, for instance, to be “good for the heart” without explaining why. Dr. Rami Doukky, chair of cardiology at Cook County Health, Chicago, said that the industry promotes itself as though its claims were substantiated.
“You cannot watch television and avoid these advertisements for all kinds of vitamins,” Doukky said. “They convince patients of a certain age group that they need to take vitamins,” and in the minds of those patients, “if it doesn’t help, then it certainly doesn’t hurt.”
Though the paper demonstrated some evidence that omega-3 fatty acids could help prevent heart attacks, it also demonstrated that taking a certain combinations of supplements – calcium plus vitamin D – was shown to increase risk for stroke. While some supplements are considered benign, if ineffective (with the exception of their usage to treat deficiencies), this clearly isn’t always the case.
“People take these things without discussing them with doctors because they think they’re benign, and they can have real side effects,” Michos said. Still, Linder believes the real danger is that patients will waste their money in a misguided attempt to improve their health.
“It can be hard to convince people if they feel pretty good and feel like what they’ve been doing is healthy,” Linder said. “I get their resistance, and the idea that this new study is going to make everybody drop their supplements is unrealistic, too.”
Still, if patients are willing to listen, there are ways they can still feel in control of their heart health. Though the paper found little evidence that specific diets are beneficial (though reduced salt intake showed some benefit), Michos said that this doesn’t mean heart-healthy diets are ineffective, as diet research is mostly observational studies. There are, in fact, dietary regulations that Doukky said are known to aid heart health: eating fresh fruits, vegetables and whole grains, exercising regularly and avoiding smoking. No need for a cabinet full of supplements; save your wallet and your time.
“In my mind, if it’s not harmful, it’s a waste of money,” Doukky said.