The Value Of Vitamins

This week the Annals of Internal Medicine published an editorial about the growing use of vitamin supplements in America that may come as a surprise to many Americans.

Entitled Enough is Enough:  Stop Wasting Money on Vitamins and Mineral Supplements, the strongly worded editorial summarizes three articles and the results of a number of large scale studies that produced “sobering evidence of no benefit or possible harm.”  The editorial’s concluding paragraph states:  “In conclusion, B-carotene, vitamin E, and possibly high doses of vitamin A supplements are harmful.  Other antioxidants, folic acid and B vitamins, and multivitamin and mineral supplements are ineffective for preventing mortality or morbidity due to major chronic diseases.”

America has become a nation of pill-poppers.  About half of Americans take some kind of dietary supplement, and Americans spend $12 billion a year on vitamins alone and $30 billion for all dietary supplements.  The notion that the vitamin supplements Americans are swallowing in record numbers are ineffective — or even harmful — may shock people. Of course, whether Americans learn of the editorial and the results of the studies, and then whether they stop taking the vitamins and dietary supplements, is anybody’s guess; one vitamin user interviewed by CBS said she would keep slugging down the pills anyway.

Why are Americans so committed to vitamins and supplements?  Some people blame the aggressive marketing of the products, but I think the root cause lies in two other factors.  First, for years Americans have been bombarded with stories about studies that conclude that something is good or bad — be it cyclamates, red dye #2, or something else.  These studies, I think, have conditioned people to believe that taking one substance, or avoiding another, could have significant health benefits.  If a “medical study” shows that avoiding something has a material effect on health, why is it so outlandish to believe that taking another substance — or a combination of substances — might have a similar beneficial effect?  The context created by the onslaught of “medical studies” establishes fertile ground for hawking vitamins and supplements.

Second, people clearly hope that a magic little pill or two can make up for their lack of exercise, poor diet, or other questionable lifestyle choices.  Like Fox Mulder on The X-Files, they want to believe — but unlike Mulder, they lack any true skepticism.  If they skip a walk and eat a quart of ice cream but take a vitamin or “fat-burning” concoction, they can rationalize that they are doing something positive about their health.  They simply don’t want to get the advice offered by one of the authors of the Annals of Internal Medicine articles:  “fruits, vegetables, nuts, beans, low fat dairy, things like that ..exercising would probably be a better use of the money.”

And that’s probably why the Annals of Internal Medicine editorial won’t have much impact.  Believers believe, and hard advice and facts usually don’t get in the way.