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Vitamin and mineral supplements: Do you need them?

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A recent review casts doubt on supplements for disease prevention. Are they still worth taking?

Following the news on supplements is a little like trying to keep up with a fast-paced game of ping-pong. One study finds supplements improve health, and then another questions the benefit of taking them. Back and forth they go.

In November 2013, the U.S. Preventive Services Task Force—a panel of disease prevention experts—conducted a comprehensive review of the research published over the past decade. They concluded there isn’t enough evidence to support the use of vitamin and mineral supplements for preventing heart disease, cancer, or deaths from these diseases in healthy adults. An editorial in the December 17, 2013 Annals of Internal Medicine even urged consumers to “stop wasting money on vitamin and mineral supplements.” But does this close the book on supplements for disease prevention?

Not quite, says Dr. Howard Sesso, associate professor of medicine at Harvard Medical School and associate epidemiologist at Brigham and Women’s Hospital. A number of clinical trials in the past have found no advantage to taking most high-dose individual vitamin and mineral supplements for chronic disease. “That was old news and was not a surprise,” he says. “But this review does allude to the fact that multivitamins have some benefit.” In the Physicians’ Health Study II trial, multivitamins did reduce cancer incidence in men. Whether these supplements might have the same effect in women will require more studies involving our gender.

A few individual vitamins and minerals also warrant further study. “There are still many promising supplements for chronic disease prevention that deserve more research and the public’s attention,” Dr. Sesso says. “For example, there’s a plethora of observational studies that suggest vitamin D may help with chronic disease prevention, but we lack good long-term randomized controlled trials.” To that end, he is currently working with colleagues on the VITAL trial, involving more than 20,000 men and women, which will study the effects of vitamin D (as well as omega-3 fatty acids) on cancer, heart disease, and stroke risks.

Your reasons for taking supplements

While the research might not yet be consistent or convincing enough to make sweeping recommendations for women about supplement use, your own health can dictate whether you take them and which ones you use.

For example, if you have or are at risk for osteoporosis, your doctor will likely recommend calcium and vitamin D supplements. Anyone over age 50 may need a vitamin B12 supplement, because this nutrient becomes harder to absorb from food as we age. If your diet in general is less than perfect, it may be a good idea to consider adding a daily multivitamin. “It’s often forgotten that the primary reason we take a multivitamin should be to prevent deficiencies or a lack of enough essential vitamins and minerals,” Dr. Sesso says. “Given the fact that we don’t believe there are any short- or long-term risks from taking a multivitamin, along with its ability to fill in gaps in the diet, I don’t see any downsides to women considering the use of a daily multivitamin.”

Choosing a supplement

Even trickier than determining whether you need a supplement is figuring out which one to take. “When you go into the supplement section of any store, even if you’re just trying to get a multivitamin, you’re confronted with shelves and shelves of options, and that can be confusing,” says Dr. Sesso.

He suggests sticking with the major multivitamin brands, which are well tested for safety and stability and are more likely to parallel the recommended low-dose daily amounts of vitamins and minerals.

Dr. Sesso generally advises against trying one of the specialized multivitamin formulations—for immunity support, heart health, energy, etc.—”unless you have a conversation with your doctor that suggests a particular formulation would be beneficial,” he says. However, if you are over age 50, a vitamin designed for seniors may be a good idea, because it may contain more appropriate vitamin and mineral levels for people your age.

If you do take a multivitamin, it might be tempting to rely on it as an easy fix for an unhealthy diet, but that’s not its intended purpose. “Improving your diet is where you always want to start, and then consult with your primary care physician about whether a multivitamin or any other supplement may fit into that strategy,” Dr. Sesso says.

Posted by: Dr.Health

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