Most of the popular vitamin and mineral supplements people take do not boost health

Journal of the American College of Cardiology : Supplemental Vitamins and Minerals for CVD Prevention and Treatment

Some popular vitamin and mineral supplements could even increase the risk of death, scientists claim. Their research concludes only folic acid is proven to reduce risks of heart disease or stroke.

2018 Study Abstract

The authors identified individual randomized controlled trials from previous meta-analyses and additional searches, and then performed meta-analyses on cardiovascular disease outcomes and all-cause mortality. The authors assessed publications from 2012, both before and including the U.S. Preventive Service Task Force review. Their systematic reviews and meta-analyses showed generally moderate- or low-quality evidence for preventive benefits (folic acid for total cardiovascular disease, folic acid and B-vitamins for stroke), no effect (multivitamins, vitamins C, D, β-carotene, calcium, and selenium), or increased risk (antioxidant mixtures and niacin [with a statin] for all-cause mortality). Conclusive evidence for the benefit of any supplement across all dietary backgrounds (including deficiency and sufficiency) was not demonstrated; therefore, any benefits seen must be balanced against possible risks.

Conclusions

Since the 2013 to 2014 assessment and report of the USPSTF, the most notable finding was the effect of folic acid in reducing stroke and CVD, with significance driven by the 5-year 20,000 Chinese CSPPT RCT, which was supported by the reduction in stroke seen in RCTs of B-complex vitamins in which folic acid was a component. Vitamin B3 (or niacin) might increase all-cause mortality, which was possibly related to its adverse effects on glycemic response. Antioxidant mixtures did not appear to benefit CVD but might increase all-cause mortality. Although sufficient studies on vitamin D exist, to be confident that there is no all-cause mortality effect, further studies on multivitamins, the most commonly used supplement, may still be useful, because of the marginal benefit seen in our analysis. In the absence of further studies, the current data on supplement use reinforce advice to focus on healthy dietary patterns, with an increased proportion of plant foods in which many of these required vitamins and minerals can be found.

Potential inverse association between maternal multivitamin supplement use and ASD in offspring

Antenatal nutritional supplementation and autism spectrum disorders in the Stockholm youth cohort: population based cohort study

What is already known on this topic

Evidence from observational studies is inconsistent about whether maternal supplementation with multivitamins, iron, or folic acid is protective against autism spectrum disorder (ASD) in offspring
Although the cause of autism spectrum disorder may differ by presence of intellectual disability, few studies have examined relations between nutritional supplements and ASD based on level of cognitive function

What this study adds

This population based study of a large cohort in Stockholm supported a possible inverse association between maternal use of multivitamin supplements in early pregnancy and ASD with intellectual disability in offspring compared with no maternal use of multivitamins, iron, or folic acid

2017 Study Abstract

Objective
To determine whether nutritional supplementation during pregnancy is associated with a reduced risk of autism spectrum disorder (ASD) with and without intellectual disability in offspring.

Design
Observational prospective cohort study using multivariable logistic regression, sibling controls, and propensity score matching.

Setting
Stockholm County, Sweden.

Participants
273 107 mother-child pairs identified through population registers. The study sample was restricted to children who were aged 4 to 15 years by the end of follow-up on 31 December 2011 and were born between 1996 and 2007.

Exposures
Multivitamin, iron, and folic acid supplement use was reported at the first antenatal visit.

Main outcome measure
Diagnosis of ASD with and without intellectual disability in children determined from register data up to 31 December 2011.

Results
Prevalence of ASD with intellectual disability was 0.26% (158 cases in 61 934) in the maternal multivitamin use group and 0.48% (430 cases in 90 480) in the no nutritional supplementation use group. Maternal multivitamin use with or without additional iron or folic acid, or both was associated with lower odds of ASD with intellectual disability in the child compared with mothers who did not use multivitamins, iron, and folic acid (odds ratio 0.69, 95% confidence interval 0.57 to 0.84). Similar estimates were found in propensity score matched (0.68, 0.54 to 0.86) and sibling control (0.77, 0.52 to 1.15) matched analyses, though the confidence interval for the latter association included 1.0 and was therefore not statistically significant. There was no consistent evidence that either iron or folic acid use were inversely associated with ASD prevalence.

Conclusions
Maternal multivitamin supplementation during pregnancy may be inversely associated with ASD with intellectual disability in offspring. Further scrutiny of maternal nutrition and its role in the cause of autism is recommended.

  • Antenatal nutritional supplementation and autism spectrum disorders in the Stockholm youth cohort: population based cohort study, BMJ 2017;359:j4273, 04 October 2017.
  • Featured image credit @bmj_latest.

When the sugar industry downplays the dangers of sweets and shifts the blame to fat

Adam Ruins Everything – July 2017

The bitter truth about sugar : fat isn’t the only thing that makes you, well, fat. Adam busts some dietary myths wide open.

Why Dietary Supplements are just Modern Day Snake Oil

Adam Ruins Everything – September 2016

In the early 1900’s, you could put anything in a bottle and sell it. Turns out that’s still true today.

The Reason we believe Vitamins are Good for Us (they’re Not)

Adam Ruins Everything – December 2015

Adam Conover tells us the real story behind the vitamin supplement overblown health craze.

Taking extra vitamins and minerals can do more harm than good and increase cancer risk

Researcher warns of increased cancer risk with excess supplement use

vitamins image
… “We found that the supplements were actually not beneficial for their health. In fact, some people actually got more cancer while on the vitamins.”…  Image via denAsuncioner.

Popular notion holds that dietary supplements are good for our health. But increasingly, research is suggesting otherwise. At the 2015 American Association for Cancer Research Annual Meeting, one researcher discusses a number of studies associating excess use of over-the-counter dietary supplements with increased risk of cancer.

Sources and more information

Vitamin drinks: little evidence that consumers benefit from the micronutrients found in those products

Some nutrition scientists are concerned that with the profusion of fortified foods, beverages and supplements, many people may be ingesting levels of vitamins and other nutrients that are not only unnecessary, but potentially harmful…

vitamin-drinks image
Some nutrition scientists are concerned that with the profusion of fortified foods, beverages and supplements, many people may be ingesting levels of vitamins and other nutrients that are not only unnecessary, but potentially harmful… Image via Julien GONG Min.

2014 Study Abstract

Changing regulatory approaches to fortification in Canada have enabled the expansion of the novel beverage market, but the nutritional implications of these new products are poorly understood. This study assessed the micronutrient composition of energy drinks, vitamin waters, and novel juices sold in Canadian supermarkets, and critically examined their on-package marketing at 2 time points: 2010-2011, when they were regulated as Natural Health Products, and 2014, when they fell under food regulations. We examined changes in micronutrient composition and on-package marketing among a sample of novel beverages (n = 46) over time, compared micronutrient content with Dietary Reference Intakes and the results of the 2004 Canadian Community Health Survey to assess potential benefits, and conducted a content analysis of product labels. The median number of nutrients per product was 4.5, with vitamins B6, B12, C, and niacin most commonly added. Almost every beverage provided at least 1 nutrient in excess of requirements, and most contained 3 or more nutrients at such levels. With the exception of vitamin C, there was no discernible prevalence of inadequacy among young Canadian adults for the nutrients. Product labels promoted performance and emotional benefits related to nutrient formulations that go beyond conventional nutritional science. Label graphics continued to communicate these attributes even after reformatting to comply with food regulations. In contrast with the on-package marketing of novel beverages, there is little evidence that consumers stand to benefit from the micronutrients most commonly found in these products..

Sources and more information
  • NCBI PubMed PMID: 25577949, Appl Physiol Nutr Metab. 2015 Feb;40(2):191-8. doi: 10.1139/apnm-2014-0252. Epub 2015 Jan 12.
  • Are Vitamin Drinks a Bad Idea? well.blogs.nytimes, JANUARY 30, 2015.

Dietary supplements, fortified food and drinks: can they be detrimental to our health?

Nutrient intakes are exceeding the safe limits established by the Institute of Medicine

vitamin-water van image
Some nutrition scientists are concerned that with the profusion of fortified foods, beverages and supplements, many people may be ingesting levels of vitamins and other nutrients that are not only unnecessary, but potentially harmful… Image via fabonthemoon.

2014 Study Abstract

Dietary supplements are a multi-billion dollar industry in the U.S., and their use is increasing exponentially. Additionally, many foods and beverages are increasingly being fortified with single or multiple vitamins and minerals. Consequently, nutrient intakes are exceeding the safe limits established by the Institute of Medicine. In this paper, we examine the benefits and drawbacks of vitamin and mineral supplements and increasing consumption of fortified foods (in addition to dietary intake) in the U.S. population. The pros and cons are illustrated using population estimates of folic acid, calcium and vitamin D intake, highlighting concerns related to overconsumption of nutrients that should be addressed by regulatory agencies.

Sources and more information
  • Food Fortification and Supplement Use – Are there Health Implications? NCBI PubMed PMID: 25036360, Crit Rev Food Sci Nutr. 2014 Jul 18:0.
  • Are Vitamin Drinks a Bad Idea? well.blogs.nytimes, JANUARY 30, 2015.

Recalled, drug-tainted dietary supplements still available for purchase years later

Dietary supplements continue to contain illegal drugs even after recalls

Reuters Top News
Doctors are urging the FDA to be more proactive in regulating supplement manufacturers that fail to follow the agency’s own guidelines.

The US Food and Drug Administration (FDA) bans the use of class I drugs in dietary supplements when products have the reasonable possibility of causing serious adverse health consequences or death. Recently, the FDA has used class I drug recalls in an effort to remove dietary supplements adulterated with pharmaceutical ingredients from US markets.

A recent study found this ruling is largely ignored by drug manufacturers ; many dietary supplements that have been recalled can still be purchased years later, and they often contain the same banned ingredients that led to their recall in the first place…

Sources and more information:
  • Presence of Banned Drugs in Dietary Supplements Following FDA Recalls, JAMA, 1917421 2014;312(16):1691-1693. doi:10.1001/jama.2014.10308.
  • Recalled, drug-tainted supplements still available for purchase, Reuters, Oct 21, 2014.
  • Dietary supplements continue to contain illegal drugs even after recalls, MNN, Oct 22, 2014.
  • FDA’s Dietary Supplement Recall Continues To Be Ignored: What Dangers Do Banned Ingredients Pose?, Medical Daily, Oct 22, 2014.

Benefits and Dangers of Supplements

Pregnant women should stay away from all supplements with the exception of a prenatal vitamin

There are not as many regulations or as much research done on supplements as there is for medications, so the most important thing is to make sure you talk to your doctor.

From multivitamins to supplements that pledge to help with everything from depression to treating athlete’s foot, whole stores are filled with these alternative medications. With so many options out there it can be difficult for patients to know what is beneficial or even where to start.

Because there is little research on the effects of supplements on a fetus Michelfelder suggests pregnant women stay away from all supplements with the exception of a prenatal vitamin.

Read What you should know about the benefits, dangers of supplements, LoyolaMedicine, Newswire.