Thanks for tracking that down. Here’s another angle. At Amazon a cheap multi-V will cost you 4-6 cents per tablet. That’s $15 - $22 per year (lower for me, who takes them sporadically for better or worse). Not peanuts, but fairly low as far as annual health care or food costs are concerned. So what the heck.
I don’t consider the pro multi-V case to be particularly strong, but I don’t see it as dubious either. Somewhere in between.
ETA: Then again, other Multi-V’s can run to 14 cent/pill and up.
So why aren’t multivitamins useful? Are the required amounts of vitamins for good health so low that even people that don’t eat many fruits/vegetables are easily able to get enough? Are enough commercial foods artificially fortified with vitamins that supplements are extraneous? Or are we not getting enough vitamins, but for some reason taking them in pill form doesn’t work?
While the amounts in many Americans diets are below the recommended daily allowances they are enough to stave off frank deficiencies and many others have even the RDA without adequate fruits and vegetables thanks to fortification of foods.
Yes, certain very limited diets and/or health conditions can cause deficiencies that should be treated, but those are very uncommon in a population of average Americans eating a typical American diet.
The benefits above and beyond avoiding frank deficiencies of diets higher in vitamins and minerals are therefore not from the vitamins in isolation; they have to do with the complete package the vitamins are delivered in. That package, a diet high in vegetables, fruits, and whole grains, is associated with a host of good health outcomes, from less dementia to less heat disease to cancer deaths and more; adding a multi instead is not.
Why don’t they just add the stuff in that “package” to the multivitamins? Problem solved.
And why don’t they recommend a daily dose of that stuff, instead of using the roundabout method of recommending a higher then necessary dosage of a compound that just happens to be found in association with that stuff in some foods.
I question the “counterargument”.
Looking through relevant parts of the paper (not sure if this link will work for everyone), I don’t see any nutritional assessment of the physicians included in the study. Is there any reason to assume they are health-conscious and well-nourished beyond their educational/professional status?
Physicians tend to work long hours and grab at whatever’s handy for meals (which is not conducive to eating a balanced diet with lots of fruits and veggies). It is also not necessarily true that they are free of bad lifestyle habits as compared to the general population (though likely that there are comparatively far fewer smokers).
It remains true that the onus is on supplement companies and those who tout the benefits of vitamins/supplements to show that such interventions are beneficial and cost-effective.
I’ve heard this argument regularly, not the least source for which is Mrs. B., whose mother assured her 40+ years ago that MVs were a waste of money.
So I wave my Sam’s Club MV at her and say, “Can you argue that this bundle of positive nutrition, even if unnecessary, is not worth 2-1/2 cents?”
I agree that very few people should be taking or spending a lot of money on general vitamin supplements, but if the argument comes down to “possibly unneeded, but no actual negatives, and a slim chance of doing good” vs. about $20 a year, it’s a no brainer.
People who are spending significant multiples of that on excess combinations, brand-name products and premium mixtures… are probably wasting their money to no good end, and can do just as well with any FDA-approved equivalent in no-name bulk.
That’s a weird argument to make since there have been posts in this thread showing research indicating there are negatives to taking vitamin supplements. Too high a dose in particular is a relatively well-known danger.
The FDA does not approve supplements so there is no such thing as a “FDA-approved equivalent”. The manufacturer can bring them to market without any FDA approval process. The FDA only takes action if there is something deemed unsafe on the market. In this case, I believe unsafe means a supplement causing immediate harm (e.g. tainted and causing illness) rather than looking at long-term results of taking the supplement.
Vitamin supplements are regulated the same way as herbal supplements, which means barely at all.
I believe the FDA does take action if the manufacturer is making baseless health claims.
OK, so I buy that multivitamins are pretty much useless unless you have a vitamin deficiency.
What I want to know is, how do I know if I have a vitamin deficiency? I mean, I try to eat healthy foods, but there are a lot of vitamins and it seems pretty likely I could be missing out on one of them. By the time I start having symptoms, go to a doctor, and get diagnosed, have I maybe already done significant damage to my health? In which case, maybe it’s worth taking the multivitamin “just in case”?
I get that too much of certain vitamins is dangerous, too, but maybe that just means I should take a lower-dose multivitamin instead of one of the “600% of the RDA for X” ones?
I suspect that fish oil is a slightly different category than vitamins and minerals. I didn’t read through the articles, though, so if it got lumped in - carry on.
(It does wonders for my dog’s coat.)
Yes. Yes I can.
2-1/2 cents > 0
There.
It isn’t.
You know what you have when you add all the stuff in that “package”? Real vegetables, fruits and whole grain foods.
More precisely put we don’t know what it is about that packaging, what other substances in what balances in what matrices that does it. Flavenoids and other phytochemicals? Maybe. Various sorts of fiber? Maybe. No one really knows? Definitely.
It really is not so hard of a concept. Eating real vegetables, fruits and whole grains, exercising regularly (at least avoiding inactivity), drinking no more than in moderation, and not smoking, will help people live longer and live better. Less likely to have their minds fog up as they age including to the point of dementia, less likely to have diabetes, less likely to have strokes or heart disease, less likely to die of cancer, less likely to get sick, less likely to get weak … so on. Multis do not work as a short cut.
Care to elaborate on this? That seems a pretty sweeping statement to make without knowing anything about my diet.
Information like “People who eat at least X servings of A, B, and C aren’t likely to have any vitamin deficiencies” would be useful to me… “You probably aren’t missing any vitamins” (based on nothing but the fact that I’m an American who “tries to eat healthy”, I guess) doesn’t do much for my confidence.
For what it’s worth, I’m a vegetarian. I eat salad (spinach, kale, romaine), apples, bananas fairly regularly. So maybe I just need to worry about my protein intake, and vitamin B-12? But hell if I know.
I’ve also lost 30 lbs recently (about 15% of my body weight), so I wonder if the fact that I’m under-consuming calories means I’m more likely to be under-consuming vitamins as well.
tim314,
You had already told me that you try to eat healthy foods. Frankly that is more than a large fraction, maybe even a majority of Americans, and the majority of Americans are not missing out on any.
The evidence is solid that for the typical American, whose diet is pretty much crap, multis add no benefit. Even they get enough. You do better than crap. Moreso true for you.
Yes, if you are a vegan you need to be aware of adequate protein and B-12 sources. Not to hard to do.
Fair enough, DSeid. Thanks for the reply.
Say what you will about them being a waste of money, but 5mg of Pregnenolone subling + one cap of red ginseng every AM and Im the life of the party! Cheap buzz, good mood, and I get my house cleaned damn fast too! 
This is something the wife and I have been wrestling with. We take a multivitamin once a day and have for years. Centrum brand. Figure it can’t hurt and maybe it does some good. It must impart some value, because I had to stop taking it a week or so before my colonoscopy due to the iron content, so it’s definitely giving me iron. But I’ve always wondered how worth it really is.
O but you can do so much more than just that safe little One-A-Day! Be wild!
I take a multivitamin because I know I am a crappy eater and have been since I started living by myself (many decades). Yes, I know I should eat properly. I should also do many other things that I don’t. I figure taking a multivitamin is a concession to good health and is extremely convenient (important for lazy people like me).
I’m not convinced that I would still need a multivitamin if I ate properly (although since they don’t cost much I’d probably still take them even after somebody beat me with a stick to eat properly).