What Kind of Medical Study Would Have Grandma Believe that Her Daily Multivitami

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Orthomolecular Medicine News Service, October 12, 2011

What Kind of Medical Study Would Have Grandma Believe that Her Daily

Multivitamin is Dangerous?

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by G. , PhD

(OMNS, Oct 12, 2011) A newly released study suggests that multivitamin and

nutrient supplements can increase the mortality rate in older women [1].

However, there are several concerns about the study's methods and

significance.

-- The study was observational, in which participants filled out a survey

about their eating habits and their use of supplements. It reports only a

small increase in overall mortality (1%) from those taking multivitamins.

This is a small effect, not much larger than would be expected by chance.

Generalizing from such a small effect is not scientific.

-- The study actually reported that taking supplements of B-complex,

vitamins C, D, E, and calcium and magnesium were associated with a lower risk

of

mortality. But this was not emphasized in the abstract, leading the

non-specialist to think that all supplements were associated with mortality.

The

report did not determine the amounts of vitamin and nutrient supplements

taken, nor whether they were artificial or natural. Further, most of the

association with mortality came from the use of iron and copper supplements,

which are known to be potentially inflammatory and toxic when taken by older

people, because they tend to accumulate in the body [2,3,4]. The risk from

taking iron supplements should not be generalized to imply that all vitamin

and nutrient supplements are harmful.

-- The study lacks scientific plausibility for several reasons. It

tabulated results from surveys of 38,000 older women, based on their recall of

what they ate over an 18-year period. But they were only surveyed 3 times

during that period, relying only on their memory of what foods and supplements

they took. This factor alone causes the study to be unreliable.

-- Some of these women smoked (~15%) or had previously (~35%), some drank

alcohol (~45%), some had high blood pressure (~40%), and many of them

developed heart disease and/or cancer. Some preexisting medical conditions were

taken into account by adjusting the risk factors, but this caused the study

to contradict what we already know about efficacy of supplements. For

example, the study reports an increase in mortality from taking vitamin D, when

adjusted for several health-relevant factors. However, vitamin D has

recently been clearly shown to be helpful in preventing heart disease [5] and

many types of cancer [6], which are major causes of death. Furthermore,

supplement users were twice as likely to be on hormone replacement therapy,

which

is a more plausible explanation for increased mortality than taking

supplements.

-- The effect of doctor recommendations was not taken into account. By

their own repeated admissions, medical doctors and hospital nutritionists are

more likely to recommend a daily multivitamin, and only a multivitamin, for

their sicker patients. The study did not take this into account. All it

did was tabulate deaths and attempt to correct the numbers for some prior

health conditions. The numbers reported do not reflect other factors such as

developing disease, side effects of pharmaceutical prescriptions, or other

possible causes for the mortality. The study only reports statistical

correlations, and gives no plausible cause for a claimed increase in mortality

from multivitamin supplements.

-- The effect of education was not taken into account. When a doctor gives

advice about illnesses, well-educated people will often respond by trying

to be proactive. Some will take drugs prescribed by the doctor, and some

will try to eat a better diet, including supplements of vitamins and

nutrients. This is suggested by the study itself: the supplement users in the

survey

had more education than those who did not take supplements. It seems

likely, therefore, the participants who got sick were more likely to have taken

supplements. Because those who got sick are also more likely to die, it

stands to reason that they would also be more likely to have taken

supplements. This effect is purely statistical; it does not represent an

increase in

risk that taking supplements of vitamins and essential nutrients will cause

disease or death. This type of statistical correlation is very common in

observational health studies and those who are health-conscious should not be

confounded by it.

-- The known safety of vitamin and nutrient supplements when taken at

appropriate doses was not taken into account. The participants most likely took

a simple multivitamin tablet, which contains low doses. Much higher doses

are also safe [4,7], implying that the low doses in common multivitamin

tablets are very safe. Further, because each individual requires different

amounts of vitamins and nutrients, some people must take much higher doses for

best health [8].

Summary: In an observational study of older women in good health, it was

said that those who died were more likely to have taken multivitamin and

nutrient supplements than those who did not. The effect was small, and does

not indicate any reason for disease or death. Instead, the study's methods

suggest that people who have serious health conditions take vitamin and

mineral supplements because they know that supplements can help. Indeed, the

study showed a benefit from taking B-complex, C, D, and E vitamins, and

calcium and magnesium. Therefore, if those wanting better health would take

appropriate doses of supplements regularly, they would likely continue to

achieve better health and longer life.

( G. is Research Associate Professor, University of

Pennsylvania Department of Neuroscience. He is a member of the Institute for

Neurological Sciences and the author of several dozen scientific papers and

reviews.)

References:

[1] Mursu J, Robien K, Harnack LJ, Park K, s DR Jr (2011) Dietary

supplements and mortality rate in older women. The Iowa Women's Health Study.

Arch Intern Med. 171(18):1625-1633.

[2] Emery, T. F. Iron and your Health: Facts and Fallacies. Boca Raton, FL:

CRC Press, 1991.

[3] Fairbanks, V. F. " Iron in Medicine and Nutrition. " Chapter 10 in Modern

Nutrition in Health and Disease, editors M. E. Shils, J. A. Olson, M.

Shike, et al., 9th ed. Baltimore, MD: & Wilkins, 1999.

[4] Hoffer, A., A. W. Saul. Orthomolecular Medicine for Everyone:

Megavitamin Therapeutics for Families and Physicians. Laguna Beach, CA: Basic

Health Publications, 2008.

[5] J, Hashmi O, Dutton D, Mavrodaris A, Stranges S, Kandala NB,

e A, Franco OH. Levels of vitamin D and cardiometabolic disorders:

systematic review and meta-analysis. Maturitas. 2010 Mar;65(3):225-36.

[6] Lappe JM, Travers-Gustafson D, Davies KM, Recker RR, Heaney RP. Vitamin

D and calcium supplementation reduces cancer risk: results of a randomized

trial. Am J Clin Nutr. 2007 Jun;85(6):1586-91.

[7] Padayatty SJ, Sun AY, Chen Q, Espey MG, Drisko J, Levine M. Vitamin C:

intravenous use by complementary and alternative medicine practitioners and

adverse effects. PLoS One. 2010 Jul 7;5(7):e11414.

[

8] RJ, Deason G. (1967) Individuality in vitamin C needs. Proc

Natl Acad SciUSA.57:16381641.

Also of Interest:

Orthomolecular Medicine News Service, April 29, 2010.

Multivitamins Dangerous? Latest News from the World Headquarters Of

Pharmaceutical Politicians, Educators and Reporters.

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