Vitamins, supplements are a ‘waste of money’ for most Americans

Lured by the allure of multivitamins and dietary supplements that fill in nutritional gaps in your diet, people in the US in 2021 spent close to $50 billion on vitamins and dietary supplements.

But Northwestern Medicine scientists say that for healthy, non-pregnant people in the United States, vitamins are a waste of money because there isn’t enough evidence that they help prevent cardiovascular disease or cancer.

“Patients ask all the time, ‘What supplements should I take?’ They’re wasting money and focusing on thinking there has to be a magic set of pills that will keep them healthy when we should all be following the evidence-based practices of eating healthy and exercising,” said Dr. Jeffrey Linder, chief of internal general services . medicine in the department of medicine at Northwestern University Feinberg School of Medicine.

Linder and other Northwestern Medicine scientists wrote an editorial to be published June 21 in JAMA endorsing new recommendations from the United States Preventive Services Task Force (USPSTF), an independent panel of national experts that regularly makes evidence-based recommendations about clinical preventive services.

Based on systematic review Out of 84 studies, the new USPSTF guidelines state that there was “sufficient evidence” that taking multivitamins, combined supplements, or individual supplements can help prevent cardiovascular disease and cancer in healthy, non-pregnant adults.

“The task force isn’t saying ‘don’t take multivitamins,’ but there’s this idea that if these were really good for you, we’d know by now,” Linder said.

The task force specifically recommends against taking beta-carotene supplements due to a possible increased risk of lung cancer and recommends against taking vitamin E supplements because it has no net benefit in reducing mortality, cardiovascular disease, or cancer.

“The harm is that by talking to patients about supplements during the very limited time we have to see them, we’re missing out on advice on how to really reduce cardiovascular risks, like exercising or quitting smoking,” Linder said.

More than half of Americans take vitamins. Why?

More than half of U.S. adults take dietary supplements, and supplement use is projected to increase, Linder and colleagues wrote in the JAMA editorial.

Eating fruits and vegetables is associated with a decreased risk of cardiovascular disease and cancer, they said, so it stands to reason that key vitamins and minerals could be extracted from fruits and vegetables, packaged into a pill, and save people the hassle and expense of maintaining a balanced diet. But, they explain, whole fruits and vegetables contain a mix of vitamins, phytochemicals, fiber, and other nutrients that likely act synergistically to provide health benefits. Micronutrients in isolated form may act differently in the body than when they are naturally packaged with a host of other dietary components.

Linder noted that people who are deficient in vitamins can still benefit from taking Dietary supplementssuch as calcium and vitamin D, which have been shown to prevent fractures and perhaps falls in older adults.

The new guidelines do not apply to pregnant people

The new USPSTF guidelines do not apply to people who are pregnant or trying to get pregnant, he said. JAMA editorial co-author, Dr. Natalie Cameron, an instructor of general internal medicine at Feinberg.

“Pregnant people should be aware that these guidelines do not apply to them,” said Cameron, who is also a Northwestern Medicine physician. “Certain vitamins, such as folic acid, are essential for pregnant women to support healthy fetal development. The most common way to meet these needs is by taking a prenatal vitamin. More data is needed to understand how specific vitamin supplements may modify the risk of adverse pregnancy outcomes and cardiovascular complications during pregnancy.”

Also, recent research from Northwestern found that most women in the US have poor heart health before they get pregnant. Cameron said that in addition to discussing vitamin supplementation, working with patients to optimize cardiovascular health before pregnancy is an important component of prenatal care.

Eating healthy and exercising is ‘easier said than done’

Dr. Jenny Jia, co-author of the JAMA editorial that studies the prevention of chronic diseases in low-income families through lifestyle interventions, said healthy nutrition can be a challenge when the US industrialized food system does not prioritize health.

“Adopt a healthy diet and getting more exercise, that’s easier said than done, especially among low-income Americans,” said Jia, an instructor of general internal medicine at Feinberg and a Northwestern Medicine doctor. “Healthy food is expensive and people don’t always have the means of finding environments to exercise, it may not be safe outdoors or they may not be able to afford a facility. So what can we do to try to make it easier and help support healthier choices?”

In recent years, Jia has been working with charitable food pantries and banks that supply free groceries to people in need to try to help customers choose healthier options from food pantries, as well as educate those who donate to provide healthier options or money.