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      Superfluous Supplements?

      Vitamin supplements have become a $12 billion industry in the U.S.
      But for most Americans, they’re a waste of money, and may even be

      by Benjamin Caballero, M.D., Ph.D.

      The Surgeon General has never recommended that healthy adults take
      vitamin supplements. Nor has the American Medical Association, the
      National Cancer Institute, the Food and Nutrition Board, or any other
      association that establishes our nation’s dietary guidelines or health policies.
      Yet half of all Americans regularly consume vitamin supplements and other
      “nutriceuticals” such as herbs — many in response to widely publicized reports
      that large doses of certain nutrients may offer protection against diseases such
      as heart disease and cancer.

      . . . But in many cases, the $12 billion that Americans spend each year on
      these supplements is a waste of money.

      . . . It’s true that some studies show that certain nutrients may provide some
      protection against heart disease, cancer and other conditions, particularly the
      antioxidant vitamins C, E and beta-carotene in doses greater than the
      Recommended Daily Allowance (RDA).

      . . . But there are also controversial results, including one study that found that
      smokers taking beta-carotene supplements had an increased incidence of lung
      cancer compared to those who didn’t take the supplements. One theory is
      that these long-term smokers may have already had microscopic undiagnosed
      lung cancer, and the supplements may have promoted its growth.

      . . . Right now, we simply don’t know enough about the long-term effect of
      high-dose supplements to recommend that the average healthy American take
      them. We do know that many nutrients can cause side effects and other
      complications when taken in doses that are 5, 10 or even 20 times above the

      The Problems with Pills

      . . . There are, however, some groups of otherwise healthy people who we
      know benefit from supplementation:

      Children who are breast-fed should receive supplementation of
      vitamins A, C and D, and there is a preparation called Trivisol that is
      the standard issue to these babies;

      Pregnant and lactating women should take a multivitamin that
      contains additional folic acid, iron and calcium beyond what they’d get
      from their diet, and most of these women get these supplements from
      their doctors;

      Elderly people may also benefit from vitamin supplements, because
      the aging process does impair the way the body can absorb certain
      nutrients. This issue is currently being considered in the ongoing revision
      of the RDA’s.

      . . . To prevent deficiencies, the average healthy American eating a sensible
      diet does not need vitamin supplements. A good diet can provide all the
      nutrients your body needs — and “megadoses” of many nutrients are just
      eliminated when you urinate. Also, when you eat certain foods, such as fruits
      and vegetables, you’re not only getting the essential vitamins and minerals, but
      also many different phytochemicals, some of which are believed to help block
      the formation of tumors.

      . . . The money wasted on high-dose supplements isn’t my only concern about
      our nation’s vitamin supplement craze.

      Some people have come to rely on supplements as a “magic
      bullet.” They assume that if they just pop a pill in the morning, they
      may get all the protection they need against diseases like heart disease
      and cancer. So they may not be as committed to eating more fruits and
      vegetables, exercising one hour every day, quitting smoking and
      avoiding some of the high-fat foods that may be contributing to obesity
      and other health problems.

      The advice people get from the media isn’t always accurate or
      complete. For instance, there have been a couple of good studies that
      have been publicized in the media showing that large doses of vitamin E
      may reduce the risk of some forms of cancer, so it’s very
      understandable that many people want to take vitamin E supplements.
      The potential adverse effects of high-dose vitamin E (and other
      vitamins) are not always publicized. Vitamin E can impair coagulation,
      which may increase the risk of bleeding, and could possibly lead to
      problems in susceptible persons.

      The reported “benefits” advertised in health-food stores of
      some vitamins aren’t always based on scientific evidence. Go to
      a health food store and you may be led to believe that if you’re feeling
      stressed, tired or depressed, you may get relief by taking certain
      supplements. That simply isn’t the case, and these claims are sometimes
      made because vitamin and herbal supplements currently are not

      Benjamin Caballero, M.D., Ph.D., is Director of the Johns Hopkins
      Division of Human Nutrition and The Center for Human Nutrition. A
      Professor of International Health, he serves on the Food and Nutrition
      Board, a committee of the National Academy of Sciences that sets
      dietary guidelines for the U.S. population.

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