Brandon Barrett's List: Sales/Advertising

• Parents of our patients often ask whether we recommend multivitamins for their  children. In most situations, the answer is no. This takes a lot  of them by surprise.

• The explanation is actually somewhat complicated. Foods that are rich in  vitamins are definitely a good thing, and many scientific studies have proven  the benefits of a diet abundant in fruits, vegetables, whole grains, fish, lean  meats, and low-fat milk. But the vitamins themselves, when taken in pill or  liquid form, can actually be harmful.
• Our bodies use nutrients most effectively when we consume them directly from  natural food sources. The healthful advantages of these nutrients depend on  their food “packaging” to provide their full benefit. Researchers have not been  able to find any benefit from most vitamins when they are taken in pill form  rather than in their natural state. None of the major medical associations,  including the American Academy of Pediatrics, The American Medical Association,  The American Institute of Nutrition, The American Society for Clinical  Nutrition, or The American Dietetic Association, recommend routine use of  multivitamins.
  

  • Effects
• In addition, many vitamins can actually be harmful if taken in excess. Too much  Vitamin A, for example, can cause birth defects, liver abnormalities, reduced  bone mineral density, and brain disorders. Too much vitamin B6 can result in  nerve damage to the arms and legs. Toxicity from these vitamins occurs almost  exclusively as a result of taking vitamin supplements. Supplements of some  vitamins and minerals can also block the body’s ability to absorb other  essential nutrients from foods.

  • Effects

• Many parents give their children vitamins because they believe they are  helping to prevent diseases. However, this is unlikely to be true. For years  many people believed in the benefits of extra Vitamin C, particularly in  fighting colds. But in every careful scientific study of the effectiveness of  taking vitamin C supplements, no benefit whatsoever has been found. Medical  researchers have also studied whether adults taking multivitamin supplements are  protected from cancer. But shockingly, many of these studies found that taking  vitamin supplements actually increased the risk of getting cancer or dying from  it. A recent study performed at the National Cancer Institute found that men who  took more than seven multivitamins per week significantly increased their risk  of prostate cancer. Several studies of adults taking extra vitamin E,  beta-carotene, and vitamin A have shown an increased risk of developing cancer  and an increased rate of death from all causes, without showing any overall  health benefit.

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• Consumer Reports warns about buying ultra-cheap vitamins from closeout and  dollar stores. In testing, half the tested vitamins did not contain the claimed  amount of at least one nutrient, and several didn't dissolve enough for the  nutrients to even be absorbed by the body. However, store brands from well-known  retailers like Wal-Mart, Walgreens, Kroger and Eckerd aren't included in this  group. In fact, many generic and store-brand vitamins from major retailers  perform just as well as well-known brands like Centrum and One-A-Day in analysis  by Nutrition Action Healthletter.
• In January 2007, ConsumerLab.com reported lead contamination in The Vitamin  Shoppe's Multivitamins Especially for Women. The Vitamin Shoppe quickly stopped  selling the product and has agreed to settle a class-action suit.
• In another case, ConsumerLab.com found a children's vitamin, Hero Nutritionals  Yummi Bears, contained 5400 IU of vitamin A in the form of retinol per daily  dose. According to the Institute of Medicine, the safe upper limit is just 3000  IU for four-to-eight-year-olds and 2000 IU for kids between one and three (they  only need around 1000 IU a day).
• Several multivitamins have been recalled because they did not have  child-resistant packaging despite containing iron, which can cause serious  injury or death if ingested by children

• Experts warn that liquid and chewable vitamins are often lacking compared to  their pill-form counterparts, so don't assume that different forms of the same  multivitamin are equal without comparing the labels. It's also best to avoid  vitamins that contain herbs or that make extra claims on the label for weight  loss, energy, stress or "maximum" benefit. Such claims haven't been proven in  testing.

• Consumers are lambasted by advertising for vitamins that help you lose  weight, vitamins that lower cholesterol and vitamins that give you energy.  However, none of that advertising answers the essential question: Do you really  need a multivitamin? Health experts agree that certain groups of people can  clearly benefit from a multivitamin. These include pregnant or breastfeeding  women, or women who are trying to conceive. Multivitamins are also recommended  for people with nutrient-depleting diseases of the gastrointestinal system,  diabetes or cancer. Those who are strict vegetarians and people on restricted  diets should also consider a multivitamin to replace nutrients they may not be  receiving through diet alone.
• However, for most other people, getting vitamins and minerals from food is best  because interactions between foods may offer benefits that can't be matched by  supplements. The reality, however, is that many of us don't eat healthy enough  diets to get all of our DV of vitamins and minerals. In 2002, the Journal of the  American Medical Association recommended that all adults supplement their diets  with a multivitamin, but a review by a federal panel in May 2006 concluded that  there's no evidence to recommend for or against multivitamins for people who  don't fall into one of the risk groups mentioned above.

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