Perspective > Medscape > Impact Factor with F. Perry Wilson

COMMENTARY – It’s Official. Vitamins Don’t Do Much for Health

F. Perry Wilson, MD, MSCE


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Description générée automatiquement Medscape Logo Wednesday, June 29, 2022

This transcript has been edited for clarity.

Welcome to Impact Factor, your weekly dose of commentary on a new medical study.

I’m Dr F. Perry Wilson of the Yale School of Medicine.

Vitamins. If you are like the majority of American adults, you took a vitamin or supplement recently.

Over-the-counter sales of these products in this country amount to over $30 billion a yearThat’s more than the market for statins — and vitamins aren’t covered by insurance.

For there to be a $30 billion market, there must be some pretty convincing evidence that vitamin supplements work to improve health, right?

Well, in the most thorough meta-analysis to date, researchers from Kaiser-Permanente crunched the numbers from virtually every randomized trial of vitamin supplements in adults to conclude that, basically, they do nothing.

Or, as we say in nephrology: Vitamins give you expensive pee.

As many of you know, the US Preventive Services Task Force (USPSTF) makes evidence-based recommendations to the American people about a wide variety of health behaviors, from aspirin for primary prevention to screening for lung cancer.

The USPSTF tasked researchers with updating the data on vitamin supplementation with two important outcomes in mind: cancer and cardiovascular death.

Why vitamins?

Because the observational data are clear and compelling. People with vitamin deficiencies are at higher risk for these bad outcomes.

Even people with lower levels of certain vitamins, not in the deficiency range, are at higher risk for cancer and cardiovascular disease.

It stands to reason that if lower levels are associated with bad outcomes, and supplements prevent you from having lower vitamin levels, then supplements could improve those outcomes.

The researchers identified 87 randomized controlled trials of adults where at least one vitamin or a multivitamin was being evaluated.

Caveat: These were general-population studies, not studies of people with known vitamin deficiencies.

The results should not necessarily be generalized to those with known deficiencies or disease states that promote deficiency.

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