June 21, 2022 – If you're healthy and not pregnant, you probably don't need vitamins or supplements, an expert panel has concluded.
The United States Preventive Services Task Force has updated its recommendation on the use of vitamins and supplements based on an evidence report that included 84 studies, 52 of them new since it last weighed in on the topic in 2014. The new findings were largely similar to those previous conclusions.
The report, led by Elizabeth A. O'Connor, PhD, with the Kaiser Permanente Center for Health Research in Portland, OR, was published today in TheJournal of the American Medical Association.
The task force, an independent panel of national experts, found there was not enough evidence that supplements help prevent cardiovascular disease, including heart disease and stroke, or cancer, the two top causes of death in the U.S. and both prevention targets for supplements.
‘If These Were Really Good for You, We'd Know by Now’
"The task force is not saying 'don't take multivitamins,' but there's this idea that if these were really good for you, we'd know by now," Jeffrey Linder, MD, chief of general internal medicine at Northwestern University Feinberg School of Medicine in Chicago, said in a news release. Linder and colleagues wrote an editorial addressing the findings.
"Patients ask all the time, 'What supplements should I be taking?' They're wasting money and focus 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," Linder said.
The task force’s guidance does not apply to children, to people with a known nutritional deficiency, or those who are hospitalized.
The task force went even further in its recommendations regarding taking beta carotene – a red-orange pigment found in plants that the body converts into vitamin A – to prevent cardiovascular disease or cancer, citing "a possible increased risk of mortality, cardiovascular mortality, and lung cancer."
The task force “concludes with moderate certainty that the harms of beta carotene supplementation outweigh the benefits for the prevention of cardiovascular disease or cancer," the authors wrote.
It also singled out vitamin E.
The task force “also concludes with moderate certainty that there is no net benefit of supplementation with vitamin E for the prevention of cardiovascular disease or cancer," according to the report.
$50 Billion a Year Spent on Supplements
The news may come as a surprise to many, as Americans spent almost $50 billion on vitamins and supplements last year, and supplement companies spent about $900 million on marketing.
What does help decrease heart disease and cancer risk is a healthy diet, including fruits and vegetables, the task force authors wrote in the editorial. While it's reasonable to think that nutrients could be extracted from fruits and vegetables and packaged into pills for the same benefit, there's no evidence that's the case.
They explained that "whole fruits and vegetables contain a mixture of vitamins, phytochemicals, fiber and other nutrients that probably act synergistically to deliver health benefits. Micronutrients in isolation may act differently in the body than when naturally packaged with a host of other dietary components."
In addition to no evidence of benefit, potential for harm is often lost on consumers.
Authors of the editorial, written by Linder, Jenny Jia, MD, and Natalie A. Cameron MD, all with the Feinberg School of Medicine, said many people view supplements as, at worst, benign products used for disease prevention, but they caution little is known about potential harms.
Supplements Relatively Unregulated
In the U.S., dietary supplements are relatively unregulated, they noted. They do include disclaimers that they have not been evaluated by the FDA.
"The very real harms of supplements are not studied as extensively as those of pharmaceuticals," they wrote.
Cameron emphasized the task force’s recommendations do not apply to pregnant people or people trying to get pregnant.
"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 to take a prenatal vitamin," she said in a news release.
Focusing on vitamins and supplements also may represent a "harmful distraction," the authors said, taking time and resources away from focusing on evidence-based preventive care including healthful diets, getting exercise, maintaining a healthy weight, and not smoking.