Happy 2014 all!

It’s that time of year when everyone is recovering from their health indiscretions over the holiday. After the Thanksgiving and holiday goodies and festivities, many will now make the choice to focus on better body care as their New Year’s resolution.

As my clients and I focus in on their individualized wellness program, I have often been asked what multivitamin I recommend. Being a devoted naturopathic and functional medicine practitioner, the answer will always be based on their needs and their specific biochemistry derived from their lab work in combination with their health history and symptoms.

Recently, my inbox was flooded with the evaluation of the use of multivitamins for health…again.

Many well-known researchers and integrative practitioners were responding to the the backlash from two recent studies and an editorial published in the December 17^th issue of the Annals of Internal Medicine. The studies attempted to discredit the value of multivitamin use in those with cognitive dysfunction and cardiovascular health. These studies were flawed in a variety of ways.

In fact, according to Science Daily, most large clinical trials of vitamin supplements are of little value because of the methodology used to study the effects.

Below I’ll review some of the problems related to the above studies. The conclusion that multivitamins were unnecessary was based on the authors’ faulty research methods which include:

1. There was no measure of baseline nutrient levels at the start of the trials or an establishment of absorption of them at the conclusion of the trials. Lack of determining the difference in nutrient levels in the blood from the beginning to the end of the studies makes it hard to prove whether multivitamins had an effect on the results.

2. The need for the multivitamin was ignored. For example, deficient individuals would benefit more than those who were already sufficient in the selected vitamins. A study blindly prescribing nutrients to everyone in a population is equivalent to giving everyone the same drug, regardless if symptoms are present, and expecting everyone to benefit from them. That’s bad medicine.

3. There were problems in the comparison groups on which the results were based. That is, how a population would fare with an intervention needs a similar comparison group of those who didn’t receive the intervention to see if an effect was accomplished.

• For the cognitive group, there was poor tracking methods used for adherence of the treatment. The treatment group was considered to have met criteria for comparison by only having to report taking the vitamins two-thirds of the allotted time. Is it really wise to base results on cognitive issues based on cognitively impaired individuals recalling if they took the intervention?
• In the cardiovascular trial, the multivitamin subjects had a larger number of diabetics in their group, making them more susceptible to cardiovascular risk to begin with. (life extensions). Furthermore, 46% of the participants stopped taking the multivitamins in the middle of the study. How can conclusions be made if almost half of those being studied no longer are taking the intervention?
• Finally, the success rate for the cardiovascular intervention was set too high at a 25% reduction in cardiovascular events with one intervention. That’s equivalent to saying a low potency and non-individualized nutrient protocol would prevent one in four cardiovascular events.

4. Treating people broadly with a low quality multivitamin without testing for absorption is not controlling for confounding factors. For example, was it the fillers, outer shell, dyes that competed with the efficacy of the multivitamin?

5. The correct form and dosages were not used.

• In the cardiovascular trial, only one form of vitamin E was used. The gamma-tocopherol was not included in the vitamin, and that form has been found to be most supportive of heart health.
• Synthetic and commercially available multivitamins found over-the-counter generally don’t use food-based sources. Rather, they are synthetically produced from chemicals which will alter the way the vitamins are used in the body.

6. The balance of nutrients was not considered. For example, Centrum Silver, used in one of the studies, does not have the proper amount of copper to balance out zinc. This can affect cardiovascular health.

Alan Gaby recently discussed this in his article in Huffington Post, “The study that included five nutrients gave 20 mg of zinc per day with no copper for 7.5 years. Centrum Silver does contain copper, but for approximately 70 percent of the 11-year study, the form of copper in the product was cupric oxide, (11) which cannot be absorbed by humans. (12)”

7. Results were over-hyped.  The cognitive and cardiovascular benefits of multivitamins in the poorly designed study did show a small benefit, but it did not reach statistical significance and was not reported as such. How could it with the cognitive trial group only taking the intervention two-thirds of the time and almost half of the cardiovascular participants dropping out in the middle of the study?

8. Most people do need additional support of the right vitamins. Read why on my saratoga.com blog.

Learn more about empowering your health at my upcoming workshops and teleseminars.

References:

Science Daily. Most Clinical Studies On Vitamins Flawed by Poor Methodology. sciencedaily.com. Dec. 30, 2013.

Gossard, B, Schmid, K. Huber, L, & Joyal, S. Flawed Research Used to Attack Multivitamin Supplements. Life Extension.

Dr. Stephen Sinatra. What’s a Bigger Waste of Money—Multivitamins or Questionable Studies? drsinatra.com. 12/17/2013.

Larson, C. The Necessity of a Good Multivitamin . ModernHCP.com  December 21, 2013

Wetherby, C. Vitamin Pills Take a Hit: Multivitamins and vitamin D doses above the RDA called unnecessary for well-nourished adults. VitalChoice Newsletter. December 23, 2013.

Gaby, A. Vitamin and Mineral Supplements Are Not a Waste of Money: Comments on a Widely-Publicized Editorial. HuffingtonPost.com. December 23, 2013.