The US is the biggest supplement market in the world. According to Grand View Research, more than half of adults in the US take supplements, and last year alone, US consumers spent an estimated $50 billion on dietary supplements.
When asked why they take supplements, most US consumers say they do so for overall health and wellness and to fill nutrient gaps in their diet, according to the 2011-2014 National Health and Nutrition Examination Survey (NHANES).
However, in a recent opinion piece published in JAMA entitled ‘Multivitamins and Supplements—Benign Prevention or Potentially Harmful Distraction?’, researchers from Northwestern University argue that supplements for most healthy, non-pregnant adults may be unnecessary.
“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,” said Dr Jeffrey Linder, co-author of the opinion article and chief of general internal medicine at Northwestern University Feinberg School of Medicine, in an accompanying statement.
Researchers react to recent USPSTF advice on supplements
The opinion piece was penned in response to a current official recommendation by the US Preventive Services Task Force (USPSTF) regarding using supplements to prevent cardiovascular disease or cancer. The USPSTF is an independent panel of national experts that makes evidence-based recommendations about clinical preventive services.
Based on new evidence and a systematic review of 84 studies, the USPSTF concluded that “insufficient” evidence supports the use of multivitamins or dietary supplements to prevent cardiovascular disease (CVD) or cancer in healthy, non-pregnant adults. It recommends “with moderate certainty” consumers not to take beta carotene supplements to prevent cardiovascular disease or cancer because of a possible increased risk of mortality, cardiovascular mortality, and lung cancer. Further, it also recommends against taking vitamin E supplements to prevent CVD or cancer.
The new position updates the USPSTF’S previous recommendation, published in 2014.
A waste of money and a harmful distraction?
Another danger to supplement use on top of the potential side effects is also to give consumers the impression of leading a healthy lifestyle when this may not be the case — researchers from the Northwestern University highlighted:
“Most people view supplements as, at worst, benign preventive products. However, in the US, dietary supplements are relatively unregulated and require to disclaim that health claims have ‘not been evaluated by the Food and Drug Administration [FDA] and they are ‘not intended to diagnose, treat, cure, or prevent any disease.”
“The very real harms of supplements are not studied as extensively as those of pharmaceuticals. Many patients do not report their use of dietary supplements, leading to a missed opportunity to discuss safety concerns with patients.”
“Beyond wasted money, the focus on supplements might be viewed as a potentially harmful distraction. Rather than focusing money, time, and attention on supplements, it would be better to emphasize lower-risk, higher-benefit activities.”
A healthy diet, exercise – and supplements in the right circumstances
The authors argued that the efforts of both individuals and public health policymakers should focus on supporting regular preventative care, following a healthy diet, exercising, maintaining a healthy weight, and avoiding smoking.
Nevertheless, the Northwestern University researchers clearly stated – as did the USPSTF scientists – that food supplements can be beneficial in the right circumstances. Women who are pregnant or trying to conceive, for instance, should take folic acid to prevent neural tube defects and iron to prevent preterm birth and low birth weight, as well as improve foetal brain development.