Stick to healthy diet for nutrients you need
DEAR DOCTOR: Doctors and nutritionists are now saying that taking vitamin and mineral supplements is worthless. But many of the foods we eat are fortified with vitamins and minerals. Are those additives worthless? If not, how are they different than taking a multivitamin?
DEAR READER: While it’s true that there’s a new awareness regarding dietary supplements, including multivitamins, the conclusion has never been that they are worthless. In some cases, vitamins and minerals can help to fill specific gaps in nutrition.
However, multiple studies in recent years have shown health claims made by many vitamin manufacturers to be empty promises at best. There is also potential for harm for individuals using mega-doses of vitamins.
While the practice of adding vitamins and minerals to food has become widespread and, at times, questionable, it had its start in legitimate health concerns. Iodine has been added to salt to prevent goiter, the visible swelling of the thyroid gland, with iodine deficiency its primary cause. Vitamin D has been added to milk in an effort to prevent rickets, a childhood disease in which young bones fail to grow properly.
When the processed food industry took off, much of the nutritional value was routinely stripped out of foods. In the early 1900s, vitamin B deficiencies were common and pellagra, a disease marked by diarrhea and skin rashes, was common. In severe cases, pellagra could lead to dementia, and in the early decades of the 20th century, it caused tens of thousands of deaths, particularly in the South. This led to the fortification of cereal flours and products with B vitamins and iron in the 1930s.
The multivitamin and supplement industry, with retail sales topping $36 billion in 2017, seems to be a cynical enterprise. To persuade people to buy its products, the industry must first frighten us into believing that our food sources are somehow inherently flawed or inadequate. But as studies increasingly show, you can get the nutrients you need with a balanced diet grounded in real rather than processed foods.
E ve Glazier, M.D., MBA, is an internist and assistant professor of medicine at UCLA Health.