Nobody can correct a faulty diet just by taking pills. A review of 18 studies, following more than two million men and women for an average of 12 years, shows that vitamin and mineral pills do not reduce risk for dying from heart disease or strokes, or even getting a stroke, regardless of age (Circulation: Cardiovascular Quality and Outcomes, July 2018;11(7)). Another study followed almost 30,000 people in China, aged 40-69, 25 years after they had taken vitamin and mineral pills for 5.25 years. They gained no reduction in death or cancer rate from vitamin or mineral pills (J National Cancer Institute, July 11, 2018).
More than 100 million American men and women take vitamin pills or supplements because they mistakenly think that they help to prevent heart attacks and strokes. North Americans spent about $36.1 billion on vitamins and nutritional supplements in 2017. Fifty percent of North American adults take at least one type of dietary supplement, while only 13 percent eat five servings of fruits and vegetables, which have been shown to help prevent heart attacks (Ann of Int Med, Dec 17, 2013). Neither the American Heart Association nor the American College of Cardiology recommend vitamin or mineral pills to prevent heart attacks, and the US Preventive Services Task Force and the National Institutes of Health recommend against the routine use of vitamin or mineral pills to prevent chronic diseases.
Who May Benefit from Specific Vitamin or Mineral Pills Many years ago, scurvy was common in people who did not eat fruit as a source of vitamin C, and beriberi was common in people who lacked thiamine because they did not eat whole grains. Today diets are more varied and many processed foods are fortified, so these deficiency diseases are rarely seen, and then usually only in illness or severe deprivation. North Americans die far more often from diseases caused by excess food than from deficiencies. Specific vitamins or minerals may be recommended for:
• pregnant women who are given prenatal vitamins
• people with vitamin deficiencies from inability to absorb certain vitamins such as B12
• people with diseases that cause body and muscle wasting
• some people with heart disease
• vegans who eat no animal products at all and need a source of vitamin B12
• some older people who may not eat properly or people with restricted eating patterns
• vitamin D for people who do not get adequate sunlight
• some people whose bodies cannot metabolize B12 (homotranscobalamine)
• possibly people with macular degeneration
• people with stomach problems who must take proton pump inhibitors
• possibly some people on metformin to treat diabetes
• There is no scientific evidence that vitamin or mineral pills prevent heart attacks in the general population.
• You cannot correct an unhealthful diet by taking pills.
• Micronutrients in food are typically better absorbed by the body than those from pills. Diana and I monitor our hydroxy vitamin D levels during the winter and take pills if we fall below 20 ng/mL. Otherwise, we take no vitamin or mineral pills or other dietary supplements, and I do not recommend them unless you and your doctor have identified a special need such as those listed above. A lousy diet with supplements is still a lousy diet.
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