For most Americans, there’s no ‘magic set of pills to keep you healthy.’ Diet and exercise are key.
From: Northwestern Now
By Kristin Samuelson
June 21, 2022 -- Drawn
to the allure of multivitamins and dietary supplements filling nutritional gaps
in their diet, people in the U.S. in 2021 spent close to $50 billion on
vitamins and dietary supplements.
But Northwestern Medicine scientists say for
non-pregnant, otherwise healthy Americans, vitamins are a waste of money
because there isn’t enough evidence they help prevent cardiovascular disease or
cancer.
“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, chief of general internal medicine in the department of
medicine at Northwestern University Feinberg School of Medicine.
Linder and fellow Northwestern Medicine scientists
wrote an editorial that was published June 21 in JAMA that supports
new recommendations from the United States Preventive Services Task Force (USPSTF),
an independent panel of national experts that frequently makes evidence-based
recommendations about clinical preventive services.
Based on a systematic review of 84 studies, the
USPSTF’s new guidelines state there was “insufficient evidence” that taking
multivitamins, paired supplements or single supplements can help prevent
cardiovascular disease and cancer in otherwise healthy, non-pregnant adults.
“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,” Linder said.
The task force is specifically recommending against
taking beta-carotene supplements because of a possible increased risk of lung
cancer, and is recommending against taking vitamin E supplements because it has
no net benefit in reducing mortality, cardiovascular disease or cancer.
“The harm is that talking with patients about
supplements during the very limited time we get to see them, we’re missing out
on counseling about how to really reduce cardiovascular risks, like through
exercise or smoking cessation,” Linder said.
More than half of Americans take
vitamins. Why?
More than half of U.S. adults take dietary
supplements, and use of supplements is projected to increase, Linder and his
colleagues wrote in the JAMA editorial.
Eating fruits and vegetables is associated with
decreased cardiovascular disease and cancer risk, they said, so it is
reasonable to think key vitamins and minerals could be extracted from fruits
and vegetables, packaged into a pill, and save people the trouble and expense
of maintaining a balanced diet. But, they explain, 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.
Linder noted individuals who have a vitamin
deficiency can still benefit from taking dietary supplements, such as calcium
and vitamin D, which have been shown to prevent fractures and maybe falls in
older adults.
New guidelines do not apply to pregnant
people
The new USPSTF guidelines do not apply to people who
are pregnant or trying to get pregnant, said JAMA editorial co-author Dr.
Natalie Cameron, an instructor of general internal medicine at Feinberg.
“Pregnant individuals should keep in mind that these
guidelines don’t apply to them,” said Cameron, who also is a Northwestern
Medicine physician. “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. More data is needed to
understand how specific vitamin supplementation may modify risk of adverse
pregnancy outcomes and cardiovascular complications during pregnancy.”
Additionally, recent research from Northwestern has
found most women in the U.S. have poor heart health prior to becoming pregnant.
Cameron said that, in addition to discussing vitamin supplementation, working
with patients to optimize cardiovascular health prior to pregnancy is an
important component of prenatal care.
Eating healthy, exercising is ‘easier
said than done’
Dr. Jenny Jia, a co-author of the JAMA editorial who
studies the prevention of chronic diseases in low-income families through
lifestyle interventions, said healthy eating can be a challenge when the U.S.
industrialized food system does not prioritize health.
“To adopt a healthy diet and exercise more, that’s
easier said than done, especially among lower-income Americans,” said Jia, an
instructor of general internal medicine at Feinberg and a Northwestern Medicine
physician. “Healthy food is expensive, and people don’t always have the means
to find environments to exercise—maybe it’s unsafe outdoors or they can’t
afford a facility. So, what can we do to try to make it easier and help support
healthier decisions?”
Over the past few years, Jia has been working with
charitable food pantries and banks that supply free groceries to people who are
in need to try to help clients pick healthier choices from the food pantries as
well as educate those who donate to provide healthier options or money.
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