All Adults Should Take a Daily Multivitamin, Recommends AMA Journal
All adults should take a multivitamin every day, according to a report published by two Harvard doctors in the Journal of the American Medical Association (2002;287:3127–9). This recommendation is based on research demonstrating that taking a multivitamin may help prevent a number of chronic diseases, including heart disease, some cancers, and osteoporosis.
According to the authors, the evidence is “conclusive” that supplementing with folic acid during the first trimester of pregnancy reduces the risk of a group of birth defects known as neural tube defects. It is also well documented that taking vitamin D along with calcium reduces the risk of fractures in elderly women with thin bones (osteoporosis). A strong, though not conclusive, case can be made that supplementing with folic acid, vitamin B6, and vitamin B12 may help prevent heart disease by lowering homocysteine levels. Additional research suggests that vitamin supplements may reduce the risk of colon and breast cancer.
The new recommendation is part of a gradual but ongoing attitude shift in conventional medicine concerning the value of nutritional supplements. For many years, the prevailing opinion among most doctors was that vitamin supplements are unnecessary because the typical American diet provides all of the nutrients necessary to maintain good health. However, as the Harvard researchers point out, that opinion is no longer defensible.
The observation that vitamin supplementation can prevent several common chronic diseases indicates that the average American diet does not provide optimal amounts of some nutrients. Subtle vitamin deficiencies can result from excessive consumption of nutrient-depleted foods such as refined sugar and white flour, from inadequate intake of vitamin-rich fruits and vegetables, and from nutrient losses due to processing, prolonged heating, or storage of foods.
While vitamin supplementation can correct certain deficiencies, it is not an adequate substitute for a good diet. That is because whole, unprocessed foods contain a wide array of beneficial substances besides vitamins, such as carotenoids, flavonoids, natural antioxidants, and other unidentified compounds. As one researcher recently suggested, the best approach to disease prevention is to eat properly and to take a multivitamin.
The authors of the new report point out that most multivitamins contain iron; supplementation with this mineral may be inadvisable for many men, non-menstruating women, and a small proportion of the population with an inherited intolerance to iron (hemochromatosis). Therefore, individuals who are taking a multivitamin should discuss with their doctor whether it is appropriate to include iron in their supplement.
The publication of this new report is an encouraging sign that conventional medicine is finally taking a more serious look at the role played by nutrition in the prevention and treatment of illness.
Alan R. Gaby, MD, an expert in nutritional therapies, served as a member of the Ad-Hoc Advisory Panel of the National Institutes of Health Office of Alternative Medicine. He is the Medical Editor for Clinical Essentials Alert, is the author of Preventing and Reversing Osteoporosis (Prima, 1994), and co-author of The Natural Pharmacy, 2nd Edition (Healthnotes, Prima, 1999), the A–Z Guide to Drug-Herb-Vitamin Interactions (Healthnotes, Prima, 1999), Clinical Essentials Volume 1 and 2 (Healthnotes, 2000), and The Patient’s Book of Natural Healing (Prima, 1999). Currently he is the Endowed Professor of Nutrition at Bastyr University of Natural Health Sciences, Kenmore, WA.
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