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Beliefs vs. science for vitamin supplements

October 17th, 2011

Marion Nestle has an interesting blog post about the two most recent studies that fail to find benefits from taking vitamin supplements. (One study followed 38,772 women for 22 years, and found that those taking multivitamins or certain single vitamins were slightly more likely to die than those not taking any supplements; the other was a placebo-controlled trial of 35,533 men, which found that taking 400 IU per day of vitamin E increased the risk of prostate cancer during a 12-year follow-up.)

The reason I’m posting this isn’t that I think vitamins will kill you — the effects were small, and for the most part I think supplements tend to do nothing, rather than have big effects either way. Personally, I suspect that the most negative effect of vitamin supplements is the feeling of false healthiness they provide, which then allows you to justify making other, less healthy choices throughout the day.

Anyway, what I found most interesting in Nestle’s post was her explanation of two very different ways of looking at research into nutritional supplements — both of which rely on a collection of “true” statements, but reach opposite conclusions:

For example, on the need for supplements, a belief-based approach rests on:

  • Diets do not always follow dietary recommendations.
  • Foods grown on depleted soils lack essential nutrients.
  • Pollution and stressful living conditions increase nutrient requirements.
  • Cooking destroys essential nutrients.
  • Nutrient-related physiological functions decline with age.

A science-based approach considers:

  • Food is sufficient to meet nutrient needs.
  • Foods provide nutrients and other valuable substances not present in supplements.
  • People who take supplements are better educated and wealthier: they are healthier whether or not they take supplements.

I’m not sure I quite agree with her labels (“belief-based” and “science-based”), but I definitely see these patterns of thinking in discussions of pretty much all areas of health and exercise research. The first set of statements makes a strong case that it’s plausible that supplements could improve health — but it leaves out the final step, which is to show that they do improve health. Similarly, the second set of statements explains why we shouldn’t be surprised if supplements don’t improve health, but doesn’t prove it. So to me, neither of these two approaches is satisfying — because the debate should be settled empirically.

Of course, research is complicated, and in many health debates it’s difficult to agree on what constitutes empirical evidence. That’s less and less true in the case of vitamin supplements, though. Study after study fails to find any benefits, so the hypotheses of the “belief-based” approach seem emptier and emptier to me.

  1. david woodward
    October 19th, 2011 at 18:54 | #1

    It has long seemed to me that the general attitude of solution-oriented, expectation-laden and short sighted demand for fast results are detrimental to both a sense of good ‘health’ and athleticism. Patience, rather than impatience, would be a great motivator versus the model of the “now” that governs our thinking about diet, fitness and self-improvement.
    When it comes to supplements we seem similarly benighted – our impatience makes us blind to the slow and subtle influences of nutrients, absent or abundant, just as many of us are effectively deaf to all but the loudest calls of habitual eating. To ‘listen to’ and observe one’s physicality need not be an exercise exclusive to new-age fuzziness. We need the patience that gives our psychology endurance of physical shortcomings, to endeavour to the goals whereby we surpass or at least optimize our limitations. The questions you raise about epigenetics, stretching and supplements taken as quick fixes all make this a new favourite site. Thank you for your efforts with respect to improving a common ground for athletes to assess and discuss these and other issues.
    Respectfully,
    dw, Toronto.

  2. October 20th, 2011 at 08:01 | #2

    Hello Alex, I as master athlete always thought that eating according the recommendations of Asker Jeukendrup or Louise Burke, would be enough and
    i did not need extra vitamins or supplements. But lately i am reading more about the benefits of a good vitamin D status. and now i started to take vitamine D. during the autum/winter. here you can read why
    http://www.scientificamerican.com/article.cfm?id=cell-defenses-and-the-sunshine-vitamin
    http://journals.lww.com/acsm-msse/Abstract/2009/05000/Athletic_Performance_and_Vitamin_D.17.aspx
    http://www.vitamindcouncil.org/news-archive/2007/peak-athletic-performance-and-vitamin-d/

  3. Richard Ascough
    October 26th, 2011 at 01:30 | #3

    Hi Alex. In your reading on the subject, do studies differentiate for diets with little or no meat and or dairy – that is, diets that rely heavily on plant sources for protein? In my own case, I have had to supplement my iron intake ( I run), but I’m never sure whether I should be taking any other vitamins or a multi. I’ve gone without doing so for a time and I’ve also taken a multi-vitamin for a while and I have not noticed an appreciable difference either way (note my rigorous scientific method!). I’d welcome any reliable resources on supplementing for (older!) vegetarians runners. Thanks.

  1. October 18th, 2011 at 18:59 | #1