Marc Joseph Nutrition - Blog

There are so many easily accessible sources for sound, scientific nutrition knowledge, including:

• Leading journals like the:
  • American Journal of Clinical Nutrition
  • Journal of Nutrition
• The OHSU Linus Pauling Micronutrient Center
• And the Institute for Functional Medicine

That’s why it’s so disappointing to see yet another mainstream media article questioning the usefulness of nutritional supplementation. This one was in the LA Times (”Daily vitamin: Is it really necessary?“).

The gist of the article is summarized in this excerpt:

“…there’s little science to support America’s love affair with vitamins…”

Yet, the resources mentioned above contain many studies indicating that nutrient deficiencies may contribute to the development of numerous chronic diseases and that nutritional supplementation may play a role in preventing or treating these conditions.

Unfortunately, the article brings up many of the same tired arguments often cited by supplement naysayers, e.g.:

Argument #1: “[M]any in public health worry that a recommendation for a pill might signal to people that actual food isn’t important.”

Response: Of course actual food is important. No responsible, knowledgeable nutritionist would say otherwise or suggest people substitute supplements for healthy food choices. It’s a silly strawman argument.

Argument #2: “People with a deficiency in vitamin B12 — and that includes a lot of elderly people — are at risk of crippling neurological damage if they take too much folic acid, because the substance masks their B12 deficiency, leaving it to languish untreated.”

Response: Of course. Any well-trained nutritionist knows that (along with many other nutrient relationships). But rather than damning individual folic acid supplementation, which can be helpful in many conditions and was a commonplace deficiency prior to food fortification, why not call for a simple disclosure on the supplement bottles that tells consumers the importance of not exceeding the recommended dose and also ensuring adequate vitamin B12 intake through diet and potentially supplementation?

Argument #3: “[T]he use of beta carotene among smokers actually increased the risk of lung cancer.”

Response: You knew it was coming. You can’t have a vitamin naysaying article without mentioning the infamous study showing the risk of beta-carotene supplementation risk to smokers. If I were a smoker, though, beta-carotene supplementation would probably be the least of my health worries.

Argument #4: “Yet many nutrition experts believe that the real issue is different — that Americans need to simply eat better. “We need to focus on the quality of our diets,” says McGinnis. “We don’t know how all of these micronutrients work.”

Response: Of course Americans need to simply eat better. But, you know what? They don’t! (in general) Given the choice between a less than optimal diet with no nutrient supplementation or one with supplementation, I’d opt for the latter every time.

Argument #5: “We can take a guess that one element in a food is the responsible agent, good or bad — but it’s a guess.” (McGinnis)

Response: Goodness, McGinnis talks about nutrition as if it’s witchcraft. It’s science! There’s plenty of credible nutrition research making a strong case for the role of different nutrients in helping to prevent and treat disease. It doesn’t have the big pharmaco dollars behind it to fund as many multi-year, double-blind, placebo-controlled, randomized studies, but there is still plenty of solid research (see the links at the beginning of this post).

To their credit, the authors do cite individuals with a more balanced viewpoint, e.g., Jeffrey Blumberg, professor of nutrition and director of the Antioxidants Research Laboratory at Tufts University:

“I think all Americans — adults, teenagers and children — should be taking a multivitamin. Period.”

The authors also mention:

Even those most dismissive of daily vitamins are quick to concede that specific groups of people, including those with underlying problems such as diabetes, have nutritional needs not typically met through diet. Almost everybody older than 65 needs a B12 supplement, for example. People dieting to lose weight and eating fewer than 1,500 calories should also take a multivitamin, as should pregnant women and women of childbearing age.

“It all depends on where you are in life,” says Ann Yelmokas McDermott, project director of the Boston Obesity, Genetics and Lifestyle Study at Tufts.

But in some ways, hand-wringing over the role of multivitamins boils down to concern over the American diet. There are no food shortages in this country, and people routinely eat far more calories than they need — but still, Blumberg says, most Americans don’t get even half of their recommended dose of vitamin C, and fall way short of vitamins A and E, and such minerals as magnesium and potassium.

Exactly!!! Given the poor diets of most Americans, multiple nutrient deficiencies are commonplace among the general population. Add up all the people who are seniors, diabetics, teens & college-aged kids, pregnant women, women of childbearing age, dieters, fast-food-aholics, etc. — and you’re talking about the majority of the people in this country! (and in most industrialized countries)

The authors note that sorting through all of the information can be confusing:

“You can’t blame people for being confused. Every week, it seems, some study appears in the literature raising a new vitamin hope or dashing an old one…

…It’s tricky stuff, deciding how much of which nutrient to take in supplemental form for optimal health — especially if one rejects the one-size-fits-all multivitamin for a personalized regimen. “If you were sufficiently expert in nutrition and could conduct a full dietary and nutritional status assessment, then you could certainly design an individualized supplement regimen,” Blumberg says. “But few people are suitably qualified.”

That’s definitely a legitimate and important point. Nutrition is complex. It’s the basis of cell function, and along with other environmental factors like toxin exposure and stress, is a primary driver of health. Many people do supplement with the wrong things at the wrong doses.

But, is that a reason to question nutritional supplementation’s usefulness? Or, should it be a call for better education of both the public and health care professionals, so that nutritional supplementation as a basic tool for preventive health can be better implemented in practice? (Don’t ask the pharmacos that last question.)

The bottom-line: I agree with Blumberg — a well-qualified nutritionist can help people to sort through it all and create an individualized supplement regimen that meets a particular individual’s needs. Nutritional supplementation is not a panacea, but it can be an important part of a well-rounded approach to maintaining good health.

This entry was posted on Wednesday, December 6th, 2006 at 11:16 pm and is filed under Nutrition - Misc.. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.