This article was originally published in the Westfield Leader.
Recently, two clinical studies published in the Annals of Internal Medicine made big time headlines. They reported that multivitamins had no beneficial effect on cognitive function and cardiovascular disease. Previously, in the same journal, there was a review article of 26 clinical studies on the effects of vitamins and minerals in various conditions the results of which were reported as negative. Regarding the effectiveness of multivitamins, one author of the current editorial said, “We don’t need a lot more evidence to put this baby to bed.” Another expert, regarding their safety, claims, “It’s dangerous” to consume them. They are both out-of order statements because there are no solid data to support either claim. In fact, Dr. Francine Grodstein, one of the authors of the cognitive function study who did not participate in the editorial, wisely admits that in order to determine the potential benefits of multivitamins requires more, sophisticated, long-term clinical studies which, in my opinion, will probably never happen.
So what’s going on? The answer is simple, but understanding it is elusive even by most medical experts. The answer is that, unlike insulin’s effect on lowering blood sugar or vitamin C’s in the treatment of scurvy both of which are easy to demonstrate in clinical studies, the evaluation of multivitamins on chronic diseases is infinitely more complicated because it involves too many unknown or variable factors to be properly statistically analyzed.
One of my favorite neurotic philosophers, and there are many of them, David Hume, once exclaimed, “Certitude is for fools.” Given that, I can tell you using my general nutraceutical formula, “Certitude minus one,” that practically all, if not all, of the long-term multivitamin studies are poorly designed and seriously flawed. Here’s, however, one flaw that most of us could understand. In both studies, a placebo was given as a control group to compare against the multivitamins. We now know that a placebo is not an inert sugar pill but, through the power of the mind, has, in itself, a significant clinical effect which could equal that of the multivitamin masking the latter’s effect.
Oftentimes, in my philosophic medical moods, I often wonder why it is difficult to demonstrate the clinical benefits of multivitamins which contain many of nature’s essential ingredients to maintain a healthy life. I also paradoxically wonder why there is a lack of detectable significant toxicity. Does the body and mind somehow just ignore their presence?
So where are we? To summarize: The benefits of the consumption of multivitamins for chronic diseases are largely unknown. (The same holds true with so-called healthy diets). Their safety record seems acceptable. Are we, therefore, dealing with Pascal’s Wager- nothing to lose but something of significant value to be gained by consuming multivitamins? Unfortunately, there’s nowhere to turn to find the truth and the decision is up to you and your mindset.
(FYI, I do know something about dietary supplements and healthy diets. I coined the term nutraceuticals which means that such products are proven to be effective in clinical studies. I designed the Nutraceutical Research and Education Act, NREA, to encourage high- level clinical research on them. It was introduced in Congress in 1989 by Rep. Frank Pallone of New Jersey, but withered away because of the lack of support from the nutrition and other health oriented communities).
Stephen L. DeFelice, M.D.
Westfield