Do We Need Vitamins?
Many of my patients ask me if they should take a vitamin or nutritional supplement. 49% of us currently use at least one supplement daily. I answer that it depends on who you believe.
According to the US Preventive Services Task Force in their 2014 statement, “The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of the use of multivitamins for the prevention of cardiovascular disease or cancer.” In a word: no. They did carve out a rare exception, such as folic acid in pregnancy, or correcting a known deficiency.
Many other groups are more generous in their recommendations. For instance, in 2016, the Campaign for Essential Nutrients noted that “data show diets of more than 90% of Americans fall short in providing the Estimated Average Requirement (EAR) or Adequate Intake (AI) for one or more vitamins and minerals.”
The National Institute of Health points out the importance of calcium and vitamin D in preventing and treating osteoporosis. They note that there are few foods that can provide us with sufficient vitamin D; our primary method of obtaining vitamin D is from skin exposure to sunlight – which is not a very good idea as the incidence of melanoma is growing more rapidly than any other cancer.
The 2016 Dietary Guidelines for Americans by the U.S. Departments of Health and Human Services and of Agriculture, identified potassium, dietary fiber, choline, magnesium, calcium, and vitamins A, D, E, and C as nutrients, “consumed by many individuals in amounts below the Estimated Average Requirement or Adequate Intake levels.”
There is no doubt in my mind that supplements can never replace a healthy diet. But there are many people who do not have the means or access to healthy fresh vegetables, many who lack good health information, and many more whose diets are sorely deficient in adequate nutrients.
I recently had the occasion to meet Dr. Mark Hyman, chairman of the Institute for Functional Medicine, 10 times New York Times best-selling author, and Director of the Cleveland Clinical Center for Functional Medicine. I asked him about his perspective on this question. He said, “I agree that perfectly healthy people with perfectly adequate diets do not need supplements or vitamins, but I have yet to meet that person.”