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D.iet & H.ealth : N.utrition Last Updated: Nov 12th, 2006 - 20:38:00

Expert panel: Benefits of vitamin supplements questioned
By Kathy Jones
May 18, 2006, 14:12

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May 18, ( – There is no evidence indicating that taking vitamins or nutrient supplements could actually help prevent diseases such as cancer and heart disease, say a federal panel convened by the NIH Office of Medical Applications of Research and the Office of Dietary Supplements.

The panel made such a comment after assessing the safety and effectiveness of multivitamin/multimineral (MVM) supplements. But the expert panel also says these supplements per se don’t cause any harm either when used properly.

After three days of deliberation and a review of existing literature, the 13-member panel did not find any concrete evidence that supported the widespread use of vitamin supplements. "The data is insufficient to make a recommendation for the general population," said Dr. J. Michael McGinnis of the National Institute of Medicine, the chairman of the panel.

He added that the evidence examined by the panel found it "especially thin" and that all trials were on a short-term basis making it very difficult for them to judge the long-term effects of the supplements.

According to the NIH draft release, panel was convened to examine
a) Current patterns and prevalence of the public’s use of vitamin supplements
b) The efficacy of single vitamin/mineral supplement use in chronic disease prevention
c) Safety of the use of supplements in the general population
d) The dietary nutrient intake in people who used the supplement and those who did not
e) Methods to further knowledge in this area by conducting extensive research

The panel designated "any supplement containing three or more vitamins and minerals; without herbs, hormones, or drugs; and with each component at a dose less than the tolerable upper level (UL) determined by the Food and Nutrition Board" as a Multi vitamin/Multimineral (MVM) supplement. The review also looked at studies that used a single or double supplement to study specific disease outcomes.

The focus was on randomized controlled trials (RCTs), which are generally regarded as reliable. The panel did admit that there were some limitations to these trials, but these were the best way to study the effect of the supplements.

The panel found that currently more than half of Americans use vitamin supplements in the belief that they will be better able to fight disease and stay healthy. The supplements industry has grown by leaps and bounds and Americans spent a staggering $23 billion annually on these pills.

Additionally the usage was found to be higher in women, the elderly, those who have more education, higher income, healthier lifestyles and diets, and lower body mass index (BMI); and residents of the far western States. The supplement usage seems to be lower in smokers and certain ethnic and racial groups, such as African Americans, Hispanics, and American Indians.
As far as the actual trials were concerned, the panel found only a few trials that were designed to test the efficacy of the supplements. It has highlighted the following findings

* Beta-carotene - Two large trials seeking to test the effectiveness of beta-carotene in preventing lung cancer actually found that the vitamin increased the incidence of the condition in smokers and male asbestos workers. Additionally the vitamin was found to be of no use in other cancers like gastric, pancreatic, breast, bladder, colorectal, and prostate cancer; as well as leukemia, mesothelioma, and lymphoma.

* Vitamin E - The panel found four trials that tested vitamin E. One large study found decreased cardiovascular deaths in healthy women who used the vitamin although there were no reports on actual cardiac events. Another study had found a reduced risk of prostate cancer in smokers.

* Vitamin B2 and niacin - A large Chinese trial had found that there was a decreased risk of development of nuclear cataracts with these supplements.
* Calcium and vitamin D - Multiple studies highlighted the fact that calcium and Vitamin D increase the bone density, but by themselves did not decrease the risk of bone fracture in post-menopausal women.

Based on the above findings, the panel said that it was able to specifically recommend the vitamin supplements in three cases

1) Vitamin B and folic acid supplements taken by women of childbearing age reduced the incidence of birth defects of brain and spine in babies.

2) Multivitamin supplements including vitamins C and E, beta carotene and the minerals zinc and copper reduced the occurrence of age-related macular degeneration, which is the leading cause of blindness in the elderly

3) Using Vitamin D and calcium supplements helped increase bone density in post-menopausal women and thus reduced fracture risk

The panel recommended that the FDA should be vested with the authority to inform the public about dietary supplements and that more research should be carried out to assess the impact of vitamins on the general well being of individuals.

The panel also agreed with the recommendations of Institute of Medicine committee in 2005, which had said, “…the regulatory mechanisms for monitoring the safety of dietary supplements, as currently defined by DSHEA, [should] be revised. The constraints imposed on FDA with regard to ensuring the absence of unreasonable risk associated with the use of dietary supplements make it difficult for the health of the American public to be adequately protected.”

Commenting on the findings, panel member Patsy Brannon of Cornell University said, "If you choose to take a supplement, the simplest advice I can give is to take one that provides 100% of the daily values."

© 2004-2005 by unless otherwise specified

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