A version of this commentary appeared in the Vancouver Sun and the Winnipeg Free Press
According to the Oxford Dictionary, vitamins “are a group of organic compounds essential for normal growth and nutrition and are required in small quantities in the diet because they cannot be synthesized by the body.”
As humans, we long for perfect health and longevity. This temptation leads us to try an endless variety of interventions to achieve this goal, with varying degrees of success. It may be this yearning for unattainable perfection that leads to decisions which appear logical but, in fact, are not.
The “vitamin logic” states, “if the body needs small amounts of vitamins to function, the body will perform even better if given more.” It is important to remember that using the “need a little so take a lot” philosophy has not turned out so well with food, alcohol, medications or vices.
There is the unfortunate reality that multiple large well-designed studies have quite consistently shown no advantage in taking vitamin supplements for relatively healthy people.
To date, well over 100,000 people have been studied over a number of years and the results have confounded vitamin logisticians and sales reps everywhere. Almost without fail, for relatively healthy people without obvious vitamin deficiencies, no change in overall death rate, cancer or cardiovascular disease has been shown. In fact, anti-oxidant vitamins, like Vitamin A, E or beta-carotene, have actually been shown to increase death for approximately 1 in every 300 who take any of those supplements for roughly three to five years.
B vitamins, believed to potentially reduce cardiovascular disease, have also been shown to have no effect. A very recent review also suggests no overall important clinical benefit from using Vitamin D supplements, except maybe reduced hip fractures, but 300-400 people need to take it to benefit one person, so the clinical importance of this is questionable.
“Vitamin logic” is so powerful that many of you may still be reluctant to believe the evidence, so we have devised some fool-proof ways for you to get the maximum benefit from vitamin supplements.
1) After purchasing any vitamin supplements, immediately drive to the house of a friend or family member that is at least five km from your house and ask them to store these vitamins in a safe place. Every day, when you generally take your vitamin supplement, simply walk to their house, pop that pill, and then immediately walk home. Briskly. The results will astound you.
2) For those of you who swear by higher dose vitamins, choose a home 10 km from your house, run there at a comfortable pace, take two pills, and run home. Note: You can actually just take one and get the same effect, which immediately cuts costs in half. Note 2: You can also take none.
3) If you have no friends or family — hopefully not a result of your vitamin “habit” — and are thus forced to keep and take your vitamins at home, there are still ways to maximize their effect. The ultimate technique is to place your favourite vitamins on your dinner plate and surround them with a variety of fresh vegetables, fruit and fish/poultry. Should you at anytime during the meal feel compelled to take one of the vitamins, pick it up, lick it, and then compare it to the taste of any of the food on your plate. If you prefer the taste of the vitamin supplement, go for it. Delicious Flintstones chewables are, of course, an exception, especially the Dino ones.
4) Fortunately, your body is equipped with a tremendous filtering system known scientifically as “your kidneys.” So effective are these organs that if you ingest more than the small amount of vitamins required for health, you pee out the excess. However, to avoid any possible strain on your kidneys, we suggest, before taking your vitamins, place them directly into the toilet and flush. Although this avoids the “middle man,” we’ll have to pray it won’t harm the fishes.
5) When you purchase vitamins, make sure they come from “natural sources” as it is well known that natural things are completely safe — for example, natural arsenic, natural tornadoes and natural snake venom.
6) Finally, if you can’t live without the belief vitamin supplements really do work, then package up the ones you buy and send them to countries where vitamin deficiency is a serious health concern. You will be proven correct, they are vital, and the effect of this generosity may be the only daily supplement you need.
Mike Allan is a family doctor and associate professor and the director of evidence based medicine in the Department of Family Medicine at the University of Alberta. James McCormack is an expert advisor with EvidenceNetwork.ca and professor with the Faculty of Pharmaceutical Sciences at the University of British Columbia in Vancouver. They both co-host a weekly podcast — Best Science Medicine Podcast — that is regularly rated one of the top medical podcasts available through the iTunes store or at therapeuticseducation.org.
See the poster based on this commentary
February 2014