Dr Ira Bernstein's opinion on the latest USPSTF study on vitamins

I would like to help educate you on a large review of vitamins published today (November 12, 2013) in the Annals of Internal Medicine and appearing the the United States Preventive Services Task Force on Vitamin, Mineral and Multivitamin Supplements for Primary Prevention of Cardiovascular Disease and Cancer. 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. It is important for me to identify important shortcomings of such review articles as I can assure you most doctors who read this study will say to you: “You see....your vitamins are a waste of money”. I anticipate that the majority of health care practitioners will not be able to see beyond the headlines (unlike me).

This information is further commented on by such “experts” as seen in the attached article. I would suggest watching the included video of Dr. Sydney Smith and understand where he is coming from. First I would like to highlight some of his comments in his video: He says: “A couple things about pills in general are that they cost money and the more pills you are taking the less likely you are to take all of your medications so patients should not be turning to over the counter nutritional supplements and think that that’s going have any benefit for their health when there may be other medications that they should take, medications that lower blood pressure, potentially medications for cholesterol. So I think we need to do a good job of informing our patients that these pills don’t appear to offer any benefit.....My advice based on this is choose your diet wisely....if you have risk factors, take medication that will deal with them effectively”. Please note carefully, those comments are from Dr. Sydney Smith, Professor University of North Carolina School of Medicine, not Dr. Bernstein, the GP! Let’s for a moment look into his credentials a little bit and see where he is coming from: A little Google research has shown the following: Dr. Smith has served as a consultant for or on the speakers’ bureaus of Bayer Corp., Eli Lilly and Co., GlaxoSmithKline Pharmaceuticals, Pfizer Labs, and sanofi-aventis; and has served as a member of the Data Safety Monitoring Board of AstraZeneca Pharmaceuticals. Hmmmm....little surprise he says take your medications and forget about the supplements.

Now, let’s look at the research itself for a moment. As a clinician myself when reviewing a study, I pay attention to the references. This study is an analysis of many previously published studies either pooled together or analyzed collectively. Interestingly the largest study included containing the most comprehensive multivitamin in ALL of the studies analyzed was the Physicians Health Study published last year showing a marginal reduction in cancer in men. What was this comprehensive vitamin used? Yes, ladies and gentlemen, it was Centrum. 

Here is an important point when reviewing literature in the nutritional field when looking at disease prevention: In general it is useless looking at individual vitamins or micronutrients as being beneficial for a disease reduction. Many of the articles reviewed did pertain to just one or a few nutrients. Vitamins, minerals, and antioxidants do not work in isolation so you are rarely going to find a benefit if you are supplementing with one or a few nutrients. Secondly, the “best” multivitamin that has ever had huge clinical trials has been with Centrum. As a result, this is what is being reported on and not surprisingly the benefits are limited given the fact that such one a day products are limited in potency and comprehensiveness. Regrettably most people in the medical community just don’t get it because they do not have the education in cellular nutrition and are not capable of critical analysis. What is also lacking in this review article is the recent significant study from the Women’s Health Initiative that did demonstrate reduced mortality in women with breast cancer who took multivitamins. So, it is important to be aware of not only what is being reviewed but what has been left out of the review.

Dr. Bernstein says: Do take your comprehensive multivitamin, mineral and antioxidant supplements. The cost of good supplements is irrelevant to the future cost of degenerative diseases, poor quality of life and is the reason I have been working almost 12 hour days in my office! 

Read study here