I am going to put hormones on hold for a day — if only it were that easy in real life! I was asked to speak this morning on GMA Health, about a study that was released in the Archives of Internal Medicine yesterday. I won’t bore you with all the details. Here is the upshot. 39,000 older women were studied over a period of 19 years. These types of observational studies look at all kinds of things that may affect health. One of the things this one looked at was the use of nutritional supplements and the risk of death. Previous studies have shown no added benefit to vitamin supplementation for healthy people. This one revealed evidence that there actually may be some associated risk. After adjusting for many variables, the study showed that:
– women who took a daily multivitamin had a 2.4% increased risk of death.
– women who took iron had a 3.9% increased risk of death.
– Calcium supplementation decreased death risk by more than 3.5%
– other vitamins and minerals were studied as well. For more details, you can look at the Archives of Internal Medicine.
This is pretty amazing stuff. Nutritional supplement sales equal billions of dollars every year. Almost 1/2 of Americans take some sort of supplement. Everyone wants to know what to do now. Throw away all your vitamins? Most sources I looked at say, “Talk to your doctor.” Uh oh! As a doctor, even one not currently practicing, this is scary. For years we have been telling people to take a daily multi-vitamin because so few people can ingest all of their nutritional requirement in one day. Now this. For what it is worth, here are my take-aways.
1. Focus on a healthy diet – Good nutrition is tried and true. Do not be lulled into a false sense of security because you take vitamins. If nothing else, this study drives home the point that, unfortunately, there is no magic pill. Good health is a responsibility and it is something that needs to be worked on and maintained.
2. Know why you are taking supplements – Many people say they have a lousy diet so they rely on vitamins to balance everything out. You may have an unhealthy diet from a fat/caloric intake standpoint but that doesn’t mean you are not getting enough vitamins and minerals. These are two separate things. The tomato on the Big Mac has the same nutritional value as the tomato on the tuna salad. And, not to throw my colleagues under a bus, but beware advice about supplements from someone who sells them in his office.
3. Unless you have a proven dietary need or a diagnosed vitamin deficiency, consider dropping the pills. Yes, talk with your doctor, but ultimately, the decision is yours. Get informed.
4. If you are taking iron for any reason other than a diagnosed iron-deficiency anemia, stop taking iron. It is constipating and in excess, can contribute to liver and heart disease. Supplemental iron will only help your fatigue and energy level if you are truly deficient. Your doctor can help you sort through this. Not all anemia is caused by a lack of iron.
5. Take calcium – Calcium was the one supplement shown to reduce death risk. From my standpoint, whew! Your bones are very important and you don’t want to look like a shriveled old lady someday; stand tall.
If you are pregnant, or are planning to get pregnant, stick with your pre-natals. If you have been advised by your doctor to take a supplement because of a specific diagnosis, keep taking it. Everyone else, consider your individual risk vs. benefit. Many people swear they feel better when they are taking vitamins. Your nails may be stronger, your hair may be thicker and much less importantly, you may have more energy. But, if you are taking them just because you have heard time and again that they are good for you, reconsider.