by Marion Nestle
Nov 14 2013

The dismal news about supplements. Why bother?

It’s not a good time for the makers of herbal and vitamin supplements.  The better the research, the fewer benefits it shows.

Herbal supplements

DNA testing is demonstrating what many of us have long suspected: herbal supplements are not necessarily what they say they are.

As the New York Times reports, a recent study shows that many products purporting to be herbal supplements, actually contain rice, corn, or wheat (gluten-sensitive folks beware):

I would feel sorry for supplement manufacturers, if they hadn’t brought this on themselves.

First, they lobbied to get Congress to pass the Dietary Supplement Health and Education Act of 1994 (DSHEA).  This lets them advertise the benefits of supplements without much in the way of scientific substantiation.  It also excused the FDA from doing much regulation.

But DSHEA also required research.  Oops.   Although the point of asking for research was to demonstrate the benefits of supplements, things haven’t worked out that way.  Most of the research shows no benefit and, sometimes, harm.

And investigations like this one show what many have long suspected.  Without federal oversight, some supplement manufacturers will do whatever they can get away with.

Fortunately, rice substituted for St. John’s Wort is harmless and hardly matters, since St. John’s Wort doesn’t seem to do much anyway.

Vitamin Supplements

The latest review of the benefits—or lack thereof—of vitamin supplements for prevention of heart disease or cancer comes to cautious conclusions.

Limited evidence supports any benefit from vitamin and mineral supplementation for the prevention of cancer or CVD. Two trials found a small, borderline-significant benefit from multivitamin supplements on cancer in men only and no effect on CVD.

Borderline significance?  Not impressive.

The Natural Products Association, which represents supplement makers, issued a response:

  • Multivitamin supplements should not be expected, without the combination of a healthy lifestyle, to prevent chronic disease.
  • Dietary supplements are used by more than 150 million Americans on a daily basis. Research has shown that when taken in combination with other healthy lifestyle practices, such as consuming a wholesome diet and exercising regularly, people can benefit from dietary supplements.

Translation: if you consume a wholesome diet and exercise regularly, you really don’t need supplements.  And if you are not doing those things, supplements won’t do any good.

As for the 150 million Americans who take supplements: the ones I know tell me that they don’t care what the science says; they feel better when they take the pills.

Let’s hear it for placebo effects!

  • parkeru

    This article refers only to cancers. Plus, his “translation” is wrong. The Natural Products Assn’s response does not mean that supplements won’t do any good if you have a healthy lifestyle. It means they won’t do any good if you DON’T have a healthy lifestyle. Writer bias is showing.

  • charles grashow
  • missjulilb

    I am not certain that I would jump to claim that supplements are always subject to the placebo effect. There have been times that I am feeling a symptom that indicates a shortage of a particular vitamin or mineral. I come to the realization that I ran out of that vitamin and forgot to replace it with a new bottle. I begin to take the particular supplement again, eliminating the symptom. But, the point being is that my body begins to react to a chemical or metal that is not being taken in; and, I am completely unaware of the accidental supplement deletion. That would not indicate a placebo effect.

  • http://albertahousekeeper.blogspot.ca/ Ekaterina Quist

    Thank you for confirming what I already suspected! Diet and exercise have been and will continue to be disregarded, since health doesn’t pay the pharmaceuticals.

  • misterworms

    This may be true for supermarket multivitamins as the doses are so paltry and not in bioavailable forms. The study says herbs were sourced from 2 or 3 companies so what if those had particularly poor quality control?

    Personally, I’ve experienced definite positive effects from various combinations of herbs and supplements and it’s not a placebo effect as I’ve experimented with withdrawing the supplements and had symptoms/issues return. I’ve been able to control allergy symptoms without the side effects of antihistamines, control tooth decay and prevent myself from catching colds my kid has.

  • http://www.nutritionprescription.biz/ Michele Jacobson

    On the whole I am in accordance with this article; however, what about the use of supplements where there is a true lack of nutrients in the diet, due to deficiency either from diet or medication? I’ve seen great effect from biotin (along with B-complex) for hair thinning, as well as supplementation of high quality fish oils for those who do not include fish in their diet.

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  • mem_somerville

    Even funnier: when the same folks who fund GMO labels weasel out of labels for themselves:

    GMO labeling proponents now fighting their own labeling legislation on supplements

  • jeffjfl

    The Times article was one-sided. It failed to report on legitimate objections to the BMC study, as explained in this article from the non-profit American Botanical Council:

    http://cms.herbalgram.org/press/2013/DNA_Barcoding_Critique.html?ts=1384529925&signature=f061f55a32b03c926c9e6c47154538da

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  • Kj Evans

    I don’t believe it provided a legitimate argument in regards to the BMC study and it seems as if exercising and dieting are constantly being disregarded.

  • StephenCataldo

    Ah blogs: either “vitamins will save you” or “vitamins will do nothing.” This article says: much of the supplements sold are ~rice fillers, and they’re not working, conclusion: vitamins and multivitamins don’t work (rather than: ~rice fillers don’t work). The research footnoted says things like “Duration of most studies was less than 10 years.” and then they look at cancer — so they’re merely finding that vitamins are not a miracle drug, and to some extent merely finding that rice-fillers are not a miracle drug… not really a strong statement. Also from the footnoted study:
    “Because the only multivitamin trial to include women used a supplement with 5 ingredients (19),
    it could be argued that there are no data on a “true” multivitamin in
    women. Most of the included vitamin trials provided less than a decade
    of follow-up, and vitamin effects on CVD and cancer may take longer to
    manifest.” And the test for multivitamins in men found some reduction in cancer in not that long (<10years being not that long for cancer to show up). A vitamin that made you healthier enough to cut your chances of death from cancer by 1% might be pretty worth taking … would it be statistically significant, show up in ten years? The blog implies as if the opposite has been proven: statistically significant evidence that these don't work, rather than a bunch of fuzzy inconclusive studies. The meta-study was also of people who were not nutrient deficient, and other than just couple of studies (one for women) tested multivitamins, they're really finding that specific supplements ("this year it's time for the Vitamin-X craze!") are not wonder-drugs… It was not studied whether high-quality multivitamin supplements taken over a long time might be mildly healthful, which is all I've ever thought they were.

  • L Holbrook

    Like many readers I’m trying to figure out if the brands I typically buy are more or less likely to be adulterated. Does it matter at all if the supplement company is GMP regulated?