In a letter to the Annals of Internal Medicine, a group of nutritionists object to all of the studies finding supplements are well-marketed but unnecessary costs for most Americans.
Their rebuttal: they don't harm anyone, they are relatively cheap and science can't prove they don't work.
Hardly a great endorsement, but the nutritionists from the Linus Pauling Institute at Oregon State University and three other institutions can't really argue for the benefits of supplements, so they instead argue that the case is not 'closed', as an editorial in the same publication last year argued.
The public doesn't really trust nutritionists in 2014 - the ones getting all of the attention are Yogic flying instructors, attractive women selling diet plans, and anti-science zealots on rants about GMOs and locally-grown food. But one thing many nutritionists get right is that a balanced diet is the best way to obtain needed nutrients.
In their letter, the researchers believe that many Americans have a less-than-perfect diet – long on calories and short on nutrients - and the vast majority are not getting enough of several important vitamins and minerals. The only people who can't have a balanced diet are poor people, and they certainly can't afford supplements.
"There's strong evidence that a multivitamin/mineral supplement supports normal functioning of the body and helps improve overall health, and may even help lower chronic disease risk. It's irresponsible to ignore decades of nutrition research and tell the people of the United States they have no need for a supplement that could be so helpful, and costs as little as $1 a month," said Balz Frei, professor and director of the Linus Pauling Institute.
Among the claims in the commentary:
- The vast majority of people in the United States do not meet all of the guidelines for dietary intake of vitamins and minerals.
- More than 93 percent of adults in the U.S. do not get the estimated average requirement of vitamins D and E from their diet; 61 percent not enough magnesium; and 50 percent not enough vitamin A and calcium.
- Many subpopulations have even more critical needs for micronutrients, including older adults, African Americans, obese persons and some people who are ill or injured.
- Concerns about "increased mortality" from supplements of vitamins A and E have been based on extremely high use through supplements far beyond the amount available in a multivitamin, and in the case of vitamin E largely refuted by comprehensive meta-analyses.
The value of proper nutrition is wide-ranging and positive. Micronutrients maintain normal cell and tissue function, metabolism, growth and development. Thus, they contend that a supplement that helps a person "cover all the bases" can help protect daily, routine health. Despite the evidence showing that finding people who would have worsened health without them are difficult to find.
Good luck finding someone with scurvy or rickets in the U.S. Certain vitamin and mineral deficiencies are still a major issue in the developing world, especially vitamin A, iron, iodine and zinc. According to the World Health Organization, more than 650,000 children under the age of five die around the world every year from deficiency in vitamin A. But supplements are not "a dollar a month". What would solve the Vitamin A problem is Golden Rice, which feeds children and gives them more nutrients. Who are among the biggest anti-science proponents of such fortified rice? Nutritionists.
The other evidence they cite for supplements is circumstantial. One of the longest, largest controlled studies ever done, the Physicians' Health Study II, found a significant 8 percent reduction in total cancer incidence in male physicians – people who, through their education, income and lifestyle, probably had diets much closer to optimal than the average American. If BMW wants to claim that their cars reduce cancer, they can use that exact same methodology.
The researchers write in their conclusion that to "label multivitamin and mineral supplements useless, harmful and a waste of money is wrong."