The first episode of public backpedaling on vitamin supplementation probably occurred during Sanjay Gupta’s segment on CNN’s Situation Room.  Reporting on the results of a recent study that associated multivitamin use with an elevated risk of breast cancer, Gupta dared to venture that we should be cautious about vitamin use.  He spoke to the fact that the great majority of the many studies on vitamins do not show benefit.  He also said something that made me cheer:  removing a  vitamin from its food source and concentrating it many times may not work; may even be harmful.  Bravo for Sanjay.

But by later that day, the CNN website had thought better of Dr. Gupta’s comments.  http://pagingdrgupta.blogs.cnn.com/2010/03/31/can-your-multivitamin-give-you-cancer/   After warning readers about the shortcomings of this study (and there certainly are many), it carefully decided to cover all bases. 

First, it took one side: 

“The National Institutes of Health have said that ‘some of the roughly 75 million Americans who buy [multivitamins and supplements] may not need them.’" 

Then, the other:

"At the end of the day, it's always better to see someone taking a vitamin than not. The benefits outweigh the risks," advises Dr. Kent Holtorf, medical director of The Holtorf Medical Group, who was not affiliated with the study.

"The bottom line is a patient is not a population," says Holtorf. "It's better to take a vitamin than nothing but your best bet is to find out if you're deficient in anything and then treat those deficiencies in an individualized way."

This article equates information from the NIH with the opinion of Dr. Holtorf.   Since I had never heard of the Holtorf Medical Group, I Googled them.   They are a practice in California that deals in natural supplementation for a whole host of conditions from menopause to “adrenal fatigue”.  They also use supplements for anti-aging medicine.   This is not exactly an academically rigorous discussion of the issues raised by the study.   

But we shouldn’t be surprised.  The media does a generally poor job of covering complex issues like medical studies and treatment.  America is hooked on the idea that supplements are a magic wand that can erase our dietary indiscretions.    Very little science supports this view.   The AJCN study is challenging because it provides the springboard for discussion and for a re-evaluation of supplementation.  We should pick up that gauntlet rather than ignore it. 

It’s particularly interesting that the people who defend supplements most vigorously are those who believe in natural solutions to health.  There may be a basic misconception here.  Is supplementation with vitamins and minerals which are extracted from food sources natural? 

Even if vitamins are useless but harmless (they make very expensive urine, as a professor of mine used to say), there is potential damage from relying on them as a kind of magic feather that allows us to eat all kinds of bad stuff and assume we’ll be saved.  We use medicines like cholesterol lowering drugs and blood pressure pills the same way. 

In the meantime, I’m personally putting my money on original, whole foods from sources that (I hope) I can trust.  I remain suspiciously paranoid about ingesting anything made in a factory or deemed to be healthy be dubious experts.  We just don’t know enough about that stuff.  We do, on the other hand, know an overwhelming amount about the positive benefits of living clean.