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Multi-Vitamins and Stroke Prevention

Nutrition in general is such a controversial topic I will usually try to stay away from such discussions. There really are no trials talking about which diet is better then others. Also there are so many variables it’s really difficult to say one diet is better then anything else. Nutritional supplements are even worse. Most people take nutritional supplements such as multivitamins in hopes of preventing disease such as a stroke, heart attack or general cognitive decline. For years this market has flourished and has become a multibillion dollar industry with really no evidence of it’s usefulness. I also took multivitamins in hopes of aiding my efforts at stroke prevention, cancer prevention and overall improving my own longevity. Recently a few trials have come out which suggest that taking a multivitamin will not prevent any ailments nor improve your life expectancy. I find this information absolutely fascinating. I must admit that a few years ago I spent some time looking at which multivitamin was the best. Some bottles and supplements can cost more then a hundred dollars a month. For all the people like myself who have been taking multivitamins daily thinking they are doing themselves good here are the facts that have come to light recently.

The Physician’s Health Study II looked at close to 6,000 physicians aged 65 and older and showed fairly conclusively that taking a multivitamin has no benefit on cognitive decline (1). Another study looked at over 1700 people who have had a heart attack to see if high dose vitamin and mineral supplementation would prevent a recurrence of their heart condition, stroke, or death. This study showed that multivitamins do not prevent strokes, heart attacks or prolong your longevity (2)

The third trial that came out at the same time was a meta-analysis of all trial from January 2005 to 2013 (3). That means the authors took all the trials published that met their criteria and analyzed them together. Of all the trials they looked at there were only two  which showed any benefit for multivitamins in reducing the incidence of cancer and even that was only in seen in men(4, 5). Looking at those trials specifically that affect while it was significant was fairly small and again did not extend to women suggesting that either as the authors of another trial (5) suggest, men have a lower level of anti-oxidants or that there was a slight bias in the selection of men to this trial. Interestingly even those trials did not show any difference in overall mortality among people taking multivitamins and people who didn’t and when those studies were included in the overall analysis there was again no difference in the overall mortality in people taking multivitamins versus those who didn’t.

We don’t know why all these trials failed to show any benefit to taking a multivitamin. One thought, which I favor, is that the anti-oxidant system in our body is so complex that taking a multivitamin either doesn’t affect it at all, or simply affects only one aspect of the system, thereby not giving us the expected results. Another thought is that the doses aren’t sufficient or that we’re missing some ingredient that is essential. Regardless, this is the information we have at this time.

The end result of all these trials is that at this point there appears to be no benefit to taking a multivitamin daily. A daily multivitamin will not prolong your life or prevent your stroke or heart attack. That said, there are subsets of people who do require additional vitamins and supplements in their diet. Some people have issues metabolizing folate and require additional levels of that specific vitamin to prevent such problems as heart attacks or strokes. There are some people who lack some vitamins in their diet or simply can’t absorb their nutrition well due to their underlying issues and those people might definitely benefit from a multivitamin. However, for the average person in most of North-America who eats a fairly well balanced diet there really is no reason to take a multivitamin. These days if you need to balance your budget I would recommend taking a long hard look at your own supplements.

 

 

1. Francine Grodstein, ScD, Jacqueline O’Brien, ScD, Jae Hee Kang, et al. Long-Term Multivitamin Supplementation and Cognitive Function in Men: A Randomized Trial. Ann Intern Med. 2013;159(12):806-814-814. doi:10.7326/0003-4819-159-12-201312170-00006.

2. Gervasio A. Lamas, MD, Robin Boineau, MD, MA, Christine Goertz, DC, PhD et al. Oral High-Dose Multivitamins and Minerals After Myocardial Infarction: A Randomized Trial. Ann Intern Med. 2013;159(12):797-805-805. doi:10.7326/0003-4819-159-12-201312170-00004

3. Stephen P. Fortmann, MD, Brittany U. Burda, MPH, Caitlyn A. Senger, MPH, et al. Vitamin and Mineral Supplements in the Primary Prevention of Cardiovascular Disease and Cancer: An Updated Systematic Evidence Review for the U.S. Preventive Services Task Force. Ann Intern Med. 2013;159(12):824-834-834. doi:10.7326/0003-4819-159-12-201312170-00729

4. Gaziano JM, Sesso HD, Christen WG, et al. Multivitamins in the prevention of cancer in men: the Physicians’ Health Study II randomized controlled trial. JAMA. 2012; 308:1871-80.

5. Hercberg S, Galan P, Preziosi P, et al. The SU.VI.MAX Study: a randomized, placebo-controlled trial of the health effects of antioxidant vitamins and minerals. Arch Intern Med. 2004; 164:2335-42.

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