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Monday’s medical myth: take a vitamin a day for better health

Forget an apple a day, vitamin manufacturers would have you believe it’s important to take daily vitamins to boost your health. And a surprising proportion of Australians do. Data from the last National…

Up to one in three Australians take vitamin supplements, but few healthy people need them. Brian Gaid

Forget an apple a day, vitamin manufacturers would have you believe it’s important to take daily vitamins to boost your health.

And a surprising proportion of Australians do. Data from the last National Health survey (back in 1995) showed that up to 30% of Australians had recently taken vitamin or mineral supplements – mostly for preventive health reasons.

More recently, the 45 and Up study of more than 100,000 Australian adults found that 19% of men and 29% of women reported taking vitamin or mineral supplements.

But most healthy people don’t need to take vitamins. A better safeguard for your health would be to spend the money you save from not buying supplements, on buying more vegetables and fruit.

The Australian Guide to Healthy Eating (AGHE) translates the national dietary guidelines into recommended daily food serves to help Australians eat better, without the need for vitamins or mineral supplements.

In a nutshell, the aim is for adults to have a minimum daily intake of:

  • two serves of fruit
  • four to five serves of vegetables
  • four to six serves of wholemeal or wholegrain breads and cereals
  • two serves of reduced fat dairy products
  • one serve of lean protein
  • a small amount of healthy fats.

The problem is, we just don’t follow the advice in the dietary guidelines, or eat like the patterns suggested in the AGHE.

The last National Nutrition Survey of dietary intakes in adults (from 1995 – this is currently being updated) found that we had inadequate intakes of vegetables, fruit, wholegrain cereals and dairy products. We also consumed too much fat, especially saturated fat and over a third of our daily energy intake came from energy-dense nutrient-poor foods, aka “junk” foods.

So what do we do: turn to vitamin and mineral supplements to make up the shortfall? Or try harder to encourage Australians to eat better?

Most healthy people don’t need to take vitamins. Andreas Feldl

I vote for the second approach because taking supplement is not without risks.

Take lung cancer, for example. Epidemiological research indicated that eating more fruit and vegetables was associated with a reduced risk of lung cancer. After this relationship was recognised, a number of clinical trials then gave people supplements of beta-carotene, given it’s a major carotenoid (pigment) in vegetables and fruit.

But the supplements had the opposite effect and actually increased the risk of lung cancer in smokers.

Medical problems that arise due to excessive intakes of vitamins and minerals are almost always due to intakes of supplements. To develop toxicity from vitamins in food you’d have to eat excessive amounts of specific foods such as carrots (which could make your skin turn yellow) or liver (vitamin A toxicity would leave you with blurred vision, dizziness, nausea and headaches).

There are, however, people with health conditions or in a particular life stage when they really need vitamins. This includes people with chronic medical problems (such as cystic fibrosis, coeliac disease, pancreatitis), people on restrictive diets to achieve rapid weight loss, those with conditions that interfere with their ability to eat properly.

Women planning a pregnancy also require additional nutrients. Folic acid supplements are strongly recommended in early pregnancy to reduce the risk of having a baby with neural-tube defects such as spina bifida.

Let’s leave vitamin supplements to those who need them, and call this myth busted.


Are you getting enough vitamins and minerals in your diet?

Take the Five Minute Healthy Eating Quiz. Developed by my colleagues and I at the University of Newcastle, the quiz compares your current eating habits against the Australian Dietary Guidelines. It also provides advice on how to improve the variety and nutritional quality of your usual diet.

Join the conversation

28 Comments sorted by

Comments on this article are now closed.

  1. peter prewett

    retired

    I took the quiz and did not find it easy to answer as the questions were loaded and to restricted, a one to ten would have been more useful and informative and the frequency was just as bad.
    I nearly gave up on the first page but persisted, the response to my answers were useless.
    Waste of time.

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    1. Carol Duncan

      logged in via email @live.com.au

      In reply to peter prewett

      I agree with you Peter. The questions were loaded to assume that we all believe the current "healthy eating" directives are actually healthy eating. I don't and there was no place to state why I don't eat things like bread or any other processed food. In the tips on my score page it told me to add vegemite to my main meals, try more veggies (but many of the veggies I do eat weren't listed). I seriously hope the quiz is not going to be used for serious scientific study because it is completely flawed.

      Some people take supplements because eg. they may work indoors all the time and therefore little chance to get some sun for vit D, Australia is also known to have selenium deficient soils ...

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  2. Sue Ieraci

    Public hospital clinician

    I would be interested to know how many health practitioners - registered and otherwise - who recommend and sell vitamins and other supplements have relationships with the manufacturers and wholesalers of these products. If so, do they declare the conflict of interest?

    If we are serious about transparency in prescribing, the entire health care industry - both orthodox and "alternative", needs to separate itself from the profit motive in prescribing.

    Do naturopaths and other prescribers of supplements have a code of conduct and regulatory structures for these issues?

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    1. Edward John Fearn

      Hypnotherapist and Naturopath

      In reply to Sue Ieraci

      Hi Sue
      I’m not sure of the relationships with manufactures, I don’t tend to fraternise much with other CAM practitioners and have never been offered a deal to only stock one brand or another. In fact I rarely stock any products of late. Some of the” practitioner only” supplement companies do run some excellent seminars, but it’s still at a cost to me. No free meals, expensive gifts or overseas holidays for me I’m afraid. (I should have studied conventional medicine …sigh)
      As Naturopaths and Medical…

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    2. Sue Ieraci

      Public hospital clinician

      In reply to Sue Ieraci

      Thanks, Edward. You say "No free meals, expensive gifts or overseas holidays for me I’m afraid. (I should have studied conventional medicine …sigh)".

      And yet, I did study conventional medicine, have practised it for thirty years, and still don't get expensive gifts or overseas holidays. Go figure.

      You say that you "rarely stock any products of late." Does that mean that you used to stock them more previously? What made you change? Did you see a conflict between recommending them and selling them?

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    3. Edward John Fearn

      Hypnotherapist and Naturopath

      In reply to Sue Ieraci

      Sue
      The free meals and gifts comment was not in any way directed at you personally. And it was intended to be a little tongue in cheek. A number of Doctors have spoken to me in depth about this issue in mostly social gatherings over quite a number of years. (At least since the late 1980’s) This whole business doesn’t really concern me because I believe the vast majority of Doctors will not be unduly influenced by such things and will always act in an ethical manner.
      For example; although the Australian…

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    4. Sue Ieraci

      Public hospital clinician

      In reply to Sue Ieraci

      Thanks for your extensive reply, Edward.

      I realise that your comment about drug company gifts was not directed at me personally. The point is that the throw-away line is always directed at medical practitioners, and rarely at other therapists.

      I suspect there are huge conflicts of interest amongst the various unregulated healthcare providers. If one is actually preparing herbal remedies, and they are evidence-based and cannot be purchased elsewhere, perhaps there is no alternative.

      On the other hand, retailing "remedies" which have been bought wholesale from multinational manufacturers is a clear conflict of interest. I am not targetting you, Edward, but I am concerned about the direct link between prescribing and selling that many providers practice.

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  3. Tim Scanlon

    Debunker

    Vitamin supplements: your daily placebo.

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  4. Russell Hamilton

    Librarian

    We seem to have had this advice a lot on The Conservation, experts who are determined to "try harder to encourage Australians to eat better". Where is the research that shows WHY people aren't eating the perfect diet? Are you addressing those issues? How much success have you had with this project?

    I did the quiz and was advised to "Try making your own yogurt at home" (I eat locally produced, plain low fat yoghurt into which I add blueberries, 5 days a week); I was also advised to "Make a vegetarian…

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    1. Russell Hamilton

      Librarian

      In reply to Russell Hamilton

      "See if you just ate a balanced diet that included meat you wouldn't need supplements."

      and yet, I choose to not eat meat and take the supplement. Not sure why that bothers so many people.

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  5. Clare Collins

    Professor in Nutrition and Dietetics at University of Newcastle

    Thankyou for taking the Healthy Eating Quizz (HEQ). Your feedback will be incorporated into version 2 to be released in 2013.
    The HEQ is a short diet quality tool designed to give people brief and rapid advice on how to select a bigger variety of foods that are healthy and aligned with recommendations in the Australian Dietary Guidelines.

    In a review we published of brief diet quality tools,the majority of studies found that those who score highest mostly have lower death rates (all cause and…

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    1. Russell Hamilton

      Librarian

      In reply to Clare Collins

      "Thankyou for your encouragement and tips to improve it. "

      Well, my last comments weren't encouraging, sorry for being so crabby. I'm not sure whether research shows that blanket recommendations - get more exercise, eat 5 vegetables a day etc - gets results, but it isn't very motivating to me. So, after a whole 2 minutes thought, my suggestion is that the quiz be set up to see in which areas people could improve, and then give very, very easy, practical solutions.

      For example, if a person…

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  6. Comment removed by moderator.

  7. Laurie Willberg

    Journalist

    Vitamins Decrease Lung Cancer Risk by 50%

    by Robert G. Smith, PhD

    (OMNS, Nov 18, 2011) A recent study [1] of the effect of B vitamins on a large group of participants reported an inverse relationship between blood serum levels of vitamin B6, methionine, and folate and the risk of lung cancer. High serum levels of vitamin B6, methionine and folate were associated with a 50% or greater reduction in lung cancer risk. This exciting finding has not been widely reported in the media, but it confirms…

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    1. Sue Ieraci

      Public hospital clinician

      In reply to Laurie Willberg

      Laurie Willberg - you have pasted an essay by someone called Robert G Smith PhD, reporting a study that looked at older adults, most of whom drank alcohol daily, and did not look at whether the participants took supplements. The essay you copies didn't even mention whether they smoked - and yet the study was about lung cancer.

      Your copied essay ends with: "So we will emphasize it here. Vitamins dramatically lower lung cancer risk. Supplements provide these nutrients in abundance. Modern diets…

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    2. Laurie Willberg

      Journalist

      In reply to Laurie Willberg

      @Sue Ieraci
      So you choose to zero in on virtually irrelevant aspects of the case study and pretend to not know what constitutes a "modern diet"? Fats and sugars are not "nutrients" by the way. You really don't have much training in nutrition, which is quite evident from your comments.
      Nutritional medicine -- orthomolecular medical -- practitioners as well as holistic nutritionists counsel patients with regard to their individual dietary requirements, test and assess nutritional deficiencies (something…

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    3. Tim Scanlon

      Debunker

      In reply to Laurie Willberg

      @Laurie

      Irrelevant aspects?!?! You mean the very basis of the conditions of the study that would determine how relevant the results are?!?

      Your anti-science stance is becoming laughable, please stop.

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    4. Sue Ieraci

      Public hospital clinician

      In reply to Laurie Willberg

      Laurie Willberg - you repeat the myth about medical training in "nutrition". In fact, I have training in all the clinical sciences - ie how the body works, from the sub-cellular to the macro level. This goes way beyond the concept of "nutrition" to the very building blocks of life.

      That's how I know that both fats and sugars are nutrients. Can a cell wall exist without lipids? Do cells use glucose for energy?

      I do not "pretend not to know" what a "modern diet" is - I ws pointing out that there…

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  8. none at all

    none

    I found it impossible to complete the quiz in a meaningful way, but checked the boxes that were as close as possible to the truth. My wife and I are healthy octogenarians who follow a life-long habit of enjoying meat or fish, potatoes, rice, or pasta; and two vegetables at our evening meals. I can't remember our last pizza or hamburger and I don't like chicken. We average fish twice a week and beef, lamb or pork on the other days. Lunch is usually a sandwich and fresh fruit. We have a large garden…

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  9. none at all

    none

    Laurie Willberg, I just read the cods-wallop you wrote, insulting and contradicting Sue Ieraci's quite logical and informed comments. I don't usually engage with people who are so biased or ignorant that logical, science-based arguments are wasted. However, I must point out that I deplore the minimal scientific education and, more importantly, knowledge of scientific method taught in our current schools, which has fostered an increasing amount of pseudo-scientific drivel and what masquerades as Alternative…

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  10. David Lee

    Student

    This article is absolutely behind the times and lacks informative information based on current research and science. Is it written for school kids?

    There are no references provided and i'm sorry to call it like it is and sincerely hope I don't offend anyone, but for a professor of dietetics to be publishing something like reflects very poorly on Newcastle Uni standards in this field.

    "So what do we do: turn to vitamin and mineral supplements to make up the shortfall? Or try harder to encourage…

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    1. Russell Hamilton

      Librarian

      In reply to David Lee

      David - articles for The Conversation aren't academic papers. This article is written with this publication in mind. It does have a link to a 288 page well-referenced document, if you follow the link provided.

      If you criticise someone else for lack of academic rigour, you probably shouldn't offer this: "I'll conclude by stating there are probably LOADS of good research articles" - probably?

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  11. David Lee

    Student

    "If you criticise someone else for lack of academic rigour, you probably shouldn't offer this: "I'll conclude by stating there are probably LOADS of good research articles" - probably?"

    There was no academic rigour ever intended for my comment! However I guess at least I provided one noteworthy reference directly related to the topic of the article, more than the actual article provided.

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  12. Sue Ieraci

    Public hospital clinician

    While I support the author's comments about supplements, I do have some more feedback about the dietary survey tool.

    I agree with other commenters that the questions are too specific and too limiting - both as research evidence and as a way of giving dietary advice. The authors could consider making the questions more categorical - ie instead of asking about single specific fruits or vegetables, ask about nutritionally-related groups of foods. After asking about meats, ask about other sources…

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    1. Russell Hamilton

      Librarian

      In reply to Sue Ieraci

      Sue - why do you support the author about supplements? What the article says is that people take supplements "mostly for preventive health reasons". Is there any evidence that people don't eat 5 serves of vegetables per day because they "turn to vitamin and mineral supplements to make up the shortfall?"

      The author writes "A better safeguard for your health would be to spend the money you save from not buying supplements, on buying more vegetables and fruit." Is there any evidence that people are…

      Read more
    2. Sue Ieraci

      Public hospital clinician

      In reply to Sue Ieraci

      Russell - why do I agree with the author on supplements? Because her statement "But most healthy people don’t need to take vitamins." is based on good evidence.

      Many people think that modern diets and non-organically-grown foods are depleted in nutrients. This is not true - see https://theconversation.edu.au/organic-food-no-better-for-you-study-9300

      The fact is, it is quite easy to have an adequate supply of all the essential nutrients, vitamins, minerals and trace elements while eating an…

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    3. Russell Hamilton

      Librarian

      In reply to Sue Ieraci

      "why do I agree with the author on supplements? Because her statement "But most healthy people don’t need to take vitamins." is based on good evidence."

      Yes, and that's all that needed to be said. But to go on about people being better off spending the money on fruit and vegetables, and oh, be careful of the harm supplements may do you ..... is to go off into some irrelevant place, unless you have evidence that supplement taking is doing any harm, causing people to eat fewer vegetables etc. It suggests to me that people running these 'eat better' campaigns are looking for easy targets to blame for the shortcomings in our diets, and not researching and addressing the real causes.

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