Do studies support taking a multivitamin? The  five doctors who penned a recent guest editorial for the Annals of Internal Medicine say no but the astonishing thing is that one could look at the evidence they considered and reach exactly the opposite conclusion.

One study they looked at was limited to investigating high dose multivitamins for the prevention of secondary cardiovascular events. In other words, would taking a high potency multivitamin prevent a second heart attack? Not surprisingly, the investigators found no statistically significant benefit. An 11% relative risk reduction was not enough to meet statistical significance given the limited scope of the study but the authors did go out of their way not to shut the door on further research, emphasizing that there were high rates of noncompliance and withdrawal from the study.

Another study cited in the editorial was the cognitive function arm of the Physicians’ Health Study II (PHS II) which included nearly 6,000 male physicians 65 and older. While the researchers did not find a benefit on cognition among the participants who took a multivitamin, they noted that the rates of age-related cognitive decline among all participants was lower than expected, making a significant difference between the two groups much more difficult to discern. Dr. Francine Grodstein, one of the lead authors of that study, said that since physicians tend to have healthy diets and be well-nourished, the added nutrients may not have made a difference in their cases. “I do think there’s room for more research,” said Dr. Grodstein, who did not write or sign the editorial.

Interstingly, two other recently released arms of the Physicians’ Health Study II did find benefit in the specific study population in reducing the risk of cancer and cataracts which the authors of the editorial did not mention. What is of particular note about the PHS II is that all the participants are male doctors. Since doctors are generally more educated and economically well off than most, their diets often reflect better than average nutrition. Even taking that into account, the benefits for cancer and cataracts were apparent.

Americans and western Europeans are commonly considered the best fed people in the world but this characterization is accurate only in reference to caloric intake. In fact, most are overfed and undernourished, eating too much sugar, refined carbohydrates, and “empty calorie” foods. Recent  USDA research results published by Stanford University showed that more than 70 percent of men and more than 80 percent of women consumed less than two-thirds of the RDA for one or more nutrients.

People are eating almost 20 percent more vegetables than they did 25 years ago but 25 percent of the vegetables consumed in the U.S. are artery clogging French fries, according to a study reported in the journal Cancer, and  a recent report on children’s eating habits indicates that “low nutrient-dense foods”, including cake, cookies, donuts, and sugary fruit drinks are major components of U. S. children’s diets and so “this compromises intakes of more nutritious foods and may impede compliance with current dietary guidelines.”

As Steve Mister, President of the Council for Responsible Nutrition (CRN),  says in responding to the editorial, “We would not suggest that vitamin supplements are a panacea for preventing chronic disease, but we hope the authors would agree that there is an appropriate place for supplements. Given that government research repeatedly demonstrates that the typical consumer diet is falling short on critical nutrients, vitamin supplements are an appropriate option to meet those needs.”

Dr. Duffy MacKay, N.D., CRN’s vice president of scientific and regulatory affairs, notes that, “We all need to manage our expectations about why we’re taking multivitamins. Research shows that the two main reasons people take multivitamins are for overall health and wellness and to fill in nutrient gaps. Science still demonstrates the multivitamin works for those purposes, and that alone provides reason for people to take a multivitamin.”