Two Harvard Researchers, Robert H. Fletcher, MD, M.Sc., and Kathleen M. Fairfield, M.D., Dr.P.H., of Harvard Medical School and the Harvard School of Public Health, have joined a growing list of scientific experts who recognize the benefits of vitamins by stating in the June 19th issue of JAMA that "we recommend that all adults take one multivitamin daily."
The researchers reviewed more than 30 years of English-language articles about vitamins in relation to chronic diseases and published their findings in two companion articles.
In the scientific review article, the two physicians consider the evidence that suboptimal intakes of a number of vitamins are associated with increased risk of chronic diseases including cardiovascular disease, cancer, and osteoporosis. In a clinical commentary, they note that "a large proportion of the general population" has less-than-optimal intakes of a number of vitamins, exposing them to increased disease risk.
Annette Dickinson, Ph.D., vice president, scientific and regulatory affairs, Council for Responsible Nutrition (CRN), states, "There is no question that the amount of scientific evidence in favor of consistent use of vitamins, particularly multivitamins, is formidable and must be taken seriously, both by the medical community and by those who create public policy. As Drs. Fletcher and Fairfield also point out, most people do not get an optimal amount of nutrients by diet alone. Supplements are a convenient and affordable way to bridge the nutrition gap." The review confirmed that Americans are not getting enough of the essential nutrients they need from food alone. According to the National Nutritional Foods
Association some key observations made by the researchers are as follows:
A large number of individuals do not observe the recommended intake of five fruits and vegetables per day. A multivitamin would significantly offset the health risks associated with inadequate diet.
Some groups of patients, such as alcohol-dependent individuals and the elderly, may have an increased risk of vitamin deficiency or an unbalanced intake of daily levels of nutrients.
The low cost associated with multivitamins make them a convenient and affordable choice for disease prevention.
A multivitamin provides low daily levels of many vitamins, reducing the risk of overdosing on individual vitamins.
With regard to B vitamins and cardiovascular disease, the Harvard researchers conclude: "until results of trials provide more specific information on vitamin doses required to minimize homocysteine levels, recommending a daily multivitamin for most adults may be the most prudent approach."
On the question of vitamin E and heart disease, they recognize that some clinical trials have failed to find a beneficial effect in people at high risk of heart disease or in patients with known coronary artery disease, but they suggest that vitamin E may yet prove useful in the primary prevention of heart disease in the general population when taken for long periods of time.
Vitamin D supplementation is recommended at a level of 400 IUs daily. This is the amount commonly included in multivitamin supplements. In addition, the authors note, "The addition of calcium may be required to realize the beneficial effects of vitamin D in preventing fracture risk."
In order to protect against having a baby with a neural tube defect, they suggest "supplementing all women who might become pregnant with folate"at a level of 800 micrograms per day. (The Food and Nutrition Board has recommended that women capable of pregnancy should get 400 mcg of folic acid per day from supplements or fully fortified cereals, in addition to the naturally-occurring folate in their regular diets.)
Dr. Dickinson adds, "Clearly, this is more good news for those consumers who already incorporate vitamins into their daily routine and should serve as a wake-up call for those who are still just thinking about it."