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BMJ 2002;324:1544 ( 29 June )

News

Popping a multivitamin daily can keep disease at bay

Deborah Josefson, Nebraska

Nearly all adult Americans have dietary deficiencies in one or more vitamins and should be taking multivitamin supplements, a new paper has asserted (JAMA 2002;287:3116-29)[Medline].

Drs Robert Fletcher and Kathleen Fairfield of the Harvard Medical School's departments of public health, ambulatory medicine, and epidemiology, reached these conclusions after reviewing the literature on vitamins, nutritional supplements, toxicities, and disease states. They recommend that all adults take one multi- vitamin pill daily and that elderly people take two multivitamin pills as they are more suscep-tible to vitamin deficiencies.

The authors searched the Medline database for articles and randomised trials involving vitamins published from 1966 to January 2002.

Nine vitamins were selected for review: folic acid, vitamins B-6 and B-12, vitamin D, vitamin E, the provitamin A carotenoids, vitamin A, vitamin C, and vitamin K. Additionally, the carotenoid lycopene was included in the review because of evidence that it might help to prevent prostate and breast cancers. Thiamine (vitamin B-1) and riboflavin (B-2) were excluded because of scant evidence of their relation to chronic disease.

Suboptimal vitamin levels are common and contribute to the chronic diseases that plague Western society, the researchers said. The literature search disclosed that people who have alcohol dependence, are elderly, are vegans, or have malabsorptive disorders are especially at risk of vitamin deficiency. In particular, low levels of folic acid and vitamins B-6 and B-12 are risk factors for cardiovascular disease, neural tube defects, and breast and colon cancers.

High homocysteine levels are associated with athero- sclerosis, and most US adults would benefit from folic acid supplementation.

© BMJ 2002
 

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Collections under which this article appears: Other nutrition and metabolism

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