Guest editorial: Steve Mister, President & CEO, CRN

Multivitamin Study: Making Lemons Out of Lemonade

Steve Mister, CRN
Steve Mister, CRN
Why is the dietary supplement industry sabotaging the recent study that showed multivitamins may potentially lower the risk of cancer? In this special guest article, Steve Mister, President & CEO for the Council for Responsible Nutrition (CRN), calls on the industry to use the results constructively.

"Recently, the dietary supplement industry received some of the best news in recent years: a large, randomized, placebo-controlled trial (RCT)​ demonstrated that using a multivitamin may reduce the risk of cancer among a well-nourished population of older men in the United States. Moreover, it was published in the highly regarded JAMA ​(Journal of the American Medical Association)​ and widely reported by network television and major print media.

You would think the industry would be celebrating that consumers are finally getting some positive news about the benefits of vitamins. So why are so many in the industry intent on making lemons out of lemonade?

For example, an activist consumer group​ has been largely critical of the study because it used a multivitamin that is marketed by pharmaceutical company. Really? C’mon guys! A rising tide lifts all boats whether they are piloted by a small natural health store or a multinational conglomerate. This study is validation that supplementing one’s diet, even a relatively well-balanced diet, with a multivitamin can improve one’s health.

Further, the consumer group derides the study’s author because in noting that the make-up of the multivitamin used in the study contained moderate doses of a variety of nutrients, he commented that perhaps earlier studies that have failed to show benefit did so because they studied single nutrients in high amounts in isolation. 

This is exactly what many in the scientific community—including some industry scientists—have been suggesting for years to explain the lack of positive findings in other RCTs. And now, when a well-respected researcher has the platform to articulate a reasonable suggestion, he’s shot down by those representing the industry.   Why are you shooting the messenger?

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"The study is validation that supplementing one’s diet, even a relatively well-balanced diet, with a multivitamin can improve one’s health" - Steve Mister

The study’s author was also chastised by this activist group because he acknowledged that a food-focused cancer prevention strategy that included large amounts of fruits and vegetables suffers from “inconsistent epidemiological evidence and lack of definitive trial data.” He is not suggesting that people shouldn’t be eating a diet rich in fruits and vegetables; he is recognizing that the mantra of so many critics of dietary supplements (“you don’t need supplements, just eat the right foods…”) also suffers for a lack of gold-standard science to back it up.  Multivitamin supplements now have a major RCT in their camp, and this fact should not be ignored or dismissed, but rather embraced.   Enough of the backroom Pharma conspiracies!

But the consumer advocacy group wasn’t the only industry-related source to put a pin in the balloon.  Next came a blog in a “natural products” media outlet​ that called the multivitamin used in the study “a low-quality supplement” for no apparent reason, other than the author would like to pick a fight that goes “my vitamin is better than your vitamin.” What is gained by deriding the particular brand used in the JAMA study? The fact is that as a result of this research, consumers who never gave multivitamins a second thought may add one to their daily regimen.

Moreover, the blogger complains that there are less expensive versions available and questions why higher dosages of the various nutrients are not used in that product.  Once again, guys, we have a major study that shows benefit – why so quick to shoot it down?

As the article suggests, multivitamins may open up the whole supplement category; consumers may start with the multi, and then incorporate an omega-3, a calcium, possibly a higher dose single nutrient—as long as the science follows—and we need to continuing to support solid science.

On the other hand, equally damaging to the industry are the opportunists. Already, consumers are being blanketed with marketing materials that tout the cancer preventing effects of multivitamins based on the JAMA​ study. Not so fast, please. We need to remember that DSHEA prohibits making disease claims in connection with the marketing of a dietary supplement. To do so is to make your product into a drug and face possible seizure, recall and criminal fines.  

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52% of Americans take a multivitamin, says recent CRN survey data

Even to promote a multivitamin as “reducing the risk of cancer” amounts to a health claim under the law which requires FDA’s advance approval and “significant scientific agreement” on the science that backs up the claim. One study, even one published in JAMA​, does not create scientific agreement. And premature shouting from the rooftops, could just turn off consumers who know the science is only starting to emerge.

Journalists have already noticed; will the FDA and FTC be far behind? One blog​ has raised the blitz of marketing messages and wrote, “failure to point out how marketing often leapfrogs/exaggerates/oversells the science does begin to make messengers complicit in a marketing campaign….[ journalists are obliged to] avoid becoming a tool of industry themselves.” It cautions reporters not to be too positive in their coverage of the JAMA​ study because of how it will be misappropriated. With the history we have in the industry of the exaggerated claims for “Dr. Oz recommended” and “As seen on Oprah,” should we be surprised that the media is cautious not to give multivitamins too positive a plug?

What we can do with this new research is use it constructively, but selectively and appropriately, with particular audiences: general practice doctors, nurse practitioners, dietitians and pharmacists – those who regularly counsel consumers about healthy lifestyle practices and can be gatekeepers for our products. We can also use this study to demonstrate the potential health effects of a multivitamin with policy makers.

What if this research could help to influence public policy like allowing SNAP (food stamp) recipients to use their vouchers on a multivitamin instead of junk food? Or promoting the inclusion of a multivitamin in a Meals On Wheels program? Or to allow employees to use their flex spending account (FSA) benefits to cover a multi? 

The industry could also cite this study in efforts to get insurance companies, third-party payers and employers to promote supplement use to their covered employees. A lot of good could come of it.

So c’mon folks, enjoy the good news and stop shooting ourselves in the foot. And by the way, did you take your multivitamin today?"

Steve Mister, President & CEO, CRN

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