This is a story on the findings from a panel of experts brought together by the National Institutes of Health to determine whether there was scientific evidence to support the contention that popularly exists that regular consumption of multivitimans has a role in prevention of chronic illness. The panel determined that there is insufficient data to support this claim. The article, however, quotes the panel chairman as stating that they “would not recommend that people stop using vitamins if they are taking them because they have arrived at their own conclusions about what’s best for their health.” The article missed a golden opportunity to explore how and why people make such determinations in the absence of evidence. And while the committee found evidence for multivitamins to prevent chronic disease to be lacking, it would have been helpful to inform readers that there is excellent evidence that intake of vitamins is essential for the prevention of vitamin deficiency disorders. This article should have included more information on both potential positive and negative impact of vitamin consumption.
The story could have presented the problem more clearly – that vitamin deficiency is unusual in the U.S., but that supplementing some vitamins may have beneficial effects on very specific health problems. The issue at hand is whether most Americans (those without specific health problems) should be taking multivitamins or specific vitamins as supplements to prevent disease. The problem the panel encountered was lack of specific evidence in this very broad field. The article relied too heavily on a few quotations that jumped out of the article and felt like conclusions, when in fact the panel recommendations were more complex.
The article contained an estimate for the overall amount spent by Americans on vitamins ($7.1 billion), but it provided no ballpark figure for how much the individual might be paying for multivitamins. This information would have been easy to access.
Although the article included several panel recommendations for specific populations that would benefit from the consumption of particular nutrients, the potential for benefit was not quantified. The article would have been stronger if it had included quantification of benefit for a few conditions mentioned (e.g., calcium/vitamin D for osteoporosis, folate for neural tube defect prevention).
Even though the panel did voice concerns about individuals getting too much of certain nutrients, the article failed to include this information. This is important as many readers will not see the panel recommendations and will rely on what is reported by the news story.
While the article reported on the recommendations of the panel of experts brought together by the NIH, it also provided contradictory comments without any context for understanding whether these were differences in nuance or different interpretation of the same information. For example, the story said, “The panel also recommends…the use of three anti-oxidants (vitamins C, E and beta-carotene) and zinc for non-smoking adults with intermediate-stage, age-related macular degeneration, an eye condition that can cause blindness.” But the panel only wrote about evidence from one clinical trial and then went on to warn about possible increased cancer risk and that other studies are trying to sort this out. So the story may have projected a far more positive light on vitamin use than the panel actually wrote. It is also difficult to sort out in the story what the panel said and what other experts not on the panel said. A Tufts professor is cited for being “at the conference” but it’s not made clear that he is not on the NIH panel.
This article did not contain elements of disease mongering.
Several sources in addition to the NIH panel appear to have been interviewed for this story.
This article did not accurately represent the findings of the NIH panel. The clearest treatment option presented in the story, voiced by a Tufts professor who was not a member of the expert panel, was his quote: “Taking a multivitamin is a smart lifestyle choice when combined with eating a healthy diet and exercising.” But this is not consistent with the NIH State of the Science recommendation. The story might have consulted other sources (including published information) that suggest a widely varied diet rich in fruits, vegetables, and whole grains as the best way to meet nutritional needs for an average person.
Though reporting multivitamin use by a variety of consumers from young to old, the article was not clear that the panel’s discussion was about chronic disease benefit from products currently available to consumers – as opposed to prescription-only preparations . The story could have been more explicit about the fact this panel deals with ordinary vitamin supplements for prevention of chronic diseases. The situation of women of childbearing age is that many women are several weeks into pregnancy (and the neural tube has closed) before being aware of the pregnancy. Therefore if all women of childbearing age take a daily multivitamin with adequate folate (400 mcg) more neural tube defects would be prevented. This does not need to be prescribed by a physician.
This article reported on the NIH panel review on the use of multivitamin/mineral use for chronic disease prevention. The panel did not find substantial evidence of benefit in terms of chronic disease preventions. It was not reported as a novel treatment; perhaps what is novel is to question the claims for benefit in this regard.
This story does not appear to be based solely or largely on a news release.
Systematic, Criteria-Driven
Monday at #ADA2021, an infectious disease epidemiologist, a journalist, and a researcher shared perspectives on communication of risk in the era of COVID-19: http://ow.ly/ROfR30rMeE7 @AstleyCM @garyschwitzer @berthahidalgo @ADA_DiabetesPro
Shoutouts to @susan_bewley @drkevinknopf @MichaelBaum11 in this call for more than fawning coverage from press releases for these kinds of stories.
Also, linked history inside goes back 5 years just on Grail apparently trying to become Holy Grail. https://twitter.com/garyschwitzer/status/1408849696416841731
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