In a recent article in Australian Prescriber: ‘The safety of commonly used vitamins and minerals’, dated 2 August 2021, Dr Geraldine Moses says that: "Dietary supplements have a range of potential risks and few benefits” and that “Consumers should be aware that there is no case for vitamin or other supplements in normal healthy people who are not pregnant or breastfeeding.” CMA respectfully disagrees.
According to researchers writing in the American Journal of Nutrition, Enhancing iron absorption. 100 mg of vitamin C may improve iron absorption by 67%.
Risks of dietary supplements - Interactions do exist, in a similar way that foods can also interact with drugs. Fortunately, decades of research have shown there are only a small handful that are clinically significant.
Dose is also important - just like every medicine when the dosage is too high, side effects my result. Geraldine Moses fails to mention that the very high doses required to result in side effects are clinically challenging to consume and unlikely to occur under normal supplemental intake.
Manufacturers of Australian complementary medicines recommend appropriate dosages on the labels. The TGA requires at least 25% of the recommended daily intake to make statements about the role of vitamins and minerals in the body.
Contrary to Dr Moses’ statement: “Unlike conventional medicines, manufacturers of vitamins and minerals are not required to provide warnings of their potential side effects,” warnings ARE required on supplement labels or before point of purchase.
More than 25 mandatory warnings apply to a variety of nutrients.
Increasing health literacy
Geraldine Moses does not acknowledge the health literacy of the Australian public either; CMA believes growing understanding is inspiring people to take increasing control of their health. Using individually-sought or shared research with the advice of health professionals (from pharmacists and integrative GPs to nutritionists, dentists and more) and by paying close attention to the individual effects that supplements are having, an increasing number of people are using nutritional supplements as an essential part of their therapeutic and preventive approaches to good health.
Geraldine Moses says there a few benefits of dietary supplements. Again, CMA disagrees and we present a small number of examples.
“Some people may not be able to spend enough time in the sun or may not be able to produce vitamin D easily. Health professionals may recommend vitamin D supplements after considering individual circumstances, including whether vitamin D deficiency is present and how severe it is.”
According to NPS Medicine Wise,
According to HealthDirect: “Vitamin B12 deficiency can be caused by not eating enough foods that contain Vitamin B12, especially meat and animal products. More often it is caused by the body not being able to absorb the Vitamin B12 properly.”
According to Harvard Health: “Older adults can have difficulty absorbing vitamin B12, and have a lower threshold when checking this level; if someone is taking an acid-reducing medication, it is very likely that they will become deficient in B12, as well as iron, vitamin D, and calcium, among other things. This cohort may very well benefit from a quality multivitamin.”
Iron deficiency anaemia
According to Australian Prescriber: Correcting iron deficiency anaemia: “Oral iron replacement is the most appropriate first-line treatment in the majority of patients.”
According to researchers writing in the American Journal of Nutrition, Enhancing iron absorption. 100 mg of vitamin C may improve iron absorption by 67%. Thus, vitamin C may help reduce the risk of anaemia among people prone to iron deficiency.
According the researchers, “B complex deficiency in alcoholism primarily arises due to malnutrition or intake of a diet deficient in necessary vitamins and minerals. Additionally, alcohol consumption exacerbates the effect of a poor diet and reduces absorption of B vitamins.
Consuming 24g alcohol (240ml red wine or 80ml vodka) per day for two weeks leads to a decrease in folate and B12 levels in healthy individuals.”
Poor nutritional status
The long-term consumption of poor dietary quantity (e.g., due to loss of appetite) or quality (e.g., restrictive, unbalanced, or low-nutrient dense diets increase the risk of poor nutritional status. In older age groups, many changes, including physical, physiological, and psychosocial factors make it more difficult for nutritional needs to be met, leading to shortfalls in nutrients.
Contrary to Dr Moses’ comments, the Australian Bureau of Statistics reports that a number of Australians are not meeting vitamin and mineral requirements.
Approximately one in twelve (9%) adult females (aged 19 and over) did not meet their requirements for folate (dietary folate equivalents) based on their intakes from foods.
Approximately 7% of males and 16% of females had inadequate thiamine intakes.
Approximately 17% of males and 14% of females had inadequate usual intakes of vitamin A (as retinol equivalents)..
Three in every ten people aged two years and over had an inadequate intake of vitamin B6.
The proportion of females aged 14 years and over with inadequate usual intakes of vitamin B12 ranged from 5 to 8% for different age groups.
Three in four females aged two years and over (73%) did not meet their calcium requirements, compared with one in two males of the same age group (51%).
One in eight people aged two years and over had inadequate usual intakes of iron. The prevalence of inadequate intakes was highest amongst females aged 14-50 years, with nearly two in five having inadequate iron intakes.
One in three people aged two years and over (37% of males and 34% of females) did not meet their requirements for magnesium. Inadequate intakes of magnesium were more common in those aged nine years and over, with 61% of males aged 14 to 18 years consuming less than their requirements for magnesium, and 72% of females of the same age.
More than one in three males (37%) and one in ten females (9%) had inadequate usual zinc intakes. The greatest prevalence of inadequacy was among males 71 years and over, where 66% had inadequate zinc intakes.