As a nutritionist, I am often asked about the effectiveness and necessity of taking various vitamin and mineral supplements. Answers are rarely straightforward. This article series will explore why.

Supplements are thought to buffer against deficiencies and disease, help manage chronic health conditions and aid recovery. A Statistics Canada survey of 35,107 Canadians found that 47 per cent of females and 34 per cent of males were regularly taking supplements. Use increased with income and education levels.

Similar numbers were reported for Americans.

This prompted the National Institutes of Health (USA) to conduct a review of long-term, randomized clinical trials in 2006. It found most synthetic supplements do not work as intended, and may make things worse.

Of the 30-plus nutrients studied, only calcium, vitamin D, selenium and vitamin E came out as probably effective. Calcium and vitamin D were shown to increase bone mineral density and reduce fracture risk in postmenopausal women, selenium showed some evidence of reducing risk for certain cancers, vitamin E seemed to decrease cardiovascular deaths in women and prostate cancer deaths in male smokers, and vitamin D alone showed some cardiovascular benefit.

Trials of vitamins B2, B3, B6, B12, and folate showed no positive effect on chronic disease occurrence in the general population, there was little evidence to recommend beta-carotene (and some evidence that it may cause harm in smokers), and high-dose vitamin E supplementation increased the risk of death from all causes.

Similarly, a famous Journal of American Medical Association (JAMA) study on antioxidants found that treatment with beta-carotene, vitamin A, and vitamin E may actually increase mortality.

Not too reassuring.

Of course, as with most studies, there are detractors. The JAMA studies in particular have been criticized for using incorrect dosage, the least potent forms of synthetic vitamins, and failing to control for nutrient interactions. Many felt the studies were designed to benefit the pharmaceutical industry.

In response to a JAMA summary that vitamins C and E had little effect on prevention of heart disease, Dr. Robert Verkerk, scientific and executive director for the Alliance for Natural Health, stated in one of their press releases that, “With three of the world’s largest drug companies, namely BASF, Wyeth and DSM — formerly Roche — supplying the low dose synthetic vitamins for the study, it’s perhaps not surprising that the outcome is made to look bad for vitamins… Why don’t they ask the people who work with nutrients on a daily basis — integrative medicine doctors — what nutrient forms, combinations and dosages are most likely to work?”

There are a number of reasons why synthetic supplements may not work: the shapes of the synthetic nutrients are different and the body does not recognize them, they are incorrectly balanced with other nutrients, or they are missing essential co-factors needed to catalyze reactions.

It does seem that science, as yet, cannot successfully reconstruct what Mother Nature has wisely put together in these tasty little packages called “food.”

So how can we obtain the nutrients we need — simply and effectively? Stay tuned to find out.