More MS news articles for Mar 2002

Are multi-vitamins too much to take in?

The huge demand and market for supplements in Britain is under the EU spotlight, reports Christine Doyle


A VITAMIN and mineral pack dropped on my desk recently - just one of the dozens I receive during the year - which recommended that seven pills, containing more than 100 ingredients, be taken every day. It included a multi-vitamin pill containing eight times the recommended daily allowance (RDA) of vitamin C and three to five times the allowance of several other vitamins. Another contained 10 times the daily allowance of vitamin E plus lycopene (tomato extract) and marigold petal extract.

There was also a flavonoids and isoflavones pill with green tea, grape seed and soya extract together with bilberry complex; a fish oil capsule; one of calcium and magnesium; a co-enzyme Q10 plus glucosamine pill; and, not least, a betaine capsule that also contains bilberry extract.

The list of ingredients, caking and glazing agents, starches and colours made me queasy. And the six warnings on the packet made me feel uneasy: if already taking a vitamin A tablet, you are advised to stop when starting the seven-a-day, freshness sealed-in, handy day-pack. If on warfarin to thin the blood, you should consult your GP before taking the isoflavones caplet. If a smoker, consult a doctor before taking the vitamin E and carotenoids capsule. Allergy warnings complete the disclaimer list.

This is chemical supplementation gone mad and might lead some people to cheer a European directive that could mean the removal of more than 300 vitamin and mineral supplements from the shelves of health food shops and supermarkets.

If the directive becomes law, as is expected today, many manufacturers will have to submit safety dossiers and make a good case for the efficacy of their product.

The idea is to inject more order into a market worth £376 million last year. Britain is, at present, among the more liberal countries in allowing doses far higher than the official RDAs. In France, over-the-counter supplements may contain only the official RDA. In Germany, three times the RDA is permitted. Anything higher must be prescribed, on clear medical grounds.

But the largely ad hoc approach to supplements in this country has, it is claimed, helped to gain recognition for genuine benefits. Sue Croft, of Consumers for Health Choice, a European consumer lobby group, points out: "It took successive governments 17 years before recognising the benefits of folic acid in lowering the risk of neural tube defects. This was a consumer-led movement.

"Widely accepted studies also link moderate amounts of vitamin E with a lower risk of heart disease. There must be dozens of other supplements, including minerals such as boron - which is linked with bone health and which may no longer be permitted in supplements - that could be proved to have specific benefit. This will not happen if their use is severely restricted."

One of the most contentious areas is the use of the antioxidants vitamins A, C and E to prevent cancer and to help those with the disease to stay healthy. Recently, however, studies suggested that huge doses of vitamin C could increase the risk. Vitamin A is also known to be harmful in high doses - in the elderly, it is linked with increased risk of osteoporosis and hip fractures.

Cancer Research UK does not recommend vitamin supplements for cancer prevention outside properly conducted trials. Lesley Walker, director of cancer information, says: "There is no conclusive evidence to suggest benefit, and recent research suggests they could be harmful in some cases." Generally, Dr Walker considers a balanced diet with five or more portions of fruit and vegetables a day "far preferable".

Wendy Doyle, spokesman for the British Dietetic Association, says: "Nutrients work together as a team; if you start taking too much of one, say iron or zinc, they compete with each other and one will be absorbed less well. The idea that the more you have of a good thing, the better it is for you is not the case. I think we need some specified upper limits." With the elderly, people who are depressed or those living chaotic lifestyles, an ordinary multi-vitamin might be helpful, agrees Dr Doyle.

Cynics suggest that all we are doing is producing ever more expensive urine. Even Sue Croft, who fears the European directive will prove Draconian, thinks the vast number of vitamin and mineral sources available over the counter "could be whittled down substantially".

© Copyright of Telegraph Group Limited 2002