Take Home Points:
An apple is reduces vascular disease as well as a statin, without the associated side effects.
Multi-vitamins are potentially a waste of money.
At COR, we have previously suggested the use of multi-vitamins, but a change ahead may be mandated after the literature released this week. Yet, our views have been shifting towards individuality, like all forms of training. Supplement use can help a deficiency, but doesn’t appear to approve all. This makes blind supplementation and recommendations for everyone far from ideal and a waste of money.
Now, many will not follow these recommendations, as they are undoubtedly brainwashed by supplement companies or their Advocare/Herbalife representatives. Everyone who is against the pharmaceutical industry must realize big pharmaceutical companies are behind supplements as well! Further, what I do recommend is to eat a better diet, exercise, and get more rest. Anyone recommending supplements or pharmaceutical medications over this recommendation must be questioned and the research does support this!
Specifically the evidence shows that taking a multivitamin is not a substitute for a healthy diet. A recent paper
in the BMJ
further makes the point that promoting a healthy diet can have a significant impact on reducing vascular risk. This is not a study, but rather a statistical model that uses existing evidence and asks two questions:
- What would happen if everyone over 50 were offered a statin, and 70% complied?
- What would happen if everyone over 50 were told to eat an apple a day (or one extra portion of some fruit) and 70% complied (and assuming no overall increase in calorie consumption)?
This study suggests:
The estimated annual reduction in deaths from vascular disease of a statin a day, assuming 70% compliance and a reduction in vascular mortality of 12% (95% confidence interval 9% to 16%) per 1.0 mmol/L reduction in low density lipoprotein cholesterol, is 9400 (7000 to 12 500). The equivalent reduction from an apple a day, modelled using the PRIME model (assuming an apple weighs 100 g and that overall calorie consumption remains constant) is 8500 (95% credible interval 6200 to 10 800).
That statin would save 9,400 lives, while eating an apple would save 8,500 lives per year … looks like a wash to me. Plus, an apple a day has fewer side effects. The increased statin use would also cause over a thousand cases of muscle disease and 10,000 new diagnoses of diabetes, two forgotten side effects of statins.
Now, the authors in this study did not recommend replacing statins with eating more fruit, as statins did have a slightly greater improvement. But, each individual must make this consideration, as an apple is cheaper, has less side effects, and is virtually as effective.
Eating healthy, exercising, and getting more sleep are not radical or one of a kind thoughts, but simply work for nearly all people. The evidence also shows that taking vitamins does not substitute for a good diet. In fact one of our criticisms of pushing vitamins is that it may lead to a false sense of security and give people psychological “permission” to persist with a suboptimal diet.
I think it’s important, in fact, to keep our message as simple as possible. I am concerned that getting overwhelmed with all the minute details of specific nutrients and nuanced diets has an overall negative effect on public health, because the more basic messages are getting lost in the noise. There is an entire industry, in fact, based upon that noise (including statistical noise in the research).
If you want to live longer, here is what the evidence clearly shows in terms of lifestyle:
- Eat a well-rounded healthy diet
- Exercise regularly
- Get enough sleep
- Don’t smoke
- Use alcohol in moderation
Perhaps an apple will replace a statin, maybe one of these days…