Vitamin Supplements: Vital or Superfluous?

In 2019, the prevalence of vitamin supplement usage in the U.S. reached historically unprecedented rates. In a survey conducted by the Council for Responsible Nutrition, 77% of Americans stated that they consumed supplements as part of their diet. However, the Center for Disease Control’s 2012 Second National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population “found less than 10% of the U.S. population had nutrition deficiencies for selected indicators.” Some scientific studies have concluded that for most adults who do not have diagnosed nutritional deficiencies, taking supplements may not necessarily bring substantial health benefits. A scientific article that reviewed multiple studies concluded that “for the majority of the population, there is no overall benefit from taking MVM [multivitamin] supplements.”

One possible explanation for the perception of vitamin supplements as widely applicable could be rooted in the loose regulation of labels and advertisements for these products. Under current regulations, supplement companies are allowed to advertise using structure/function claims, which only “describe the intended benefit of the supplement on the structure or function of the body.” This stands in stark contrast to health claims, which “describe an established scientific relationship between supplement ingredients and a reduction in the risk of a disease or health-related condition.” Unfortunately, consumers roaming the pharmaceutical aisles may not understand the difference between the two claims and end up buying unnecessary products.

The actual contents of supplement products also face relatively lax regulations. In fact, dietary supplements do not even need approval from the Food and Drug Administration to hit the shelves at stores. Not only that, but they also do not need to withstand the rigorous clinical trials that prescription drugs go through. According to the FDA website, “FDA’s role with a dietary supplement product begins after the product enters the marketplace.” At that time, the FDA can address some safety concerns by “monitoring mandatory reporting of serious adverse events by dietary supplement firms and voluntary adverse event reporting by consumers and health care professionals.” Ashley Reaver is a lecturer at UC Berkeley for the Department of Nutritional Sciences and Toxicology and a registered dietitian with a specialization in sports dietetics. “The responsibility is not on companies to show that their supplements are safe,” Reaver explains. “It’s not on companies to show that the ingredients that they are putting into their supplements are safe, not to mention whether or not they’re actually effective.” She suggests that consumers look for supplements that have undergone third-party verification to help address this issue. Third-party verification, conducted by organizations such as the United States Pharmacopeia, would consist of a comprehensive review that checks for correct dosage and potentially harmful contaminants. “Many supplements do go through third-party testing kind of as a way to verify, but most consumers don’t know that that’s a thing,” Reaver notes. “They’re not looking out for that, they’re not making supplement decisions based on that; they have no idea that supplement companies can put anything that they want into those supplements.” She also recognizes that one downside of third-party verification is that smaller companies may not be able to afford it.

There could also be negative health consequences for overuse or misuse of dietary supplements. Water-soluble vitamins such as B vitamins and vitamin C are relatively safer, since the body builds up stores of them anyway and expels excess amounts through urine. “They’re pretty safe, but they’re expensive pee, basically,” Reaver jokes. Fat-soluble vitamins, on the other hand, have the potential to accumulate in the body’s fat stores, and at high doses, they can eventually reach toxic levels. Additionally, Reaver notes that taking too many different types of supplements or extremely high doses can impact liver health.

Besides the loose regulation of supplement advertisements, the rise of companies such as Ritual and Care/of may have also influenced supplement usage trends. As a CNBC article puts, these companies “are making big bucks reinventing the un-glamorous pills for the Instagram era” with their “sleek packaging, digital-only sales model and social media savvy.” According to the same article, Ritual argued that “‘[r]esearch shows that it can be difficult for your body to get all the nutrients it needs from food, all the time.’” Reaver responds by saying that “for the vast majority of people that have access to a wide variety of foods, supplementation is just not necessary.” Ritual has built a brand around emphasizing transparency and openness, but Reaver points out that this “doesn’t necessarily change the fact that [their multivitamin] probably still includes a lot of nutrients that you don’t need.” Care/of’s speciality is personalized packages of various vitamin supplements. Again, Reaver emphasizes that “just because they’re in a packet and not all in one multivitamin still doesn’t mean that you need all of them.” She adds that “in particular for Care/of, they make more money the more supplements you put into your packet every day,” so consumers may want to be wary when companies profit from recommending additional supplements.

So, the big question remains: who actually needs vitamins? “Typically, if someone isn’t able to eat a variety of foods or in the right quantities, then it would make sense [to take vitamins],” Reaver explains. She points out that people with very restrictive diets, limited access to a variety of foods, or certain medical conditions—specifically those that either hinder absorption of nutrients or come with high nutritional needs—would benefit from vitamin supplementation. Getting a blood test to check for deficiency in specific nutrients can also help confirm whether supplementation is necessary, she suggests. Otherwise, the best idea is usually to turn to food sources for nutrients. “If it’s possible to do that, that [would always] be my recommendation just because you’re going to benefit more than just a single nutrient when you can add an entire food source.”

Although adults aged 55 years and older tend to have the highest usage of dietary supplements, the issue is pertinent to many college students as well. “College is a time when many people start experimenting with a vegan or vegetarian diet without the education of knowing the types of nutrients that you can’t get in the right amounts with just foods from those diets,” Reaver notes. For example, vitamin B12 is typically found in animal products and protein; she suggests that adopting diets that do not regularly incorporate those foods could warrant looking into supplementation with vitamin B12. Even protein in general, Reaver surmises, might be consumed by some college students in smaller amounts than recommended because of the reality that animal protein tends to be relatively expensive. In that case, she recommends trying out cheaper alternative sources of protein, including tofu and nut butters. Calcium is another example of a nutrient that students who transition to a no-dairy diet could unintentionally miss; Reaver suggests looking for plant-based milks that have been fortified with calcium, because it can be difficult to absorb calcium from plants themselves. She also notes that calcium intake could be a concern especially among females, who “tend to also kind of shy away from consuming dairy after a certain point in their life.” Importantly, most people are able to store calcium in their bones up to only about age 30. Later in life, calcium deficiencies could increase the risk of osteoporosis, a medical condition in which bones become more fragile. Reaver emphasizes that “dairy is not the only source of calcium, but it is incredibly important that you don’t cut off a final third of [the] period of time that your body has to really build strong bones that are going to last you for the rest of your life.”

The lack of research-based justifications for relatively healthy, well-nourished adults to take vitamin supplements and the emergence of companies that advertise their supplements to younger audiences are important for college students to consider. For individuals without significant nutritional deficiencies, a healthy diet is often enough to ensure sufficient amounts of nutrients. Students who are concerned about the misconceptions surrounding dietary supplements can inform their friends and family or even advocate for changes in the way these supplements are regulated. Readers who are interested in learning more about this topic in general are encouraged to explore the resources linked on this page. After all, it’s up to each individual to proactively investigate whether vitamin supplements are vital or simply superfluous to their personal health.