A new study has reviewed the usage of nutritional supplements in relation to disease and clinical outcomes. Commenting on this latest study, dietitian, Dr Carrie Ruxton from the Health & Food Supplements Information Service notes: “Supplements are for topping up nutrients in people who want to achieve recommended dietary requirements and should not be viewed as quasi-drugs for treating or preventing disease.
“Firstly, it was not a randomized controlled trial and, as a result, did not provide any data about the nutrient status of the study population nor the amounts of vitamins and minerals in the supplements taken. It is, therefore, impossible to make causal links with effects in this study.
“Secondly, government data2 show so many of us are short of vital nutrients like vitamins D, C, E, Folate, which support our immune health, plus minerals like iron, zinc and selenium, as well as omega-3 fats. As a result, people should carry on eating a well-balanced diet, bridging any dietary gaps with a multivitamin and multimineral supplement as well as fish oil or omega-3 supplements.”
“Looking at the study in detail, this was a cross sectional study amongst 21,063 users and non-users of multi-vitamin and mineral supplements from the US 2012 National Health Interview Survey. It was a self-rated health status survey which found that nutritional status was better amongst those who took supplements. Clinical outcomes, such as history of chronic conditions and severity of stress, were no different in those who took supplements versus those who didn’t.
“Vitamin and mineral supplements are intended for use across the population, particularly in the large numbers of people who have low intakes and are at risk of deficiency. In the UK, the National Diet and Nutrition Survey (NDNS) shows that shortfalls of vitamins and minerals across the board are evident, increasing the risk of poor health.  In fact there is not a single nutrient tracked in the NDNS where there are not significant numbers of people falling short of the target recommendation.
“With regards to vitamins, nine out of ten women of child-bearing age now have such low levels of folate that if they became pregnant, their child would be at increased risk of neural tube defects. A quarter (24%) of girls aged 11 to 18 years have inadequate intakes of vitamin A while one in eight adults (13%) is falling short of vitamin A. One in ten adults aged 19 to 64 years has low intakes of vitamin B2, with 14% of women falling short, compared with 6% of men.
“The NDNS also reveals widespread shortfalls of minerals and trace elements. Iron deficiency affects one in ten women, potentially having a negative effect on immunity and cognitive function. One in five (22%) girls aged 11 to 18 years fail to achieve the target for calcium, an increase of 47% since the first NDNS; intakes are also falling among boys of the same age with 16% now failing to meet the target, compared to 11% a decade ago. One in ten (9%) adults aged 19 to 64 is not getting enough calcium and 11% of women over 65, who are at increased risk of osteoporosis and fragile bones, are falling short. One in eight (12%) working-age adults are also not getting enough iodine — an increase of 71% since the first NDNS.
“More than a quarter of teenage boys (27%), and half the girls in this age group, are not achieving the minimum target for magnesium. The equivalent figures for adults are 13% of working-age adults and 16% of over-65s. 
“In the case of zinc, the NDNS data reveal that more than one in four 11 to 18-year-olds (22%) fail to achieve the recommended intake., More than a third of teens (35%) and working-age adults (36%) and over half of over-65s (52%) fail to achieve the minimum target for selenium. Two out of three (66%) women over 65 years are lacking selenium, a rise of 29% since the first NDNS.”
In summary, Dr Carrie Ruxton adds: “Vitamins and minerals can be obtained from a healthy diet but data show that very often this does not happen. In the context of the serious vitamin and mineral shortfalls in the UK diet, it remains prudent to recommend that people take a multivitamin and multi-mineral supplement. Of key importance is that the government currently recommends that everyone consider taking a vitamin D supplement of 10 micrograms daily which is particularly important during this period of shorter hours of sunlight. This study should not be used to dissuade the public from supplementing what, for many people, is a diet low in micronutrients.”
 Paranjpe M et al (2020). https://bmjopen.bmj.com/lookup/doi/10.1136/bmjopen-2020-039110
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