Industry responds to U.S. Preventative Services Task Force conclusion on vitamin supplementation

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The U.S. Preventive Services Task Force (USPSTF) has released its final recommendation statement on vitamin, mineral, and multivitamin supplementation for the prevention of cardiovascular disease and cancer. The Task Force concluded that with “moderate certainty” that there were harms to beta carotene supplementation that outweigh the benefits for the prevention of cardiovascular disease or cancer, and that there was no net benefit of supplementation with vitamin E to prevent cardiovascular disease and cancer. When it comes to multivitamin use, USPSTF concluded that there was insufficient evidence to determine the harms or benefits of supplementation. It drew the same conclusion for supplementation with single or paired nutrients for the prevention of cardiovascular disease and cancer. This recommendation replaces its 2014 recommendation, but the conclusion is the same, despite the assessment of new evidence.

Given the narrow scope of the Task Force’s review, advocates of the dietary supplement industry contend that USPSTF’s conclusions should not discourage supplement use given supplementation with vitamins and minerals fill nutrient gaps, and has been shown in research to impart numerous other benefits. Nor are dietary supplements designed to prevent or cure diseases.

“This is no surprise to anyone in the dietary supplement industry, because any manufacturer claiming that the products could have these kinds of effects would be in violation of laws against false claims," Daniel Fabricant, PhD, president and CEO of the Natural Products Association (NPA; Washington, D.C.), in a statement. "The USPSTF plays an important role in the federal government’s approach to health care and reimbursement considerations, but this research is akin to studying a hammer and concluding it is unsuitable for turning a screw. Dietary supplement manufacturers are prohibited from saying their products would help prevent cardiovascular disease or cancer because they cannot, plain and simple."

“The USPSTF found again what it found in 2014 and in 2021, that there is not yet enough evidence to determine if vitamin and mineral supplements help prevent cardiovascular disease (CVD) and cancer. However, dietary supplements should not be confused with drugs, and beyond the narrow focus of this review, the broader evidence base for the benefits of dietary supplements is growing rapidly,” said Duffy MacKay, ND, senior vice president of dietary supplements at the Consumer Healthcare Products Association (CHPA; Washington, D.C.), in a prepared statement. “The NIH Office of Dietary Supplements reminds consumers and healthcare providers that supplementation can be helpful for people including those over 50, those who could become pregnant, breastfed babies and toddlers, those who avoid certain foods or who have poor diets, and many others.”

“Numerous research studies support the use of multivitamins by most Americans for a range of benefits. First, multivitamins fill in significant nutrition gaps in Americans. Government data shows that most Americans fall short in many key nutrients. In fact, the Food and Drug Administration and the 2020–2025 Dietary Guidelines for Americans identified that under-consumption of calcium, potassium, dietary fiber, and vitamin D is of public health concern for the general U.S. population because low intakes are associated with numerous health concerns,” said Andrea Wong, PhD, senior vice president, scientific & regulatory affairs at the Council for Responsible Nutrition (CRN; Washington, D.C.), in a statement.

“Second, the recent Cocoa Supplement and Multivitamin Outcomes Study (COSMOS) is among the growing evidence that multivitamins help delay cognitive decline in older people,” Wong continued. “Finally, results of the Physicians’ Health Study II, a large-scale, randomized, double-blind, placebo-controlled trial showed an 8% reduction in overall cancer risk in older male physicians who took a multivitamin. These are just a few of the many benefits from multivitamins, not to mention the benefits from individual ingredients that are in the multivitamin like B vitamins, vitamin D, etc. The apparent limited evidence should not be misinterpreted as the absence of benefit.”