Vitamin and mineral supplements: What clinicians need to know

While recent nationwide polls indicate that more than one-half of American adults take at least one dietary supplement, the research also shows that much of this consumption is uninformed, inappropriate, and potentially dangerous. However, according to JoAnn E. Manson, MD, DrPH, of Brigham and Women's Hospital in Boston and Shari S. Bassuk, ScD, of the Harvard School of Public Health, clinicians are in a prime position to encourage appropriate use and avert improper use of micronutrient supplements. A key part of this responsibility, they write, entails advising patients that supplementation cannot take the place of a healthful and balanced diet and typically provides little to no benefit beyond what they would get from eating right. Additionally, Manson and Bassuk recommend that health care providers emphasize the importance of deriving vitamins and minerals from food instead of from supplements. Micronutrients in food are typically better absorbed by the body and trigger fewer potential adverse effects. However, in certain high-risk populations who may not achieve nutritional requirements through diet alone, the authors note, supplementation may be justified. Those groups include pregnant women, infants, and midlife and older adults. Individuals with certain medical conditions—including pernicious anemia, osteoporosis, Crohn disease—or taking certain medications, like proton pump inhibitors, also are viable candidates for dietary supplements under a provider's direction.