Provide evidence: Harvey challenges CM industry


CMs in half an orange

Dr Ken Harvey has issued a challenge to complementary medicines manufacturers to provide evidence to support their products.

Articles in mainstream media including the Herald Sun and the Daily Mail over the weekend featured comments from Dr Harvey stating that multivitamins are a “waste of time and money”.

Complementary Medicines Australia slammed the reports this week, with chief executive Carl Gibson saying that while it’s important to emphasise that vitamins and minerals are not a substitute for a good diet, supplements do have an important role to play alongside a healthy diet and exercise.

“Australia’s eating habits are less than ideal, with most Australians not meeting the minimum recommended serves for the five major food groups,” Gibson says, citing ABS data.

“The typical Australian is eating plenty of food but is still starving of quality nutrients from vegetables, fruit, diary products, lean meats and grain-based foods, instead filling up on energy-dense, nutrient-poor ‘discretionary foods’ such as cakes, confectionary and pastry products.”

“Complementary medicines, including vitamins, minerals and multivitamins, are generally regulated in Australia as Listed, low risk medicines, used for minor self limiting conditions, maintaining health and wellbeing, or the promotion or enhancement of health.

“Multivitamins, which can contain anywhere from 12-25 plus ingredients per dose, are designed to protect against broad nutritional deficiencies.

“Multivitamins can play a role in improving general health and decreasing the risk of chronic disease. For example, the Physicians’ Health Study II, which is the largest randomised clinical trial of a multivitamin supplement conducted to date, showed a statistically significant 8% reduction in total cancer incidence in male physicians.

“It is perhaps not surprising, then, that in Australia there has been a growing use and acceptance of complementary medicines by individuals keen to care for their general health and wellbeing.

“Many people take multivitamins because they know they don’t always eat as well as they should, with the typical Australian diet shown to fall well short of the recommended daily nutrient requirements.”

However, Prof Harvey told the AJP today that the inclusion of more ingredients in a product does not necessarily mean the product is more efficacious.

“The aim appears to be who can include the most ingredients; presumably on the marketing principle that the more ingredients the greater the appeal to consumers,” he says.

He says he defies Mr Gibson and manufacturers “to provide scientific justification for many of the ingredients in these products, especially the herbs, fruit and vegetable powders”.

“I am unaware of any evidence that shows the small amount of fruit and vegetable extracts in capsules are a substitute for eating the real thing.

“Australians should spend their money on fruit and vegetables; not multi-vitamin pills.”

He criticises the use of the Physicians’ Health Study II as support for multivitamin use in cancer prevention.

“It’s important to use absolute numbers, not relative numbers when discussing treatment benefits,” he says.

“In absolute terms the difference in this study was 1.3 cancer diagnoses per 1000 years of life (18.3 compared to 17 events, respectively).

“This difference may have been statistically significant but is it clinically significant? Mr Gibson did not mention an accompanying editorial to the paper in JAMA which was dismissive of the report on several counts.

“In addition, this is just one study in a crowded field; the majority of studies suggest no effect of vitamin supplementation on cancer risk and some show evidence of harm.

“A subsequent editorial in the Annals of Internal Medicine titled, ‘Enough Is Enough: Stop Wasting Money on Vitamin and Mineral Supplements’ concluded, ‘Evidence is sufficient to advise against routine supplementation, and we should translate null and negative findings into action. The message is simple: Most supplements do not prevent chronic disease or death, their use is not justified, and they should be avoided’.

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5 Comments

  1. Ken Harvey
    17/06/2016

    Let’s be more specific, Swisse Men’s Ultivite contains 53 vitamins, minerals, antioxidants and herbs and fruit extracts. Blackmores Alive! Men’s Multivitamin has 56 ingredients, including 20 fruit and vegetable powders such as grape, apple, asparagus, banana, beet, broccoli, cabbage, carrot, cauliflower, red pepper, kale, orange, raspberry, spinach, strawberry, elderberry and black currant! Evidence please?

    • Ian Carr
      17/06/2016

      I don’t have any evidence, Ken, but I reckon it would be delicious if reconstituted back to food.

  2. Sue Ieraci
    17/06/2016

    It makes sense that the Chief Executive of CMA would try to defend his products – that is his job. But just saying that “supplements do have an important role to play” does not make it true. Gibson cites a single study: Multivitamins in the Prevention of Cancer in Men
    The Physicians’ Health Study II Randomized Controlled Trial (JAMA 2012)

    Let’s look at that one study:
    They tested the use of a commercial multivitamin plus vitamins E, C and beta carotene “in the prevention of cancer, cardiovascular disease, eye disease, and cognitive function among 14 641 male physicians aged 50 years or older.22 The beta carotene component was terminated on schedule in March 2003.

    The results were mostly negative: there was a tiny difference between the groups in total cancers, but no difference in any of the other endpoints.

    If purveyors of commercial products want to make claims about efficacy, they should provide solid evidence, or withdraw the claims.

    Dr Harvey has no vested interests here – just the interests of public health.

  3. Ken Harvey
    20/06/2016

    There is a relevant editorial on this topic by Rosemary Stanton in the current issue of the MJA, “Changing eating patterns versus adding nutrients to processed foods” (and supplements). Available at:

    https://www.mja.com.au/journal/2016/204/11/changing-eating-patterns-versus-adding-nutrients-processed-foods?

  4. Mira Clota
    25/06/2016

    I am uninformed of any confirmation that demonstrates the little measure of foods grown from the ground removes in containers are a substitute for eating the genuine article. Pretty Herbs & Dietary Supplements Multi Vitamins : https://dietarysupplements.searchub.com/multi-vitamins/

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