by Andrew Shao, Ph.D.
The Dietary Guidelines for Americans are intended to help “guide” Americans to good dietary habits that promote health and reduce risk for major chronic diseases—a difficult feat considering ours is a country struggling with obesity, heart disease and other health concerns stemming from calorie-rich, nutrient-poor diets and sedentary lifestyles. The Guidelines, available online (CNPP.usda.gov/DietaryGuidelines.htm), must, among other things, provide dietary advice that is consistent with the Institute of Medicine’s (IOM) Dietary Reference Intakes (DRIs). Unfortunately, the 2010 Dietary Guidelines Advisory Committee (DGAC) in its 2010 Report (CNPP.usda.gov/DGAs2010-DGACReport.htm) all but ignored a simple step that could help ensure Americans avoid nutrient shortfalls—taking a daily multivitamin, or other nutritional supplements, to fill nutrition gaps.
The DGAC notes a significant number of Americans are still coming up short for 10 essential nutrients, with the probability of adequacy “tenuous.” Yet, the report goes out of its way to avoid recommending dietary supplements to fill these gaps, even noting the impractical recommendation of “guava” as a good way to fill the void for vitamin C.
As surprisingly, the 2010 Report takes the position that low nutrient intakes are only of public health significance if they result in overt deficiency. In other words, unless you have scurvy, the DGAC does not seem to be bothered by the portion of the U.S. population that is not reaching the Recommended Dietary Allowance (RDA) for vitamin C. Yet, the government goes to a good deal of trouble and expends substantial resources to fund the IOM’s development of the DRIs, which includes the RDA. These, in turn, serve as the basis of Daily Value labeling on nutrition products, including dietary supplements. So, one would think nutrient shortfalls—meaning not just deficiency but also inadequacy—would be a concern the Dietary Guidelines would address, in any safe, reasonable way possible. Yet, the DGAC appears to take the position that it is better for consumers to live with a shortfall rather than taking the convenient, cost-effective and calorie-free step of adding a multivitamin or other nutritional supplement to a well-rounded nutrition program.
A concern of the DGAC appears to be the notion that, if sanctioned, Americans will rely on a pill to substitute for a healthy diet or “make up” for a poor diet. However, there is no evidence this assumption holds. In fact, survey research consistently demonstrates those who take dietary supplements are more likely than non-supplement users to engage in other healthy habits.
By recognizing multiple nutrient shortfalls, but discouraging multivitamin use, the DGAC is, in effect, saying living with shortfalls is preferable to reasonably filling nutrient gaps with dietary supplements. But, it seems unfair to ask the general public to wait until nutritional shortfalls reach the cataclysmic level of deficiency, like rickets or anemia, before recommending additional nutritional support. Survey after survey reports Americans, including children, pregnant women, developing teenagers and aging Americans, are not meeting the basic nutrient recommendations through diet alone. As a nation, can’t we reasonably agree it is better to achieve RDAs established by the IOM than not? In other words, in the absence of clear deficiency or prevention of chronic disease, isn’t achieving recommended intakes, by definition, beneficial?
It’s time for the government to provide advice that is as practical as it is science-based. The use of a multivitamin by health-conscious consumers who are taking proactive steps to better health should be supported rather than discouraged, particularly if they are trying to stay within a reasonable calorie limit, which U.S. consumers are having a difficult time doing.
