We tend to think of them as emporiums of health, stocked with potions, powders and pills that promote well-being.
But a surprising amount of shelf space in drug stores is actually devoted to items which may not provide the health benefits we think they do, products for which the evidence base is not as sound as consumers might believe.
Some experts suggest anyone looking to save money could think about being more discriminating in the aisles of cough and cold medications, vitamins and supplements and antibacterial soaps.
Studies have suggested at least some of these products don’t really make us healthier, help us recover faster or protect us from many of the illnesses caused by germs.
“What many therapies offer really is hope in a bottle. And it’s unfortunate because many of them don’t offer the benefits that we think they offer,” says Muhammad Mamdani, director of St. Michael’s Hospital’s Applied Health Research Centre in Toronto.
Mamdani says products like multivitamins play into the modern culture of convenience – the notion that good health can be achieved and maintained without effort.
“It’s far easier to take a pill and hope for the best than to resort to what we really know works and what we’re more traditionally used to, such as exercise, eating healthy and that sort of thing,” he says.
Dr. David Juurlink concurs.
“I think people have this natural inclination to take something. That’s probably never going to go away,” says Juurlink, a former pharmacist who now practises internal medicine and clinical pharmacology at Sunnybrook Health Sciences Centre in Toronto.
“And pharmacies are always going to sell these things because a) they might not appreciate that they don’t work, b) it gets people in their store and c) it makes money.”
So what are we talking about here? Let’s start with vitamins.
It seems intuitive that ingesting added nutrients would promote good health. And millions of people subscribe to that belief. Vitamins and supplements are a huge business, generating sales of US$28-billion in the United States in 2010, Mamdani notes. The Canadian Health Food Association estimates the natural health products industry contributes $3-billion a year to the Canadian economy.
That organization suggests a large number of Canadians suffer from nutritional deficiencies, pointing to a 2012 Health Canada report on whether Canadians meet their nutritional needs through food alone to back the statement.
The Health Canada study actually says that the majority of Canadians consume adequate amounts of most micronutrients for which an estimated average requirement has been set, though it does note the diets of significant portions of the population are deficient in magnesium, calcium, vitamin A and vitamin D.
Still, multiple studies have come up with mixed or negative results when they put oral nutritional supplements to rigorous tests. In fact last month an editorial in the Annals of Internal Medicine urged people to stop buying multivitamins after the journal published three studies which said the pills don’t stave off memory loss, improve heart health or help people live longer.
“The message is simple: Most supplements do not prevent chronic disease or death, their use is not justified, and they should be avoided. This message is especially true for the general population with no clear evidence of micronutrient deficiencies, who represent most supplement users in the United States and in other countries,” the editorial states.
The Canadian Health Food Association counters the findings, saying other studies support the effectiveness of multivitamins. “It is difficult to conduct direct comparisons between individual ‘positive’ or ‘negative’ study findings due to differing methodologies, and overall more high-quality research is needed to further explore the benefits of multivitamins,” the association said in an emailed statement.
The vice-president for scientific and technical affairs for supplement maker Jamieson Laboratories also challenges the recent findings, saying studies that set out to see if multivitamins prolong life or prevent heart disease are asking the wrong questions.
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