Study: Doctors who take multivitamins realize no greater benefit in preventing heart disease
CHICAGO — A study published Monday online by JAMA may skew the conversation over multivitamin use negatively, despite the fact that study authors maintain the study cannot be generalized across the general population given the study’s subjects — namely, practicing physicians.
In a randomized study that included nearly 15,000 male physicians who were middle-aged or older, daily multivitamin use over the course of more than 10 years of treatment and follow-up did not result in a reduction of major cardiovascular events, heart attack, stroke or death from cardiovascular disease, according to a study appearing in Nov. 7 issue of JAMA.
“Although multivitamins are used prevent vitamin and mineral deficiency, there is a perception that multivitamins may prevent cardiovascular disease," noted lead researcher Howard Sesso of Brigham and Women’s Hospital and Harvard Medical School in the report. "Observational studies have shown inconsistent associations between regular multivitamin use and CVD, with no long-term clinical trials of multivitamin use.”
“We’re not surprised by these results, but they don’t discount the many other benefits that multivitamins provide, including filling nutrient gaps, helping prevent neural tube birth defects and serving in combination with other healthy habits as a basic and affordable insurance policy for overall wellness," stated Duffy MacKay, VP scientific and regulatory affairs for the Council for Responsible Nutirition. "Even though two weeks ago, this same study demonstrated a modest but significant reduction in total cancer risk in this same population, no one should expect the multivitamin to wipe out all diseases known to man," he said.
The population in question would have skewed heart-healthier without regard to multivitamin use, MacKay noted. “This particular population was extremely healthy, with the physicians doing everything right to prevent heart disease. Their diets were healthy, their BMIs were low, they exercised, very few smoked, and the majority were on a daily aspirin regimen," he explained. "The floor in this population may have been too close to the ceiling for a simple multivitamin to have demonstrated additional benefit for preventing strokes and heart attacks," he added. "It’s unfortunate that the accompanying editorial makes negative assumptions about the habits of vitamin users, when the research demonstrates supplement users are taking them in combination with other healthy lifestyle choices."
According to MacKay, other studies show that supplement users are more likely to be leaner and more physically active than supplement non-users — not as a consequence of supplement use, but in conjunction with supplement use. "Our own research shows similar kinds of results, with supplement users being more likely than non-users to try to eat a healthy diet, engage in regular physical activity and see a doctor regularly," MacKay said. "It’s the whole lifestyle package — including consistent, long-term use of vitamins — that helps lead to good health.”
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Gummy vitamins not just for kids
Target and CVS are some of the first retailers to group adult multivitamins and supplements available in gummy format into one 4-ft. set. The idea is to make shopping vitamins and supplements easier. For the 12 weeks ended Sept. 9, SymphonyIRI Group tabulated $202 million in sales of multivitamins, up slightly by 0.8%, across food, drug and mass (excluding Walmart).
“Gummy vitamin buyers tend to be different than the typical VMS consumer, a little bit younger,” noted Doug Jones, Pharmavite spokesman. Pharmavite this summer launched a line of seven gummy vitamin SKUs with a taste profile targeting an adult palate.
The article above is part of the DSN Category Review Series. For the complete VMS Sell-Through Report, including extensive charts, data and more analysis, click here.
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Dieters still hungry for weight-loss products
The opportunity for weight loss certainly hasn’t gone away — sales of diet-aid liquids were up 12.8% to $1.2 billion for the 52 weeks ended Sept. 9 across food, drug and mass (excluding Walmart), according to SymphonyIRI. And due to the temporary absence of GlaxoSmithKline’s Alli — unavailable because of a raw-ingredient sourcing issue — sales of diet-aid tablets are down with a 7% decline to a dollar base of $205.4 million. Alli had been removed from the market in March due to the third-party supply issue and returned in late June.
But GSK’s Alli is back, not only to market but also on the planning boards of GSK’s internal marketing team. “Our [new] campaign is called ‘Let’s fight fat,’” said Deborah Larsen, GSK’s marketing director for Alli.
The campaign focuses on partnering with dieters on their path to weight loss, Larsen said. “There will be TV advertising; there will be print. We have quite a few value-added programs [around which] we are working with our major retailers right now,” she said. For example, GSK will be offering a cookbook with low-fat recipes as part of an Alli purchase.
One of the first changes made to Alli following its “relaunch” was a revamped website at MyAlli.com. “We have [always had] live moderators that are part of the site, and we’ve continued that,” Larsen told DSN. “We’ve learned, for example, that although information about the product is extremely important, [dieters] really need some day-to-day support in areas like a recipe that [contains] the right fat content, [and] maybe some motivation because they’ve been working on their journey for a while and their weight loss is not going as fast as they’ve hoped it would.”
A second marketing enhancement new to Alli is its foray into social media sites like Facebook and Twitter. “Facebook is a very significant place for new users,” Larsen said. “We do encourage new users to go to MyAlli.com from Facebook. But what is particularly gratifying about Facebook is that many of our loyal users are sharing tips, tools, approaches, techniques and encouragement to each other,” she said. “The weight-loss consumer is really hungry for information … so that they can make the right decision for themselves.”
That approximate four-month hiatus of the leading diet-aid tablet ($32 million in sales for the 52 weeks ended Sept. 9, down 38.1%) may have helped contribute to the uptick in meal replacement bar sales (up 15.9% to $1.1 billion). “As we saw the decline of the diet pill business and shift toward meal replacement, we developed products to capitalize on this customer demand,” said GNC’s chairman, CEO and president Joe Fortunato during the specialty retailer’s second-quarter conference call. “We are seeing success with both genders, and are building on this by expanding Total Lean ready-to-drink flavors and by adding complimentary products like breakfast bars and a branded Total Lean Vitapak.”
Another potential driver to sales of diet aids and meal replacements in the nonprescription aisle is two promising prescription-only weight-loss solutions. In June, the Food and Drug Administration approved Arena Pharmaceuticals’ Belviq (lorcaserin hydrochloride), designed for use alongside reduced-calorie diets and exercise for chronic weight management. Eisai distributes the drug. The drug works by activating the brain’s serotonin 2C receptor, which is believed to help people eat less and feel full after eating smaller amounts of food.
And in July, the FDA approved Vivus’ new weight-loss drug Qsymia (phentermine and topiramate), an extended-release diet aid designed for use by overweight and obese adults alongside a reduced-calorie diet and exercise for chronic weight management. Those prescription options are not likely to cannibalize OTC sales, as they’re targeting the more than 15 million morbidly obese people, but they are likely to raise awareness.
“With the approval of these new treatments, we strongly encourage individuals affected by obesity to have the discussion of weight with their healthcare professional,” stated Joe Nadglowski, president and CEO of the Obesity Action Coalition. “Quite often, individuals affected avoid the conversation of weight due to a lack of treatment options. Thanks to the FDA’s recent movement toward increasing options, Americans will now have more tools in the toolbox to address their weight and health.”
“With two-thirds of Americans being overweight or obese, having one OTC brand is not enough to really serve everybody who needs help,” Larsen noted. “Those Rx customers for the past two years have been underserved.”
One thing’s for sure — the market for weight-loss products won’t be going anywhere anytime soon. The proportion of Americans who are severely obese — those people 100 pounds or more overweight — continues to increase rapidly and much faster than those with moderate obesity, though the rate of growth has slowed according to a new RAND Corp. study released in early October. That feeds into an overall health-and-wellness trend being driven by employers and health plans — health-and-wellness initiatives that will help populate diet-aid aisles.
“This is a really important trend in the retail space,” Larsen said. “The approach will drive consumers into the store. Retailers are doing a lot of very aggressive promotion around helping people achieve their optimal health and wellness,” she said. “Consumers are really looking to engage. They want to be part of something.”
The RAND study found that from 2000 to 2010, the proportion of Americans who were severely obese rose from 3.9% of the population to 6.6%, an increase of about 70%. “The proportion of people at the high end of the weight scale continues to increase faster than any other group of obese people, despite increased public attention on the risks of obesity,” stated Roland Sturm, lead author of the report and a senior economist at RAND, a nonprofit research organization. “But for the first time in the past 20 years, there is evidence the trend is slowing.”
The prevalence of severe obesity was about 50% higher among women than among men, and about twice as high among blacks when compared to Hispanics or whites. For all levels of obesity, the increases over time were faster among age groups younger than 40 years.
To be classified as morbidly obese, a person must have a body mass index of 40 or higher — or roughly 100 pounds or more overweight for an average adult man. People with a BMI of 25 to 29 are considered overweight, while a BMI of 30 or more classifies a person as being obese. To download a pdf of the Rand study, click here.
The article above is part of the DSN Category Review Series. For the complete Diet/Sports Nutrition Buy-In Report, including extensive charts, data and more analysis, click here.
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