Vitamin and dietary supplement use has increased steadily in the United States, with a whopping 85% of women in the Iowa Women's Health Study reporting supplement use. The 1994 Dietary Supplement Health and Education Act helped to foster the growth of this industry by creating a new regulatory framework, which puts the onus on the US Food and Drug Administration (FDA) to show that supplements are unsafe before it can take action. Manufacturers are not required to disclose to the FDA or to consumers the evidence they have regarding their products' safety, nor must they empirically back up claims of purported benefits. This permissive approach has encouraged sales of more than $20 billion annually for dietary supplements. Mursu et al find that consumers are getting little value for this expenditure and that increased mortality is associated with most of the commonly used vitamins and mineral supplements, not to mention the opportunity costs. A better investment in health would be eating more fruits and vegetables, among other activities. Because commonly used vitamin and mineral supplements have no known benefit on mortality rate and have been shown to confer risk, this article has been given our “Less Is More” designation.
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