The vitamin epidemic: How did we get so hooked on pills?

This story is a part of our series exploring the benefits and cost of vitamins to our health and hip pocket.

Vitamins were named for their vital properties, and they can indeed be life-saving.

But, they can also be a waste of money, and even dangerous.

Yet, the majority of Australians still consume vitamins, often just in case.

A cure-all in a bottle? The rise of vitamins.Credit: Aresna Villanueva

While some may not even be able to afford fresh food, others don’t scrimp on our supplements, contributing to a global market that is projected to hit $US98.6 billion in the next five years.

How did we become so convinced we needed to buy pills and powders instead of the eating the whole foods that naturally contain those vitamins?

The path to isolating vitamins as a cause of – and cure for – disease started in France nearly 200 years ago.

White rice, gelatinous broth and artificial milk

Marie Antoinette may or may not have suggested starving subjects eat cake in the absence of any bread, but it didn’t catch on. Luckily, the elites of the country had another idea: what if, after they enjoyed their meat, they boiled the bones to extract gelatine and fed the broth to the sick and destitute?

To test whether the gelatine broth could sustain people, the Gelatine Commission was established in 1831.

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After discovering the dogs fed the gelatinous soup died of starvation, a series of experiments established that gelatine lacked what we now know as essential amino acids to be a complete source of protein and was not a complete food source either.

In a separate experiment testing the sustenance of nitrogen-deficient foods (that is, foods without protein), dogs were fed nothing but sugar and water. They developed sores on their eyes and died within a month.

When another French doctor noticed that the malnourished orphans in his care had eye-sores similar to the dogs in the nitrogen studies, it sparked questions about which nutrients were necessary to survive and thrive.

These observations laid the groundwork for further experiments and nutrition-related studies.

The dominant theory at the time was that germs caused disease, yet it did not explain all illnesses, including common conditions such as eyesores and blindness (vitamin A deficiency), scurvy (vitamin C deficiency), beriberi (thiamine, or vitamin B1, deficiency), rickets (vitamin D deficiency) and pellagra (niacin or vitamin B3 deficiency).

Scientists puzzled over the mysterious substances present in certain foods that seemingly caused disease and even death when removed from the diet.

Mysterious substances in milk and other foods had researchers stumped.Credit: Getty Images

The dairy shortage during the Siege of Paris in the late 1800s was one of these instances.

The city was encircled, cutting off the fresh milk supply from the country’s farms. The resulting surge in deaths among babies and young children led some chemists to attempt to manufacture artificial cow’s milk. The artificial milk, made with sugar, albumin, water and fat, didn’t save the children.

“We must renounce, for the present, the pretension to make milk,” wrote French chemist, Jean Baptiste Dumas.

There were “indefinite substances” in the real milk that contributed to the sustenance of life: “The smallest and most insignificant traces of matter may prove to be… indispensable.”

Researchers continued to try to isolate the elements in foods such as eggs, rice, fruit and vegetables and fresh milk that could cause – and remedy – disease.

A breakthrough occurred in 1912, when a Polish chemist with a cool name, Casimir Funk, came up with the term vita for “life” and amine (Latin for containing nitrogen).

Funk had become intrigued by research that found that chickens fed polished rice, with no bran, developed the equivalent of human beriberi. In Asia, beriberi did not affect those who ate mostly brown rice (which contains the bran rich with thiamine), but was rife where milled white rice was the staple, leading to weakness, nerve damage, and heart problems.

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Doctors wrote graphic accounts of how the illness cause patients to lie “like logs in their beds”, unable to move even a finger:

“Some are atrophied to skeletons; others are swollen out with dropsy; and some show just sufficient dropsy to conceal the atrophy the muscles have undergone.”

Through his work feeding polished rice to pigeons and, when they began displaying the symptoms of beriberi, feeding them the bran, Funk managed to identify what would become known as vitamin B1.

These diseases, he concluded, were the result of deficiencies of these vital amines (when it was later discovered that they were not all amines, the “e” was dropped from the word).

Within a year, American chemists found that a fat-soluble substance in egg yolks and butter sustained rats whereas the fat from lard or olive oil did not. That substance became known as vitamin A.

Over the next three decades all 13 known vitamins were discovered, named in the order they were found: Eight forms of vitamin B; vitamin C; and the four fat-soluble vitamins A, D, E and K.

An alluring way to optimise health

Vitamins became a common addition to the diets of many households following World War II.Credit: Getty Images

Nobel prizes flowed and by the 1930s the vitamin industry was booming.

The onset of World War II saw them become a staple of many households. This was because one third of American men drafted to serve suffered from health issues linked to poor nutrition. In response, the first US government-recommended daily allowances (RDAs) for six vitamins and two minerals were established in 1941.

And, as Professor Oliver Jones of Melbourne’s RMIT University says: “What works for the army can also work for the general population.”

No longer were vitamins being used to treat the sort of disease sailors (or soldiers) got when they had no access to fruit and vegetables, or when there were no eggs, milk, or anything other than white rice. Now, vitamins were being marketed as the cure-all for virtually any ailment and as a means of self-enhancement.

“The idea emerged that taking small daily doses could prevent not only deficiencies but also perhaps treat chronic diseases and optimise health.”

“The idea emerged that taking small daily doses could prevent not only deficiencies but also perhaps treat chronic diseases and optimise health,” says dietitian and nutrition research scientist, Dr Tim Crowe.

Kellogg’s Pep cereal advertisement.Credit: Kellogg’s

“Fuelled by aggressive marketing and the allure of a ‘natural’ way to maintain health and wellness, they have moved well into the mainstream and appeal to the wider population rather than just the subset who would have a legitimate medical reason to take them.”

For men, vitamins were marketed as helping “strengthen the nerves and invigorate the body”, whereas vitamins supposedly gave women the energy to do more cooking and cleaning.

The tagline on one 1938 cereal advertisement for the vitamins B and D-fortified Kellogg’s Pep, read: “The harder a wife works, the cuter she looks.”

Motherly guilt, worry and love, meanwhile, were exploited. One 1974 ad for Flinstones Vitamins, a line of vitamins for children, encouraged mothers to “do your best… help make sure kids get vitamins they may be missing.”

To all of us, vitamins were promised as a form of nutritional insurance, covering our needs so we could have our cake (in the form of a single pill) and eat it too, as one ad captured neatly: “We usually eat what we like instead of what’s good for us.”

As the money rolled in and confusion arose over whether vitamins and supplements should be regulated as food or drugs, the industry (and claims) grew wildly.

In 1994, the Dietary Supplement Health and Education Act in the US changed the classification of dietary supplements to the category of food, meaning manufacturers did not need to prove safety or effectiveness before marketing them.

This led to another rapid increase in the number of supplements in the marketplace, from an estimated 4000 in 1994 to more than 100,000 today.

In Australia, regulations for vitamins and supplements are stricter. While the regulatory body, the TGA, does not test a vitamin before it is sold, products can only contain ingredients from a list of products that have already been assessed for safety and quality.

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Still, it’s not foolproof as recent cases of vitamin B6 toxicity, poisoning and contamination of various supplements and vitamins demonstrate.

And the misleading and deceptive dietary supplement advertising on the internet remains a problem.

If you believe the claims, vitamins and supplements could treat everything from AIDS, Hepatitis B, cellulite, baldness, cancer and Alzheimer’s disease. That’s before you use them to enhance sleep, sex, performance, cure your child of all ailments and optimise your brain function.

No wonder we became convinced vitamins were an essential part of our lives. And even if we didn’t believe all the hype, what was the harm? The harm can be insignificant or significant.

Vitamin supplements can do considerable damage to your hip pocket, diverting hard-earned money from highly nutritious products like fresh, whole foods; or simply pass without being absorbed. But the harms can go beyond expensive urine or a lighter wallet.

As many foods come fortified with vitamins and many of the vitamins we buy contain amounts that differ greatly from what the labels claim, it is not difficult to overconsume them.

Fortified foods such as breakfast cereal became common.Credit: Getty Images

Symptoms of overconsumption include diarrhoea, nausea, vomiting, headaches and fatigue at a minimum.

There has been a dramatic rise in the number of Australians suffering the effects of vitamin B toxicity, which can cause irreversible nerve damage leading to tingling, numbness, burning or weakness in limbs.

Too much vitamin A can cause headaches and liver damage, reduce bone strength, and cause birth defects, while excess iron causes nausea and vomiting and may damage the liver and other organs. High doses of vitamin D can also reduce bone density, new research suggests.

Research also indicates that beyond known toxicities at high levels, dietary supplements may contribute to increased risk of cancer. That is before we even talk about potential heavy metal, bacterial and fungal contamination.

So where does that leave us?

Vitamins, in their isolated form, were designed for those who needed them. That is, those with deficiencies or when their nutrient needs (as in pregnancy).

With the help of experts, this series will help us better understand what’s inside the pills we buy and how to choose between them; what researchers are still trying to understand; whether we can use vitamins to “optimise” our lives; and what the evidence is behind the most popular vitamins we consume in Australia: vitamin D, vitamin C, multivitamins, fish oil, and iron.

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