Nutrition Discussion Forum

Many population subgroups that are at high risk of illhealth have multiple micronutrient deficits. These subgroups include the elderly, the socially and economically deprived, hospital patients and the mentally ill, among others. Placebo-controlled trials of simple micronutrient supplements have shown that they can improve immune function and reduce time suffering from infections in older people, reduce length of stay in hospital and improve clinical outcomes, improve pregnancy outcomes and reduce violent behaviour. If these findings could be transferred to the general population, the improvement in health and the reductions in cost of the service would be immense. Three main factors, however, are blocking both further research and the implementation of what we already know. These are: (1) reductionist attitudes among scientists who want to study only one micronutrient at a time; (2) holistic attitudes among dietitians and nutritionists who, with a lack of realism, want the relevant groups to change diet rather than take supplements; (3) governments who have created a regulatory framework that is commercially inimical to the development of multinutrients to treat disease. All of these attitudes need to change if we are going to apply what we already know about nutrition to the improvement of human health. But if attitudes do change we could see the fastest ever, and also the cheapest, improvement in human health. Suppose we were to discover a new drug that we could be certain would never produce an important adverse reaction, would prevent and relieve a great deal of suffering due to depression, violence, cardiovascular disease, infections, inflammatory disease and a range of other conditions, and could be sold at a trivial cost when compared with most other medical interventions: would we rush to introduce such a drug into clinical medicine, would governments be keen to market it and promote its use, would doctors be keen to prescribe it? The answer to all these questions is probably no. For we have such a drug and it is hardly used by those who could most profit from it. The drug is a combination of all known essential nutrients present at levels approximately equivalent to the official national recommended daily allowances. It is a drug which is widely used at their own expense by the affluent and relatively affluent middle classes who do not need it, and therefore benefit little from it, because they already consume most of the nutrients in adequate quantities in their diet. It is a drug that is rarely used, and rarely prescribed, for those who do need it: the socially and financially deprived, the elderly poor, the mentally ill, those in prisons, and those at high risk of obesity and cardiovascular disease. The evidence of its value is considerable, so why do we so rarely employ such a safe, low cost and effective remedy? The answer lies in a mix of scientific reductionism, holistic obscurantism, regulatory rigidity, the absence of commercial incentive, and a failure of the imagination on the part of government.