The value of nutritional supplements in promoting and protecting humanhealth is intensely debated. Some argue that supplements provide aconvenient and effective means for supplying the optimal intakes ofessential nutrients that people need for good health. Others argue thatthere is no conclusive evidence that supplements provide any true healthbenefits at all. The latter argument has been bolstered over the pastseveral years by a steady stream of negative research reports published inleading medical journals.

This paper examines the supplement debate and questions some of the recentevidence suggesting that nutritional supplements are ineffective and unsafe.It is argued that much of the current controversy and negativity surroundingnutritional supplements results from inappropriate use of a pharmaceutical,acute-care model in the clinical evaluation of nutritional products;products whose real value is in preventing rather than treating disease. Asa result of this mismatch, nutritional supplements are often testedinappropriately, results of studies are interpreted less than objectively,and valid but non-clinical evidence of benefit is often discounted orignored.

As a case in point, I focus on vitamin E supplements and their role inpreventing heart disease. But the central tenets raised in this paperpertain to nutritional supplements in general, and to much broader issuessurrounding the field of primary prevention as a whole. We now spend about$2.0 trillion dollars annually on healthcare in the US. Ninety-eightpercent of this spending goes to the treatment of injuries and disease.And, the lion�s share goes to the treatment of chronic degenerative diseases(e.g. heart disease, cancer, and type 2 diabetes), the leading causes ofpremature death and disability in our society. Only 2% of our healthcaredollars are spent on primary prevention; measures designed to keep healthypeople healthy. This despite the fact that most chronic degenerativediseases are highly (60-90%) preventable.

In this light, increased emphasis on primary prevention holds tremendouspotential for improving the effectiveness of our healthcare system. MostAmericans have the opportunity to add years of health to their lives byembracing prudent lifestyle strategies and habits over the long-term.Clearly, such strategies need to be broad-based, encompassing diet,nutrition, exercise, stress management, and the avoidance of harmful habitslike smoking. And just as clearly, a program of responsiblesupplementation, designed to compliment healthy eating habits and providethe advanced levels of essential vitamins, minerals and antioxidantsrequired for lifelong health, can play an important role in this endeavor.The science, when approached broadly with an open mind, is convincing onthis point.