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The Guardian - UK
The Guardian - UK
Lifestyle
David Cox

Are personalised vitamins the key to good health?

illustration of medicine capsules formed out of fingerprints
Illustration by Observer Design. Illustration: Guardian Design

Could a customised supplement plan created specifically for you be the answer to refreshing sleep, easy weight loss and a sunny state of mind? These are just some of the promises offered by the world’s personalised vitamin providers as I flick through their various questionnaires, each hinting at the tantalising possibility of looking healthier, happier and younger, all for the price of a subscription.

I settle on one particular provider, Nourished, a company that offers an intriguing blend of tailored vitamins and 3D printing for a monthly fee of £35.99. Rather than popping a series of pills each morning, it promises to combine all the nutrients you need – based on your answers to questions that range from the minutiae of your exercise regime to how regularly you travel internationally – into a single layered gummy.

As a 33-year-old journalist with a penchant for unhealthy snacking, I list my screen time as excessive, my goals as weight loss/toning and a little extra energy and wait as the algorithm whirs and spits out my results. A few days later, a sleek box arrives in the post, filled with little sachets marked “Personalised Nourishments for David”.

Nourished is the brainchild of Birmingham-based entrepreneur Melissa Snover, a self-described “avid vitamin user” who previously ran a confectionery business 3D printing sweets. Snover says she conceived the idea for the company after spilling a bag of supplements while travelling through Düsseldorf airport. “I realised, maybe we could do something with 3D printing technology to combine everything into one easy, personalised format,” she tells me, “that was more enjoyable to take and more convenient, which would increase adherence.”

But while Nourished’s products certainly look appealing – its gummies more closely resemble fruit pastilles than anything in Holland & Barrett – do they really do anything for your health? Like most of its competitors Nourished makes big claims. Some of the benefits listed for my personalised combination of vitamin B12, tart cherry, beetroot, Lutemax 2020, ginger extract, white kidney bean extract and a probiotic called BPL1 include suppressing appetite, reducing cravings, protecting my eyes from blue light and boosting sleep quality.

But when I run these ingredients past a series of nutrition experts, they are far from impressed. “It all looks bullshit,” says Margaret Rayman, professor of nutritional medicine at the University of Surrey. “I don’t think there’s much information about any of these things changing your sleep.”

Clare Collins, professor of nutrition and dietetics at the University of Newcastle in New South Wales, Australia, agrees, describing the ingredients as “bogus”, arguing that the research cited in support of them tends to be of low quality.

Snover vigorously defends Nourished’s selections, saying that the research reports they use to vindicate the products they recommend are put through an extremely rigorous auditing process. “The Lutemax ingredient that you’ve got recommended is actually a patented ingredient based on lutein, which has tons and tons of clinical data around how it can protect your eyes,” she says. “We use a lot of patented ingredients because of the level of clinical data behind them. When it comes to white kidney bean extract, there’s a lot of data there too. We’re looking for research that has been peer reviewed, that has been published in a reputable journal, that has been done on a decent number of people.”

However Collins says that when she had reviewed the literature, in her opinion there was no good evidence lutein could protect your eye health. “There haven’t been the rigorous, randomised controlled trials with tolerability for dose, looking at the side-effects,” she says. “That research simply isn’t there.”

In recent months, the rapid rise of the personalised vitamin industry has come under increasing scrutiny from journalists and academics. The global personalised retail nutrition and wellness market was valued at $1.8bn in 2020 and some of the biggest food companies in the world have begun eyeing up this lucrative new industry. In 2019, food and beverage conglomerate Nestlé acquired the personalised vitamin subscription service Persona for an undisclosed sum.

But while consumers are flocking to providers in droves – after launching in January 2020, Nourished reported a turnover of £1.5m in its first year and now ships more than 10,000 boxes a month – questions are being raised over what is being marketed to consumers.

When BBC journalists tested a range of personalised vitamin companies in May for their Sliced Bread podcast, including Vitl and Vitamin Buddy, they found that they were recommended exactly the same supplements, despite entering different details in the personalisation quiz.

Emily Burch, an accredited practising dietitian and researcher at the University of Queensland in Australia, is particularly cynical about companies that charge more for every supplement they recommend. She believes that: “Many of these companies cherrypick and overinflate the results from single research studies that have low scientific evidence. Their website might say, ‘Oh, there is science behind this vitamin for this group of people,’ but the findings don’t conclusively support what they are claiming.”

Do we really need vitamin pills at all?

Burch’s scepticism points to some of the general issues with vitamins as a whole. These have long been one of the wellbeing industry’s most reliable income generators to the extent that in recent years, major pharma companies have even got in on the game. Pfizer, GSK, Novartis and Unilever all manufacture and sell their own vitamin supplements.

Vitamin hype first began in the US in the 1940s, as people flocked to their neighbourhood drug stores to get their hands on these apparent wonder pills. Since then, they have never stopped, with the purported benefits of vitamins spreading around the globe and helping to create an industry that is now worth an estimated $129.6bn (£107.5bn).

But despite decades of research – the US National Institutes of Health has spent more than $2.4bn studying vitamins and minerals since 1999 – the evidence for whether they can significantly alter your health remains unclear. While there is some data to support the benefits of folic acid supplements in early pregnancy, and zinc may help slow down age-related macular degeneration, there is no good evidence that vitamins will make you live longer, slow cognitive decline or lower your chances of chronic illnesses, such as heart disease, stroke, cancer or diabetes. A 2020 British Medical Journal analysis states that “randomised trial evidence does not support use of vitamin, mineral, and fish oil supplements to reduce the risk of non-communicable diseases [cancer, cardiovascular disease or type 2 diabetes].”

In fact, some of the clearest evidence has found that in certain cases, taking vitamins can actually harm your health, especially if you smoke or take existing medications that could interact with a particular supplement. Both vitamin A and beta carotene have been found to increase the risk of lung cancer in smokers, while vitamin K can reduce the potency of blood thinners such as warfarin, and St John’s wort may make drugs such as antidepressants less effective.

Nutrition experts tend to feel that the average, healthy person is far better off trying to get their essential vitamin intake through eating a balanced diet with a wide variety of vegetables and fruits, through which essential nutrients will be better absorbed by the body, rather than taking additional supplements. Rayman points out that tomatoes contain all your potassium requirements, while minerals such as selenium can be found in shellfish.

Collins also cautions that people who take excessive amounts of supplements can be prone to a condition called hypervitaminosis, which refers to abnormally high storage levels of vitamins in fat tissue that can go on to cause problems. As an example of this, some research has associated folic acid supplementation with an increased risk of prostate cancer in men. Excessive levels of iron can accumulate in the brain, which has been associated with different neurodegenerative diseases.

“I think some people see vitamins as an extra insurance policy but they’re not without harm,” says Collins. “If you don’t need them, the water-soluble ones you’re weeing out and the fat-soluble ones just get stored in your adipose tissue in your body or in your liver. But if you eat more vegetables in contrast, there are no harms, only benefits.”

Specific dietary requirements

Where nutritionists do see a role for vitamins is in individuals with specific medical conditions or dietary requirements, as they may be deficient in certain minerals. Burch describes how people living with chronic pancreatitis, cystic fibrosis, celiac disease and Crohn’s disease, among others, have problems with vitamin absorption. Studies have also shown that people following a vegan diet are likely to benefit from additional vitamin B12 supplementation, although in all these cases it is advisable to seek professional advice from a dietitian.

Ailsa Welch, professor of nutritional epidemiology at the University of East Anglia, says that the age group who might actually benefit most from personalised vitamins is the elderly, who are more likely to become deficient in certain nutrients. “People who tend to have vitamin deficiencies are particularly older men, living alone and living on a very restricted diet,” she says. “But by and large, those who are taking extra micronutrients are generally those who don’t need them because they already have a healthy diet.”

This seems to fit the profile of most subscribers to personalised vitamin providers. Nourished says its core customer base is aged between 29 and 45, while a typical Made4 Vitamins customer lies somewhere between 25 and 45.

Rayman argues that if personalised vitamin providers are really doing their job, their algorithms should be able to recommend the right supplements when presented with a profile of someone who is likely to be deficient in certain nutrients.

To test this out, we created a specific user profile – Sania, a 29-year-old Indian woman living in the UK who follows a vegan diet and is trying to get pregnant. We then attempted to enter these details into a range of personalised nutrition providers: Nourished, Persona, Made4 Vitamins and Vitl.

“They should recommend vitamin D because her skin is dark and so will have a higher requirement,” says Rayman. “They should also suggest B12, which is missing in all vegan foods, iodine, which is crucial for brain development in the womb, and the main source in the UK is milk, dairy products and fish, as well as calcium because vegans tend to be low and have higher risks of bone fracture. Finally, long-chain n-3 fatty acids or fish oils, which are vital for the developing baby’s brain and eyes and cannot be made up from a vegan diet.”

The only provider that offered all these options, and suggested the expected supplements, was Persona. However, this was also by far the most expensive option – while Persona offer a 60% discount on month one, the usual price would be $98 (£81).

It is clear that one of the major limitations with all of these providers is that the personalisation aspect relies entirely on a user-completed quiz. Some feel that, in future, new technologies such as genotyping or microbiome sequencing may be able to provide a more precise and scientific method of identifying who is deficient in which nutrients, but this research is in its early stages.

“In terms of genotyping and vitamin deficiencies, the science is promising for some things, but it’s not concrete and 100% there yet,” says Burch. “The interaction of nutrients with genotypes is complex and involves a lot of different genetic variations, so it is difficult to pin this down to only one or two variations.”

In the meantime, if you really want to take vitamin supplements, most nutritionists recommend saving your wallet and buying a multivitamin tablet.

“The prices these companies are charging seem a bit ridiculous,” says Rayman. “If you have any doubt, you can buy yourself a multivitamin that contains, say, 10 micrograms of vitamin D, 50mcg of selenium and 140 or 150mcg of iodine… from any supermarket and it costs virtually nothing.”

• This article was amended on 21 August 2022. Due to an error in the editing process, references to micrograms in the final paragraph had been abbreviated to “mg” rather than “mcg”.

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