Vitamania: Vitamins in American Culture (review)

The word vitamine was coined in 1911, and shortened to vitamin a few years later. One of the pioneers in this line of research wrote: “the name was a stroke of genius . . . such a captivating word was necessary to focus the attention of the public.” ¹ And the public were indeed captivated. By 1937, before any pure vitamins were available, nearly six million gallons of cod-liver oil were purchased each year in the United States, as a potent source of vitamins A and D. The use of vitamin and mineral supplements continued to grow until, in 1994, more than 80 percent of families were purchasing them at a total cost of $4 billion per year. Yet, throughout this period the official advice of both the American Medical Association and the Food and Drug Administration (FDA) was that they were a waste of money for people eating a well-balanced diet, and were profitable only to their manufacturers and distributors.

Rima Apple had a rich field to study, and has foraged widely in the archives of federal agencies, pharmaceutical companies, and institutions. Much of the controversy studied here was between the FDA and the pharmaceutical companies over the claims being made for their products. For example, in 1961 it was claimed that “Acnotabs,” which contained vitamin A, would “clear up pimples fast . . . from inside the body” and were “thoroughly tested by doctors.” The FDA seized this product on the ground that its label was “false and misleading” (pp. 110-11); in a subsequent court case the makers could not present satisfactory records of testing, and finally the product was withdrawn. In another example, the Miles Company, which marketed “One-a-day” capsules from 1940 on, tried to stay away from controversial claims and had the FDA preview their labeling, with its message of a regular supplement providing “nutritional insurance” (p. 87). The FDA view was that the American diet was adequate without supplementation, but it was unable to prevent this kind of claim, particularly after the U.S. Department of Agriculture had published the results from a large study of American diets that indicated that a considerable proportion contained less than the recommended dietary allowance (RDA) of one or more micronutrients.

Another fierce debate concerned whether vitamins should be classified as “foods” because they were constituents of food (as grocers wanted), or as “drugs” (as retail pharmacists wanted, in order to have a monopoly of their retail distribution). If they were drugs, used to treat or prevent specific diseases, then physicians expected, in turn, to have the monopoly of providing prescriptions for pharmacists to sell them. Pharmacists were unable to maintain a monopoly, and both “direct mail” and “health food stores” obtained important shares of the market.

A further complication arose with the ideas of Linus Pauling and others who recommended, from 1970 on, the consumption of megadoses of vitamins—that is, doses perhaps 10–100 times greater than the orthodox RDAs, which were themselves at least twice the minimal requirement to prevent any overt signs of deficiency disease. FDA officials were even more alarmed at this development: vitamin supplements at around the RDA level might be unnecessary, but there was no reason to think them harmful. However, high doses of the fat-soluble vitamins A and D, on the other hand, accumulated in the body, and could undoubtedly be toxic. The FDA proposed that over-the-counter sales be restricted to relatively low-potency products, with megadoses requiring a physician’s prescription. The health food industry felt threatened and it encouraged customers to protest. Members of Congress received more mail on this issue than on any other, except for the Vietnam War, and the FDA had to give up their attempt. The author suggests that the issue was one of the public’s being treated as adults with “freedom to choose” (p.145). Why, it was asked, did the FDA threaten...