In 2017, Americans spent 35 billion dollars on supplements, including vitamins, minerals, protein powders, vitamin enriched shakes and drinks, and fruit and vegetable capsules. To say it’s big business is an understatement. The idea of quickly getting your daily value of micronutrients is appealing. Who wouldn’t want something that’s relatively easy and could make you healthier? One such product is Juice Plus+, but is it as healthy as eating whole fruits and vegetables?
There has been extensive research on how important various nutrients are for basic body functions. We know that nutrients are absorbed best when we eat them in food. Food is a complex balance of hundreds of vitamins, minerals, antioxidants, fiber, and other components. They all work together in ways that aren’t yet entirely understood.
Does a supplement’s source matter?
So the real question is—does it make any difference if a supplement comes directly from food? The “quality” supplements made from “whole foods” are still highly processed. Our bodies don’t deal with these supplements in the same manner as a whole food, similar to how juice has less nutritional value than whole fruit. We know that drinking orange juice provides all the sugar with none of the fiber that’s in an orange. Fiber helps with bowel regularity, decreases cholesterol, keeps blood sugar levels more stable, and makes us feel full.
Unfortunately, no matter how convincing websites and personal testimonials can be, taking a manufactured pill is not even close to eating real food. Sometimes we forget that these companies producing “healthy products” are businesses seeking profit. That’s not to say all health-focused businesses are bad, but those making promises or claims about nutrition in a pill are not necessarily improving your health in ways they may have you believe.
There are many companies claiming they sell the next best thing to food, but one that stands out is Juice Plus+. The company’s webpage broadcasts their “research”, highlights clinically proven claims, has many testimonials, and promotes the doctors working for their company. You’ll even see big claims that their products are the “next best thing to fruits and vegetables.” Sounds pretty amazing right?
What is Juice Plus+ and what can it do for our nutrition?
According to their website, “Juice Plus+ products are made from the juice powder concentrates and oils from 48 different fruits, vegetables, and grains.” They admit Juice Plus+ isn’t a substitute for eating fruits and veggies, or whole food-based products, but they proclaim their products “support a healthy diet by offering a much wider variety of naturally occurring vitamins, along with antioxidants, and phytonutrients found in fruits in vegetables”. Their featured product is Juice Plus+ Fruit, Vegetable, and Berry Blend Capsules for $71.25 per month. Here’s why you should always remain skeptical of easy health fixes.
Most people probably don’t consider Tang to be a health food. Take a look at the nutrition label—it contains one vitamin, one mineral, comes with lots of added sugar, and has a disclaimer that it’s not a good source of fiber.
Compare Tang’s label to the label of the featured product for Juice Plus+. It even has the same disclaimer as Tang, stating it’s not a good source of fiber. You have to take 2 capsules of each bottle daily if you’re an adult (a total of 6 capsules per day) to receive the nutrition they recommend. Sure, it doesn’t have all the added sugar, but what’s shocking is there are only four vitamins in this product across the 3 bottles! Juice Plus+ has additional ingredients that may provide nutrition, such as calcium ascorbate, but they were not included in the nutrition label so we do not know how much is present in the product.
Compare the labels below. Click on any label to view larger images. Note that the multivitamin label is a “Supplement Facts” label while the others are “Nutrition Facts” labels. Supplements are regulated and labeled differently than foods and beverages.
Now compare those Juice Plus+ nutrition facts labels to the supplement facts label for a generic multivitamin found at Walmart. It’s only $7.74 for 200 supplements that are taken once daily. That would provide you with a six and half month supply and meet more of your daily value for many vitamins and minerals than Juice Plus+.
Most multivitamins contain 30 or more vitamins and minerals, whereas Juice Plus+ only contains four. Now Juice Plus+ doesn’t claim to be a multivitamin, but they do claim to “offer a much wider variety of naturally occurring vitamins, along with antioxidants, and phytonutrients found in fruits and vegetables”. If Juice Plus+ were the next best thing to fruits and veggies, it should at least contain some fiber and more than four vitamins, right?
Juice Plus+ “clinically proven” claims
Juice Plus+ makes impressive claims such as “Clinically proven to put the Plus+ in your life.” Many products try to entice people with such claims, but do they hold up? The supplement industry is not well regulated. “Clinically proven” sounds like a product went through intensive research with a clinical trial on many people, but that may or may not be true. Scientific sounding claims can make consumers feel reassured, so are often used in marketing.
Juice Plus+ states that their products reduce oxidative stress, promote cardiovascular wellness, support a healthy immune system, and help protect DNA. However, experts at Memorial Sloan Kettering Cancer Center have raised doubts about these advertised benefits. They report that studies on the ability of Juice Plus+ to reduce plasma homocysteine levels, a risk factor for cardiovascular disease, were not reproducible. Additionally, they note that studies on cardiovascular effects, such as changes in blood pressure and cholesterol levels are inconclusive.
On top of that, many studies cited by Juice Plus+ are funded by Juice Plus+ or by those selling their products, which means there’s a risk that the research is biased. Many of the links to their studies report changes in lab findings that are associated with increasing body functions, but aren’t necessarily reflective of change in health outcomes. To be clinically significant, a study has to demonstrate an improved health outcome, and most of the JuicePlus+ studies don’t fit the bill.
Companies know most of their consumers will never actually look at the research and may not understand it if they do read the studies. It’s important to be skeptical of studies cited by companies in support of their products.
Larger studies with higher impact
We’ve learned that a generic multivitamin contains more nutrients than Juice Plus+ and may be a better investment. But do multivitamins fair better in terms of health outcomes? A meta-analysis and systematic review was recently published on supplemental vitamins and minerals to try and answer this question, looking at all-cause mortality, cardiovascular mortality, and total cardiovascular risk or related outcomes such as strokes or myocardial infarctions (mini strokes).
This study looked at 179 randomized controlled trials (which is the highest standard of medical research) between 2012 and 2017 on the four most common supplements, which included multivitamins, calcium, vitamin C, and vitamin D. This impactful study determined that conclusive evidence for the benefit of any supplement across all dietary backgrounds was not demonstrated. If you use these supplements there was no apparent advantage and they found no significant effect on cardiovascular mortality or all-cause mortality.
However, this study did find that some individual nutrients may have associated benefits or risks. On the beneficial side, folic acid and B complex vitamins were found to aid in reducing strokes. The reduction in stroke however was done in a community without folic acid fortification in their food supply like we have in the US. When reduction of homocysteine was achieved, it was not associated with stroke reduction. Conversely, niacin and antioxidants were associated with an increase in all cause mortality—it was small but statistically significant.
The evidence isn’t enough to say anyone should or shouldn’t take supplements with these micronutrients. Those who have dietary restrictions that limit sources of particular vitamins and minerals may benefit from individual supplements, and should consult with a registered dietician or other health professional.
The National Institutes of Health sums up the science of supplementation this way (paraphrased for clarity and emphasis added):
No US government health agency or health professional organization promotes regular use of a multivitamin or individual nutrients without first considering the quality of a person’s diet. Individuals with poor nutrient intakes from diet alone, who consume low-calorie diets, or who avoid certain foods might benefit from taking multivitamins. Healthcare providers sometimes prescribe multivitamins for people with medical conditions and diseases that impair digestion, absorption, or use of nutrients. Some supplements might help people who do not eat a nutritious variety of foods to obtain adequate amounts of essential nutrients. However, supplements cannot take the place of the variety of foods that are important to a healthy diet.
What is recommended for overall health?
Today our diets offer much more variety than they used to. We have access to all kinds of food due to global trade. Nutrition deficiencies are not as common among Americans as some websites, books, and people may claim. What is also true is that most Americans simply aren’t eating enough fruits and veggies. Only one in ten meet their recommended five servings of produce intake per day. But there is no quick fix or shortcut to a better diet.
It’s not physically possible to pack all or most of your nutrients into a tiny capsule and it also isn’t the same as eating whole foods. Much of the protective effects of fruits, vegetables, and whole grains come from their fiber content and pills have nearly all of that removed. It makes more sense to look at diet patterns rather than single nutrients, as our bodies need to get nutrients from whole foods. Ultimately, it’s what we eat, how much we eat, and how we eat that has the greatest impact on our health.
Healthy eating can seem confusing, especially when you’re surrounded by information focused on specific food nutrients. There are no super foods, there are just foods. Your best bet is to start by adding one extra produce item per day. Gradually increase to one fruit or vegetable with each meal and snack. Enhance what you’re already eating by adding fruits to oatmeal or yogurt, or add veggies to your pasta or omelette. Eat a diet that’s rich in fruits, vegetables, and whole grains. It’s really the big picture instead of the details that make the biggest difference in your health.
Take time to eat and enjoy your meals by focusing on flavor, texture, variety. Focus on eating a variety of foods. While most supplements will not harm you, they will certainly shrink your bank account. Taking supplements is a personal choice, but it’s good to have science-based information to help you make these personal decisions.
This guest post was written by Danielle Penick, RD.
Danielle is a writer and registered dietitian who connects cancer survivors with evidence based research on nutrition and health. She is the creator of Survivors’ Table, an online resource for cancer survivors, and she is a practicing dietitian in Phoenix, AZ. For updates, you can follow Survivors’ Table on Facebook.