Whether they are doing Lisa any good at all is a matter for debate among doctors, nutritionists, dieticians and complementary therapy practitioners. But whatever the truth of her claims of improved health, Lisa is probably paying over the odds for at least some of the capsules. Last week, six of the world's biggest vitamin manufacturers, including Roche of Switzerland, BASF of Germany and Rhone-Poulenc of France, admitted price-fixing in the US. They are to be fined $1.1bn (pounds 688m). For some of the companies involved, it's the second time this year that they have been caught inflating prices artificially, and this pushes up the prices of foods that are fortified with extra supplements; in the US, a number of major food producers have been affected.
The Office of Fair Trading (OFT) is launching an investigation into whether vitamin prices have been forced up by big manufacturers in Britain too. According to the Consumers' Association, it is not unlikely. "If this has happened in the US, where competition laws are tough, and can involve huge fines and company directors going to jail, then we must look at the situation here," says the association's senior policy researcher Phil Evans. As for the effect on food pricing, he says: "No one knows how many foods here have got these ingredients in, because it is only when a case like this comes up that people start to collect statistics. But there is no doubt that the use of ingredients like vitamins in prepared food is increasing." Manufacturers Nestle and Procter and Gamble (which makes the popular vitamin-fortified juice drink Sunny Delight) declined to comment on the possible implications for British food manufacturers.
The market for food supplements is worth around pounds 340m a year, of which around pounds 129m is spent on vitamins. The research company Mintel estimates that around 40 per cent of us take extra supplements. We buy most of these, 40 per cent, in the chemists', 26 per cent at the supermarket, and 5 per cent through mail order. While the heaviest users are women older than 45, they are by no means the whole market; young people are also enthusiastic. Mean-while, manufacturers are piling "healthy" additions into foods including yoghurts, biscuits, cereals, drinks, juices and breads. Some are moving into the field of "functional food" or "nutraceuticals" which are fortified with products designed to bring down cholesterol levels, build bones, and protect against disease. High doses of supple- ments such as vitamins A and D have an adverse effect. But even if the amounts put into foods are not enough to cause a toxic reaction, do they do us good?
Conventional dieticians, nutritionists and doctors are quite clear: following a balanced diet that includes a wide range of fresh foods means that artificial supplements are unnecessary. Professor Vincent Marks, dean of medicine at the University of Surrey, says that supplements for the young and healthy are a waste, and that tinkering with staple foods will do little good. "A good education on what is appropriate to eat is more important than wasting money on vitamins," he says. He has long been a critic of the alternative health market - but he too is changing his mind, at least partially. "As you get older, you don't eat as much as you used to," he says. "You need as many vitamins and minerals, but fewer calories. For older people a multivitamin and mineral supplement are probably a good idea."
Gaynor Bussell of the British Dietetic Association says that many people will not follow the best advice on what to eat. "People aren't eating the balance we recommend," she says. "Some dieticians would now say that adding vitamins and minerals to food is a good thing." She cites the addition of folic acid, important for pregnant women, into flour as a positive step.
But Dr Tim Lobstein, co-director of the Food Commission, an independent consumer watchdog, says there is no evidence to suggest that added vitamins are any more than "a marketing ruse", though he says there is an exception to be made for folic acid for pregnant women. And both Professor Marks and Dr Lobstein criticise the use of vitamin-enrichment to disguise the fact that foods are high-fat or high-sugar. "We have long been worried that fortification encourages parents to think it's OK to buy junk food," says Dr Lobstein. He is scathing about the use of vitamin C, which helps processed meats and soft drinks that contain juice to maintain an attractive colour. "They include the vitamin C as an anti-oxidant and then boast about it," he says.
There seems little doubt that the consumer market will continue to grow or that manufacturers will continue to find new ways to fortify food. If the Office of Fair Trading inquiry does find that vitamin prices in the UK have been pushed up artificially by manufacturers, it will soon be allowed to impose some of the toughest sanctions outside the US. The OFT's power to punish is being beefed up: the Competition Act, which comes into force next March, will give it the power to impose fines of up to 30 per cent of their UK sales on companies found to be breaking the law. Given the size of the market for vitamins, that could mean an awful lot of money.
THE 15-A-DAY HABIT
PATRICIA MAHER, (left) 52, runs Winton Health Foods in Bournemouth, Dorset:
"I was a nurse and I became interested in herbal medicine because of the side-effects of drugs. When we moved to this area, I started to work in the health food shop, and later on I bought it. I've noticed a lot of extra interest from customers in the nutritional side of things, and in supplements like St John's wort, which people buy because they don't want to take mind-altering drugs.
"The first thing I take every day is a high-dose multivitamin, from a top-quality manufacturer - I wouldn't buy a supermarket's own brand, because the amounts aren't high enough and they aren't made from natural ingredients. I also take an extra gram of vitamin C, garlic, chromium for the blood sugar level, dandelion for the liver, zinc, which is healing and protecting, Q-10 bioquinone, a co-enzyme that releases energy and is good for healing, and ginkgo-biloba to improve circulation. At night I take a multi-mineral, evening primrose oil, either fish oil or saff oil, vitamin E, boron, which aids the utilisation of calcium, and rutivite for the circulation - and St John's wort with magnesium and passiflower.
"It's quite a ritual - I have two pots, one for me and one for my husband, for the supplements we take, and I put them out for both of us each day. There are three other things I take periodically, usually for a three- week period every three months. These are acidophilus, which replenishes the bacteria in the gut, echinacea for the immune system and milk thistle for the liver. Taking all these makes me feel so much brighter and more energised. I'm never, ever ill. My mother, who is 94, swears by the things I send her, while one of my regular customers is nearly 102, her sister is 103, and they're both very healthy and happy."