Should I take a multivitamin?

Growing up, both of my parents made home cooked meals almost exclusively, eating out was a rare treat, and my brother and I definitely took our daily Flintstone’s vitamin. My parents knew the benefits of eating healthy and the importance of remaining active. During college I worked at a local health food co-op. I sold many health foods and of course lots and lots of multivitamins. It seemed like almost everyone in line was buying something to help supplement their nutrition and many of them loved to tell me all about what they were taking and why. I took a daily multivitamin that was made from “whole foods” and prided myself in doing something good for my health. It was my safety net to ensure that I was getting everything that I needed in case my well balanced diet didn’t quite make the cut in terms of nutrients.

Last year American’s spent 35 billion dollars on supplements, which includes vitamins, minerals, protein powders, vitamin enriched shakes and drinks. To say that it is big business is an understatement. The idea that you can take a pill to ensure that you are getting your daily value of vitamins, minerals, and other micronutrients is quite appealing. I mean who wouldn’t take something to potentially make you healthier if it’s relatively easy and could help – especially if you have well-intentioned friends and family suggesting you to do this?

After taking nutrition courses during my undergrad and during graduate school, I learned that there has been extensive research on vitamins and minerals and what they can do for us and how vital for life they are for everyone for basic body functions. This research is ongoing and we find out more everyday. The interesting thing that we do know about vitamins, minerals, antioxidants, and other micronutrients is that they are absorbed best and more powerful when we eat them from food. There is no question. We know of many of these individual micronutrients and what research has found is that our bodies don’t benefit from them the same way as we do when we take them in isolated supplement form.

Food is a complex balance of hundreds of vitamins, minerals, plant chemicals, fiber, and also with components in food that we have yet to discover that all work synergistically together in ways that manufacturers are not able to mimic. Even the “quality” vitamins made from “whole foods” are made from highly processed foods mixed together in a very different way than nature designed them. Boy was this a surprise to me. Vitamins really have an appeal, but real food is superior to any vitamin.

What about using vitamins as a safety net if you are eating a well balanced diet?

For about eight years I was a pescotarian. Meaning I didn’t eat meat, except for fish. I also ate dairy and eggs and thought I ate pretty well. I still took a vitamin despite this just in case. During my course work to become a dietitian I learned that if you don’t eat any animal products that you were likely deficient in vitamin B12 and possibly iron so I thought a multivitamin would be a good way to make sure. It turns out that most people can get adequate nutrients from a well balanced diet as long as you aren’t omitting entire food groups.

Nutrition deficiencies are not as common among Americans as some websites, books, and people may claim. There are many people all over the world that have true vitamin and mineral deficiencies as a result of malnutrition caused by starvation from food insecurity due to being in impoverished areas. Some supplements for these people can be life saving, may be necessary, and required as a result of their deficiencies. With that being said I do think vitamin and mineral supplements can serve a purpose and are important among a select group of people such as:

  • Pregnant women or those who are thinking of becoming pregnant
  • A true vitamin deficiency that has been diagnosed by a physician (which can be more common during cancer treatment).
  • If you are a vegan or strict vegetarian you will need vitamin B12 as this comes from animal products only
  • If you’ve had gastric bypass surgery
  • If you have short bowel syndrome due to risk malabsorption as the small intestine is where almost all of your nutrient absorption takes place
  • To help manage a potential side effect from cancer treatment that is being monitored by a physician and registered dietitian (example: short term use of Zinc for taste changes)
  • Other genetic abnormalities that prevent you from metabolizing certain nutrients that a physician has diagnosed you with
  • Food allergies or intolerances that prevent you from eating an entire food group or groups (talk with a registered dietitian or physician)
  • If your intake is poor to minimal due to lack of appetite, taste changes, or mouth sores then you may not be able to eat enough (if you are drinking nutrition supplements, check the label as you might be getting enough depending on how many you drink per day)

So many of our foods now are fortified with vitamins and minerals such as cereals, whole grains, flours, and even some of the drinks we consume. It’s all too common for us to think “more must be better”. If we eat a balanced diet and take supplements we can get an over abundance of certain vitamins and minerals which can out compete others (example: an excess of Copper can cause a Zinc deficiency). But not everyone is eating a healthy diet – in that case a vitamin may be helpful, but still not as good as a healthy diet would be.

The advice I give to everyone is always speak with your physician or registered dietitian about your diet and past medical history and only take recommended supplements based on true vitamin deficiencies or medical conditions that limit your ability to absorb nutrients adequately before taking them or in the short term to manage some side effects from cancer treatments.

I thought due to modern technology our produce now has less nutrients in it and it’s impossible to get enough from our food?

At one point I thought this could be true, however it is a partial truth. A study completed by Donald Davis at the University of Texas investigated the soil nutrition and nutrition in produce from 1950 though 1999, which found that mineral content has fluctuated because of different farming practices. Unfortunately there weren’t scientists collecting data on the nutrients in soil and produce prior to the 50’s so we don’t have much to compare it to in order to know how much less we may be actually getting and if it is nutritionally significant. Another factor to consider is that there is now more of a selection for larger produce versus smaller produce. Smaller produce may have more nutritional value than larger counterparts. There are now also heirloom varieties that are being grown more which may have a different nutrient composition. So analyzing the data from a span of over 40 years is difficult to do when you have new varieties of produce also included. Davis even admits that historical data can be misleading and inaccurate. Check out this Time write up about his thoughts on his research that was cited above.

Though there may be less vitamins and minerals in produce, they are still extraordinarily rich in nutrients, antioxidants, vitamins, minerals, fiber, and beneficial phytochemicals. You should still eat vegetables and fruits, as they are our best sources for these beneficial compounds. Another study recently published, compiled a review of the literature found that you still can get adequate vitamins and minerals though a well balanced diet and that the changes in produce are not nutritionally significant. If you’d like to see how much you are getting from your daily food intake compared to the recommended daily value, a good website to use is Supertracker. It’s free and easy to use. You can also try looking at the National Institute of Health’s (NIH) website to get an idea if you may be getting enough though your diet. For example, a male that is 19 years old or older would need 90 mg of vitamin C per day. By looking at the food sources of vitamin C chart, you can see that you could get that by eating ½ a red bell pepper or an 8 oz glass of orange juice per day.

What do you do?

Today, I no longer take a daily multi-vitamin. I generally eat a well-balanced plant based diet with some fish and small amounts of meat. I get my labs tested when I see my doctor to monitor for potential deficiencies periodically (though not all vitamins and minerals can be tested for, but your doctor can monitor for symptoms of deficiency as well). The only supplement I do take is Vitamin D3 because I was deficient in this. The short of it is unless you have one of the above mentioned conditions that warrants supplementation, or you aren’t eating a well balanced diet, you are probably okay not taking a vitamin supplement and focusing on eating foods from each food groups, especially your fruits and veggies. But if you want to continue to take a daily multivitamin as insurance you may be okay doing so. If you choose to do so I would make sure it’s not just any brand that’s out there. More on that in my next post…

 

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