Good Candidates for Multivitamins
If everybody ate a perfect diet, there wouldn’t be much need for nutritional supplements.
Of course, everyone doesn’t. Further, there are some nutrients that have proved to be important in quantities that are almost impossible to get from even the best diet. Vitamins C and E and calcium fall into this category, and we do recommend individual supplementation of these nutrients.
Among the most frequent questions asked by our readers are ones about multivitamins. There are some good reasons to take a multivitamin, and some people who should consider taking them. The following list would include more than half of all Americans.
* If you’re over 60, you may not be getting all the nutrients you need. Some older people do not eat as well as they should. This may have to do with social isolation and economics, but the aging process itself may also make it more difficult to utilize certain nutrients from foods. In particular, vitamins D, B-6, B-12 and folic acid, along with the mineral zinc, may fall short in the diet.
* Women who might become pregnant should supplement their diet with at least 400 IU (international units) of folic acid every day to guard against neural tube birth defects that occur so early in the gestation period that there might not be time to supplement after conception occurs. The folic acid found in supplements and fortified grain products seems to be better absorbed than that which occurs naturally in food.
* Pre-menopausal women often do not consume enough iron to compensate for what is lost during menstruation.
* Vegans eat no animal products at all and may be low in vitamin B-12, zinc and calcium.
* Dieters may be shortchanging themselves for many nutrients.
* Heavy drinkers may tend to substitute alcohol for food and therefore wind up being widely deficient in nutrients.
* Poverty and malnutrition often go hand in hand. We don’t like to suggest that pills substitute for food, but they may help to compensate for a poor diet.
* Pregnant women should take a multivitamin, but this should be discussed with a health-care professional early in prenatal care.
* Anyone who is not eating a balanced diet (at least five fruits and vegetables, whole grains, low-fat dairy and adequate protein) may be falling short in some important vitamins and minerals.
Here are some tips in choosing a multivitamin:
* A good multivitamin does not have to be expensive. Most store brands and generic products are fine. Each pill should not cost more than a few cents.
* Look for “USP” on the label. It means that the vitamins have been tested under controlled conditions for standard qualities such as disintegration. Many brand-name vitamins do not carry this designation because they rely on name recognition to sell the product. Generic and store brands usually do carry the USP seal.
* Make sure your brand contains up to 100% of the Daily Value for vitamins A (some from beta carotene), B1 (thiamine), B2 (riboflavin), B3 (niacin), B6, B12, folic acid and D, plus the minerals copper, zinc, magnesium, iron, iodine, selenium (not more than 200 micrograms) and chromium (not more than 200 mcg). It should also have very small amounts of boron, manganese and molybdenum.
* Don’t pay extra for potassium, phosphorus, pantothenic acid and biotin because you can easily get enough in food.
* If a vitamin has 200 to 800 IU of E and 250 to 500 milligrams of C, go for it, but you may have to take additional supplements of these vitamins to get enough.
* Calcium is very bulky, and multivitamins cannot possibly contain enough, so you should probably take separate supplements. Everybody needs at least 1,000 milligrams a day from food and supplements. Older men and women should be taking more (1,200 to 1,500 milligrams per day).
* Pre-menopausal women should look for 100% of the Daily Value for iron. Anyone who has been diagnosed with hemochromatosis (absorbing too much iron) should avoid it.
* More is not necessarily better. Up to 200% of the B vitamins is OK, but large doses of vitamins A and D can be dangerous.
* If you take a multivitamin, take it with food. If it contains iron, don’t take a calcium supplement at the same time because iron will interfere with the absorption of calcium.
* Watch out for useless and expensive terms such as “stress formula,” “sugar free,” “starch-free,” “natural,” “super-potency,” “senior formula,” “slow-release,” “enzymes,” “hormones,” “amino acids,” “PABA,” or “ginseng and other assorted herbs.” Simple is better.
* Multivitamins and other supplements are helpful additions to a well-balanced diet, not a substitute for one. Foods contain many other health-promoting substances and the way Mother Nature packages them may be one of the real keys to a long and healthy life.
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Dr. Sheldon Margen is professor of public health at UC Berkeley; Dale A. Ogar is managing editor of the UC Berkeley Wellness Letter. Send questions to Dale Ogar, School of Public Health, UC Berkeley, Berkeley, CA 94720-7360, or to daogar@uclink4.berkeley.edu. Eating Smart runs every Monday.
