Truth on Tuesday

 

Should you be taking a Multivitamin?

All too commonly people think that a pill can fix just about any health issue.  A lot of times it can, but what about when it comes to things that can obtained naturally, from food, rather than resorting to a man-made product?  When clients ask me about whether or not they should be taking a multivitamin I always tell them that it is best that they get their vitamins and minerals from actual food.  However, there are certain circumstances in which taking a multivitamin can be beneficial and in theses instances it is important to be consuming the right multivitamin.  

 

Although multivitamins and  multiminerals, are commonly used, they have no standard scientific, regulatory, or marketplace definitions (1).  Therefor it is important to do your research before heading out to your local GNC.  The actual amounts of vitamins and minerals listed on the product often deviate from label values. Furthermore, vitamin and mineral bioavailability (the amount that it taken up and absorbed by the body) for dietary supplements also lack both a standard scientific and regulatory definition. This can lead to much discrepancy and possible nutrient imbalances.

Excessive Intake

A recent survey done in Hawaii & Los Angeles revealed that 48% of men and 56% of women take some form of a multivitamin. While those who supplemented with a multi did have, on average, higher intake of 17 key nutrients, they also were also more likely to have potentially excessive intakes, particularly for iron, zinc, vitamin A, and niacin (2). Deviations of even 25–50% from label values, given the relatively high quantities of vitamins and minerals in marketed multivitamins, can result in significant errors in estimates of dietary intakes (1). This evidence supports the notion that excessive vitamin and mineral intake are likely more of a concern than vitamin and mineral deficiency in normal healthy individuals.

Athletes/Active Individuals

While you may have heard from a trainer, or read in magazine that athletes and active individuals are at higher need for vitamins and minerals and therefor need to supplement, there is actually very little evidence to support this idea. Rather, individuals who meet at least 70% of the DRI for nutrients do not need to supplement. While some research supports the supplementation of minerals when sweat and urine losses are high, the quantities needed can be obtained through dietary intake (3).  Athletes who are at the greatest risk for poor micronutrient status are those who restrict their caloric intake,  eliminate one or more of the food groups, or those who consume unbalanced diets. These individuals  may benefit from a daily multivitamin/mineral supplementation, however, use of vitamin and mineral supplements does not improve performance in individuals consuming nutritionally adequate diets (4). Adequate assessment of an individual's dietary intake and activity level in addition to specific laboratory tests will help to identify whether or not a person is at risk for a nutrient deficiency and determine whether or not supplementation is warranted.   

So who will benefit from a multivitamin?  Additional marcro and micronutrients are needed during times of growth and development or during times when nutrients are lacking from the diet such as in the case of strict vegans or vegetarians.  It is also recommended that women who are pregnant or trying to conceive be taking a multivitamin, preferably a pre-natal multivitamin with at least 400 micrograms  of folic acid.  The Academy of Nutrition and Dietetics (formerly the American Dietetic Association) recommends that women of childbearing age, strict vegetarians, adults older than 60, and those who aren't consuming an optimal diet take a daily multi to boost nutrient levels. Also, if your are following a reduced calorie diet (less than 1500 calories/day), taking a multivitamin might be necessary to help you meet the recommended daily values.  

Choosing a Multivitamin

The first thing to look at is for the product to have a USP (United States Pharmacopeia) seal.  A product with the USP-verified mark ensures that the multivitamin contains the ingredients and amounts stated on the label, disintegrates properly for ideal absorption, and is free of contaminants.  Also be sure that the product label lists levels of vitamins and minerals that are at or near 100% of the Daily Values established by the U.S. Food and Drug Administration.  There is not

*Remember: 

Taking a  multivitamin supplement will not make up for poor food choices!  Even if you do choose to take a multivitamin, it’s still important to choose a healthful diet containing a wide variety of foods from all food groups.  Supplements do not function as food replacements, and have not been proven to boost energy, speed weight loss or improve your mental function.  For the average active individual who eats a balanced diet, a multivitamin is not required. If you would like to take it as a little security blanket to make up for the lack of fruit and vegetable in your diet, then be my guest.  I will admit that it is very difficult to achieve the 9-11 serving of fruits and veggies daily that are recommended by the Dietary Guidelines.  However, it is not impossible. Here are a few tips on how to meet your quota by adding in fruits and vegetables throughout the day.  

Start at Breakfast:

• Add mushroom, onion,  and bell pepper to an omelet
• Top off your cereal with fresh berries
• Spread peanut butter on toast and top it off with sliced banana
• Enjoy a piece of fruit as a part of your healthy breakfast

Sneak Veggies in at Lunch:

• Add lettuce, tomato, onion, and cucumber to sandwiches
• Choose a broth based soup with vegetable at lunch  
• Opt for a side salad instead of French fries when at the drive thru  

Incorporate Vegetables into Dinner Staples

• Add broccoli, tomatoes, green beans and other vegetables to pastas and casseroles
• Create an entrée salad by placing grilled chicken, steak, or fish on a bed of lettuce with tomatoes, onion and other veggies
• Ask for extra veggies when you order pizza

1. Yetley, E. (2007). Multivitamin and multimineral dietary supplements: defintiions, characterization, bioavaliability, and drug ineractions. American Journal of Clinical Nutrition, 85, 269-276.

2. Murphy, S., White, K., Park, S., & Sharma, S. (2007). Multivitamin-multimineral supplements' effect on total nutrient intake. American Journal of Clinical Nutrition, 85, 280-284.

3. Dunford, M. (2006). Vitamins, Minerals, and Exericse.  In J. Muzinic (Ed.),  Sports nutrition: A practice guide for professionals (pp. 61-85). United States: American Dietetic Association.

4. Rodriguez, N., DiMarco, N., Langley, S. American Dietetic Association, Dietitians of Canada, & American College of Sports Medicine. (2009). Position of the American Dietetic Association, Dietitians of Canada, and the American College of Sports Medicine: Nutrition and athletic performance. Journal of the American Dietetic Association, 109(3), 509-527.