- Nutrition -

Multivitamin Maze

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Yes, you should probably be taking a multi, but how do you decide which one?

After years of dismissing multivitamins as useless money-wasters, the medical community seems to have had a change of heart. The prevailing attitude used to be “wait and see,” meaning doctors were waiting for conclusive scientific evidence of multivitamin supplements’ effectiveness before they started recommending them to their patients. Now that attitude has evolved to something more like “better safe than sorry.”

To which a great many dedicated vitamin takers can only respond: “Duh!” If the connection between optimal nutrition and optimal health seems like a no-brainer to you, you are not alone. But you might be surprised by how long it has taken everybody else to get on board. Over 10 years ago, Time magazine ran an article titled “The New Scoop on Vitamins,” announcing that vitamins were turning out to be “much more important than doctors thought in warding off cancer, heart disease and the ravages of aging.” The article concluded: “Vitamins promise to continue to unfold as one of the great and hopeful health stories of our day.”

Since then, a great many well-regarded clinical trials have shown vitamins in an increasingly positive light, and both health professionals and consumers have taken notice. Plus, with both chronic diseases and healthcare costs on the rise, and a lot of aging baby boomers determined to stay healthy, many people are taking a keener interest in preventative care. Instead of waiting for their doctors to make specific nutritional recommendations (notoriously unlikely), or depending on them to write pharmaceutical prescriptions after they get sick, many consumers are taking health maintenance into their own hands.

The net result? Vitamin supplements have gone mainstream. In fact, just about every kind of supplement has gone mainstream, and the supplement industry has swelled beyond anyone’s expectations. But some things haven’t changed – namely the confusion surrounding just exactly what we should be taking, and how much.

Daily Dosage

Stroll down the vitamin aisle at any health food store – or grocery store for that matter – and you will be confronted with a jaw-dropping array of choices. Consult a few books or articles on supplementation and you’ll get an even more bewildering array of advice about which nutrients your body needs, in what form, and in what quantities.

While most health professionals continue to refer to the FDA’s Reference Daily Intakes (RDIs) or Daily Values (DVs) for essential vitamins and minerals, many nutritional experts say that, for most people, those guidelines are likely to be totally inadequate, misleading and/or inappropriate.

First, the old Recommended Daily Allowance (RDA) values – from which the current RDIs and DVs evolved – were never formulated with “optimal health” or boundless vitality in mind. Rather, they were developed during WWII as baseline requirements for preventing serious nutritional deficiencies like rickets and scurvy. Second, the current DVs represent very general guidelines for a mythical “average healthy person,” and do not take into consideration the different needs of different genders and age groups, much less individual nutritional needs or biochemical profiles. They’ve been adjusted and averaged and reformulated several times, and according to the FDA, they are now set for postmenopausal women.

Plus, get this – even the FDA says that its RDIs and DVs are not to be construed as recommendations! According to Christine Lewis, Ph.D., director of the division of technical evaluation in the FDA’s Office of Food Labeling: “They’re not recommended intakes. They’re really just reference points to help people get some kind of perspective on what their overall daily dietary needs should be.”

Okay … if that seems a little murky or confusing to you, visit www.fda.gov/fdac/special/foodlabel/dvs.html for a more complete explanation (then you’ll really be confused!). To complicate matters, the FDA continually adjusts and expands the DVs based on emerging, moving-target clinical criteria, so what qualifies as 100 percent today may turn out to be 50 percent or 150 percent down the road.

Meanwhile, many Americans just want to believe they can pop a pill and be done with it. After all, if you are taking a multivitamin that says it contains all sorts of essential vitamins and minerals, you should be able to eat what you like and not worry, right? Wrong! Here’s why:

  • The merits of the current FDA’s DVs aside, even if you could somehow manage to get all your nutrients from a supplement, it wouldn’t negate the damage caused by an overload of poor-quality, additive-laden food.
  • No vitamin (or combination of vitamins) can offer you the full array of crucial micronutrients, phytochemicals and other substances that are present and abundant in fresh food. Vitamins don’t contain the protein, carbohydrates and amino acids necessary to sustain energy and metabolism.
  • There is no guarantee that all the vitamins and minerals contained in a supplement will be broken down and fully absorbed by your body.
  • Your vitamin supplement may not even contain all the nutrients that its label claims in the first place. (See Ask the Experts article for more on these last two snafus.)

Super. So given all this, why even bother with a multivitamin? Well, if you’re in excellent health and happen to be part of that tiny 3 percent of the American population that is regularly eating all the recommended servings of fruits and vegetables, it is possible – just possible – that you don’t need to. But the chances of that are slim. And even if you do eat right, you still face the realities of mineral-depleted soil, agribusiness-farming methods and whatever other paces (e.g., transport, processing, storage, cooking) your produce goes through before it enters your mouth. Realistically, virtually no one can be absolutely certain of getting all the nutrients they need from diet alone unless they put a heck of a lot of care, determination and energy into it.

Unfortunately, that isn’t energy most American consumers seem ready to expend. Many of us would rather reach for something we can toss back in a single swallow.

One-a-Day Deception

It sounds nice, doesn’t it? Just one little pill, once a day? Well, forget about it. According to reputable vitamin formulators, it is downright impossible to get all the nutrients you need into in a single pill without that pill being the size of a hockey puck. That’s why most good-quality multivitamin formulations require you to take at least two pills or capsules a day just to get the baseline requirement of most DVs. Vitamins designed for optimal health (as opposed to merely staving off a serious deficiency) will contain a wider spectrum and greater volume of nutrients, and will thus require even more real estate (meaning their serving size may amount to four, six or even eight pills a day).

You may not like the idea of having to swallow so many tablets, but if your vitamin proposes to “cover all the bases” with only one pill, you might want to take a closer look at the label. You’ll see they’ve probably skimped on calcium, magnesium and other minerals to save space. Less expensive vitamins may also skimp on quality, using synthetic vitamin E, for example, which has been shown to be absorbed much less readily by the body. Or they may use retinol, a form of vitamin A that can accumulate in the body in toxic levels, as opposed to carotenoids – compounds that allow your body to manufacture vitamin A in whatever amounts it requires. When it comes right down to it, even though multivitamins are designed to make nutrition simple, you still have to do some work in order to make an informed choice that’s right for you. Your best bet is to familiarize yourself with material from several reputable nutritional sources (keep in mind, they won’t all agree!), then weigh the information for yourself, based on your diet, your lifestyle and your priorities.

MultiVitamin Basics

  • A multivitamin is supposed to fill in some blanks in your diet, not write the whole nutritional story. A balanced diet of real, nutrient-dense food is crucial to your health whether or not you take a multivitamin. So while you are shopping, don’t skip the produce aisle!
  • Forget “one-a-day” solutions. The nutrients you need won’t fit in a single pill. Plus, some vitamins are most needed and best utilized during the day, while others are best absorbed at night, so breaking up your dosage is a good idea anyway. Make sure you compare the combined daily dosage of all the tablets recommended in a serving.
  • You can easily pay too much for a low-quality vitamin, but you almost certainly won’t get a great vitamin super cheap. Compare brands across a few price ranges. Consider both the quantity and quality of ingredients. If you opt for a lower- priced multi, but then buy separate supplements to get adequate minerals, amino acids and extra antioxidants like C, A and E, you may wind up spending about the same.
  • Absorbability is key: Look for the USP (United States Pharmacopia) seal on the label, which ensures the formula has been independently lab tested and that its digestibility and ingredients have been verified.
  • While the issue is hotly debated, in many cases, natural vitamins made from food sources seem to be more “bioavailable” (better absorbed and employed by the body) than lab-created synthetics. This is particularly true of vitamin E: Look for d-alpha-tocopherol or mixed tocopherals (natural) not dl-alpha-tocopherol (synthetic).
  • It’s possible to overdose on vitamin A from retinol; if you are taking lots of antioxidants, choose supplements made from carotenoids instead.
  • Look for balanced Bs – at least 100 percent of DVs for B1 (thiamine), B-2 (riboflavin), B-3 (niacin), B-5 (pantothenic acid), B-6 (pyridoxine), B-7 (biotin), B-12 (cobalamin), and folic acid (folate or folacin). Note: Biotin is the most expensive B vitamin and an important biocatalyst for other Bs, but cost-cutting manufacturers often skimp on it.
  • For minerals like calcium, magnesium and phosphorus, a combo of chelated and non-chelated minerals is best (steadier release). The presence of trace elements like chromium, molybdenum, vanadium, boron, selenium and manganese is a good sign.
  • Avoid products with added sweeteners, colors, shellacs or wax coatings. They are unnecessary and bad for you.
  • Remember that it’s what you do regularly and long term that counts. Taking a multivitamin now and then, on and off, probably won’t have much impact on your health. Take them daily and plan to stay the course.
  • If you are taking prescription medications or have special health concerns, do check with your doctor before beginning to take any kind of vitamin, mineral or herbal supplement.


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