The Vitamin Debate: Pro (Part 2)

Part 2 of the debate will discuss why vitamin supplements can be beneficial to certain demographics.  Some examples include pregnant woman, the elderly, vegans, and people who don’t get enough sunlight. There are several reasons why certain people should take a daily supplement.  If you fit into one of the following groups, I would recommend a daily supplement:

• Vegans: Supplementation is especially important for vegans, as vitamin B12 is only found naturally in animal products
• Pregnant: Pregnant women need to take a daily prenatal vitamin to ensure their folic acid needs are met in order to reduce the chance of birth defects
• Elderly: As we age, our bodies require extra Calcium and vitamin D to prevent frail bones and osteoporosis. It’s easier for the elderly to fill these vitamin/mineral needs with a pill, especially if their appetite has decreased so they aren’t eating enough.  Additionally, the body doesn’t absorb vitamin B12 as well thus requiring B12 injections to meet daily requirements. 
• Inadequate sun: Some people have a hard time getting enough vitamin D from food sources and the sun. In the winter, it's impossible to produce vitamin D from the sun if you live north of Atlanta because the sun never gets high enough in the sky for its ultraviolet B rays to enter the atmosphere.  Also, dark-skinned individuals don’t absorb vitamin D from the sun well.
• Alcoholic: Long-term alcoholics have a hard time absorbing a number of nutrients due to decreased digestive enzymes and damage to stomach and intestinal cells so they are advised to take thiamine, folate, and a B-complex vitamin.  Also, they tend to have poor diets since they usually choose alcohol more than fruits and vegetables. 

The Bottom Line

A patient once asked me if he could survive on a multivitamin alone because his body will break down his meals into vitamins anyways.  I explained that a MVI is made up of micronutrients (vitamins and minerals), while food provides macronutrients (carbs, protein, and fat) that fuel the body.  Additionally, vitamins are useless without macronutrients to shuttle them around: think of fats as the subway commute for vitamin E.  This story emphasizes the importance of food vs supplements.  A diet rich in fruits and vegetables, whole grains, legumes, low fat dairy, and lean meat will provide the needed macro and micronutrients. Supplements can’t take the place of a balanced healthful diet but they can ensure that you are receiving basic nutrition: think of a MVI as added insurance that you are meeting your nutrition needs.  If you are susceptible to vitamin deficiencies (see list above), vitamin supplementation is recommended.  If you are an average healthy person, your first priority should be to maintain a healthy diet and use a MVI to fill in the holes.

The Vitamin Debate: Con (Part 1)

Do you need to take a daily multivitamin (MVI)?  Is there validity to doubling up on vitamin C when a cold is on the horizon?  The debate regarding dietary supplements is controversial and not exactly clear cut.  I decided to approach this topic as a 2 part series to cover all the sides.  I’m not going to tell you what to do because everyone is different and requires individual plans to meet one’s daily nutrient needs.  Look at all the sides and talk to your Doctor if you have special medical concerns.

 If you walk into the average American home you are bound to find a variety of vitamins and minerals lining the cabinet shelves.  Dietary supplements, including vitamins, minerals, amino acids, enzymes, and botanicals, have become quite trendy these past few years.  Truthfully, people have been using herbs and botanicals for over 2000 years as forms of alternative medicine but the amount of processed “bottled” herbs has grown notably in popularity.  Some examples of botanical supplements are Echinacea, Black Cohosh, Fenugreek, and Ginkgo.  Popular vitamins/minerals include D, E, K, C, and calcium.  

 Keep in mind regarding the negatives of dietary supplements:

• They don’t have the same rigorous standards as prescription drugs i.e. they don’t have to be tested for effectiveness and safety before they are sold so it’s hard to know if and how they’ll work.  Dietary supplements are only required by the FDA to list the contents, amount of active component per serving, and any added ingredients like flavoring or fillers.  Unlike prescription drugs, these specifications don’t tell us much.
• They may interact with your medications i.e. Coumadin and vitamin K; St. John’s Wort may reduce the effectiveness of some drugs for depression or seizures.
• If a health claim sounds too good to be true, it probably is. 
• Some vitamins have toxicity levels such as vitamin A, D, E, and K so make sure those vitamins on the label are less than 100% and don’t take a MVI and a separate pill of those vitamins
• The added fillers and colorings in MVIs make it hard for the body to absorb so most of the vitamin is excreted in the urine
• Excessive supplementation may have side effects i.e. too much vitamin C may cause diarrhea; extra calcium and vitamin E may raise the risk of prostate cancer
• Make sure there is no phosphorus in your MVI since it interferes with calcium absorption and is abundant in the American diet

These are some of the reasons supplements may not be the best way to get your nutrients.  Sign up on the right to receive notifications of new blog posts via e-mail and stay tuned for the second part on supplements.