Why You Might Want to Rethink That Multivitamin

by Maryann Tomovich Jacobsen, MS, RD on November 3, 2010

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Multivitamins have been in the news lately — and the news is not so great.  Studies are showing that multivitamin supplements do little to help prevent chronic disease and promote health.  And preliminary research shows that in certain populations, they could even do harm.

Yet more than half of the US populations take multivitamins (53 percent) every day.  Kids take them too — 30 percent according to a 2009 study published in the Archives of Pediatrics and Adolescent Medicine.

Before you ditch multivitamins from your household, consider whether or not they truly enhance the health and well being of your family.  Here are three things to consider when making your decision.

1. Do they promote health? According to the 2010 Dietary Guidelines Report, there is little evidence that multivitamins prevent chronic disease.  On the other hand, people with healthy diets including fruits, vegetables, whole grains, nuts, beans, fish and little meat, have been shown to have lower chronic disease risk.

It is not just the vitamins and minerals in healthy foods that prevent diseases like diabetes and cancer, but the synergistic effects of phytonutrients, fiber and vitamins and minerals naturally found in food.  Research also dismisses the need to take additional amounts of antioxidant vitamins such as vitamins A, C and E as they do not appear to improve health outcomes as previously thought.

2. Is there any harm in taking them?  It is one thing if multivitamins don’t prevent disease but another if they are actually bad for health.  While most research shows no adverse effects of taking multivitamins, there are potential problems with getting too much, especially given the fact that many food products are fortified, including cereals, bars and drinks.

While adequate folic acid in one’s diet is good for health, too much may not be good.  Some studies suggest that too much folic acid may increase the risk of cancers, especially colon cancer.  A recent Swedish study revealed that in a small sub-set of women, high folic acid blood levels increased breast cancer risk.  Research has also shown that supplementing with beta carotene increases the risk of lung cancer in smokers.

It’s important to note that the research in this area is far from conclusive and studies contain many inconsistencies.  There’s simply too much researchers don’t know about the combination of supplements people take and how they affect health.   The key is to aim for a healthy, varied diet and avoid excess amounts of vitamins and minerals through fortified foods and supplements.

3. Am I (or my kids) missing out on key nutrients? The 2010 Dietary Guidelines Report acknowledges that multivitamins and supplementing with key nutrients are beneficial for certain populations.  The main reason for taking a supplement should not be for insurance, but to address key nutrients that are lacking in one’s diet.  Here are some tips to help you decide:

  • Two recent studies showed most infants, toddlers and preschoolers get most adequate nutrition through food (except vitamin D). If children eat a variety of food, including fruits and (some) vegetables, they probably don’t need one.   Before giving kids multivitamins, check the amount of vitamins and minerals that come from fortified products.  Some children under 3 may benefit from a multivitamin with iron if they eat little meat and iron-fortified cereals.
  • The Center for Science for Public Interestrecommends men and post-menopausal women who consume multivitamins take them every other day so they don’t get too much folic acid.  On the other hand, women capable of becoming pregnant should take a multivitamin with 400 mcg of folic acid daily to lower their risk of having a baby with neural tube defects.
  • Most people need additional vitamin D because the primary source is the sun.  Adults can get their blood levels checked at a routine physical and supplement if needed.  The AAP recommends that kids consuming less than 4 cups of milk daily take a supplement with 400IU daily.

In my next series, I’ll address key nutrients that are most likely to be missing in your family’s diet, making the decision to supplement much easier.  Not knowing if your child is meeting his or her nutritional needs is unnerving so the goal of the series is to give you peace of mind.

Got any questions about this sticky topic of multivitamins?  Leave them in the comments.

References
2010 Dietary Guidelines Report

Shaikh U, Byrd RS, Auinger P. Vitamin and mineral supplement use by children and adolescents in the 1999-2004 National Health and Nutrition Examination Survey: relationship with nutrition, food security, physical activity, and health care access. Arch Pediatr Adolesc Med. 2009 Feb;163(2):150-7.

Ericson U, Borgquist S, Ivarsson MI, Sonestedt E, Gullberg B, Carlson J, Olsson H, Jirström K, Wirfält. Plasma folate concentrations are positively associated with risk of estrogen receptor beta negative breast cancer in a Swedish nested case control study. J Nutr. 2010 Sep;140(9):1661-8.

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{ 3 comments… read them below or add one }

cyrell November 14, 2010 at 2:31 am

Hy there,

i wanted to add something to the matter of folic acid and also Vitamin D.
Please be aware that milk contains normally nearly zero Vitamin D, it is only added before packaging.
So if you can drink no animal milk(cow, goat, sheep), just drink fortified plant milk(rice, oat, soy,almond), get enough sun(15minutes daily with bare face and arms under the shade of a tree) or take pills.

Never take more Vitamin D than the Daily Allowed Intake or you risk exactly what you wanted to prevent.

Too much Vitamin D takes calcium out of the bones and makes them weak but also the free calcium will build stones in your kidneys and makes problems in the soft tissue of the body.

With exposure to sunlight that can not happen, but with pills you can get so much Vitamin D that it will be doing the opposite thing which it should normally do.

Also now on to folic acid:

I saw during the period of 15 years when the recommendation for folic acid raised from 100 to now 800mcg.

But there are still cases where the defects happen, even in women who did take supplements before they got pregnant.

Maybe it is a special condition in these women, but we also should not forget that folic acid alone is not the holy grail.

Other B-Vitamines and also fatty acids are needed for the healthy growth of body cells.

We still know only a small part of things which are in fruits and vegetables and makes them so precious for our health.
Only since a couple of years scientists are working on the phytophenole and other secondary substances which are neither vitamin nor mineral.

Multivitamin pills and powders are not enough for a good nutrition and because the recommendation raised from 100 to 800mcg it should show us that there is more than just folic acid

Whole foods with these vitamins are much more safe to help against prenatal problems then pills could.
Because vitamins produced naturally and in combination with all the other substances are in foods, which can not yet get paked in a pill, i would recommend for every women brewers yeast tabletts or also nutritional yeast.

The folic acid is isolated out of yeast as is B12 and other B Vitamins and sold in pills which cost much more then the brewer yeast pressed into tablets..why not get the whole deal?

You also get minerals and protein.
If you are not allergic to yeast this is the safest way for women to not only get their folic acid.

Also wheat germs contain much B Vitamins and folic acid and you should eat wheat germs, leafy greens, beet root, tomatoes, nuts and other vegetables raw because all these vitamins are destroyed by heat.

90% of the vitamins are gone after cooking spinach, carrots or brussel sprouts.

But luckily most vegetables also taste raw good and you can keep the cooking time down so the vegetables have still a bit of crunch.

Wheat germs can go bad pretty fast because they contain essential fatty acids in big ammounts which can turn rancid very fast. Put the wheat germs once the package is opened in a sealable container and put them into the freezer and use them as a nutty sprinkle over salad, soup, stew, even casseroles and pizza or over your cereals.

Some women even like them eaten by spoon or mixed in a shake. Just do not heat them to get the full benefits.

Add them after the cooking process and only on the portion you have on your plate.

Reply

Maryann Tomovich Jacobsen, MS, RD November 16, 2010 at 4:56 pm

Thanks for your comment. I would love if you could send me research behind the claims you make. As for vitamin D, I advise people to get their levels checked at the doctors. That way you can take the right amount (or none at all). Higher levels are needed for people with inadequate blood levels.

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Machines & Devices July 20, 2013 at 11:34 am

WOW just what I was searching for. Came here by searching for multivitamin

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