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.

Last week I wrote about how omega-3 fatty acids, DHA and EPA, can play a role in preventing ADHD. I have been searching for a DHA/EPA supplement for my almost 3 year-old daughter for some time now. I tried a gummy/candy DHA supplement from Trader Joe’s and she didn’t like it. I’ve tried supplemented food but she never seems to get enough from those products. So I bought Carlson for Kids Very Finest Fish Oil Lemon Flavor to see if I could sneak it in her food. I tried putting it in lemon yogurt and she could tell immediately. I tried a smoothie – and once again, she turned it away. Then one night I just put it in a spoon and gave it to her and she took it down. Not only did she take it down, she wanted more! Was it really that easy? After a week of her accepting her bedtime lemon “treat” I realized that she likes it. Yeah!

What I like about giving her fish oil is it contains both DHA and EPA. Even though DHA is the star, it works synergistically with EPA. I mean, if she were eating fish she’d get both. I still offer her salmon once a week hoping that eventually she’ll eat more fish. But for now, I feel good knowing she’s getting the essential omega-3 fatty acids she needs.

So this product gets a big “thumbs up” from me!

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