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    Archive for the ‘multivitamins’ Category

    You Ask, I Answer: Why Isn’t a Multivitamin Enough?

    Get_the_Right_MultivitaminsThis morning, my 13 year-old son asked me why I always want him to have a healthy breakfast.

    I explained that I wanted to make sure he got the vitamins and minerals his body needs.

    His response was: “Well, why can’t I just have two Pop Tarts and [a multivitamin]?”

    I didn’t really know what to say to that!  What would you have said?

    — Teresa Womell
    (Location withheld)

    “Because as long as you’re living under MY roof…”

    No, kidding.

    Truth is, your initial answer backed you into this corner.  You mentioned that eating healthy foods is important in order to get necessary vitamins and minerals.

    While that is certainly an important part of the equation, nutrition goes far beyond vitamins and minerals.

    Foods also offer phytonutrients, flavonoids, and antioxidants — chemical compounds that offer a variety of health benefits.

    Take an orange, for example.  It is a great source of vitamin C, folate, thiamin, and potassium.

    That’s fabulous in its own right — but there’s more!

    Oranges also offer approximately 150 phytochemicals and over 50 flavonoids that help lower our risk of heart disease, several cancers, and high blood pressure!  You simply can not get that from a supplement.


    The (Non-Existent) Battle of the Sexes

    300054755506The makers of Centrum are heavily advertising their newest multivitamin — Centrum Ultra Women’s — on television.

    This product — “specially formulated with key nutrients to help meet a woman’s nutritional needs” — contains additional amounts of Vitamin D (which the commercial points out “has been shown to promote breast health”) and calcium.

    Sounds lovely, but this is marketing hype in its purest form.

    First of all, the link between vitamin D intake and breast cancer is only suggestive at this point.  More research is certainly needed.

    Additionally, there is a growing body of research which suggests that adequate levels of vitamin D may help lower men’s risk of developing prostate cancer.

    As for the extra calcium (the Ultra Women’s formula provides 500 milligrams, while the Ultra Men’s offers 210 milligrams) — why?  Men and women have the exact same calcium recommendations (these fluctuate according to age, not sex).

    Main takeaway: both sexes equally benefit from adequate nutrition.

    His and hers multivitamins are simply a result of Madison Avenue looking to maximize profit.  Don’t fall for it.


    You Ask, I Answer: Supplements, Cumin

    Do you object to supplementation in general via a basic multivitamin/mineral product?

    I recall [reading in the Center for Science in the Public Interest’s] Nutrition Action Healthletter that adult males [should] avoid iron supplementation (perhaps due to a possible link between excessive iron intake and the development of a certain type of cancer?).

    Is iron something that adult males should indeed avoid in a supplement?

    [Lastly,] do you see any merit to taking curcumin or cumin supplements (especially for someone with an inflammatory disease such as asthma)?

    Obviously, a whole food is preferable, but I think that massive amounts of curry would need to be ingested in order to derive any possible benefits.

    — Rob White
    Boston, MA

    My stance on supplementation varies depending on context.

    I despise the notion that as long as you take a multivitamin once a day, you don’t need to worry about the nutrient composition of what you eat the rest of the day.

    Multivitamins do not offer the vast amount — literally THOUSANDS — of healthy phytonutrients and other compounds naturally found in foods.

    Additionally, absorption from multivitamins is often lower — and less effective — than if that same nutrient is derived from actual foods that contain those nutrients.

    I do, however, fully support the supplementation of Vitamin D. Unless you live near the Equator, your body can not synthesize this nutrient from sunlight between the months of October and April.

    For the record, I recommend supplementing 2,000 International Units of Vitamin D a day.

    I also don’t have a problem with individuals supplementing a specific vitamin or mineral that they would otherwise be deficient in (i.e.: vegans without access to fortified foods and B12).

    The issue of iron supplementation and men can also apply to post-menopausal women. Since iron is very hard for the body to excrete (menstruation being the exception), supplementation in these two populations raises the risk of a condition known as iron overload.

    Iron overload can cause a variety of symptoms and problems, from heart arrhythmia and hypothyroidism to impotence and arthritis.

    This is why, if you examine the label on a “men’s formula” multivitamin, you will find that iron is MIA.

    As far as curcumin supplements in regards to asthma, it gets complicated. There is very little data on the efficacy of these supplements. Consequently, dosage values have not been clearly determined.

    Additionally, certain individuals (those with weakened immune systems, diabetes, and stomach ulcers) are advised to steer clear of these supplements, as they can aggravate those conditions.

    I think you are better off implenting more curry-spiced dishes into your diet. After all, populations that are believed to benefit from this spice include it in their recipes, not swallow it in pill form.


    Numbers Game: Answer

    A single-serve 11-ounce bottle of ready-to-drink Carnation Instant Breakfast Essentials contains 5.25 teaspoons of added sugar.

    I never understood Carnation Instant Breakfast’s reputation as a health product. It’s nothing more than fortified chocolate milk (the second ingredient is sugar).

    There is absolutely no difference between starting your day with Carnation Instant Breakfast and downing a multivitamin along with a glass of Nesquik.

    In fact, if your breakfast consisted of an 11 ounce glass of non-fat milk with a tablespoon of chocolate syrup, you would be consuming half the amount of sugar in a bottle of ready-to-drink Carnation Instant Breakfast.

    Depending on which way the wind is blowing, Carnation Instant Breakfast and rice cakes are at the top of my “nutritionally overrated foods” list.


    In The News: Eat Food, Not Vitamins

    I fear how some members of the mainstream media will report on the latest finding from the Physicians Health Study that “Vitamin C or E pills do not help prevent cancer in men.”

    I certainly hope I don’t come across any “why oranges may not be as healthy as you might think,” teasers on any news shows.

    I am actually quite glad these well-publicized studies are arriving at these firm conclusions.

    They make it absolutely clear that simply isolating nutrients in pill form and downing them with a glass of water every morning has very little to do with disease risk reduction.

    In fact, this is precisely why dietitians have been recommending the consumption of fruits, vegetables, legumes, and whole grains for decades.

    It is not just one vitamin or mineral that helps lower disease risk.

    Rather, it is the interaction and interplay between vitamins, minerals, antioxidants, polyphenols, and other compounds in food that provide health benefits. An orange is much more than vitamin C in a refreshing package.

    Don’t expect the multivitamin companies to let you in on that tidbit anytime soon.


    You Ask, I Answer: B Vitamins & Mental Health

    What do you think about those TrueHope EMPower vitamins that make all kinds of claims about aiding mental health?

    I know B-complexes aid mental functioning, but is all of that really even bioavailable?

    — Anonymous
    Via the blog

    What do I think? I think it is an extremely disturbing — and dangerous — product.

    TrueHope advertises itself as “bringing hope, healing, and health through the research, development, and promotion of high effective nutritional supplements designed to correct mood disorders and other nutrient-depleted conditions.”

    In essence, they claim that mental conditions caused by chemical imbalances (such as bipolar disorder and depression) can be cured by popping what is, in essence, a daily multivitamin.

    This claim is based on “evidence” from very shoddy trials.

    In fact, there are a grand total of three, none of which are randomized, double-blind, placebo-controlled clinical trials (check out this Wikipedia link for “clinical trial 101” reading.)

    Anyhow, their “mood-corrective” formula contains very high (sometimes above the upper tolerable intake) doses of a multitude of vitamins and minerals, plus a handful of other ingredients like grape seed extract and methionine.

    One particularly disturbing included ingredient is vanadium, a trace mineral that people with bipolar disorder have been shown to actually have high levels of.

    I am at a complete loss as to why this is present in EMPower.

    Although it is true that the B vitamins play a role in mental function, that is very different from mood disorders.

    The idea that B vitamins help with bipolar disorder is equivalent to someone claiming that since Vitamin C supports immune system function, megadoses could be effective in curing someone of AIDS.

    If anyone ever attempts to tell you they can correct a mental disorder caused by a chemical imbalance through vitamins and minerals, be sure to run in the opposite direction and stay far, far away.

    By the way, this product has been extremely controversial in its native Canada, where psychiatry and mental health organizations have warned patients of the dangers of relying on a combination of vitamins and minerals to control their mood disorders.

    It has also been alleged that these pills “were supposedly designed to stop pigs from chewing each other’s tails.”


    Survey Results: Multivitamins

    The latest Small Bites survey found that 45% of respondents pop a multivitamin every day, while 31% feel no need to supplement their diet with an “all in one” pill.

    An additional 17% reported taking multivitamins not on a daily basis, and 5% are only concerned with getting specific vitamins and minerals in pill form.

    Although vitamin supplementation has its place (i.e.: Vitamin D for almost everyone, several key nutrients for the elderly and people on very low calorie diets, Vitamin B-12 for some vegans, folate for women planning to get pregnant, etc.) it can also lull many people into a fall sense of security.

    I recall a conversation with someone who told me he didn’t feel the need to eat fruits or vegetables since she was getting every single vitamin and mineral in pill form every day.

    Not quite. Many people forget that:

    1) No multivitamin offers 100% of every nutrient. Calcium, for instance, takes up a lot of space, so any pill offering an entire day’s worth (1,000 milligrams) would be too big. Besides, the body can only assimilate 500 milligrams of calcium at one given time, so a single dose of 1,000 milligrams is ineffective.

    2) Since multivitamins fall into the “supplement” category, they are not regulated by the Food & Drug Administration. In other words, the label may say 100% of 23 vitamins and minerals, but no entity is making sure such a statement is accurate.

    3) Multivitamins do not offer the hundreds of phytonutrients found in fruits, vegetables, and whole grains. These phytonutrients play important roles in health promotion and help certain vitamins and minerals operate efficiently in the body. Oranges, for instance, aren’t just about Vitamin C; they also provide flavonoids that help with blood sugar and cholesterol regulation.

    4) Intake does not equal absorption. Synthetic forms of vitamins and minerals are less bioavailable than their naturally occurring brothers and sisters. According to estimates, absorption of most nutrients in multivitamins does not go above the 50% mark.

    5) More is not always better. Some multivitamins contain excessive amounts of Vitamin E, which have been show to cause more harm than good.

    6) Nutrition and health go beyond simply getting enough vitamins and minerals. Calories, added sugars, saturated and trans fats, and fiber are just as worthy of attention. Getting a day’s worth of a handful of vitamins and minerals isn’t that spectacular if you aren’t consuming enough fiber and eating an overabundance of calories.

    I don’t think standard multivitamins as insurance for a balanced and adequate diet are cause for alarm, but anybody looking to get optimal nutrition should really look to food first (Vitamin D is the only nutrient I think everybody should be supplementing in their diet).


    You Ask, I Answer: B Vitamins

    How much energy do B vitamins provide?
    — Michael Gardner

    Buffalo, NY

    Ah, yes, the “vitamins give energy” myth. I can understand why many people would think so, given the misleading advertising witnessed in vitamin and energy drink advertisements.

    Centrum Performance multivitamins, for example, state that they use “higher levels of five essential B vitamins” to help create a blend for “the vitality of your mind and body.” Monster Energy drinks boast about their high B vitamin level content.

    From a metabolic standpoint, energy is exclusively derived from the three calorie-containing nutrients: carbohydrates, fats, and protein. Vitamins (and minerals) do not contain calories, and therefore can not be used to produce energy.

    So what’s all the B vitamin hype about?

    Well, the B vitamins play a major role in energy metabolism. Without them, our bodies wouldn’t be able to get sufficient energy from our food.

    In the United States, though (and other developed nations), deficiency of the B vitamins is practically unheard of.

    Remember, the Enrichment Act of 1942 mandates that thiamin (B1), riboflavin (B2), and niacin (B3) be added to bread products, while a 1996 ruling by the Food and Drug Administration resulted in the required fortification of folic acid (B9) in enriched bread products.

    Additionally, B vitamins are found in fruits, vegetables, legumes, meats, and dairy products. They are certainly not hard to come by!

    The one group of people who are at risk for a vitamin B12 deficiency are vegans.

    This deficiency results in a condition known as pernicious anemia (in which the body is unable to produce enough red blood cells, thereby causing fatigue), but can be prevented through adequate supplementation.

    If your B vitamin intake already meets the recommended values, extra B vitamins will not provide more energy. Since they are water soluble (like Vitamin C), they will simply be excreted in your urine.

    If you are eating sufficient amounts of food and lethargy and lack of energy have been a problem for several weeks, be sure to get a blood test. Chugging energy drinks loaded with B vitamins will do nothing but provide empty sugar-laden calories to your day.


    You "Ask", I Answer: Multivitamins

    [In response to you saying that people eating balanced diets do not need to take multivitamins every day,] I think that’s true–which means that there are a lot of us who had better pop that multi-vit on a regular basis.

    — Dirk Hanson
    Location Unknown

    Dirk, you have a point. It is estimated that approximately two thirds of adults in the United States are not meeting their recommended fruit and vegetable servings.

    However, people should be working towards a long-term goal of including fruits, vegetables, legumes, and whole grains in their diet, rather than settling for a Centrum pill accompanying a donut breakfast.


    You Ask, I Answer: Multivitamins

    What is your response to Dr. Willett, who suggests a multi-vitamin as an inexpensive form of insurance in his book Eat Drink & Be Healthy? My understanding is that a multi-vitamin is a good idea regardless of diet since aside from providing the daily minimum amounts of vitamins it also provides certain things like minerals which even for a smart eater can sometimes be overlooked?

    — Guy Betterbid
    New York, NY

    For those of you who don’t know, Dr. Walter Willett is a professor of Epidemiology and Nutrition at Harvard’s School of Public Health as well as Professor of Medicine at Harvard Medical School.

    A renowned medical researcher, Dr. Willett is perhaps most famous for his revised dietary pyramid, which places exercise and weight management at the base, plant oils and whole grains on the second level, and red meat, butter, and refined grains as neighbors at the tip.

    Along the side, Willett borrows from the Mediterranean food pyramid by including alcohol (in moderation) but then adds his own touch by including multi-vitamin supplements.

    I’m not quite as gung-ho as Dr. Willett on the thought of people popping a Centrum once a day.

    First off, there is so much fortification in today’s food that getting most vitamins and minerals is not too difficult. Even the sweetest and least nutritious of children’s cereals provides 100% of many of these nutrients.

    On top of that, we have beverages — such as Vitamin Water and even Diet Coke Plus — as well as “energy bars” that also throw in a day’s worth of vitamins and minerals.

    It’s crucial to realize that it does not take extreme amounts of food to get a daily supply of certain vitamins and minerals. As I recently posted, just half a cup of red peppers provides 100% of our vitamin C needs.

    Meanwhile, half a cup of baby carrots provides 300% of our vitamin A requirements, one cup of raw spinach packs in 181% of the Vitamin K we need each day, and a sandwich made with two slices of whole wheat bread contains 60% of our daily manganese needs.

    It is true that the recommended intakes for minerals like calcium, potassium, and magnesium are only achieved by having a combination of foods rich in them.

    That being said, I believe it is important to recommend people get as much of their vitamins and minerals from real food as possible.

    When you eat a carrot, you aren’t just getting Vitamin A. You are also getting fiber, phytonutrients, carotenoids, and antioxidants that are not available in pill form.

    Additionally, increasing dietary potassium often correlates with a reduction in sodium intake. That’s two birds killed with one stone if vitamin and mineral consumption is first tackled via diet.

    I also believe that relying on supplements tends to give people false security, thinking that popping a multi-vitamin in the morning is a free pass for going through the rest of the day without paying attention to the food they are eating.

    I think it is much wiser to take a look at what vitamins and minerals one tends to be deficient in and then tackle that problem specifically (ideally by altering one’s diet first).

    Vitamin D is not readily available in many foods (and most people in the world do not get enough from the sun during winter months), so I do not see anything wrong with supplementation. I also think calcium supplementation is important if the diet does not provide sufficient coverage.

    Additionally, people on restricted diets often need to supplement their diets appropriately (i.e.: vegans and vitamin B12).

    While we’re at it, I would like to clarify that vitamins do NOT provide energy. Calories provide energy. Vitamins do not contain calories.

    Yes, the B vitamins are necessary for energy pathways to work properly, but they do not give a boost of energy in and of themselves.

    Back to the original question: people eating balanced diets do not need to pop a multi-vitamin every day.

    They are better off seeing what nutrients they are actually deficient of, see if they can get them by altering their diet, and, if that’s not possible, look to supplement that specific vitamin or mineral by means of a pill.


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