Last week three studies came out showing that taking vitamin supplements did not lower disease risk. Does this mean we should toss our supplements? Are they not worth the money? Or, should we toss the studies and keep taking the supplements? Elizabeth Somer, registered dietitian and author of numerous books, including the Essential Guide to Vitamins and Minerals helped sort out the confusion.
Supplements are one factor in a healthy diet and lifestyle that has been shown absolutely to lower disease risk, help keep you slim, boost mood, extend life and the healthy years, and lower the chances of having to take medication. That's why they are called "supplements" not substitutes. We should be making sure that we get optimal amounts of all those essential nutrients, along with eating a good diet, exercising every day, maintaining a healthy body weight, not smoking, and embracing all the habits that lead to good health today and down the road.
You should eat at least 8, preferably 10, servings a day of colorful fruits and vegetables. You need at least 5 servings a day of 100% whole grains, three servings of calcium-rich foods like milk or plain nonfat yogurt, and two servings a day of a protein/iron/zinc-rich food such as chicken breast or black beans. In addition, at least twice a week, you need to include salmon or other fatty fish in your diet. But, guess what....almost no one is doing that. In fact, every national nutrition survey spanning decades of research has repeatedly and consistently found that many Americans do not meet the basic needs for certain vitamins and/or minerals. One study from the National Cancer Institute found that 99 out of every 100 Americans don't meet even the minimum standards of a balanced diet. The USDA's Healthy Eating Index, a tool to assess Americans' eating habits, rating them on a scale of 0 to 100, consistently finds that most Americans score below or in the 60s, equivalent to an "F" or a "D" ranking on nutrition. If our children came home with grades like that, we would ground them and get a tutor!
Why not fill in the gaps with a moderate-dose, well-balanced multi supplement on the days when people don't eat perfectly? As these three studies found, there is no harm in taking a multi. In fact, it is one of the lowest cost preventive measures we can adopt. I can find no reason not to supplement.
Can you help us make sense of studies like this and the fact that we need these nutrients?
Multivitamins are not intended to prevent disease. They are intended to help meet nutrient needs and fill nutrient shortfalls, promoting overall health and wellness. Supplements are meant to do just that - supplement the diet. These studies and the media frenzy that resulted from them are striving to link multivitamins to preventing disease, which is beyond their intended function. For instance, one study looked at reducing cardiovascular events after a heart attack by taking multivitamins and minerals. The researchers found that there was no reduction in subsequent events. However, multivitamins are not intended to prevent a heart attack, especially in someone who already has had one!
What are your guidelines for supplementing?
This is what I take:
A Multi: A multiple vitamin and mineral is the place to start. Nutrients are supplied as teams in food, so if your diet is low in one nutrient, it's a sure bet it's low in others, too. A multiple is a convenient, inexpensive way to supply a balance of nutrients, while avoiding secondary deficiencies that result when you take too much of one nutrient and crowd out another. For example, many of the minerals compete for absorption, so taking a large dose of one, such as iron, could result in a deficiency of another, such as copper or zinc. Take a good multi and you won't have to worry about that.
Select a broad-range multiple that supplies as close to 100%, but no more than 300%, of the Daily Value for a wide variety of vitamins and minerals. For quality sake, stick with the major brands, such as Centrum or Nature Made, or with a product with the USP quality seal that guarantees high standards. Most of these are inexpensive.
Vitamin D. If your multi or calcium does not have at least 1000 IU, then consider a separate supplement here, since you can't get enough from food and optimal intake is associated with lowered risk for muscle weakness, gum disease, diabetes, insulin resistance, arthritis, multiple sclerosis, hypertension, and certain cancers, including colon, breast, pancreas, and prostate cancers. Vitamin D also reduces the incidence of falls by up to 60% in seniors.
Minerals: When it comes to calcium or magnesium, you need so much of these minerals that the multi pill would be the size of a golf ball. Typically, multis give only lip service to these nutrients. You need calcium to keep your bones, skin, nerves, and muscle in tip top shape, while magnesium is critical for coping with stress, maintaining a healthy heartbeat and blood pressure, and improving muscle, nerve, and bones. Unless you include at least three servings daily of calcium-rich milk products or fortified soymilk and lots of magnesium-rich soybeans, nuts, and wheat germ, you should supplement these two minerals.
Calcium and magnesium are best absorbed and used when supplied in a 2:1 ratio of calcium to magnesium. You get some of these minerals in your diet, so you only need to fill in the gaps by taking a supplement with 500 milligrams calcium and 250 milligrams magnesium, if your multiple is low in these minerals. When it comes to magnesium, more is not better. Magnesium is the active ingredient in Milk of Magnesia, which means you could be a bit "looser" than you'd like if you exceed the upper limit.
Omega-3s: If you don't consume at least 2 servings a week of fatty fish, such as salmon, mackerel, or herring, then take an omega-3 supplement. You need at least 220mg of the omega-3 DHA, and possibly up to 900mg/day to lower the risk for heart disease (the #1 killer for both men and women), depression, and possibly even lower Alzheimer's risk by 70%.
Let me just say again, these are supplements, not substitutes. You still need to eat really well, then supplement responsibly!