Multivitamins – The Right Choice

By Edna Cox Rice, RD, CSG, LD

Whether to supplement with vitamins is a contentious issue today. In the past, medical experts told consumers that supplements were a waste of money. Now there are concerns that due to an unregulated industry, supplements may be dangerous, even life threatening. On the other side are health authorities, including many physicians, who recommend vitamin supplementation enthusiastically.

While there are many good reasons to take a multivitamin, supplemental nutrients are not substitutes for whole foods that contain them. Taking supplements does not excuse you from eating a diet rich in a variety of fruits and vegetables. A diet of unprocessed, unrefined, real foods is truly the best way to get the vitamins and minerals you need. In our fast-paced, convenience-based lives, it’s often difficult to eat the recommended five or more servings of fruits and veggies daily. Multivitamins are a convenient way to fill in the nutrient gaps if your meal plan is less than perfect. Changing nutritional needs, strict dieting, poor appetite, and poor food choices are good reasons to consider supplementation. 

Why take a multivitamin?

The 2010 Dietary Guidelines for Americans identified calcium, vitamin D, dietary fiber, and potassium as concerns for inadequate intake in adults and children. In general children and adults might benefit from taking a multivitamin daily. The Harvard School of Public Health recommends a once a day multivitamin with extra D for most people as nutritional back-up.

The biggest challenge consumers face is deciding which multivitamin to take. The aisles in a pharmacy or health food store are packed with every vitamin and combination under the sun. The sheer number of options available can make choosing stressful. There are thousands of supplements to choose from. Some are good, but many are total rip-offs.

Get the Basics.

Most multivitamins include the following vitamins and minerals: vitamin C, B1 (thiamine), B2 (riboflavin), B3 (niacin), B6, folic acid (B9), B12, B5 (pantothenic acid), biotin, A, E, D2 or D3 (cholecalciferol), K, potassium, iodine, selenium, borate, zinc, calcium, magnesium, manganese, molyb-denum, betacarotene, and iron. Look for a supplement that provides 100% of the Daily Value (DV) for most of the vitamins and minerals in that supplement. Nutrients like calcium and magnesium are rarely included at 100% of the DV because the amount needed is too large to fit into a multivitamin and the pill would be too large to swallow. Vitamins containing these basics are usually the least expensive and a good way to fill nutrient gaps found in your diet.

Today’s multivitamins are available in a wide variety of formulas that are aimed at helping people with specific nutritional needs or conditions. Multivitamins containing iron are one of the more popular ones. Other multivitamins contain additional select nutrients like antioxidants. Stick to the basics. Your multi doesn’t need a lot of bells and whistles. With each additional extra comes an increase in the cost of the supplement.

Avoid multivitamins that contain more than 100% of daily recommended values, because supplements are in addition to food, and some, in large doses, can be too much of a good thing. Certain nutrients may build up and become toxic. Some may even contain herbal formulations. Herbs are not nutrients: they are taken for very specific effects on the body.

Choose a multi designed for your age and sex so that the nutrients included will be right for you. Most multivitamins are formulated for various stages of life because nutrient needs change as we age.

For women only vitamins are designed for women in the child-bearing years, these include nutrients in the amounts close to the requirements for women from 18 – 50. Iron and folic acid are two nutrients included to help prevent birth defects when women become pregnant.

Just for men includes nutrients tailored for adult men to age 50. These multis don’t often include iron because men need less.

Senior formulations take into account that after age 50 absorption slows down for several nutrients such as calcium, vitamins B6 and B12. Extra vitamin D is needed. The body no longer produces enough of the acid needed to break down the naturally occurring vitamin B12 from food. Synthetic vitamin B12 from dietary supplementation is easier to absorb and does not require the acid from the body. 

Should you choose all-natural, sugar-free, or slow-release products? Most vitamins are available in capsules, tablets, powders, gummies, liquids and injectable formulations. The difference in them is the rate your body absorbs the supplement. Liquids tend to be absorbed quicker. Coated pills are slower because the coating prevents absorption in the stomach. Gel-coated capsules may be easier to swallow.

People may prefer all-natural or sugar-free products. But none of those terms mean the product is better absorbed. There is not enough evidence that slow release vitamins offer any advantage to counter the extra cost.

The time multivitamins are taken really doesn’t matter. Taking them with food can help lessen any stomach discomfort.

How safe are multivitamins?

Vitamin supplements are regulated by the FDA as “dietary supplements,” which are products taken by mouth intended to supplement the diet. A measure of safety is to look for the designation “USP” on the label. A multivitamin that meets the requirements of the U. S. Pharmacopeia (USP) meets the standards and ensures the product is pure and actually contains listed ingredients.

Most importantly, listen to your body! What’s right for others may not be right for you. You definitely should feel a measureable difference in your health and energy within a few days with the right supplement. Remember that nutritional supplements are not food and do not take the place of real food. They only provide an additional boost to your current food choices.