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Do I really need a multivitamin?

By Paul Kriegler, RD

News headlines often remind us that we’re an overfed nation, but neglect to mention that we’re also undernourished. More than 80 percent of adults in the United States don’t consume enough fruits and veggies to supply adequate vitamins and minerals in their diets, according to the Centers for Disease Control and Prevention. [1] Not surprisingly, deficiencies in key micronutrients — including magnesium, vitamin D, B12, and calcium — have become increasingly common. [2]

But health experts disagree about the value of taking multivitamins to help fill nutritional gaps. Several well-publicized studies challenge the efficacy of multivitamins to prevent diseases such as heart attacks or cancer, [3] [4] for example, and many experts dismiss these vitamins as a waste of money at best.

What isn’t as well publicized is the fact that many of these large studies are riddled with serious limitations: low participant compliance, inconsistent quality and dosages of the multivitamins taken, and high participant dropout rates, to name a few. (Further, conditions such as heart disease and cancer are complex, multifactorial diseases; even under ideal circumstances, supplementation alone should not be expected to resolve these risks.)

As a registered dietitian, I see a role for supplementation, even for those who strive to eat a healthy, whole-foods-based diet — and especially for those who don’t. Virtually every aspect of your health is supported by the nutrients your body absorbs, and while eating nutritious food is crucial to your health, taking a quality multivitamin can ensure you’re getting enough of what you need to thrive.

Our Bodies Run on Nutrients

When our bodies are low on vitamins and minerals, our metabolic health — and overall health — can suffer in several ways. Vitamins and minerals play essential roles in making metabolism possible and, without them, normal biological function is compromised. [5]

“Inadequate micronutrient intake, sometimes at borderline levels of deficiency, has been linked to stunted growth and neurocognitive deficits, as well as increased risks of various symptoms and [health] conditions,” writes nutritionist Elizabeth Ward, RD, in Nutrition Journal. “Most nutrients act in all tissues, and all tissues need all nutrients; therefore, inadequate intakes may adversely affect every body system.” [6]

Conversely, getting adequate micronutrients appears to support whole-body energy metabolism — and supplementing can help greatly with adequacy. Research has found that achieving more consistent nutrient intake by supplementing with multivitamins improves blood flow, resting energy expenditure, and fat metabolism, and may also promote weight loss, fat loss, as well as improved glucose sensitivity and cholesterol profiles. [7] 

Most of Us Fall Short

Are you trying to restrict calories to lose weight? Is your diet sometimes lacking in nutrient density? Are you active or athletic? Do you regularly drink alcohol or take medication? Do you live a demanding or stressful lifestyle?

If you answered yes to any of these questions, you likely have considerably higher micronutrient needs than indicated by any given Recommended Daily Allowance, or RDA. [8]

RDAs, which are established by the Food and Nutrition Board of the Institute of Medicine of the National Academy of Sciences, are meant to denote nutrient requirements that are likely adequate for most people to avoid deficiencies. But avoiding deficiency and getting adequate nutrition to promote optimal health are quite different objectives.

And while making an effort to eat more whole-food sources of good nutrition is important, taking a multivitamin is one of the easiest ways to be sure you’re getting what you need. (Note: Even if you don’t “feel” the benefits of supplementation — they can be subtle and gradual — you will likely notice the difference if you stop taking the multivitamin for a week or so.) 

Not All Multis Are Equal

Many researchers and medical professionals are quick to lump all supplements into one giant category and evaluate them as a whole. But as with other consumer goods, there’s a wide range of quality when it comes to dietary supplements. Keep these factors in mind when you’re looking for a high-quality multivitamin:

    1. Choose a multi your body can easily absorb and utilize. Most multis contain synthetic vitamin forms and non-chelated (pronounced: key-lated) mineral forms that don’t break down effectively in the body. [9] One of the easiest ways to spot an inferior vitamin formula is to look for folic acid on the ingredients list. Folic Acid is the synthetic form of vitamin B9, which is less effective than the metabolically active methyl-folate, often listed as “5-methyl-tetrahydrofolic acid glucosamine salt.”
    2. Understand how form affects function. The explosive popularity of adult gummy vitamins is perhaps one of the most brilliant money-making schemes the dietary supplements industry has hatched in decades. Gummies are fun and brightly colored, but they are notorious for delivering low levels of nutrients per dose. They also rely on added sugars, artificial colors, and synthetic flavorings.

Another popular yet low-potency form are compressed tablets. Manufacturers press together inexpensive and low-quality synthetic vitamins and inorganic (non-chelated) minerals with the help of binders, fillers, glues, and coatings. These tablets are slow to break down in the digestive tract (if they break down at all) making them neither effective nor well-tolerated.

Liquid formulas are a popular, though costly option. They’re also not the most stable choice. Many nutrients degrade when exposed to moisture and/or oxygen, which means liquid multivitamins quickly lose their potency once you open the bottle.

The most stable and most easily digested multivitamin form are capsules. Comprised of a vegetable-based cellulose shell containing a formula of loose, powdered nutrients, capsules don’t require heat or pressure to be produced, so the nutrients aren’t subjected to harsh conditions. The shells break down in the gastrointestinal tract in a matter of minutes to allow effective nutrient dispersion and absorption. One downside is that loose powder in a capsule takes up more space than a hard-pressed tablet, so it may require more “pills” per day.

    1. Look for purity, potency, and consistency. Life Time has been creating its own nutritional products for nearly 20 years, which gives us tight control of every aspect of ingredient selection, testing, formulation, production and finished goods testing. With our manufacturing partners, we carefully evaluate each raw ingredient supplier, test and verify every batch of ingredients, closely monitor the production process, and verify our finished goods meet the specifications of our labels.

Invest in Quality

If you’re interested in incorporating a multivitamin into your health regimen, it’s best to steer clear of a bargain version. Just as fresh, organic foods typically cost more than mass-produced packaged goods, a high-value multivitamin costs more to produce, which will be reflected in the price. The value for you as a consumer is in how you feel and how you function.

I agree with the skeptics’ assessment that many multivitamins on the market are of little value. But when potent and bioactive nutrients are delivered in a way that is safe and easily assimilated, I’ve seen profound results in the health of my clients. If you’re striving to accomplish the same for your own health, I encourage you to consider starting or upgrading your supplement routine using high-quality products.

Resources:
[1] https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6426a1.htm
[2] https://www.healthline.com/nutrition/7-common-nutrient-deficiencies
[3] http://annals.org/article.aspx?articleid=1789253
[4] http://annals.org/article.aspx?articleid=1767855
[5] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2585731/pdf/559.pdf
[6] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4109789/pdf/1475-2891-13-72.pdf
[7] https://www.nature.com/articles/ijo201014
[8] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3823510/pdf/644.pdf
[9] http://www.albionnutritionalfacts.com/
The posts on this blog are not intended to suggest or recommend the diagnosis, treatment, cure, or prevention of any disease, nor to substitute for medical treatment, nor to be an alternative to medical advice. The use of the suggestions and recommendations on this blog post is at the choice and risk of the reader.
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