The Scoop On Taking Multivitamins


didn’t start taking vitamins until a few years ago, after Target began selling adult multivitamins in the form of gummy bears. I’ve been dutifully popping two bears a day ever since, getting my daily candy fix while ostensibly improving my health. After all, to hear the $28 billion supplement industry tell it, the gummies could be all that stands between me and scurvy.

“Some people, like if you’re eating kale for breakfast or something, get all their nutrients from food,” says Duffy MacKay, vice president of scientific and regulatory affairs for the Council for Responsible Nutrition (CRN), the industry’s leading trade group. “But in this complex world, that’s getting increasingly rare.”

According to a survey by the National Institutes of Health, nearly a third of Americans take multivitamins regularly. The Vitamin Shoppe, a chain with more than $700 million in annual sales, has been growing by double digits year after year. Yet mounting data suggests that multivitamins aren’t the nutritional wonders the industry would have us believe. “There is virtually no evidence that they make healthy people healthier,” says author Marion Nestle, one of several nutritionists who told me that vitamin deficiency is quite rare in the United States. (Her latest book, Why Calories Count, is due out in April.)

Despite manufacturers’ coded claims that multivitamins ward off chronic illness—D “promotes breast health,” B is “heart healthy“—a large 2009 study of postmenopausal women published in Archives of Internal Medicine found that multis didn’t protect against any of the diseases studied, including heart disease and lung, breast, and colon cancer. A 2011 study involving nearly 39,000 women reached similar conclusions.

What’s more, if you’re the kind of person who takes a multi you may literally be pissing away your hard-earned dollars. According to another oft-cited study, typical vitamin users are more likely than nonusers to get their quota from food alone. And with so many fortified products crowding supermarket shelves, it’s not hard to exceed recommended daily limits for certain vitamins and minerals.

In some cases, that can be dangerous. Several studies link excessive folic acid intake—the amount you might get from popping a multi and eating two bowls of Total—with lesions that can lead to colorectal cancers. For seniors, who usually get all the iron they need from fortified rice, cereals, and sliced breads, a multi with iron can increase the risk of heart disease. And pregnant women who pop standard multis containing the retinol form of vitamin A may boost the likelihood of birth defects. (Prenatal vitamins are formulated to be very low in retinol.)

Thanks to the unceasing pressure of politicians like Sen. Orrin Hatch (R-Utah), the Food and Drug Administration doesn’t regulate the labeling of supplements. Last June, Sen. Dick Durbin, an Illinois Democrat, introduced a bill that would force manufacturers to slap a warning on supplements that could cause health risks. Naturally, the industry opposes it. “We believe in the safety of our products across the board,” Mike Greene, CRN’s vice president of government relations, assured me.

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But not all companies police their own labels well. In a recent analysis of 60 common multivitamins, found fault with about a third of the label claims: For instance, one gummy for kids exceeded the upper daily limits of vitamin A and zinc, and one adult multi had double the recommended dose of vitamin A.

While federal health officials recommend multis for picky-eater kids and anorexics, and specific supplements for certain categories of people (see chart), most of the nutritionists I talked to encourage their healthy patients to stop fretting about vitamins. Our diets may be chock full of sugar, sodium, and fat—but when’s the last time you met someone with rickets? Most people, Nestle says, “will have adequate nutrient intake from whatever they are eating,” even if they don’t chomp kale for breakfast.

Given all of this, I’ve decided to give up my daily vitamin regimen—and spend the money I save on good old unfortified gummy bears.

Calcium Older women, vegans Strengthens weak bones
Vitamin D Older adults, people with dark skin or with limited exposure to sun, breast-fed infants Needed to absorb calcium; can make from sunlight, but dark-skinned people produce less; not enough in breast milk
Folic acid Women pre-pregnancy and in early pregnancy, alcoholics Cuts risk of a neurological birth defect; alcohol interferes with absorption
Vitamin B12 Vegetarians, vegans, people over 50 Animal products are main source; older people absorb less from their food
Iron Pregnant women, toddlers, teen girls

Helps build new hemoglobin/blood

Source: National Institutes of Health

Many of us wrestle with whether or not we should take a daily multivitamin. And recent news reports may have left some of us more undecided than ever. Here’s the scoop on taking multivitamins from an interview with Duffy MacKay, ND, vice president of Scientific & Regulatory Affairs for the Council for Responsible Nutrition.

We’re reading in the news that multivitamins are unnecessary; in fact, they may even cause harm.

Multivitamins are generally safe. In fact, the Physicians’ Health Study II of 14,000 participants who took multivitamins showed no adverse events associated with taking them. The U.S. Preventive Services Task Force shows overwhelming evidence of their safety.

What you are hearing about in the news—but what is not made completely clear—is older data about supplemental high doses of beta-carotene and its adverse effect on smokers and asbestos workers. But it’s important to note that this is limited only to these two groups.

So, can a multivitamin help prevent things like heart disease and cancer?

The evidence that everyone should take a multivitamin to reduce the risk of cancer and heart disease is limited. But some studies do show a modest reduction in cancer among individuals who take multivitamins. It’s a tough thing to measure—that group studied may be a group that is more likely to practice healthy behaviors in the first place. The evidence that multivitamins protect against age-related cognitive decline is limited. In conclusion, if you’re taking a multivitamin to prevent serious disease, you will be disappointed.

Under what circumstances should people take a multivitamin?

The number one reason is to fill in the nutrient gaps in our diet. We know that most Americans are deficient in vitamin B, potassium, calcium and fiber. Additionally, a small percentage of people over 50 will have a tough time absorbing enough vitamin B-12 and may be deficient. And pregnant women will need supplemental folic acidand iron in many cases.

Remember, a multivitamin is not a magic bullet. Neither is it a weight-loss pill. It just fills your nutrient gaps, as the typical diet for most men and women doesn’t supply enough of certain vitamins (most commonly, vitamin D).

How do people know if they are deficient in certain vitamins and minerals?

Once you start asking people what they eat and don’t eat, the list expands rapidly. For example, vegetarians are generally low in vitamin B and iron. If someone is lactose intolerant, where’s their calcium coming from? They likely will need a calcium supplement.

Only .05 percent of the population eats “right” and has close to a perfect diet. They may not need a multivitamin … but for all others, I’d recommend it.

Remember, it’s best to discuss your diet with your health care provider to access where the nutritional gaps exist.

The cost of using a multivitamin is relatively small, ranging from between $20 and $30 per year for brand-name products. If you purchase the large economy-sized containers, it can run as little as $10 annually.

How can you know what brand to buy?

Nationally recognized brands or store brands from a trusted retailer will help ensure a product’s safety. These companies have a lot at stake and, as a result, invest a lot of time, effort and resources to ensure their products live up to their reputation.

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