Paging Dr. Frischer - Multivitamins

Nearly every one of my patients has asked at one time or another: "Should I take a multivitamin, and how do I choose?" There are so many options. Should your multivitamin include additional calcium or vitamin C? What is so special about "special" formulas? Regular or age-specific formulas? Added minerals or not? Herbs or no herbs?Multivitamin products were first introduced around 1930 in order to supplement Vitamins A and D. By 1934, the first multivitamin tablet was introduced, made from natural dried and compressed vegetables and fruit concentrates. The first synthetic multivitamin was produced in the early 1940's. Today's general guidelines for vitamin and mineral doses come from the National Academy of Science's Institute of Medicine, and the Recommended Daily Allowances (RDA) by life stage are available on the United States Department of Agriculture (USDA) website. Multivitamins differ by type and dosage of each vitamin, mineral and herb; number of pills per day; size of pills; types of fillers, binders and colorings; and cost. Note that claims that a formula is all natural, sugar-free, starch-free, or slow-release do not necessarily imply that the product is better absorbed, more potent, or better tolerated. Whether you would benefit from a multivitamin generally depends on your diet. If you are healthy and consuming ten servings of fresh fruits and vegetables per day, with ample protein and whole grains, then I would argue that a supplement is unnecessary. Unfortunately, it's a safe bet that the vast majority of us do not consistently eat this well. That is why most dieticians and nutritionists recommend a multivitamin. By supplementing the diet with additional vitamins and minerals, multivitamins can be a valuable tool for those with dietary imbalances or particular nutritional needs (including pregnant women and the elderly). This would also include those on a restrictive diet, and those who can't or won't consume a nutritious diet. Research has yet to conclusively demonstrate that taking a multivitamin yields significant benefits in the primary prevention of cancer, cardiovascular disease, cataracts, age-related macular degeneration, or cognitive decline. There is, however, data to support that multivitamins have beneficial effects in people with poor nutrition, that vitamin D and calcium help to prevent fractures in older people, and that iron is beneficial for people at risk for anemia. What about herbs in your multivitamin? While herbs may be seen as an added value, they are typically recommended for specific health reasons. In this case, one size does not fit all. Some common herbs found in multivitamins include bee pollen, broccoli, cabbage, spinach, cauliflower, garlic, licorice root, and alfalfa. So far, most studies show that the more expensive vitamins are not superior in quality or more easily absorbed. Generic brands tend to cut costs through lack of advertising, less fancy packaging, being the imitator rather than the creator, and larger sales volume. You may find that the best multivitamin for you is in generic form at your local drug store. Do you need a special formula? Pregnant women, lactating women, or those intending to get pregnant, should take a prenatal vitamin with extra folic acid, iron, zinc, and calcium. Those of us who are over 50 can use more vitamin D, vitamin B12, and calcium. Younger women benefit from extra iron and calcium. However, most of us will look for a supplement that contains 100% of the RDA (see above) of recommended vitamins and minerals. Unsubstantiated promotional advertising claims for vitamins and nutritional supplements can be enticing: weight loss, energy, stress relief, hair growth, cancer prevention, etc. I encourage you to consider your multivitamin as a supplement that will help to fill nutritional gaps in a good diet, and not as a miracle drug or as a substitute for healthful food. When it comes to vitamin cost and added ingredients, less can be better. I wish you the best of health and nutrition!

********** Published: June 11, 2010 - Volume 9 - Issue 8