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Mon February 27, 2012
Many people take some form of vitamin supplement to begin the day. But taking vitamins doesn’t come without potential risk. In our KERA Health Checkup, Sam Baker talked about this with Susan Rodder, a clinical nutrition instructor at U.T. Southwestern Medical Center. To start, do you need vitamin supplements if you maintain a balanced diet?
Susan Rodder: In certain populations that might have a higher need, for example, a post menopausal woman who is elderly and doesn’t need many calories, she may need to take some supplemental vitamin D, because vitamin D is not found in a lot of foods. It’s in salmon, sardines. It’s fortified in milk and cereal. But she may need to take supplemental vitamin D and, for example, supplemental calcium if she doesn’t like dairy products. But, otherwise, if you’re eating a well-balanced diet, there’s no need for you to take dietary supplements.
Sam: If you’re not eating a well-balanced diet, if you’re eating junk food even, can you take vitamin supplements in hopes of balancing things out?
Susan Rodder: You can, and if you take a multivitamin to cover some of those nutrients you’re not getting in food, that may be helpful in terms of getting adequate vitamin C or adequate vitamin A, for example. But it’s really easy to get the amount of nutrients you need as a reflection of vitamins and minerals from foods in a well-balanced diet. I mean, most people feel like they need much more vitamin C than they would really guess, whereas if you have a glass of orange juice or if you eat one orange, you’ve pretty much met your vitamin C requirement for the day.
Sam: Why, then, are so many people taking multivitamins? There’s a huge market for them.
Susan Rodder: I think they’re drawn to it because they think by taking that supplement, they’re going to benefit their overall health: maybe prevent a chronic disease, maybe increase their level of energy during the day. But unfortunately the studies don’t show this is what occurs. In contract, they usually confer no benefit or maybe even a small amount of risk when we take a dietary supplement of a vitamin.
Sam: It’s a subject, though, of great concern to many people.
Susan Rodder: Absolutely. There’s a lot of concern now over how many supplements people should take and if they should take them at all, especially as more foods are fortified with vitamins. For example, Vitamin Water. Is this a good choice? We know if we take a bowl of cereal that’s been fortified, that that may not be such a bad idea. Because although that’s been fortified with vitamins and minerals, we’re typically only going to eat one bowl of cereal. But, for example, with Vitamin Water, we could have a teenager drinking three or four bottles of Vitamin Water and they may be getting too much of a particular nutrient.
Sam: And that is a concern as to how much of a vitamin supplement you should take, if you indeed take one.
Susan Rodder: The risks have been published in different forms of studies looking at micronutrients, getting them in excess forms. Most recently, in the Iowa Women’s Study, where we’re seeing multivitamin use is increasing the risk of mortality as it relates to multivitamins and individual nutrients like folic acid, B6, etc.
Sam: You mentioned it would be a good idea in some cases for pregnant women to take vitamin supplements. Are there any other groups that would benefit from them?
Susan Rodder: Yes. Post-menopausal getting adequate calcium in vitamin D. And those people who have a family history of age-related macular degeneration. We see that in the vitamin supplements that are specifically designed that progression of age-related macular degeneration, there’s a 25% reduction. So that’s an antioxidant that includes zinc and copper.
Sam: Of course, on the other hand, who should stay away from vitamin supplements?
Susan Rodder: I think that anybody who is looking for a vitamin supplement to promise some miracle of relief in terms of…
Sam: That extra boost, the fountain of youth?
Susan: Exactly. And what people have to remember is that you don’t have to get so much more. They’re always thinking a little bit more or a lot more will be better, but that’s not what’s panning out in terms of the research. The research is showing when we start increasing these levels of vitamins and minerals, you know, ten times what’s recommended, that that’s when they’re detecting there may be a risk.
Sam: But usually when we see commercials for multivitamins, they’re aimed at children. Are they in need of them?
Susan Rodder: Well, no. And if they eat a well-balanced diet they are not in need of a multivitamin. In contrast, if you’re taking a multivitamin as an insurance plan, then you may lean toward not bothering to eat that fruit or vegetable or not bothering to drink that glass of milk because you received that nutrient from your supplement. But there are so many phytonutrients that are available in food that haven’t been isolated and put into supplement form that that’s what people are missing. So if we, for example, take someone’s diet and run it through a software program, and it shows us how much vitamin C and vitamin A we’re missing they’re getting, and it shows that they’re not getting enough, and they supplement that with a vitamin supplement, you can see that they’re getting adequate C and A. But what they don’t realize is that they’re not getting all these phytonutrients that are in food that help fight chronic disease that aren’t isolated and put into supplement form. For example, whole grains have polyunsaturated fats in the germ and they have phytonutrients embedded in the fiber. And so people who eat more whole grains have less heart disease.
Sam: Vitamins supplements are certainly easy to get. Should you consult a doctor before taking any?
Susan Rodder: Yes, it’s a good idea to consult a doctor. Many primary care physicians are looking at vitamin D levels in their patients to make sure they’re getting adequate vitamin D through their diet or through exposure to sunshine. And then some of the supplements interfere with other medications that a patient might be on. So they need to consider that as well.
Sam: And, or course, the vitamins aren’t cheap. Are you better off trying to get the vitamins through food? Is it cheaper?
Susan Rodder: Absolutely. It’s not only cheaper, but I cannot find in the literature any adverse effect from getting any micronutrient in food form. But I can find in the literature, as it’s related to supplements, so, in other words, if you get calcium and D and omega 3 fats through food, there’s no harm, no risk. But I can’t say that about dietary supplements 100%.
Susan G. Rodder is a clinical nutrition instructor with U.T. Southwestern Medical Center and its Program in Preventive Cardiology.
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