Vitamin supplements no substitute for healthy eating

VIEW ON HEALTH

When University of Nevada, Las Vegas, associate professor of nutrition Susan Meacham begins one of her wellness seminars, she can spot the do-it-yourself nutritionists in the time it takes to wash down a One A Day with extra calcium. They are usually sitting in the front row clutching grocery sacks full of vitamin and mineral supplements — lots and lots of supplements, in fact.

“They will pull out 20 products, and my first response is to remain calm, and say ‘What do you eat?,'” she said.

“It’s not about dropping a bunch of pills … Our bodies are an incredible, choreographed performance every day and every hour, and in some cases it can go on for 100 years. Yet, we take a very myopic view of nutrients,” Meacham said.

Vitamins and minerals are actually quite complex, working in conjunction with one another to do everything from support our immune system to retain the health of our skin. They are co-enzymes which means they help enzymes, which are protein-based molecules, perform their job as catalysts to the chemical reactions that are constantly taking place in our bodies. Since they are not made by the body, we need to get most of them in some form every day, preferably through the foods eat, according to experts.

So many of us, however, are looking at vitamin and mineral supplements as “magic bullets, solutions of hope in a bottle” rather than understanding what they really do for us, how they can enhance our diets and what kinds of dangers they pose if used improperly, Meacham notes.

It is a shortsighted view that is understandable. Whether it is folate or vitamin C, these micronutrients and the studies surrounding them are constantly being touted in everything from magazine articles to the neighborhood newsletter. The only problem is it takes time for the scientific community to examine the research and actually decide how supplements can help or harm us.

“The media and marketing get way ahead of the science which is slow, tedious and costly. All the things the general public doesn’t like,” Meacham said.

In the meantime, we are heading to the nearest health food store or supermarket with the latest announcement clenched in our fist like a winning lottery ticket.

What we do know is there are 13 vitamins and 15 minerals that are essential to good health, and keep our bodies nourished and functioning as they should. And, yes, in some cases they can have amazing benefits.

When the government learned that folic acid, the synthetic form of folate, could help protect against neural tube defects in newborn children if taken by the mother before and during pregnancy, the agency required manufacturers in the late 1990s to add it to grain products such as bread and cereals. Since then, the number of neural tube defects in the U.S. has gone down by about one-third, according to experts.

Vitamin D has gotten a lot of recent attention due to the discovery that most Americans are deficient in the nutrient which is actually produced when the skin is exposed to sunlight. While it is found in some foods, the most efficient way to build it up in the body is by getting regular doses of sunshine in small increments.

“We know that 60 percent of Americans are getting insufficient amounts so if you’re going to pay attention, this is a good one to pay attention to. This is not one out of 10, this is six out of ten,” noted Roberta Anding, a spokesperson for the American Dietetic Association and director of sports nutrition at Texas Children’s Hospital in Houston.

Anding calls vitamin D “the bossy conductor of the orchestra that tells cells what to do, what to be and how to work together.” It also helps the body absorb calcium and, therefore, needs to be taken in conjunction with calcium for strong bones and to help prevent osteoporosis.

Look at the National Institutes of Health Office of Dietary Supplements website, click on “vitamin and mineral fact sheets” and check out the other micronutrients. The benefits seem all-encompassing, from the immune-boosting properties of vitamin A, to the role of zinc in everything from the creation of DNA, to aiding our senses of taste and smell. Magnesium alone is used in more than 300 biochemical reactions within the body.

As far as going beyond health benefits and looking at disease prevention, agencies such as the NIH are just not ready to go there. In fact, conclusions outlined in an NIH report from a State-of-the-Science Conference on Multivitamin/Mineral Supplements and Chronic Disease Prevention in 2006 still stand:

“In systematically evaluating the effectiveness and safety of MVMs (multivitamin/mineral supplements) in relation to chronic disease prevention, we found few rigorous studies on which to base clear conclusions and recommendations. Most of the studies we examined do not provide strong evidence for benecial health-related effects of supplements taken singly, in pairs, or in combinations of three or more,” the report states.

But even if there is no proof vitamins and minerals can prevent diseases such as cancer or diabetes, their reputation for promoting health in a seemingly endless number of ways is irreproachable. Even the American Medical Association now advises every adult to take one multivitamin a day to make up for the shortfall in the typical American diet, and according to the NIH report about one-third of us isactually doing it.

So just what is the best way to ingest vitamins and minerals, and in amounts that are the most beneficial?

In a perfect world, everyone would be eating a well-balanced diet full of nutrient-dense foods, the vitamins and minerals would be absorbed into our bodies and we would go about our business. After all, how often did we see our grandparents, or great-grandparents for that matter, down a supplement?

But today we have busy lifestyles that do not allow as much time for meal preparation, convenient, over-processed foods are everywhere you turn, and the stress of living in a fast-paced world is taking its toll on our bodies. As Anding puts it: “We are a processed-food generation. We like something quick and easy, and in a package.”

The first line of defense is still healthy meal planning and taking in micronutrients through food just as it was meant to be, noted Joanna Gorman, a registered dietician and certified diabetes educator with University Medical Center in Las Vegas. The next line of defense is to take a multivitamin “as sort of an insurance policy because nobody eats perfectly,” she said.

Just make sure any supplement is not used as a replacement for food or the antidote to an unhealthy lifestyle, she added. “I get a lot of, ‘What can I eat and have more energy,’ and I say, ‘Sleep.’ There is no magic pill out there. They can’t take supplements to fill in the gaps.”

Anyone who wants to get a close look at the vitamin and mineral content in their diet can consult a registered dietician, or seek the advice of a doctor who can also recommend a blood test that includes a vitamin panel. Keep in mind, however, that doctors do not necessarily have a strong background in nutrition, Anding said.

Those who may want to seek the advice of an expert before taking supplements include anyone with a chronic illness, senior citizens, even parents who are trying to balance the diets of their little fussy eaters at home, Anding said. Anyone taking medications should always seek the advice of a doctor before starting supplements, she added.

Consumers should also keep in mind that there are water-soluble vitamins which are not stored in the body and, therefore, usually pose little danger as far as toxicity, and fat-soluble vitamins, specifically A,D, E and K, which are stored in body tissue so pose a higher risk for toxicity, experts note.

While it takes fairly high doses of supplements to create toxicity in the body there are dangers consumers should be aware of, according to Carol Haggans, a spokesperson for the NIH Office of Dietary Supplements. Too much supplemental vitamin E, for example, can increase the risk of bleeding in patients on anticoagulant or antiplatelet medications. High doses of magnesium in supplement form, as opposed to that in the diet, can also create problems such as diarrhea and abdominal cramping, and the most common victims of iron toxicity are children who eat too many of their sweetened, candy-like multivitamins, Haggans added.

Meacham advises consumers who are seeking information on their own to look for impartial sources such as government agencies and universities, and to stay away from vitamin companies that simply want to sell their products.

Sources such as NIH’s Office of Dietary Supplements website offer thorough information on individual nutrients, their food sources, the Recommended Dietary Allowance (RDA), possible interactions with medications, and the latest information based on verified research. Others sources include the Harvard School of Public Health (www.hsph.harvard.edu/nutritionsource) and the Dietary Supplements Labels Database (www.dietarysupplements.nlm.nih.gov).

There is even a site called mypyramid.gov which is sponsored by the U.S. Department of Agriculture. It takes information such as age and weight, and provides a dietary plan taking into account all of the six basic food groups for those interested in getting more of their vitamins and minerals from what they eat, Meacham said.

When purchasing multivitamin/mineral supplements look for those that have 100 percent or slightly less of the RDA for each nutrient, and try to get into a regular routine by taking them around the same time every day, Haggans said. Check the labels of different supplements to see if the manufacturer recommends taking them with or without food, and remember that the RDA of certain vitamins and minerals varies based on factors such as age.

Premenopausal women, for example, need 18 milligrams of iron a day while men need only eight, and those over age 50 may need additional vitamin D and vitamin B-12 supplementation in their diet, she said.

Finally, while it is important not to chase every new study that hits the blogosphere, it is a time to be optimistic. While it looks like all the vitamins and minerals have been discovered, science is still finding health benefits in plant-based phytochemicals such as carotenoids and isoflavones, supporting the idea that foods are the true miracle workers when it comes to health, according to Haggans.

Anding agrees.

“You can’t jam everything into a pill. It is the red in the watermelon, the blue in the blueberries and the purple in the grapes; this is where all the heroes are,” she said.