By Michael Krueger
Lately, and for a reason unknown to me, I have had more questions about the pros and cons of taking vitamins than I have ever received before. I always tell them that I’m not a dietitian, so take my opinion for what it’s worth.
Also, I’m not talking here about vitamins that have been prescribed by a doctor. There are medically justifiable reasons that a physician might prescribe a vitamin or mineral supplement. I’m talking about self-medication and the premise that if you take vitamins you’ll be stronger and healthier.
I’ve read that Americans have the healthiest urine in the world because we take so many unneeded supplements that just pass right on through. Based on my reading and understanding of the evidence, I would agree with that.
That being said, let’s take a look at what’s going on in the supplement marketplace.
Vitamins and Disease
Here are a few maladies in the world that are linked to vitamin or mineral deficiencies. The diseases and the deficiency, in no particular order, are as follows:
Rickets: Vitamin D along with calcium and potassium
Pellagra: Niacin or vitamin B3
Scurvy: Vitamin C or ascorbic acid
Beri Beri: Vitamin B1 or Thiamine
Night Blindness: Vitamin A
Goiter: Iodine
Anemia: Iron
Kwashiorkor: Protein (not exactly a vitamin deficiency, but it shows up in extreme malnutrition so I’ve included it in this list)
Depression: Has recently been linked to vitamin B7 or Biotin
Osteoporosis: Vitamin D and calcium
Now, aside from depression and osteoporosis, when is the last time you met someone having any of the above listed diseases? Occasionally, you’ll find someone with a goiter, but it’s rare in the United States unless it’s of a congenital nature, and pregnant women have a higher risk of anemia and need to be aware of iron intake. Other than these examples, diseases caused by vitamin and mineral deficiencies are very rare–not unheard of, but rare.
Even the overly processed, prepackaged, fast foods that dominate the U.S. diet will, for the most part, provide enough nutrition to ward off these illnesses. They primarily afflict the parts of the world where famine and abject poverty are rampant; in our country of abundance and obesity, not so much.
Supplementing
If you still think you need to take supplements, there are a few acronyms that you need to be familiar with. The first is RDA, which is the Recommended Daily Allowance (also known as Adequate Intake or AI). This is the amount you need to not get the disease that the vitamin or mineral is meant to prevent. You are most likely already getting this amount, if not more, in your daily food intake. I guess if you don’t know for sure, taking a daily multi-vitamin wouldn’t hurt … unless it does; so read on.
The next is UL which is the Tolerable Upper Intake Level. This is the amount of a specific vitamin that you can consume without risking overdose or an adverse reaction to over supplementing. This can be complicated, because to really know if you are approaching this limit, you would need to take into consideration the amount of each vitamin you are getting from the food you’re eating in addition to the amount in your supplement. Remember that a great many foods, including but not limited to milk, bread, pasta, breakfast cereals, and orange juice, are fortified with various vitamins and minerals. (Just as a little additional information, if a food is said to be “enriched,” it means that the vitamins or minerals that were lost during processing were then added back in.)
Overdosing on most vitamins isn’t fatal but not particularly pleasant either. Common symptoms include diarrhea, hair loss, fatigue, nerve damage, joint pain, headache, excessive bruising, and constipation. On the upside, it’s unlikely that you would overdose taking just an additional multi-vitamin every day. Overdosing usually occurs when taking single vitamin mega-doses or the so-called “energy” drinks. Water soluble vitamins aren’t much of a threat, but beware of the fat soluble ones. These can build up in your body to toxic levels. Mega-dosing or even substantially exceeding the RDA, and certainly exceeding the UL, always carries certain risks.
Lastly is DV, or the Daily Value. This number is the percentage of the RDA of a nutrient you are getting in a single serving of the food you’re eating or the pill you’re taking. It’s based on a 2,000-calorie diet.
Do You Need More?
First, let’s be clear that vitamin supplements cannot and do not take the place of good diet. Food is the best medicine, and if you eat even reasonably well, you won’t have any deficiency issues. Of course, this is not the message you hear from the supplement industry. Americans spent more than $21 billion on supplements in 2015. That is a lot of money for no discernible benefit.
Taking even a simple multi-vitamin every day has not been shown to improve your health. It doesn’t extend your lifespan, it doesn’t ward off illnesses, it doesn’t do anything other than cost you money. Some people insist they feel better and have more energy when taking vitamins, but double blind studies have shown that taking a placebo works just as well. My opinion is that for some people, taking vitamins lulls them into a false sense of security that they are doing all they can to be healthy and make up for their less than stellar diet. Food has many micro-nutrients that aren’t covered by taking laboratory created supplements, so on this count, food wins out big time.
Most people who take a multi-vitamin take them as insurance. They figure it can’t hurt to take a pill that guarantees you’re getting at least the minimum requirement for good health. On the other hand, no study has shown that this is the case. In fact, no study has even shown that vitamins taken in pill form make it out of your digestive system and into your body in any meaningful way.
What to Do?
Well, you know what to do: eat a better diet. Eat food that isn’t processed to death. Eat fresh fruits and vegetables. Eat lean meats, drink clean water, avoid sugar … you know the drill. Eat like an intelligent adult.
If you really need a supplement due to a diagnosed illness, then be sure you take it as directed. Also, make sure you discuss with your doctor what you need to do with regard to your diet while you are taking them and, more importantly, if there is any way you can increase your intake of the deficient nutrient by improving your diet. Food is always a better option (if it’s an option as your treatment) than synthetics.
So, if you decide to take a supplement (and remember that the supplement industry is largely unregulated, so it’s tough to even be sure you’re getting what you think you’re getting) know why you are taking it and find a way to determine if it’s giving you the end result you are looking for. Unless you have a plan for determining efficacy, you don’t have a clue whether the supplements are helping, hurting, or just costing you money.
In the end, eating good food in reasonable quantities is the key to good health …
…and in that case, you can leave the supplement pushers on the sideline.
Michael Krueger is an NSCA-certified personal trainer. He got his start in fitness training while serving in the United States Coast Guard. He works with firefighters and others in and around Madison, Wisconsin. He is available to fire departments, civic organizations, and athletic teams for training, consulting, and speaking engagements. He has published numerous articles on fitness, health, and the mind-body connection and was a featured speaker at the IAFC’s FRI 2009 Health Day in Dallas, Texas. E-mail him at MKPTLLC@gmail.
