What to look for in multivitamins

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The first multivitamin was released in 1943. In the 1950s, their bottles can be found on many family tables. The Americans were eating them – even now. But do we need them?

“People see them as a form of insurance,” said Joanne Manson, a professor at Harvard Medical School and head of preventive medicine at Brigham and Women’s Hospital. “They are hedging their stakes. I will not stop anyone from taking a multivitamin. But multivitamins and other supplements can never replace a healthy diet. ”

One-third of American adults and a quarter of children and teens take multivitamins, with total sales in the United States reaching $ 8 billion in 2020, according to the National Institutes of Health’s Bureau of Dietetic Supplements.

morning or evening? With or without food? Answers to your questions about getting supplements.

Some experts believe that a balanced diet should be sufficient for many people. Donald D., Associate Professor of Nutrition and Preventive Medicine, Mayo Clinical Medical College. “I focus on helping my patients eat right.”

But other experts say it’s more complicated because people need more vitamins at certain stages of life, or their health makes it harder for them to digest vitamins. Some need supplements in addition to multivitamins.

“Some foods are very difficult to get from food, such as vitamin D, because they are naturally low in food,” says Bonnie Liebman, director of nutrition at the Center for Science in the Public Interest (CSPI). “Many older people do not get enough stomach acid to get the natural vitamin B-12 from milk, meat or eggs. Vitamin B-12 deficiency can lead to irreversible nerve damage and mimic dementia – something you want to avoid.

Facts about multivitamins

Researchers studying multivitamins say there is growing evidence that multivitamins have additional health benefits, including slowing cognitive impairment in the elderly. For example, a three-year, three-year study of more than 2,200 participants aged 65 and older, funded by the National Institute on Aging, found that those taking daily multivitamins significantly improved their ability to decline with normal aging, including in the short term. Executive functions such as memory and decision making compared to placebo recipients.

The unpublished results presented at the scientific conference in the fall showed that those who took multivitamins deteriorated mentally for only 1.2 years, not three years. In other words, they kept their sanity for 1.8 years – almost 60 percent. The study was part of a larger test examining the effects of multivitamins on cancer. The results of the study are expected to be announced soon.

A major study called the Cocoa Supplement and Multivitamin Outcomes Study, or COSMOS, began in 2014 and sought to replicate the results of a previous test called Physicians’ Health Study II, which ran from 1997 to 2011. PHS II 8 Percentage reduction in total cancer among people 50 and older who take multivitamins daily, but – unlike COSMOS, showed no cognitive benefit. However, the COSMOS study lasted only 3 years and did not find any reduction in cancer.

About half of parents give their children dietary supplements

However, the researchers point out that differences in the design and length of the two studies, which are the same in both studies, produce seemingly contradictory results.

“SPACE wasn’t enough to ridicule the effects of cancer,” said Howard Cesso, an associate professor of medicine at Harvard Medical School and one of the researchers. “For cancer, it really takes more time to determine the impact of dietary measures. We’re tracking participants and sending them surveys to see if they’re still taking multivitamins, and if they have cancer.”

There were also significant differences between the two studies in how they recognized. For example, the first baseline cognitive assessment in PHS II was one or two years after participants began taking the pills, so the researchers would have missed any cognitive improvements from those first two years, Cesso said.

“COSMOS had a better research design,” he says. “The first baseline cognitive assessment was before they started taking a multivitamin or placebo. The potential benefits were observed in subsequent assessments at one, two, and three years.

However, experts say that multivitamins are important for people suffering from digestive disorders such as poor digestion, medications, gastrointestinal surgery or Crohn’s disease, ulcerative colitis, inflammatory bowel disease and celiac disease.

Multivitamins can also provide the nutrients you need at certain stages of life. Anyone planning to become pregnant should take multivitamins before and during pregnancy to ensure that they receive enough folic acid to prevent fetal neural tube defects such as spinal bifida. Postmenopausal women, on the other hand, should avoid iron-containing multivitamins because they do not lose iron during menstruation.

What role does vitamin D play in your health?

Some people also require supplements such as vitamin B-12 and vitamin D. The latter, which is necessary for bone health, is often lacking in those who are not exposed to the sun – the wisdom to prevent skin cancer – and indoors, for example, in nursing homes. residents.

Manson has conducted several studies on vitamin D supplements, and they found that taking vitamin D supplements reduces the risk of developing autoimmune diseases and reduces cancer deaths, but does not prevent it. “Vitamin D can change the biology of tumors, so they give fewer metastases,” he says.

He is also studying the effects of vitamin D on the symptoms of coronavirus, namely whether it can reduce high respiratory infections, but there are no results yet. Still, he thinks it’s a good idea to get a little more. (Recommended daily allowance or RDA 600 international units, or IU, or 15 micrograms, but this amount varies between multivitamins.)

“During the pandemic, I would recommend 1,000 to 2,000 IU, but the jury is still not on the benefits during the covid,” he says. “It’s very safe. 600-800 is enough for bone health and other chronic diseases.

Experts say it is also wise to take vitamin B-12 later. Most multivitamins contain 2.4 micrograms of RDA for adults, but some people may need more, experts say.

“About 15 percent of people over the age of 65 have early vitamin B12 deficiency,” Hensrud says. He recommends that patients of this age receive between 500 and 1,000 micrograms per day. “Vitamin B-12 is not well absorbed and has a large safety margin,” he said. “It’s probably the safest vitamin.”

Most dietary supplements do nothing. Why do we spend $ 35 billion a year on them?

CSPI warns consumers not to rely on multivitamins to get enough calcium and potassium. Liebman says, “Instead of looking for extra food, you should fill half of your plate with vegetables and fruits and get enough potassium.” “Whether you need calcium supplements or not depends on how much you get from food.”

According to him, women and men under the age of 70 need 1,000 milligrams of calcium every day. “You can’t trust a multi to get it because it doesn’t fit on a tablet and you can get enough from food.”

Women need 2,600 milligrams of potassium a day, while men need 3,400 milligrams, he said. “Potassium helps lower blood pressure or prevents it from rising as you get older,” Libman says. In addition to fruits and vegetables, other sources of potassium include dairy products, beans, and seafood.

Most experts agree that taking multivitamins is not harmful and may help, and people do not need to spend a lot of money on them.

“I think a simple multivitamin-mineral supplement is reasonable for a lot of people,” Libman said. “You don’t need a Cadillac multivitamin. Chevy is good. Many store brands are usually perfectly adequate.

What vitamins should be in a multivitamin

Vitamin 700-1,050 mcg (2,300-3,500 IU)

Vitamin D 20-25 mcg (800-1000 IU)

Vitamin E. 13-35 mg (20-80 IU)

Thiamine (B-1) 1.1 mg or more

Riboflavin (B-2) 1.1 mg or more

folic acid Premenopausal women 660-680 mcg DFE (equivalent of dietary folic acid) (400 mcg folic acid); others 400-680 mcg DFE (235-400 mcg folic acid)

Vitamin B-12 2.4 mcg or more

Calcium Don’t trust multivitamins

iron Premenopausal women 18 mg; others (not more than 8 mg)

potassium Don’t trust multivitamins

(Note: “Or more” does not mean that the food is safe in any dose, but the levels of multivitamins are unlikely to be harmful. This list does not apply to prenatal multivitamins for pregnant women. See your doctor.)

A source: Science Center of Public Interest

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