The 2005 Dietary Guidelines for Americans recommends people get most of their nutrients through consuming foods. The best multivitamins vary by person. Barbara Schneeman, Ph.D., director of the U.S. Food and Drug Administration's Office of Nutritional Products, Labeling, and Dietary Supplements, explains that the Guidelines recommend that supplements be used to fill a specific nutrient gap not being met by food. She adds, "An important point made in the guidelines is that nutrient supplements are not a substitute for a healthful diet."
Special Dietary Needs Populations
However, the FDA does state multivitamins can benefit population segments with special nutritional requirements. Pregnant and other child bearing-age women need folic acid to prevent birth defects, iron to oxygenate the blood and calcium to support bones. People on restricted diets or those with nutrient-depleting illnesses, such as diabetes, cancer or gastrointestinal disorders, should take the antioxidants vitamins C and E. Vegetarians should supplement with calcium, vitamin D, iron and vitamin B12 unless they totally understand how to get all these nutrients from foods.
Recommended Daily Allowances
There are 13 essential vitamins: A, C, D, E, K and the B vitamins (thiamine, riboflavin, niacin, pantothenic acid, biotin, vitamin B-6, vitamin B-12 and folate). The Joslin Diabetes Center, a Harvard Medical School affiliate, recommends picking a multivitamin with no more than 100 to 150 per cent of the daily value for the listed vitamins and minerals, with at least 20 listed. It should contain 400 mg of folic acid and 400 IU of vitamin D. Look for a maximum of 5,000 international units (IU) of vitamin A, primarily from beta-carotene sources such as carrots. New guidelines for vitamin D and calcium were released in late 2010, so some brands may not yet reflect the new guidelines. Most store-brand vitamins are fine, according to Consumer Reports, but watch out for discount store brands; many have been found to be over-reporting nutrient levels.
The FDA recommends you talk to your doctor before taking multivitamins. Some supplements interact badly with pharmaceuticals and can have unwanted effects pre- or post-surgery, such as excess bleeding with vitamin E. Men don't need any iron in their supplements, unlike women. Never give adult multivitamins to children; their nutritional needs are different those of adults. Out-of-date vitamins lose their effectiveness and oils become rancid, so check dates. Adverse effects from vitamins should be reported to the FDA and your doctor as soon as possible.
Safety and Purity
Just because a multivitamin company claims certain levels for nutrients doesn't make it true, according to Consumer Labs, LLC. The company provides independent test results for more than 350 brands of vitamins to help consumers identify best quality products. It publishes an annual Survey of Vitamin & Supplement Users for its paid membership. Although low-dose vitamins may only waste your money, according to Vasilios Frankos, Ph.D., director of FDA's Division of Dietary Supplement Programs, "Vitamins are not dangerous unless you get too much of them, especially fat-soluble ones." For some vitamins and minerals, the National Academy of Sciences has established upper daily limits of intake (ULs) it recommends not to exceed.
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- ConsumerReports.org: Multivitamins -- What to Avoid, How to Choose
- U.S. Food and Drug Administration: Fortify Your Knowledge About Vitamins
- U.S. Food and Drug Administration: Tips For the Savvy Supplement User: Making Informed Decisions and Evaluating Information
- Joslin Diabetes Center: What Are the Best Vitamins and Minerals to Take?
- Cleveland Clinic Journal of Medicine: Should Everyone Over Age 75 Take a Multivitamin?
- March of Dimes: Pregnancy and Prenatal Vitamins