Yes, You DO Need a Multivitamin

By Jason Barker, with Larissa Long

Believe it or not, the multivitamin debate continues. Every few months or so, some study shows that multivitamins (or supplements in general for that matter) are not necessary.

Those on the anti-multi side of the table argue that you simply don’t need them. First, they claim that eating a well-rounded diet and the recommended amounts of fruits and vegetables provides you with all of the vitamins and minerals your body needs, and that multivitamins are only beneficial in those people who have deficiencies.

Second, those against the use of multis believe that they are unsafe. They assert that multivitamins are not only “unregulated,” but they can actually increase your risk for cancer. As “proof” of this second point, opponents point to a study from the American Journal of Clinical Nutrition, which found that women talking multivitamins were 19 percent more likely to be diagnosed with breast cancer.1 Similarly, a 2007 study in the Journal of the National Cancer Institute found that men taking multivitamins had increased risk of prostate cancer.2

Ridiculousness all around. But before I get to the heart of why multivitamins are a critical foundation of good health, let’s first address the ludicrous assertions listed above.

Breaking Down the “No-Multi” Claims

The idea that “eating a well-rounded diet” can give you all the nutrients you need for optimal health is insane at best. While most Americans do not suffer from the type of severe malnutrition in other parts of the world, this does not mean that we are consuming optimal levels of vitamins and minerals.

According to the Centers for Disease Control and Prevention (CDC), less than one-third of Americans eat two or more fruits per day and a mere 27 percent eat vegetables three or more times a day.3 That is grossly insufficient to meet our vitamin and mineral needs.

Additionally, as we reported in the March 2012 issue of the newsletter, many minerals such as selenium are depleted in our soil, due in large part to over-farming. Then, of course, there’s the issue of high stress and nutrient depletion, as well as our standard American diet of trans fats and processed and refined foods wreaking havoc on our bodies, increasing free-radical production and causing rampant inflammation.

These concerns were echoed in a 2002 issue of the Journal of the American Medical Association.4 In the study, researchers found that suboptimal intake of certain vitamins, even at levels higher than those technically required to indicate true vitamin deficiency, was associated with increased risk of chronic diseases, especially the elderly.

They considered the risk significant enough that they concluded, “Most people do not consume an optimal amount of all vitamins by diet alone. Pending strong evidence of effectiveness from randomized trials, it appears prudent for all adults to take vitamin supplements.”

Given this, multivitamin advocates maintain that it is not only practical but critical that people use multivitamins to fill in the nutritional gaps left by a poor diet, high stress, malabsorption issues and other deficiency-related concerns.

As for the issues raised regarding supplements being unsafe, the argument falls flat once again. While the FDA does not oversee supplements in the same way it oversees pharmaceuticals, this doesn’t mean the supplement industry has free rein in terms of production and claims.

Under the Dietary Supplement Health and Education Act of 1994 (DSHEA),5 the dietary supplement or dietary ingredient manufacturer is “responsible for ensuring that a dietary supplement or ingredient is safe before it is marketed.” The FDA’s role is to police unsafe supplements.

Additionally, there are Dietary Supplement Current Good Manufacturing Practices (CGMPS) in place for quality control. Lastly, the supplement manufacturer is required to submit all serious adverse event reports associated with the use of their supplements to the FDA.

Finally, when it comes to the cancer-related issues, even the authors of those studies mentioned above raised concerns. In the case of the Swedish study on women and breast cancer, the authors noted, “Although we adjusted for known breast cancer risk factors, we cannot rule out the possibility that our findings may be due to residual confounding.”1

And in the instance of prostate cancer, that finding was particularly tricky. In their conclusion, researchers indicated, “These results suggest that regular multivitamin use is not associated with the risk of early or localized prostate cancer. The possibility that men taking high levels of multivitamins along with other supplements have increased risk of advanced and fatal prostate cancers is of concern and merits further evaluation.”2

The takeaway? A multivitamin is an inexpensive form of health insurance, one that is meant to fill “holes” in your diet. And while the necessity of taking a multivitamin shouldn’t be in doubt, quality is a concern.

Which leads us to…

Choosing a Multi

The old adage “you get what you pay for” is especially true in the supplement and multivitamin arena. Supplement quality is loosely regulated in the U.S., and manufacturers need only to include a few basic vitamins and minerals in their formulation to create a “multivitamin.” As a result, there is a pretty big range in both price and quality of multis. And you can be all but certain that if the price is dirt cheap, the quality is likely to be as well.

Take many of the multivitamins available from groceries, pharmacies and big box stores for example. The vast majority (if not all) are overly processed and contain poor quality ingredients, binders, unnecessary additives, food coloring and preservatives.

Given this, it’s difficult to argue that one’s health isn’t worth the slightly increased cost of a quality nutritional supplement. We do ourselves a disservice when we forgo quality multivitamins for cheap supplements full of unnecessary additives and poor quality ingredients.

Fortunately, with a bit of education, you can spot the differences between poor and good quality nutritional supplements.

Avoid the “Expensive Urine”

Before we discuss what your multi should include, here are some common things that make that inexpensive supplement little more than “expensive urine.”

Binders are added ingredients that act as “glue,” holding the vitamin together. In fact, these often work so well that many vitamins made with these chemicals don’t even break apart in your GI tract and are excreted intact.

Common binders include:

  • Croscarmellose
  • Cellulose
  • Shellac

Additives are used to fill space or enhance the appearance of the vitamin. Oftentimes, these are food ingredients that are also common allergens. They often include:

  • Sugar
  • Aspartame
  • Corn
  • Soy
  • Lactose

Food coloring is only included to make the vitamin look pretty. But, let’s face it, you didn’t buy it for its appearance! Unfortunately, artificial coloring can damage our DNA6 and organs,7 and are often implicated in behavioral problems.8

A few of the more common food coloring “ingredients” to look out for are

  • FD&C Red 40 Aluminum Lake
  • FD&C Yellow #6 Lake
  • FD&C Yellow #5 (tartrazine) Lake

Preservatives are simply things you don’t need and, worse yet, can be actually harmful to your health. For example, of the three more commonly used preservatives found in supplements, hydrogenated palm oil is a trans fatty acid, butylated hydroxytoluene (BHT) has several toxic effects9 and sodium benzoate also has toxic effects.10

Not one of these additions to your multivitamin will enhance your health whatsoever, and may in fact harm you. Therefore, be sure to choose a multivitamin (or any supplement for that matter) without these additives.

New Trends in Multis

A quick look through the more popular magazines or a brief glimpse at many of the newer TV commercials, and one trend is clear—more and more manufacturers are creating (and marketing) multivitamins with gender- and condition-specific formulas.

While our early understanding of health only highlighted certain vitamins and minerals, newer discoveries have led to the utilization of other plant and food chemicals that also strongly benefit our health. Popular condition-specific multivitamins focus on heart health, brain function and different female and male age groups. These are all good things!

Additionally, many multivitamins contain many of the more recently discovered phytonutrients (plant chemicals) that reflect current healthy dietary recommendations, such as the Mediterranean diet. A Mediterranean diet includes plenty of vegetables, fruits, olive oil, herbs, seafood (fish oil) and minimal red meats and dairy products. Best of all, this type of diet has been shown to have several health benefits, particularly against cancer and heart disease.11

Such a diet contains several “super foods,” designated as such because of their unique nutritional ingredients and quantity. These include kale, beets, cabbage, broccoli, spinach, pomegranates, olives, tomatoes, turmeric, grape seed, green tea and red wine. New technology allows for many of these plant phytonutrients to be extracted and utilized in supplements, bridging the gap between diet and supplementation.

And while a diet-specific multivitamin is a big improvement over a basic multivitamin, an even better improvement would include nutrients that target several vital systems and processes in the body.

Key areas include:

  • Neurological (brain)
  • Cardiovascular system (heart and blood vessels)
  • Mental-emotional (mood)
  • Vision
  • Digestion
  • Inflammation
  • Oxidation (antioxidants)

Let’s look at each of these systems in more detail, highlighting a few of the more ideal nutrients to keep an eye out for in a multi.

Neurological Support

Memory and other brain functions slowly decline with time, which is why it is important to keep the brain sharp as we age. Fortunately, there are specific nutritional factors that may support brain function and slow the aging process.

Ashwagandha (Withania somnifera) is an herb derived from Ayurveda (a traditional Indian medical system) with neuroprotective effects. A May 2003 study showed that Ashwagandha protected the brain by acting as an antioxidant,12 while a review published in 2011 mentions its usefulness against neurodegenerative conditions such as Parkinson’s, Huntington’s and Alzheimer’s diseases.13

Fish oil—specifically omega-3 fatty acids—also have protective effects on the brain. A January 2010 study stated that there is a protective association between omega-3 fatty acids and cognitive decline, and may prevent dementia by limiting inflammation, clotting and improving function of brain vessels.14 Plus, docosahexaenoic acid (DHA), a component of omega-3, is a major building block of brain cells.

Cardiovascular Support

Heart disease is a major aging-associated illness and the leading cause of death in the Western world.15 Prevention of heart disease should begin well before symptoms appear, as it, like many chronic diseases, takes years to develop.

Coenzyme Q10 (CoQ10) is an important nutrient responsible for cellular energy production. It is produced in the body and available as a supplement as well. A May 2012 study found that higher blood levels of CoQ10 were significantly associated with a reduced risk of heart disease.16

In addition to helping your brain, fish oil (omega-3 in particular) has also been found to be heart protective. A 2008 study states that therapeutic use of fish oil plays a role in preventing and reversing heart disease and heart attacks.17 Additionally, a December 2008 study showed that fish oil supplementation significantly reduced cardiac-related deaths.18

Resveratrol is plant-derived polyphenol (plant chemical) with strong anti-inflammatory and antioxidant effects. Consumed in large amounts as part of the Mediterranean diet, resveratrol is associated with a reduced risk of heart diseases.19

Finally, green coffee bean extract is a compound with significant blood pressure-lowering effects. Studies published in September 2005 and July 2006 showed that it could safely lower blood pressure in people with mild hypertension.20-21

Mental-Emotional (Mood) Support

A positive mental balance is an important, and often overlooked, aspect of health. Low mood, depression and other mood disorders are associated with several other negative health outcomes including heart disease and asthma.22-23

Rhodiola rosea is an Asian herbal that has antidepressant and stress-reduction benefits, just to name a few.24-26 In a March 2008 study, rhodiola was also shown to significantly improve the symptoms of Generalized Anxiety Disorder in test subjects.27

Panax ginseng is another Asian herbal with a variety of positive health benefits. In a March 2002 study, it was shown to improve mental health and social functioning in study subjects.28 An October 2003 study states that ginseng may improve psychologic function.29

Eleutherococcus senticosus (Eleuthero or Siberian ginseng) has similar mood-supporting effects as Panax ginseng. A 2004 study showed that in elderly patients, eleuthero improved mental health and social functioning.30

Vision Support

Overall vision quality declines with aging. Taking preventive steps to keep the eyes functioning at their best should start early.

Lutein is a well-researched supplement in the area of vision support. As a carotenoid compound, it is similar to the antioxidant pigments found in carrots. Lutein can protect the retina through its antioxidant effects.31-32 Because it cannot be synthesized by the body, it must be consumed in supplemental form or from the diet.

Once again, fish oil (as omega-3s) rears its head as protective, this time to the eyes. Dry eye disease is a condition suffered by many people, and fish oils have shown benefit for this condition, according to studies published in September and November 2011.33-34

Additionally, a July 2011 study showed that fish oil consumption significantly decreased risk of developing age-related macular degeneration.35

Digestive System Support

It is often said that health begins with digestion, and keeping digestive function running smoothly with digestive enzymes can ensure that food is properly digested and assimilated. Digestive enzymes play an important supportive role in many digestive disorders and can enhance the digestive process.36

Spirulina (blue-green algae) and chlorella (green algae) are popular “superfoods” with numerous health benefits. In a study published in December 2009, chlorella showed a significant ability to protect the intestinal lining and prevented the absorption of bacteria and digestive toxins.37

Spirulina has known anticancer, antiviral, antibacterial, antioxidant and anti-inflammatory effects. Research from a 2011 study showed that spirulina was beneficial in an experimental model of inflammatory bowel disease.38

Inflammation

Inflammation is the primary mechanism by which the immune system defends us. However, left unchecked, inflammation lies at the heart of nearly all disease processes.

One of the most powerful natural anti-inflammatories is the spice turmeric. It is useful in protecting against many health conditions that have their origins in inflammation.39-41

Not surprising, fish oil is also a major anti-inflammatory, with broad spectrum effects across a number of health conditions.42 Supplementing with fish oils can decrease the amount of pro-inflammatory molecules within cells, which decreases inflammation where it is first generated.43

Antioxidants

Similar to inflammation, oxidation is a process that slowly chips away at our health over time. Oxidation is one of the main causes behind aging, and can be thought of as “biological rusting.”

Using antioxidant nutrients such as green tea, resveratrol, quercetin and alpha lipoic acid prevents oxidation. These are among the most well researched and most effective antioxidants. They can prevent cellular dysfunction, boost immune status, protect the heart and lungs and limit nerve damage.44-47

Quality In, Quality Out

When selecting a multivitamin, avoid those containing poor quality ingredients and additives. Look for a multivitamin that is free of additives, and contains both food extracts and organ/condition specific nutrients.

Selecting a quality multivitamin such as this will provide a much greater health benefit than a cheap, processed big-box store multivitamin.

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