Are you taking your multivitamin? A recent research article published in the Archives of Internal Medicine found that older women who took a daily multivitamin or vitamin/mineral supplement had an increased risk of dying from heart disease and cancer. This article has created much buzz in the media and much concern, especially in women, about whether they should continue taking vitamins or not.
The answer is not simple. It depends on how much you eat and what you eat. For years nutrition and health professionals have studied the need for multivitamins and mega doses of vitamins and minerals. There have been several studies proving mega doses of certain vitamins and minerals are harmful to your health, therefore professionals usually do not recommend these. However, it is standard practice to recommend a multivitamin if clients do not obtain the recommended number of servings of fruits, vegetables, dairy and whole grains each day.
Even though this is just one study and further research is needed before conclusive recommendations can be made concerning multivitamins, if you are interested in getting all of your needed vitamins and minerals from food instead of supplements: keep reading!
There are two main classes of nutrients: macronutrients and micronutrients. Macronutrients include: carbohydrate, fat and protein. Micronutrients basically contain: vitamins and minerals. There are two types of vitamins: water-soluble and fat-soluble. Most of your micronutrients can be obtained in food if you consume adequate calories for your height, weight, age and activity level. However, according to the United States Department of Agriculture (USDA), the typical American diet is usually lacking in a few key nutrients: Calcium, Magnesium, Potassium, Fiber, Vitamin C, Vitamin A, and Vitamin E. The reason for this is because the typical American does not consume enough fruits, vegetables, low-fat dairy and whole grains. So, why are these nutrients so important?
Calcium, along with Vitamin D, is important in building strong bones and preventing the development of osteoporosis. Magnesium is important in helping your body to produce energy, and in helping your muscles, arteries and heart work properly. A diet high in potassium and low in sodium helps maintain normal blood pressure and prevent the development of hypertension.
Vitamins A, C and E are antioxidants that help reduce inflammation in your body, thus decreasing your risk for multiple chronic diseases such as: heart disease, diabetes and cancer. Vitamin A is associated with normal vision and cellular growth and maintenance. Vitamin C is used to make collagen in blood vessels, bones, cartilage and muscle. Collagen is the main protein used as a connective tissue in the body. Vitamin E's main purpose is to act as an antioxidant to help fight damage to cells in the body from free radical exposure.
Fiber is important in keeping you regular and helping to prevent certain types of cancer. It is also beneficial for blood sugar control, preventing obesity and lowering cholesterol levels. Most Americans only get 15 grams of fiber per day when the recommendations from the USDA range between 25 grams per day for women and up to 38 grams per day for men.
So, you're probably thinking: well, how much is enough? General recommendations for health include at least 5 and upwards of 9 servings of fruits and vegetables together, 3 to 4 servings of low fat dairy each day, and consuming at least half of your grains as whole grains.
Think it's impossible for you to eat enough? Think again: below is an example of a typical day's worth of food for an average middle-aged adult.
Breakfast: ½ cup bran cereal with raisins mixed in 8 oz fat free vanilla yogurt with 1-cup fresh blueberries and 2 tbsp slivered almonds. To drink: 1 cup of green tea of drink.
Snack: 1 medium banana with 4 walnut halves and 1-cup skim milk.
Lunch: 2 slices whole wheat bread with 4 slices low sodium deli turkey and 1 slice Swiss cheese with 1 tsp Dijon mustard and a salad containing: 1 cup baby romaine salad with ½ cup raw carrots, ½ cup raw red bell peppers, ¼ of a medium avocado, ½ cup chopped tomatoes and 2 tbsp light balsamic vinaigrette dressing. To drink: a 16-ounce glass of water with lemon.
Snack: 1 oz cheddar cheese and 8 thin wheat crackers with an 8-ounce glass of water.
Dinner: 4 oz broiled halibut, 1 large baked sweet potato topped with 1 tbsp non-hydrogenated margarine plus 1 tsp of cinnamon, and 1-cup cooked frozen spinach. To drink: a 16-ounce glass of water with lemon.
This typical day not only meets the requirements for the typically missing nutrients, it exceeds several of the recommendations. This day includes 3 servings of fruit, 4.5 servings of vegetables, 4 servings of low-fat dairy, 5 servings of whole grains, and provides approximately: 1884 Calories, 237 gm of Carbohydrate, 108 gm of Protein, and 56 gm of Fat (50% of Calories from Carbohydrate, 23% from Protein, and 27% from Fat).
As far as the potentially insufficient micronutrients, this day contains: 1604 mg of Calcium, 490 mg Magnesium, 4854 mg of Potassium, 35 mg Fiber, 152.5 mg Vitamin C, 4404 micrograms of Vitamin A (retinol activity equivalents), and 15.35 mg Vitamin E.
The Recommended Dietary Allowances (RDA) or Adequate Intakes (AI) for these micronutrients for most adults includes this daily range: 700-900 micrograms of Vitamin A (in terms of retinol activity equivalents), 75-90 mg Vitamin C, 15 mg Vitamin E, 1000-1200 mg Calcium, 320-420 mg Magnesium, 4700 mg Potassium and 25-38 grams of Fiber per day. These levels are distributed by the USDA and created by the Institute of Medicine's Food and Nutrition Board. The needs for pregnancy and lactation are different than the above levels. Visit this link to look at the full tables of recommendations for all age groups and genders.
What's interesting about the RDA and AI for micronutrients is that a cushion is built into the recommendations to allow for the occasional less-than-perfect diet without creating deficiencies. For example, scurvy is the disease that manifests from chronic sub-optimal Vitamin C intakes. It only takes 10-15 mg of Vitamin C per day to prevent scurvy, however, the RDA for Vitamin C is 75 mg/day for adult women and 90 mg/day for adult men. So, even if you have a bad day nutritionally, starting fresh the very next day with adequate fruits, vegetables, low-fat dairy, lean protein and whole grains should guard you from deficiencies.
Don't like the foods mentioned in the example? That's ok! There are plenty of foods high in the potentially missing nutrients. To find out if you are meeting all of your nutrient needs with your current eating habits or to find out if you need a multivitamin supplement, set up an appointment with a registered dietitian.
Rebecca M. Lee, RD, LDN, is the registered and licensed dietitian / nutritionist at East Jefferson General Hospital's Wellness Center. Lee specializes in adult weight management, chronic disease prevention and sports nutrition. To schedule an appointment with Lee, call: (504) 849-6801, (504) 849-6868 or e-mail: firstname.lastname@example.org.