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Little Oversight
Vitamins and supplements also lack the government oversight that medical drugs get, and this adds to the confusion and potential dangers. Consumers have no real way of knowing whether labels accurately reflect what’s actually in a pill.
ConsumerLab.com, a supplement industry watchdog site, recently tested 21 different brands of multivitamins and found that 11 failed quality standards, including meeting their own label claims. For example, their test showed that one product had only about half the calcium its label boasted, and another had almost 300 percent more. One product was found to be tainted with lead. Three didn’t break apart properly, violating the U.S. Pharmacopeia’s 30-minute limit on how quickly a pill should dissolve (to make sure you get the full dose).
Another study discovered that half of the B-complex supplements analyzed didn’t provide the claimed amounts of folic acid. But that should change over the next few years, thanks to a new FDA ruling that says supplement manufacturers must ensure their products are tested for purity and accurately labeled.
The Real Benefits
Not all the news is disappointing. Studies show that vitamin D plays an important role in the absorption of calcium and in boosting bone health. The National Osteoporosis Foundation recommends that adults under 50 get 1,000 mg of calcium and 400 to 800 IU daily of vitamin D3 (the form of D that best supports bone health), and those 50 and older get 1,200 mg of calcium and 800 to 1,000 IU of D3 from food and supplements. But vitamin D may do even more, as Reader’s Digest reported in September 2006. Several studies suggest a link between vitamin D deficiency and cancer, as well as other diseases. And there seems to be little downside to taking vitamin D supplements.
But some people may need more than the standard recommended amounts of certain vitamins, including pregnant women, who require extra folic acid to help prevent birth defects, and the millions of young women with anemia, who may benefit from iron supplements. Postmenopausal women can take calcium and vitamin D to reduce fracture risk, and those at risk for age-related macular degeneration may benefit from antioxidant and zinc supplements.
Food Versus a Pill
Clearly, the jury’s still out on what vitamin supplements can really do. An NIH panel determined last year that there wasn’t yet enough evidence either for or against the use of multivitamins to make a recommendation. One thing that’s clear, though: Getting vitamins and minerals from pills is not as effective as getting them from food, says Dr. Roizen. No one knows for sure why a food source may be more beneficial, but one theory is that nature provides a perfect balance of compounds that isn’t fully replicable in the lab.
While there’s evidence that vitamins C and E and beta carotene protect the heart when you get them from food, a recent Harvard study found that they don’t provide protection when you get them from a supplement. The Women’s Antioxidant Cardiovascular Study followed 8,100 women with strong risk factors for heart disease for nine years, and the researchers concluded that “widespread use of these individual agents for cardiovascular protection does not appear warranted.”
Rather than just turning to pills as a remedy, eating a healthy, balanced diet may help you avoid those conditions in the first place, says Robert Eckel, MD, who specializes in preventive cardiology at the University of Colorado School of Medicine and is the immediate past president of the American Heart Association.
“I believe in getting the DRI from food as a way of preventing deficiency diseases,” says Dr. Roizen. “But I take a vitamin and mineral supplement as an insurance policy against a less than perfect diet.”
“There have been many studies looking at supplements,” says Blumberg, “but the most consistent evidence we’ve had over the past 30 years is that eating a healthy diet, low in salt and saturated fat, losing extra weight, exercising moderately, reducing stress, and quitting smoking are our best guarantees against disease and premature death.”
5 Not to Take
Everyone needs vitamins and minerals, which are crucial for good health and long life. What we don’t need are megadoses of these essential nutrients in pill form. The greatest health benefits come when we get our vitamins from a balanced diet—but only 3 percent of us eat well enough for that. So unless your doctor has advised you to take a supplement for a specific medical reason, a daily multivitamin is all most healthy individuals need. Read labels to see how much you’re getting of each nutrient, and ask your doctor before starting any vitamin regimen, especially if you already take prescription drugs. Based on the latest studies, here are ten you can skip:
Vitamin A: Excess amounts accumulate and can be toxic. Too much A can blur vision, cause headaches and vomiting, and also lead to liver, bone and central nervous system problems, among others.
RDA*: Men - 900 mcg. Women - 700 mcg. One 7-inch carrot has 600 mcg. Other food sources: fortified cereals, dark leafy greens, fruits, sweet potatoes.
Beta Carotene: The body converts this into vitamin A. Supplementation is not recommended for the general public and should be avoided especially by smokers, who have a greater risk of lung cancer with regular use. Another recent study found that high levels of beta carotene in the blood were linked to three times the risk of aggressive prostate cancer.
RDA: None established. You can get what you need from dark green and orange fruits and veggies.
Vitamin C: There’s no conclusive evidence that it prevents colds, heart disease, cataracts or cancer.
RDA: Men - 90 mg. Women - 75 mg. Smokers need an extra 35 mg. A glass of OJ will give you almost all you need.
Vitamin E: Large doses can thin the blood and may increase the risk of hemorrhagic stroke in those with uncontrolled blood pressure. Has not been proven to protect the heart or prevent cancer.
RDA: 15 mg. An ounce of dry-roasted almonds will provide almost half your daily needs.
Selenium: Most Americans get enough of this trace mineral in their diet. One new study suggests that adding more via a pill may increase the risk of developing type 2 diabetes.
RDA: 55 mcg. Grab a tuna sandwich or a handful of Brazil nuts instead.
5 More Not to Take
Folic acid: It’s a must during pregnancy to help prevent birth defects, but recent studies show no real effect for the rest of us against heart disease, cancer or depression. The connection between folate and reduced risk of Alzheimer’s is not yet conclusive either.
RDA: 400 mcg. Find it in dark green leafy vegetables, fortified cereals and whole-grain breads.
Niacin: This B vitamin can be used to treat high cholesterol, but only under a doctor’s supervision due to the risk of potentially serious side effects, including liver damage.
RDA: Men - 16 mg. Women - 14 mg. A multivitamin gives you 20 mg. Some products will give you 500 mg. Stick to meat, fish, poultry, nuts and eggs instead.
Lycopene: Two studies, one by the FDA, recently concluded that consuming lycopene as a supplement or in rich food sources, such as tomatoes, does not offer strong cancer-fighting protection, as was previously promoted.
RDA: None established. You should still eat tomatoes (tomato sauce is even better) because they’re full of other important nutrients.
Iron: Only women who are pregnant or have heavy periods, as well as people with diagnosed deficiency disorders such as anemia, need extra amounts of this mineral. Iron supplements can interact with meds, other dietary supplements and food, and can worsen conditions like ulcers.
RDA: Women over 50 and all men - 8 mg. Women ages 19 to 50 - 18 mg. Red meat, poultry, fortified cereals, dried beans and lentils, and dark leafy greens are good sources.
Zinc: High doses can interfere with how the body metabolizes copper and iron, may weaken the immune system and may also reduce levels of HDL (good) cholesterol. Studies are mixed about its effect on the common cold. Zinc supplements can also interact with certain drugs, including some antibiotics, blood pressure medications and NSAIDs.
RDA: Men - 11 mg. Women - 8 mg. Meat and poultry are high in zinc; vegetarians should eat plenty of grains, beans, nuts, lentils and dairy products. |
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