Vitamins for vitality: supplements can fill in the missing ingredients for a healthy diet

Twenty years ago, on NBC's Today Show, I dismissed vitamin pills as a waste of money. "Just eat right and you'll get all the vitamins you need," I said. I was convinced that a well-balanced diet could meet our needs, and I was troubled by the lack of scientific evidence to prove that nutritional supplements were safe and effective.

I was wrong. A recent USDA study revealed most adults fail to consume even the minimum recommended amounts of some vitamins. The majority of American women fall short in their intakes of vitamins A, B6, E and folic acid, and are consuming inadequate amounts of several critical minerals. Many men fall short of the minimum daily values for vitamins A, B6, C, E, thiamin, riboflavin, folic acid, calcium and magnesium.

These findings are especially troubling because the government's minimum recommendations for some nutrients may be well below the ideal levels required for optimal health. For example, research shows that much higher levels of vitamin E may be necessary to achieve the maximum benefits of this nutrient. The recommended daily value for vitamin E is only 30 international units (IU), but research reported this spring in the Journal of the National Cancer Institute showed men who supplemented with 50 IU per day had 41% fewer prostate cancer deaths than the men who did not receive supplemental vitamin E. Another study showed the risk of heart attacks was reduced most in people who consumed at least 100 IU per day.

These studies and others suggest we consume at least 100 IU of vitamin E per day, but it's not possible to get that much from food. You'd have to eat seven cups of peanuts, two cups of corn oil or 19 cups of spinach a day. That's not like likely to happen (and it shouldn't).

The same kinds of studies support supplementation for many other nutrients. A 1996 study of 1,300 men and women found selenium supplementation was associated with a 37% reduction in the overall incidence of cancer and a 50% decline in total cancer deaths. And a study of 80,000 nurses showed a 24% reduction in the risk of heart attacks among the women who used multivitamin supplements regularly. The National Academy of Sciences recommends all women of child-bearing age take 400 micrograms of supplemental folic acid daily.

I now recommend vitamin supplementation for all adults--not as a substitute for a good diet, but to complement healthy eating and regular exercise. But you can get too much of a good dung. A recent study of vitamin C suggests some of the antioxidant benefits may be lost if daily doses reach 500 mg. or more. The same problem has been noted with vitamin E with daily doses of 800 IU or more. The truth is, almost any vitamin or mineral can cause adverse reactions if you push the daily dose too high. So what's an appropriate vitamin strategy to follow? Here's my advice:

* Use food as the foundation of your nutritional program. Foods supply you with important substances you can't get from vitamin pills, including proteins, carbohydrates, essential fatty acids and many other natural elements that promote health. Personalize your vitamin program to meet your own unique needs.

* Talk with your doctor, pharmacist or nutritional adviser to determine if special supplements are necessary because of your age, sue or medical condition.

* Use vitamins and minerals to complement healthful habits, not to compensate for an unhealthful lifestyle. Nutritional supplements will not rescue you from the harmful effects of poor eating and a sedentary life.

Research shows this nutritional strategy, combined with a regular program of modest physical activity--even just walking--and regular preventive exams by your physician, can reduce your risk of high blood pressure, heart attack, stroke, diabetes and certain cancers. It can also add healthy years to your fife. It's another example of the fact that sometimes the best medicine isn't medicine.

Percent of Individuals Meeting 100% of the 1989 RDAs (in 1994)

Just how inadequate is the average American's diet? This chart shows the percentage of men or women who actually consumed the minimum recommended daily amount (RDA) of each given nutrient during a two-day study perfiod.

VIT A    VIT E    VIT C    THIAMIN    VIT B6    FOLATE    VIT B12

Males 20 and over
 41%      38%      62%        69%       48%       67%       88%

Females 20 and over
 41%      28%      57%        59%       34%       52%       72%

Art Ulene, M.D., reported on health issues an NBC's Today Show for nearly 20 years. He currently is chair of Feeling Fine Company.

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