Vitamin smarts - includes related chart on the contents of multivitamins - Cover Story

Nutrition Action Healthletter, Nov, 1995 by Bonnie Liebman, David Schardt

Do you need to take vitamins?

There is no simple answer.

According to most health authorities, you don't need vitamins if you eat a "balanced diet" or a "variety of foods." That's just another way of saying that you don't need vitamins in a pill if you get enough vitamins from your food.

But do you?

Only a painstaking analysis of what you eat in an average week or so could - perhaps - answer that question.

Our advice: take a multivitamin for insurance. We can't prove that most people need to, but as long as you don't overdose or overpay or use it as an excuse to eat a lousy diet, you've got a little to lose (we're talking a dime a day or so).

Of course, choosing a multivitamin can be as confusing as buying life insurance. But don't despair. We've come up with a guide to help you figure out what to look for...and what to ignore.

Okay. You've decided to take a multivitamin. Now what?

Most people figure that they should find one that has 100 percent of the U.S. Recommended Daily Allowances (USRDAs - sometimes also called Daily Values, or DVs) for everything they need - sort of a cover-all-bases "One-A-Day."

That's good thinking, but it's not so simple. Basic multivitamins seldom have 100 percent of the 12 vitamins and eight minerals for which there are USRDAs. Two of the five varieties of One-a-day, for example, have no minerals.

Others, like Centrum or Myadec, do include most minerals. But they still have less-than-USRDA levels of nutrients like biotin, calcium, magnesium, and phosphorus.

Some of those - phosphorus and biotin, for example - you don't need anyway (see pages 8 & 9). But others - like calcium and magnesium - might be worth taking.

So you have two choices:

* Pick a basic, inexpensive model and buy other nutrients separately. That's the most sensible approach for most people, because the missing - or almost missing - ingredients may not be worth the price you'd have to pay to get them in a single supplement.

* Pick a more expensive model that has everything. If you're the kind of person who takes out a $5 million life insurance policy when you probably only need $500,000, you'll no doubt want to go for a fancier model, even though it may require taking four or more pills a day.

AVOIDING IRON

As if it weren't hard enough to decide what you need, you've also got to think about what you don't need. The high doses of B-vitamins in many supplements, for example, are unnecessary, but they won't hurt you.

What might hurt you is iron. Too much can lead to hemochromatosis (iron overload) in the one out of every 250 Americans who inherited genes for this disease from both parents. Iron overload can lead to death from liver damage or heart failure.

Some researchers are also worried that too much iron can increase the risk of cancer@specially colon cancer - or heart disease. But so far, the evidence is shaky.

Nevertheless, there's little reason for men and postmenopausal women - both of whom have a low risk of iron deficiency - to take any iron. They should already get plenty from foods like meat, fortified breakfast cereals, and breads and pasta that

It's reasonable for premenopausal women to take a supplement with iron, though, because they lose a little each time they menstruate. But even premenopausal women should know that iron can be constipating, usually only at doses higher than the USRDA.

THE CADILLAC OF

VITAMINS

Want a supplement that supplies 100 percent of just about everything you need? We found one (though there may be more). And it comes with or without iron. Natrol My Favorite Multiple even has a day's worth of calcium and magnesium, plus high doses of most vitamins, including E and C. The catch is: you have to take four tablets a day, at a cost of close to $20 a month.

For some people, it's worth the price. For others, that's too many tablets and too much to pay for "insurance." After all, you eat food, too. A multivitamin is supposed to supplement your diet, not replace it.

And what if you have high blood pressure and worry that a high dose of vitamin E (Natrol has 400 IU) may increase your risk of hemorrhagic stroke, as one large study suggests? Or, what if you just don't want high doses of vitamins on the off-chance that they may turn out to be harmful?

If that's not your idea of "insurance," read on.

BACK TO BASICS

It wasn't hard to find a basic, no-frills multi that had enough vitamins. Finding one with enough minerals was another story.

Only three low- or medium-iron supplements - Nature Made Mature Balance and two multis made by Your Life - met our criteria and cost less than $4 a month. Finding a good cheap higher-iron supplement was no problem. Centrum (and most Centrum-imitation store brands) and a half-dozen others qualified.

Spending less than $4 a month has appeal, but don't forget that these no-frills pills may require add-ons. The most important to consider (see "How to Read a Vitamin Label") are:

* calcium (especially for women),

* vitamin E (to possibly lower your risk of heart disease), and

* vitamin B- 12 (if you're 65 or over). (You'd need extra B- 12 even if you took a complete" multi like Natrol.)