A Wellness Guide to
Multivitamin/Mineral Pills

It's possible and preferable to get your nutrients from a healthy, balanced diet. But surveys show that many fall short in a variety of key vitamins and minerals. Moreover, recent research has underscored the importance of some of these nutrients, notably vitamin D and folic acid. And some studies suggest that people who take multivitamin/mineral pills have a lower risk of several diseases, including colon cancer and possibly cardiovascular disease, and may have a better immune response.

Consider taking a multi if you are in one of these groups:

• People over 60. Most don't get the nutrients they need, for a variety of reasons. For instance, aging itself may make it more difficult to absorb and utilize certain nutrients. The major problem nutrients for older people are vitamins D, C, B6, B12, and folic acid, as well as minerals such as zinc, calcium, and magnesium.

• Women of childbearing age. They need 400 IU daily of folate (the form in supplements is called folic acid). This B vitamin helps prevent neural tube birth defects; women need to build up their folate stores at least several weeks before becoming pregnant. The folic acid in supplements and fortified foods is better absorbed by the body than the folate found naturally in food (this is also true of vitamin B12). In addition, many premenopausal women do not consume enough iron and can benefit from the amount in a basic multi.

• Pregnant or breast-feeding women should probably take a multi, but should discuss their special needs with their doctors.

• Strict vegetarians, who eat no animal products, may not get enough vitamin B12, zinc, iron, and calcium.

• People on weight-loss diets, as well as heavy drinkers or smokers, are likely to have a shortfall of vitamins and minerals.

• Anyone not eating a balanced diet (at least five fruits and vegetables a day, as well as whole grains, low-fat dairy, and small servings of lean meat, poultry, or fish) may not be getting enough folic acid, B6, and B12. These B vitamins play a role in lowering homocysteine levels in the blood and thus may help reduce the risk of heart disease and, recent studies suggest, Alzheimer's disease and osteoporosis. Folic acid may also help prevent cervical and colon cancer. Most multivitamin supplements have 100% of the daily recommended intake of these Bs.

But keep in mind: Even if you take a multi, you still need to have a healthy, balanced diet. These pills are not magic bullets. Foods, particularly fruits, vegetables, and whole grains provide fiber as well as countless beneficial phytochemicals not found in any pill.

Ten things you should know

• A multi need not cost more than a few cents a day. You don't need a fancy multi. Most store-brand and generic products are fine.

• Most important: Look for 100% of the Daily Value of the following vitamins: Vitamin D, B1 (thiamin), B2 (riboflavin), B3 (niacin), B6, B12, and folic acid (another B vitamin). Plus at least 20 micrograms of vitamin K, for strong bones.

• Lower levels of vitamin A. The multi should contain no more than 5,000 IU of vitamin A (that's 100% of the Daily Value), but at least 40% of this should be in the form of beta carotene (the label will say, for instance, 50% as beta carotene under vitamin A). Getting more than about 6,000 IU of vitamin A itself from food and supplements increases the risk of fractures in people over 50. Beta carotene is safe for your bones, though high doses (more than in a basic multi) may increase the risk of lung cancer in smokers.

• Look for up to 100% of the Daily Value of these minerals: copper, zinc, iodine, selenium (preferably from yeast, but not more than 200 micrograms ), and chromium (not more than 200 micrograms). Most multis also contain some magnesium.

• Most multis contain 100% of the Daily Value of vitamins C and E, but this may not be enough to provide their full anti-oxidant effects, especially for those who are physically active and exercise regularly. Make sure you get 250 to 500 milligrams of C a day, and that you get the additional C from fruits and vegetables, if possible. Recent research on the potential benefits of larger doses of vitamin E has yielded disappointing or conflicting results.

• Calcium is bulky, so a multi will contain only a small amount of it. Unless you consume enough dairy products, collards broccoli, fortified OJ, and salmon or sardines (with bones), you should take a separate calcium supplement. Everyone needs at least 1,000 milligrams of calcium a day from food and/or supplements. Women over 50 and men over 65 need 1,200 to 1,500 milligrams a day.

• Premenopausal women should look for 100% of the Daily Value of iron. In contrast, people with the genetic disorder hemochromatosis (who absorb too much iron) should avoid supplemental iron. Men and postmenopausal women need only 45% of the Daily Value, and may be better off with a multi containing no iron.

• More than 100% of the Daily Value isn't necessarily better. Higher doses of the B vitamins are okay, but large doses of copper, for instance, can interfere with the absorption of zinc, and vice versa. And large doses of vitamin A or zinc, for instance, can be dangerous.

• Take your multi with food. If it contains iron, don't take a calcium supplement at the same time, since iron interferes with calcium absorption.

• Words you don't need to see listed on the bottle: high-potency, senior formula, stress formula, starch-free, natural, or slow-release. Added ingredients such as enzymes, hormones, amino acids, PABA, ginseng, and other herbs serve no purpose and add to the price.

More Information
See our Vitamin Guide
More on Vitamin Supplements
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