Getting Your Vitamins?
Like most health information these days, there seems to be a great amount of confusion when it comes to vitamins. And rightly so — it can be challenging to know what to take, how to take them and why. Personally, it seems as though it’s a guessing game for most people and in turn, some people are taking full cocktails of pills daily, while others are skeptical to take any.
Why the confusion? True for any scientific matter, as we gain more evidence, what we believe changes. Take vitamin E, for example. In the ’90s vitamin E was touted as a miracle antioxidant that was protective against cardiovascular diseases and cancer and health experts advised everyone to take additional vitamin e along with their daily multivitamin. Recently, this information has been rescinded and the medical community has denounced any benefit of supplementing with vitamin e aside from the DRI (Daily Reference Intake) set by the Institutes of Medicine, even suggesting potential detrimental effects of extra supplementation. The latest information recommends focusing on naturally occurring vitamin E from foods such as nuts, seeds and vegetable oils, which has shown to be safe, effective and without the potential risks supplementation with vitamin E provide.
Another question about supplementation concerns the multivitamin. Is it a good or bad thing? While it's generally accepted a multivitamin can have its place in everyone's diet, by no means should it be insurance for healthy nutrition (no, you cannot eat a diet of fast food and revive yourself each day by taking a multi). There can be many ways a multivitamin can fall short. The first is in absorption. If you find a multivitamin with 100 percent of the DRIs, it does not necessarily mean you will be absorbing 100 percent of each vitamin.
There are a couple factors at work in absorption. When we look at vitamins, we basically break them down into two groups: the fat-soluble vitamins — A, D, E and K — and the water-soluble vitamins B and C. In order for the fat-soluble vitamins to be absorbed, bile, which is excreted from the liver, is needed to help absorb and store these vitamins. To initiate this process, some fat is needed to be eaten when these vitamins are taken to signal to the liver to excrete bile. Water-soluble vitamins are much more easily absorbed, but can just as easily be lost through excretion in the urine.
Then then we get to problems with competition for absorption. Think of it like a perfect situation for each vitamin: to be properly escorted and absorbed though the body, vitamin D and calcium need one another. That's why milk is fortified with vitamin D. However, calcium hinders the absorption of iron. Assuming you are taking a multivitamin with minerals as well, some vitamins aren't going to be absorbed fully. (If you are taking extra iron, you may want to note that iron needs vitamin C to be absorbed, so taking it with a glass of OJ can help). The bottom line here is to note proper nutrition can’t be found in a pill, even if what you take says it will provide you with 100 percent of the RDI. Quality, whole foods are needed to ensure your body gets enough of the essential vitamins and minerals. But as a back up, a multivitamin should always be taken with some food, preferably something with a little protein and fat, and a full glass of water.
The latest in dietary research brings attention to vitamin D. In 2007, Time magazine declared vitamin D one of the top 10 medical breakthroughs of 2007. An abundance of studies bringing forth the vital properties of vitamin D since then have surfaced. From nearly every type of cancer to common colds, autoimmune diseases, diabetes and heart disease, vitamin D seems to play a role in prevention, survival and recovery. It almost seems too good to be true, except in this case, the numerous amount of research backs this vitamin up. The Vitamin D Research Council (www.vitamindcouncil.org) does a great job linking published scholarly studies to the numerous diseases vitamin D has been studied with. The major problem with vitamin D, often referred to as the sunshine vitamin (since our skin can produce it from the sun), is that many, if not most of us, aren't getting enough.
"Its an evolving science," says Washington Center for Weight Management’s Jan Gagen, a nurse practitioner who has had her vitamin D levels tested and believes in supplementation. "Basically everyone is in agreement that most Americans are deficient."
The evolving question is: by how much? In light of strikingly convincing research supporting vitamin D, new standards are needed, as most scientists and practitioners believe the requirement currently set at 400 IUDs is significantly too low. Gagen currently takes between 4-5,000 IUDs daily.
"Looking at vitamin D and cancer research, it is ideal to stay above 50 ng/mL [of circulating vitamin D, known as serum 25-hydroxyvitamin D] to prevent against cancer and the reoccurrence of cancer," says Gagen. While normal ranges can start as low as 25-30 ng/mL and can be indicated through a simple blood test, it all depends on where you and your physician feel comfortable your level should be. In the meantime, supplementing your multivitamin with extra vitamin D seems to be the general consensus of the medical community. The Canadian Cancer Society was one of the first to issue a recommendation to all of its citizens in 2007 to take 1000 IUDs daily. The Institute of Medicine's Food and Nutrition Board has been reviewing the convincing data on vitamin D and plans to come with a report on vitamin D in summer 2010.
With all this new information, it is important to tell your primary care physician what you are taking and ask what you should be taking. Be sure to list off everything you take, even if you only take it occasionally. Supplements can powerfully influence nutrition and because we get them over the counter, we often think they can do little harm — this couldn’t be further from the truth! There are a variety of biochemical reactions that occur with each supplement you take and it can be easy to unknowingly take a supplement that acts against a medication. Certain vitamins like vitamin K should be limited and monitored to people on a blood thinner like coumadin (warfarin) due to its blood thinning properties. Other supplements like gingko can block absorption of certain medications, especially blood pressure medication, thus hindering their effects. Be cautious for every new supplement you take and check with your health care provider.
Looking to eat better? Check out our vitamin guide.