One per day is fine; Food supplies the rest?

Question: YOU HAVE STATED THAT A MULTI VITAMIN SHOULD BE AT LEAST 2X’S PER DAY FOR BETTER PROTECTION REGARDING THE WATER SOLUBLE VITAMINS. A VERY WELL KNOWN NUTRITIONIST SAYS THAT ONCE A DAY IS FINE, BECAUSE THE CONSUMER SHALL OBTAIN THE VITAMINS FROM HIS FOOD. WHAT’S YOUR TAKE?

Answer: There are several reasons why I think your “well known nutritionist” is providing you with poor advice.

First, my reasons for preferring a “two per day” multivitamin or B-complex over a “one per day” formulation are very simple. For one thing, the water-soluble vitamins will be excreted within a half day, so logic dictates that maximum benefit will be obtained if they are taken at least twice a day. In addition, you can fit more into two tablets than one. So a “two per day” formulation has the capacity to provide a more comprehensive or broad spectrum of nutrients.

Second, to say that your vitamin supplement needs are minimized due to the fact that you get the nutrients you need through diet is fine in theory, but clearly not true in real life. I recently commented on this on our radio show (The Willner Window, WOR (710 AM in NY) and WGKA (920 AM in Atlanta)). Here is an excerpt:

Don: There were some very interesting studies published in the last couple of weeks, and I think they tell an important story. As you know, the value of nutritional supplementation remains a matter of controversy, at least in the minds of some people. There are those who jump at every possible opportunity to downplay the value, even the advisability of taking vitamins supplements. So let’s look at some research.

Sam: First, there was a study issued by the Centers for Disease Control and Prevention. It was a comprehensive nationwide behavioral study looking at fruit and vegetable consumption. They found that only 26 percent of the nation’s adults eat vegetables three or more times a day.

These results fell far short of health objectives set by the federal government a decade ago. The amount of vegetables Americans eat is less than half of what public health officials had hoped. Worse, it has barely budged since 2000.

“It is disappointing,” said Dr. Jennifer Foltz, a pediatrician who helped compile the report. She, like other public health officials dedicated to improving the American diet, concedes that perhaps simply telling people to eat more vegetables isn’t working.

“There is nothing you can say that will get people to eat more veggies,” said Harry Balzer, the chief industry analyst for the NPD Group, a market research company.

His company released the 25th edition of its annual report, “Eating Patterns in America.” The news there wasn’t good, either. For example, only 23 percent of meals include a vegetable, Mr. Balzer said. (French fries don’t count, by the way, but lettuce on a hamburger does.) The number of dinners prepared at home that included a salad was 17 percent; in 1994, it was 22 percent.

Don: There was more, but I want to stop with that, and make the following point. Why did we start off with this study? Because it shows the reality of the situation. Critics of vitamin supplements usually state, as part of their rant against taking supplements, that all you need to do is eat well balanced meals, properly prepared, with the recommend amounts of fruits of vegetables.

That’s very nice. And it is a noble and proper goal. But the fact is that most people do not do it. Forget the reasons for the moment. Whatever the reasons, they just do not do it, and these are not the first studies that confirm this fact!

So, if we accept the facts, and accept the reality of the situation–that telling people to eat a balanced diet has been proven not to work, what is so bad about taking multivitamin supplements as one way of compensating for this? No one is saying–certainly not me–that taking vitamin and mineral supplements is better than eating good food.

But if food is good for you, if fruits and vegetables are good for you, than how can supplements that contain the active constituents of fruits and vegetables not also be good for you?

Sam: Good point, Don. At the same time, of course, there is a steady stream of studies that show the value of nutritional supplements. Not every study is positive, but most of them are. Not every study is one that stands up to the highest levels of scientific scrutiny, but many of them do. Of course, if you follow the news, you know that the same can be said for studies on pharmaceuticals and drugs as well, unfortunately.

Here is a recent example. According to the authors of a study published in the journal Public Library of Science One, “We have shown that treatment for two years with B vitamins markedly slows the accelerated rate of atrophy in people with mild cognitive impairment.”

The researchers claim their findings could be the first step towards finding a way to delay the onset of Alzheimer’s.

Don: Stop right there, Sam. I wanted to bring this study to your attention not because we want to talk right now about Alzheimer’s disease. Nor do I want to delve into the details of this study–the fact that they followed 168 people for over two years, that those taking the vitamin supplements had on average 30 to 50% less brain atrophy, the role of homocysteine, etc.

Instead, I want to make a more important point. Here is one more study indicating, at the very least, that various vitamins might be beneficial to your health and/or the prevention of disease, even in ways greater than food. There are a constant stream of studies like this. How many do we need, regardless of their quality, to start to conclude that “well, the benefit seems likely, even if not proven beyond any doubt, and the cost is relatively small. Why not do it?

Sam: At some point, you have to rely on common sense. Do you really need absolute proof that everything works for everything you do, before you do it? Of course not. There are few things in life that are absolute.

Everybody should take a multivitamin and multimineral supplement. Doctors know this. Nutritionists know this. And that is why surveys show that they do take supplements–in spite of what they might say in public.

Don: Now, those of you who listen to this program on a regular basis know that when we say there is a steady stream of research showing the value of vitamin and mineral supplements, we support that claim by reporting on those studies. I’m sure there are some people listening who are new, and think we are just saying this. Well, we just mentioned the study showing that B-vitamins seem to slow the onset of mild cognitive impairment. Let’s tell you about another recent study on B-vitamins. Sam?

Sam: OK, Don. In a prospective, population-based study involving data collected from 31,671 women with no history of cardiovascular disease and 2,262 women with a history of of cardiovascular disease , between the ages of 49 and 83 years, use of multivitamins was found to be associated with a reduced risk of myocardial infarction. Furthermore, using multivitamins for at least 5 years was found to be associated with a significantly greater reduced risk. The authors conclude, “The use of multivitamins was inversely associated with myocardial infarction, especially long-term use among women with no cardiovascular disease.” This study was published in Am J Clin Nutr, 2010 Sept 22

OK, I hope we have made our point. I guess we are trying to get you to focus on what is really important. Don’t be distracted by details that prevent you from properly appreciating what is really important. Don’t fail the see the forest for the trees.

Don: The same can be said for herbs, by the way, and if we have time, I will expand on that at the start of the second hour, using a new study about cranberry and prostate cancer as my example.

The argument that supplementation is unnecessary is even less valid, of course, when you are talking about using supplements as therapeutic agents. Preventing a vitamin deficiency is one thing, and should be easily achieved in the United States with a proper diet. Preventing a sub-clinical deficiency may not be so easy. And reaching therapeutic levels through diet alone is most likely impossible.

Don Goldberg

About Don Goldberg

Hello. I am what you might call a Nutritional Pharmacist. After college, I worked in the Pharmaceutical and Nutritional Industry, first in Quality Control, and then in Manufacturing and Product Development. Increasingly, as the years passed, I became more involved with nutritional supplements. I spent many years detailing physicians, herbalists, and homeopaths about nutritional and herbal therapies and products. In 1992, along with my friend Arnie Gitomer, I bought Willner Chemists, a well-established nutritionally oriented pharmacy. For the first time, I had an opportunity to communicate directly with the consumer, the patient, and the customer. I love it. This blog is an additional way for me to extend my personal views and opinions directly to you. You can also hear me on the radio, every Sunday, from 2 to 4 pm on WOR radio in NY (710 AM), or WGKA in Atlanta (920 AM). Or check our website, www.willner.com.
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