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What to look for in a multivitamin . . .

mackfactor Posts: 766 Joined: 2002/10/17

2003/02/10, 12:39 PM Not often asked enough. Posted on another message board by coulditbe: Are You Taking the Right Multivitamin? The wrong multivitamin could leave you open to depression and illness. Find out if you're safe! by Colleen Pierre, RD Are you taking a daily multivitamin? Good, because there's accumulating evidence suggesting that daily multis can make a healthy difference in your life. In Harvard University's Nurses' Health Study, for example, women who took multis for 15 years had 75% less risk of colon cancer (Annals of Internal Medicine, Oct 1, 1998). I advise everyone I counsel to take a daily moderate multi, containing about 100% of the DV for most vitamins and minerals. Although a multi is no substitute for a good diet, I believe it's sensible nutrition insurance. Yet when many clients first come see me, I discover that the specific multi they're taking is wrong for them: one that may not deliver the nutrients they especially need and, in some cases, can actually be a barrier to better health. By taking this quiz, you'll know how to avoid the common mistakes my clients make and how to choose the healthiest multi for you. Absorption For your multi to work properly, it must: A. Disintegrate quickly B. Dissolve completely C. Be timed-release D. All of the above Answer: A and B, disintegrate quickly and dissolve completely. Did you answer C, timed-release? Although that sounds like a great idea, drug studies suggest that timed-release supplements might really shortchange you on folic acid, a vitamin critical to preventing birth defects and possibly for reducing heart disease and colon cancer. "Folic acid is absorbed high in the small intestine, just after it leaves your stomach," says Stephen Hoag, PhD, at the University of Maryland School of Pharmacy in Baltimore. That means that folic acid that's released later has missed its window of opportunity and won't be absorbed. A and B are correct. In order for that pill you're swallowing to pass through your intestinal walls and get into your bloodstream, your stomach first churns away, causing the pill to disintegrate, or fall apart in small pieces. That disintegration allows the nutrients to dissolve in your stomach acids and get absorbed in your small intestine. In just-completed studies of several multis, Dr. Hoag learned that multis that disintegrated quickly were the ones that also dissolved and delivered. Quick Tip: To see if your multi disintegrates quickly, says Dr. Hoag, drop it into 1/2-cup of vinegar. Stir gently every now and then. In 20 minutes, your vitamin should be completely separated into tiny pieces. If not, choose another brand. Men & Iron If you're a man, how much iron should your multi have? A. 0% of the DV B. 50% of the DV C. 100% of the DV D. 150% of the DV Answer: A, 0% of the DV (or, at the most, B, 50% of the DV) Iron is essential for red blood cell formation. But men usually get all they need, because they're bigger than women and eat more food, especially meat, poultry, and fish that contain the best-absorbed type of iron (called heme iron) and lots of iron-fortified bread and cereals. So unless a man has been diagnosed with anemia, there's no reason to take extra iron, according to David Baker, PhD, a nutrition researcher at the University of Illinois in Urbana-Champaign. "It's pretty easy to absorb iron," he adds, "but very hard for a man to get rid of it after he's got it." Another group who needs less iron is women over 50, who should look for a multi with 0 or 50% of the DV for iron. Once a woman stops menstruating and losing blood each month, she normally loses very little iron. What's wrong with getting more iron than you need? Too-high iron intakes can cause constipation and other gastrointestinal problems and might cause oxidation of LDL cholesterol, increasing heart disease risks. Also, about 1 in 300 people of Northern European descent carry the HFE (C282Y) gene for hemochromatosis, which triggers excessive iron accumulation and can lead to liver, heart, and pancreas damage. A simple, but rarely performed, blood test for serum ferritin levels can help identify the problem. Best Copper Combinations The type of copper in your multi should not be: A. Copper sulfate B. Cupric sulfate C. Copper oxide D. Copper gluconate Answer: C, copper oxide Copper and cupric mean the same thing, and you can find a variety of combinations such as sulfate and gluconate that work just fine. But copper oxide (or cupric oxide) is the densest form packed in a pill, and your body absorbs very little of it, according to Dr. Baker. It's also the most commonly used form. Dr. Baker's research suggests that many people aren't getting enough dietary copper, which is needed for healthy immune systems and joints, red blood cells, and heart function. To make matters worse, zinc and copper are absorbed through similar mechanisms, so if you take a supplement packed with well-absorbed zinc and poorly absorbed copper, you can aggravate a copper deficiency, possibly weakening your immune system. And here's a surprise: You can't rely on a brand name. One brand's "50 Plus" version that we found contains cupric sulfate, while their "Active" version contains cupric oxide. Go figure; then go read the ingredients list. Good food sources of copper are seafood, nuts, seeds, wheat bran cereals, and whole grain products. Don't worry about the other oxides in your multi, such as magnesium or zinc. They're absorbed just fine. Copper oxide is the exception. Women of Childbearing Age Women of childbearing age, it is critical that your multi has: A. 100% DV for vitamin A B. 100% DV for calcium C. 100% DV for iron D. 100% DV for folic acid Answer: D, 100% DV for folic acid. This one is official: The Institute of Medicine, Centers for Disease Control and Prevention, and the March of Dimes all agree that any woman who could possibly become pregnant should be getting 400 micrograms (mcg) of folic acid daily-before she becomes pregnant. And they say she should get it from a supplement or fortified food-because the synthetic form is much better absorbed-along with another 400 mcg from folate-rich foods such as orange juice, broccoli, asparagus, and legumes. Studies have found that this amount can prevent neural tube birth defects, which happen in the first month after conception. But just because your supplement says it has 400 mcg of folic acid, how do you know it's actually in there? Women Over 50 Over 50, make especially sure that your multi has: A. 100% DV for thiamin B. 100% DV for vitamin B12 C. 100% DV for vitamin C D. 100% DV for vitamin D Answer: B and D, 100% DV for vitamins B12 and D. After age 50, the rate at which your stomach makes hydrochloric acid, which is needed to digest protein and release the attached vitamin B12, slows down in about 10 to 30% of us. That's enough so that, on paper, your diet may look like you're getting lots of B12 from meat, but your digestion isn't delivering what you need. Over time, that can lead to vitamin B12 deficiency, causing neurological problems that often show up first as memory loss and depression. Helen Rasmussen, RD, of Tufts University in Boston. "We did a lot of work with lab-created B12, and we know it's better absorbed than what you get from food." The Institute of Medicine now advises adults over 50 to get the Recommended Dietary Allowance (RDA) of vitamin B12 from a supplement or fortified food. Then there's your skin. The pace at which it converts sunshine to vitamin D, which is absolutely necessary for getting calcium into your bones, continues to wind inexorably downhill from its youthful vigor, so that at age 50, you start needing help. "The skin cells of 80-year-olds don't have the same capacity to synthesize vitamin D as those of children," explains Rasmussen, who recommends getting your vitamin D from a multi. Between 51 and 70, you need 100% of the DV for vitamin D, or 400 IU. After age 70, you need 150% of the DV, which you probably won't find in a multi. Look for a separate D supplement or calcium supplement that will supply you with the extra 200 IU, but consult your doctor to make sure you're not getting too much. Vitamin D can be toxic in high doses. Pregnant Women True or false: If you're taking a prescription prenatal vitamin, you can assume it's complete with all the nutrients you need. Answer: Amazingly enough, false. All prescription prenatals are not alike nor are they complete as your multi, as Prevention fitness editor Michele Stanten found out after she became pregnant. The second time she had her prescription filled, she asked the pharmacist for the nutrient breakdown. The big surprise? Except for iron, there were no other minerals present, including zinc, which is needed in higher amounts during pregnancy for the fetus's growth and development. "Even my obstetrician didn't know what was in it!" Stanten says. "Any supplement designed for pregnant women should contain zinc," says Myron Winick, MD, professor emeritus of nutrition at Columbia University College of Physicians and Surgeons in New York City. Also of concern in a prenatal vitamin are the B complex vitamins (B6, B12, and folic acid), which are critical for brain, spinal cord, and nerve development, and iron for blood and tissue development. So check out the multi your obstetrician prescribes to be sure it's well balanced. Getting enough vitamin A (5,000 IU) early in pregnancy is critical for baby's development. But too much(more than 10,000 IU) of what's called "preformed vitamin A" can lead to birth defects. To avoid exceeding the limit, add up the IUs of preformed A in any supplement you use, plus what's in any fortified foods (often including milk, cheese, and margarine). To ferret out preformed A, check ingredients lists for vitamin A palmitate, vitamin A acetate, vitamin A esters, retinal acetate, or retinal palmitate. They all count toward reaching the Safe Upper Limit of 10,000 IU. Don't worry about getting too much A in the form of beta-carotene. Your body eliminates what you don't need. Smokers Smokers, make sure your multi includes A. Extra beta-carotene B. Extra vitamin C C. Extra vitamin E D. Extra vitamin B6 Answer: B, extra vitamin C. Yes, it's true; smoking burns up the antioxidant vitamin C. In fact, among people who get the same amount of vitamin C, blood levels are lowest in smokers, highest in nonsmokers. That's why the new RDAs call for smokers to get extra vitamin C to help maintain your especially crucial levels of cancer-fighting antioxidants. To meet the new RDA requirements for smokers, women need a multi with about 150% DV for vitamin C; men need a multi with about 200% of the DV for vitamin C. Great food sources of vitamin C are juicy oranges, tangerines, and grapefruits, luscious berries, and melons. Did you answer A, extra beta-carotene? Be careful. In two major studies, high doses of beta-carotene actually raised lung cancer risks for smokers instead of lowering them, according to Robert Russell, MD, chairman of the panel that set the RDA for vitamin A, of which beta-carotene is a precursor. What should smokers do? Stop smoking, and limit beta-carotene supplements to 5 mg/day or less. "It appears that beta-carotene supplements are only risky at high levels," says Dr. Russell, "but the problem is, we don't know exactly how high." Quick Tip: There's one nutrient smokers need more of-and one they should avoid in high doses at all costs. Want More Energy? Some of my clients think that multis with high levels of B vitamins or extra antioxidant vitamins C and E will give them more pep. The truth is, neither extra antioxidants nor high levels of B vitamins has ever been shown to increase energy. Unless you're diagnosed with iron deficiency anemia by a blood test, don't expect a multi with extra iron to fire you up either. For more energy, I tell my clients to get more sleep, build in some playful downtime, eat healthy, balanced meals, and get a moderate amount of exercise. It works wonders! How to Pick a Perfect Multi Look for a good multi supplement to have close to 100% of the Daily Value (DV) for most vitamins and minerals-with important exceptions. Some people actually need more or less than the DV for certain nutrients; we list those exceptions in red. And don't expect to find a multi with 100% of the DV for everything. No multi has that much calcium, magnesium, or potassium, so we suggest how much to look for. Tempted to take higher levels? With exceptions noted below, Prevention does not recommend this practice. But if you do take more than the DV for any nutrient, we've also listed the Safe Upper Limit. Always stay under this level to avoid harmful or unpleasant side effects. Vitamin A Needed for healthy eyes and skin · 100% Daily Value: 5,000 IU · Safe Upper Limit: 10,000 IU Vitamin C Helps keep immune system strong. (Consider taking 100 to 500 mg extra.) · 100% Daily Value: 60 mg Smokers: You need about 200% of the DV, or 120 mg--and stop smoking · Safe Upper Limit: 2,000 mg Consider taking 100 to 500 mg vitamin C. Some multis contain extra C, or you may need a separate supplement. Vitamin D Makes it possible for you to absorb calcium from your food · 100% Daily Value: 400 IU Over age 70: Take an extra 200 IU in a separate supplement. · Safe Upper Limit: 2,000 IU Vitamin E Squelches free radicals that foster heart disease · 100% Daily Value: 30 IU · Safe Upper Limit: 1,500 IU natural;1,100 IU synthetic Consider taking 100 to 400 IU vitamin E. Some multis contain extra E, or you may need a separate supplement. Vitamin K Essential for your blood to clot · 100% Daily Value: 80 micrograms (mcg) · Safe Upper Limit: 30,000 mcg Thiamin Helps turn carbohydrates into energy · 100% Daily Value: 1.5 mg · Safe Upper Limit: 50 mg How to Pick a Perfect Multi (continued) Riboflavin Needed for energy production in all your cells · 100% Daily Value: 1.7 mg · Safe Upper Limit: 200 mg Niacin Helps your body use sugars and fats · 100% Daily Value: 20 mg · Safe Upper Limit: 35 mg (unless by prescription) Vitamin B6 Used in making antibodies that fight infection · 100% Daily Value: 2 mg · Safe Upper Limit: 100mg Folic acid Critical for making perfect DNA in new cells · 100% Daily Value: 400 mcg · Safe Upper Limit: 1,000 mcg Vitamin B12 Keeps nerves healthy · 100% Daily Value: 6 mcg · Safe Upper Limit: 3,000 mcg Iron Part of red blood cells that carries oxygen to your body · 100% Daily Value: 18 mg Postmenopausal women and all men: 0-8 mg · Safe Upper Limit: 45 mg Iodine Part of a thyroid hormone that regulates rate of energy burn · 100% Daily Value: 150 mcg · Safe Upper Limit: 1,100 mcg Zinc Important for a strong immune system and wound healing · 100% Daily Value: 15 mg · Safe Upper Limit: 40 mg Selenium Helps knock out free radicals that may cause cancer · 100% Daily Value: 70 mcg · Safe Upper Limit: 400 mcg Copper Needed for healthy blood vessels and immune system · 100% Daily Value: 2 mg (not as copper oxide or cupric oxide) · Safe Upper Limit: 10 mg Chromium Works with insulin to help your body use blood sugar · 100% Daily Value: 120 mcg · Safe Upper Limit: 1,000 mcg Supplements The following supplements are unavailable 100% in single multis. Here's what to look for: Calcium Helps make strong bones; fights high blood pressure · What to look for: About 100 mg · Safe Upper Limit: 2,500 mg Consider taking 500 mg calcium as a separate supplement up to age 50. Over 50, consider taking 700 mg separately-but not more than 500 mg at a time for best absorption. Magnesium For strong bones, healthy nerves and muscles · What to look for: About 100 mg · Safe Upper Limit: 350 mg Potassium Helps fight high blood pressure · What to look for: About 40 mg · Safe Upper Limit: 99 mg (unless by prescription) How to Give Your Multi a Checkup An independent testing agency, ConsumerLab.com, recently evaluated 27 multivitamins to check disintegration, lead contamination, and folic acid, calcium, and vitamin A content. One-third of the pills tested failed and remain nameless, including one prenatal vitamin that delivered only 75% of the folic acid it promised. But for $5.25, you can get the list of those that passed. $15.95 buys you a year's subscription to all their tests. Visit their site. http://www.consumerlab.com/results/multivit.asp To view the complete review on this site, they require you to sign up for a fee. ---------------------------- "Don't follow leaders and watch your parking meters!" -- Bob Dylan