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Susan B. Dopart, M.S., R.D.

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Vitamin Supplements: A Quick Guide

Posted: 05/11/11 09:48 AM ET

Confused about which vitamins to take? You're not alone. With more choices, research and money at stake, we live in a time with a lot of controversy about the necessity of supplements.

Even prominent researchers have contradictory viewpoints. At the February 2011 American Society for Nutrition Advanced and Nutrition Controversies Conference, researchers were at odds over what's really essential.

Since nutrition is a young science and research is constantly evolving, there's more to come. But, here's what you need to know right now about which supplements are critical.

Vitamin D
Vitamin D is also known as the "sunshine vitamin," and its deficiency can lead to rickets or soft bones in children. In adults, the risk of deficiency is softening of the bone (osteomalacia) or bone loss (osteoporosis). Vitamin D helps the body absorb calcium and promotes bone mineralization.

Many health care professionals also see it as a protection against many forms of disease. According to V. Tangpricha, M.D., Ph.D. of Emory University of Medicine, more than 900 genes use vitamin D, and its deficiency can be associated with increased risk of cancer, diabetes, hypertension, heart disease and obesity.

In November 2010, the Institute of Medicine (IOM) , which is the health arm of the National Academy of Sciences, gave out recommendations for vitamin D. These recommendations rocked the science world as they seemed low compared to what most health care professionals were advising.

What some may have missed is that these levels were lower as they were recommendations for healthy populations. Previous guidelines recommending higher doses took into account those at-risk for health concerns like insulin resistance, diabetes and cancer.

If you don't take any other supplement, Vitamin D is the one not to ignore.

Levels of vitamin D are declining by 50 percent even in healthy populations due to low levels in our diet and avoidance of the sun. And, as obesity increases, so do stores of vitamin D since belly fat holds onto vitamin D and causes less of it to be available to the body.

The correct dosage to take each day depends on your blood values. A basic amount to start with is 1,000 IU per day. Although the IOM recommends 600-800 IU per day, this level may not be adequate to reach optimal levels for many individuals. The Endocrine Society has new guidelines coming out June 6, 2011, and it is predicted that they will recommend between 1,000-2,000 IU per day.

Fish Oil
Omega-3 fats are hot in the literature. Since the dry weight of our brains is 60 percent fat, omega 3-fats are critical for brain function. They also have a powerful anti-inflammatory effect in the body versus omega-6 fats, which are thought to be pro-inflammatory, thus working against the benefits of omega-3's.

A century ago, many of the omega-6 fats we know today -- like cottonseed and soybean oils -- did not exist. These seed oils require industrial processes for extraction, and are not a product of evolutionary diets. Today, they are common in processed or prepackaged foods.

The ratio of omega-6 to omega-3 fats 100 years ago was approximately 2-to-1. Recent estimates show our food supply has changed the omega-6 to omega-3 ratio to 20-to-1, which demonstrates how unbalanced our food intake has become.

In addition, how animals are fed depends on the types of fats we receive in our diets. When animals are fed grass, we receive higher levels of omega-3 fats. When they eat corn or grain we receive higher levels of omega-6 fats. Even organic meats and poultry are fed corn, making it difficult to consume enough omega 3-fats unless you eat wild fish several times a week.

The three types of omega 3-fats are ALA, DHA, and EPA. Just one tablespoon per day of ground flax seed provides your needs for ALA. Optimal amounts of DHA and EPA vary according to your age, level of health and medical issues. Since Western diets barely contain 100 mg. of either DHA or EPA, taking a supplement containing at least 500 mg. each of DHA and EPA is recommended.

Multivitamins
Research on the need for multi-vitamins has been disappointing at best. Unless you are eating below 1,500 calories per day or have a medical issue needing a certain supplement, you may not need a multivitamin. Since vitamin companies can be several years behind the research, here are some tips if you want to take a multivitamin:

1. Unless you are a woman of child-bearing age or are pregnant, iron is not necessary and may increase your risk of cardiovascular disease. Men of any age and women over 40 should make sure their multivitamin is iron-free.

2. Since most multi-vitamins contain at least 400 mcg. of folic acid, take them only 3 times per week, unless you are pregnant or are planning to get pregnant. There is so much supplementation of folic acid in foods that many individuals are receiving excessive amount of folic acid on a regular basis.

Although folic acid has been shown to lower levels of the amino acid homocysteine (where elevated levels are believed to cause narrowing and hardening of the arteries), research has not shown it to be helpful in preventing cardiovascular events. And, overdosing of folic acid can increase the risk of colorectal, breast and prostate cancers.

Over 60
If you are over 60, you may need a calcium supplement of 1,000-1,200 mg. per day, especially if your diet does not contain dietary sources of calcium. However, in August 2010 The British Medical Journal published a review of different studies looking at the outcome of women taking calcium supplements for risk of fractures and bone density. Surprisingly, they discovered women taking calcium supplements had an increased risk of heart disease, or more specifically heart attacks. In addition, they did not find any benefit from the supplements. Again, the recommendation for calcium is very individual.

Many are concerned about not having enough B12. With aging, a B12 supplement may be necessary since less B12 is absorbed with age due to inadequate amounts of stomach acids required for absorption of B12.

Where does all this information leave us?
The important point to remember is that vitamins over certain levels are shown to act like drugs. Many individuals take vitamins not knowing what amounts they are receiving or why they are taking them, putting them at risk for other issues.

The research is controversial, but solid evidence lies in taking at least Vitamin D and omega-3 supplements. Whether you need a multi-vitamin or other separate supplements depends on your age, health or medical situation, and your dosages should be tailored accordingly.

It is worth your while to have your medical or health status evaluated to know exactly what to take for your individual needs. Taking the same vitamins for years, or taking supplements without appropriate knowledge, can be problematic, so be responsible with respect to your needs.

Finally, when you think of supplements, think of the definition: things you take to supplement an already healthy diet full of nutrient dense foods, and not something you take as a substitute for an unhealthy diet.

Susan is the author of "A Recipe for Life by the Doctor's Dietitian." For more information, visit susandopart.com

 
 
 

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Confused about which vitamins to take? You're not alone. With more choices, research and money at stake, we live in a time with a lot of controversy about the necessity of supplements. Even promin...
Confused about which vitamins to take? You're not alone. With more choices, research and money at stake, we live in a time with a lot of controversy about the necessity of supplements. Even promin...
 
 
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03:24 PM on 06/23/2011
Thanks for sharing this article.Nice information about vitamins,minerals and
Organic multi vitamins .
03:47 PM on 05/14/2011
This is a press release rather than the paper from the conference, but looks very interesting, especially given the relatively low level of supplement used.

Study: Vitamin D could help fight hepatitis C
http://www.haaretz.com/print-edition/features/study-vitamin-d-could-help-fight-hepatitis-c-1.261432
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katmeyster
We don't have a spending problem.
02:17 AM on 05/14/2011
When my sister was diagnosed with MS, one of the first things they tested her for was Vitamin D deficiency -- which she had, as do many people diagnosed with MS. She was prescribed a high dosage immediately.

When I told my physician of her diagnosis, the first thing she tested me for was Vitamin D deficiency (along with other auto-immune markers) -- which I did not have, probably because I take 5,000 IU per day in the summer and 10,000 IU in the winter.

It is important.
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The Revolving Diet
Doing a Different Diet Weekly & Blogging about it
02:39 PM on 05/13/2011
I have been taking B12 for years. In winter I add Spirulina. I am alert and full of energy, rarely get a cold. If I happen to get a cold it's mild.

I had gotten on a vitamin craze years ago and I became very sluggish - too many vitamins that I didn't need. Check with your doctor before taking anything and if after it's prescribed/suggested, see how your body reacts. Your body is going to tell you if you should or should not continue.
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Waterphoneman
artist, musician, inventor & mouth from the south
02:18 PM on 05/13/2011
Since we are all different and at different stages of our life we need to each look at our weak health areas and take supplements that help the weak areas become strong. Granted there is nothing like a healthy diet but a healthy diet is very difficult to afford and maintain in our culture.
EvolveorPerish
R E anna what have you done?
01:19 PM on 05/13/2011
And I would add, a good probiotic would be something everyone should take. A healthy gut is the foundation for absorbing nutrition, whether from food or vitamins.
IMOPINIONH8D
because I want it empty...
10:46 AM on 05/15/2011
Thanks, you are correct.
11:34 AM on 05/13/2011
The amounts of omega 3 needed for good health depends on several factors, age, diet and state of health. The idea is to get closer to the ideal omega 6 / omega 3 of 1/1. Normally, this ratio is 20/1 or even 50/1, it depends of the amounts of omega 6 (basically, grains and grain oils a person ingests).

So, if you want to have a better control of the inflammation ( heart disease, high triglycerides, diabetes, arthritis, etc.) in your body and of the elasticity of all your cellular membranes, you should be pointing to a 1/1 ratio.

It varies with your diet. If you have a high omega 6 diet, with lots of grains, pasta, breads, cookies, starches and low in vegetables, fruits and omega 3 meats, you should take more than 6.000 mg per day of fish oil (1.800 mg of omega 3 fats, DHA plus EPA).

Read more at http://www.omega-3-fish-oil-wonders.com/omega-3-fatty-acids-dosage.html
02:11 AM on 05/13/2011
HORRIBLE article. Vitamin D is best absorbed through sun. But if their is ONE vitamin you should take it's vitamin k2. Only now are scientists understanding how this super vitamin that used to be present in our food, but isn't due to denaturing, pasteurization, and other processes, is super vital. Google it. Oh and studies have shown multi vits are largely useless and ppl who don't take em are actually healthier.
02:59 AM on 05/13/2011
and when was the last time you exposured a significant amount of skin to the midday sun. For vitamin d the sun must be high in the sky, before 10:00 and after 3:00 will not do, neither will the winter, not when there is snog, fog or cloud. It also has to be direct sunlight not through glass.
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jgarma
05:08 PM on 05/12/2011
The answer posed by this article has many answers. Ask various health practitioners and get various answers.

It would seem that there is no one answer for everybody, although the author makes a good case for vitamin d, etc. being useful for most of us.

To get a basic level understanding of what inputs are needed to get healthy, I encourage a listen to Kevin Rose's interview of Dr. Andrew Weil on the subject: http://wp.me/pA04z-pB

If you'd see Dr. Hyman's list of four supplements that help reduce health care cost, read this: http://wp.me/pA04z-yn

But, as mentioned, would be a good idea to know if you're deficient in any particular vitamin. One relatively cheap way to do this is to have your hair analyzed. This article will set the stage for that:
http://wp.me/pA04z-4F
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Wil80
Ask not for what your Country can do for you.....
02:07 PM on 05/12/2011
If we had to eat all the foods from the food pyramid each day along with all thee oter foods necessary for vitamin efficiency we would do nothing buy eat all day long. How much of those viamins do we loose each day by having that can or two of beer or two glasses of wine for heart health.
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aligatorhardt
Cut on the bias
12:13 AM on 05/13/2011
The food pyramid is a marketing tool created by the Meat and Dairy Association.
10:27 AM on 05/13/2011
No it was designed to fit more on the plate.
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katmeyster
We don't have a spending problem.
02:11 AM on 05/14/2011
Actually agriculture and grain producers have had a larger influence than meat and dairy.
12:45 PM on 05/12/2011
Read your article with great interest. Don't agree with people getting enough vitamins from food due to deteriorating soil. A scientist testifying before Congress 30 years ago stated "a bunch of carrots grown in today's soil has the nutritional value of a toothpick". I would like for your readers to know that I have been on a multi vitamin and mineral product that has 135 whole food based ingredients with all the goodies such as vitamins, minerals, amino acids, antioxidants, greens, acai, noni, goji, mangosteen and tastes great. And it's very reasonably priced. http://www.passion4lifevitamins.com/articles_whyliquidvitamins.html
12:18 PM on 05/12/2011
As a pharmacist I am faced with choosing the right vitamin for patients all the time. I am grateful for all information that can help improve patients health. And I do believe in vitamins and supplements. They have to be great quality and they need to given for a reason.

Inna@ http://www.gluten-free-today.com/
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aligatorhardt
Cut on the bias
12:14 AM on 05/13/2011
Belief is great in church, but nutrition is a science.
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limanecasimi
10:44 AM on 05/12/2011
Have you ever seen a plantain in the produce section of your local supermarket and wondered how to cook it? Here's a fried plantain recipe.
http://sweetcoconuts.blogspot.com/2011/04/what-is-your-favourite-haitian-food.html
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frank day
Obama cares about all of U.S.
09:13 PM on 05/12/2011
Any recipes for Thai Fish in Oyster Sauce?
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seehowtheyrun
Without music, life would be a mistake
07:11 PM on 05/14/2011
Thanks. I love Plantains. See in the grocery store all the time.
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Cayce58
10:18 AM on 05/12/2011
Magnesium deficiency symptoms similar to ADHD. A teaspoon of epsom salts(magnesium sulfate) will tell you if a child's behavior is due to one or the other.
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Gregory Ashby
the health maestro
02:29 PM on 05/12/2011
Bad choice of Magnesium unless the child is really deficient in magnesium otherwise all you get
is diarrhea. A liquid trace mineral or powered magnesium will absorb much more.
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frank day
Obama cares about all of U.S.
09:13 PM on 05/12/2011
Epsom salt is nasty.
10:09 AM on 05/12/2011
I can personally attest that my husband almost died from lack of Vitamin D and it is THE ONE vitamin to take if you do not want to get into a load of pills!!! Absolutely....Vitamin D is beyond essential! The change in his appearance in just a few weeks was astounding. Please, do yourself a favor and have your doctor check your Vitamin D level and get a supplement if needed. It will same your appearance and your life!!!
12:24 PM on 05/12/2011
I was feeling really bad and the doctors insisted there was nothing wrong with me. I thought I would just fall over and die and had no clue as to why I felt so bad. I went to a new doctor and she checked my vitamin D level and it was 11. I started taking 5000 a day and I am starting to feel much better. I think I still have a ways to go, but this is for sure a big change in how I feel.