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The Multivitamin Myth

by Brett Hall, RD

There are literally hundreds of thousands of biochemical reactions taking place in our bodies every second of every day. These reactions are the stuff of life...the processes that keep our heart pumping, our brains thinking and our muscles moving. Each and every one of these reactions has one thing in common – they ALL rely upon the assistance of vitamins and minerals. Without vitamins and minerals in our system to act as cofactors and catalysts for these life-giving reactions we would be no more than lifeless lumps of tissue. Suffice it to say, maintaining a proper balance of vitamins and minerals in the body is one of the very first and most important steps you can take in your quest for vibrant health and a fit physique.

Why Use a Multivitamin?

One of the most common questions I hear regarding multivitamin supplements is, "Isn’t a properly balanced diet of whole foods sufficient to provide the vitamins and minerals our bodies need?" Well, if we were asking that question 200 years ago the answer probably would have been 'yes'. At that time our agricultural process was in a much more natural state. Crops were raised in low-lying valleys and flood plains that were naturally irrigated by nearby water sources and prone to seasonal and cyclical flooding. This flooding, while inconvenient to the farmers at times, served a vital purpose. It insured that the soil remained robust and fertile by depositing large amounts of mineral laden silt in the valleys during each flood. Mineral density in topsoil (along with nitrogen content) is of utmost importance when assessing the health of that topsoil and its ability to raise healthy, vitamin and mineral rich fruits and vegetables. (Fruits and vegetables can only produce vitamins with the assistance of plentiful levels of minerals. Therefore, if the mineral content of the soil is rich the plants will also be able to produce robust levels of vitamins).

So, as you can see, 200 years ago the combination of small scale farming with the natural flooding cycle, the use of natural crop rotation techniques and natural manure fertilizers ensured a steady supply of sustainable, mineral and nitrogen rich topsoil. This in turn produced hardy, healthy fruits and vegetables bursting with vitamins and minerals. In that era a balanced diet of plentiful fruits and vegetables would indeed have supplied sufficient levels of vitamins and minerals for optimal health.

However, times have changed – and the soil we grow our foods in has changed with the times. And not for the better I'm afraid.

With the advent of the industrial revolution came the need and desire for agricultural production on a massive scale. In order to accommodate this production rivers were damned to control flooding, "dry land' farming was begun (where farms were created in arid areas, relying on man-made irrigation), crops were no longer rotated, and chemical fertilizers began to replace natural fertilizers. The end result…our nations topsoil suffered tremendously.

Within 20 years this type of mass production farming had caused such damage to the vitality of our topsoil that in the year 1936 a statement was issued as "A Warning to the American People” by top nutrition experts within the United States Senate Committee. Here is an excerpt from that statement entitled Document #264:

"The alarming fact is that foods (fruits, vegetables and grains) now being raised on millions of acres of land that no longer contain enough of certain minerals are starving us - no matter how much of them we eat. No man of today can eat enough fruits and vegetables to supply his system with the minerals he requires for perfect health because his stomach isn't big enough to hold them."

That was almost 70 years ago. More recently at the Earth Summit meeting in 1992 the following statistics were presented.

"The mineral content of the world's farm and rangeland soil has decreased dramatically. Percentage of Mineral Depletion from Soil During The Past 100 Years, By Continent:"

From these statistics it is abundantly clear that the fruits and vegetables we find in our supermarkets today simply aren't the rich source of vitamins and minerals they once were. That being the case, it would be difficult for even the most diligent among us to meet our vitamin and mineral needs through a whole food diet…even if we religiously follow the USDA Guidelines and consume 9 servings of fruits and vegetables per day. And if you do this on a daily basis, you are far more conscientious about your diet than 99% of Americans.

For this reason, vitamin and mineral supplementation becomes important in order to assure proper daily intake and body balance of these vital nutrients.

The RDI...Is It Enough?

How do we know how much of which vitamins and minerals to take when and why? These questions can seem a bit overwhelming. Most of us simply don’t have the time, training or inclination to research this topic. Therefore, if we decide to take vitamins at all, we typically just go for the ones that are most convenient and recognizable. Maybe we try a Centrum™ One-a-Day, and we figure because it says it “covers your core vitamin and mineral needs” and lists 100% of the RDI (Recommended Daily Intake) on the label that it must be what we need. But that’s probably just not the case.

Let’s start with a quick explanation of the RDI, and why this "recommendation" may leave your body lacking. Did you realize that before 1941 there was no such thing as an established RDI? That’s right; no one really understood the incredible importance of these nutrients until very recently. Only when foot soldiers in World War II, being sustained solely on vitamin and mineral-poor “K-rations” for extended periods of time, began to become sick and even die due to malnutrition did scientists start looking at the biological necessity of vitamins and minerals in earnest. This group of scientists was directed by the U.S. Food and Nutrition Board to establish human vitamin and mineral needs to avoid deficiencies. This research is what led to the establishment of the RDI.

The RDI is defined as:

"The levels of intake of the essential nutrients that, on the basis of scientific knowledge, are judged by the Food and Nutrition Board to be adequate to meet the known nutrient needs of practically all healthy persons."

What this means is the RDIs were established to avoid deficiency syndromes, not to promote optimal health. We'll discuss optimal health levels shortly. But first let’s look at one other set of guidelines the FDA has recently established regarding vitamins and minerals.

In 2001 the FDA created a recommendation for “Upper Limit” (UL) intakes. This is the upper level of intake considered to be safe for use by adults. By "safe" the FDA means that intakes over and above this level, taken consistently over long periods of time, could cause side effects due to a toxic build up of the nutrient in your body.

Below is a chart showing the current RDI and the UL based on vitamins and minerals respectivly.

ND = Not Determined

What are Optimal Vitamin and Mineral Intake Levels?

This is a tricky question, and one that has been a topic of heated debate among nutrition professional for decades. It’s much like asking a bunch of tech geeks, “What’s the best computer on the market?” At first they’ll look at you kind of cross-eyed, and then the barrage of qualifying questions will begin. “Are you going to use it for graphic design or more for office functions…to play video games or write a novel…to surf the internet or process complex calculations…to program software or store music? Are you interested in ultimate virus protection, a stable platform, compatibility with other machines? How much can you spend? Do you travel or is a desk top okay, etc.?” The computer that is best for you depends upon how you live, your goals for use of the computer, your budget and a myriad other nuances. Not to mention the fact that technological advancements are literally taking place daily. Just when you’ve settled into your new computer, it’s behind the times due to some new discovery or application.

As it is with computers, so it is with vitamins and minerals. The levels you need are quite dependent upon your lifestyle, your diet, your exercise regimen, your goals. And…new discoveries about the value and functions of vitamins and minerals are being made regularly. Recommendations do, and will continue to, change as new discoveries are made.

All of that said it is possible to quantify a range of what could be considered optimal vitamin and mineral intake levels. However, the establishment of these optimal intake levels must be based on the latest science available, and certain qualifying factors need to be considered.

One of the most important of these qualifying factors is your activity level. Your level of physical activity plays a larger role than you might think. Let’s take a look at the facts.

Do Active People Need More Vitamins and Minerals?

As we just discussed, the RDI for vitamins and minerals is just enough to keep the typical healthy person from becoming deficient. But what if you’re not the typical healthy person? What if you are a dedicated fitness buff? What then?

By "fitness buff" I mean you aren’t the typical sedentary American couch surfer. You have an interest in making regular, rigorous exercise an ongoing part of your life by consistently working out 3 to 5 times per week, for 30 to 60 minutes, at a moderate to intense level. If this sounds like you, then consider yourself a fitness buff.

Okay, so for you fitness buffs, while it is well understood that consistent exercise is the single best thing you can do for your body, it’s important to know that exercise can almost double your body’s usage of certain vitamins and minerals.

Multiple research studies have shown that as physical activity increases so does the demand for a variety of vitamins and minerals, including – thiamin, riboflavin, vitamin B-6, vitamin B-12, vitamin E, and zinc.^1-5 Whereas a sedentary individual may get by on the RDI, an active person may actually develop deficiency symptoms on the same vitamin and mineral intake level. Even if true deficiency never presents itself, there is a good chance that without supplementation of the proper vitamins and minerals, body stores of the fitness buff will become marginal, thus effecting bodily functions in subtle ways.

Signs, Symptoms & Risks of Marginal Vitamin and Mineral Deficiency

Because vitamins and minerals play such an active and crucial role in virtually every biological process taking place in your body even marginal deficiencies can have widespread effects. These include both short-term symptoms and long-term health risks. To help you ascertain if you may be marginally vitamin and/or mineral deficient the following is a list of both short-term symptoms and long-term risks associated with some of the more common vitamin and mineral deficiencies.

The group of B-Vitamins (including Thiamine, Riboflavin, Niacin, B6, Folate, B12, Biotin and Pantothenic acid) are integrally involved in the function of nerve cells, production of hormones, neurotransmitters, muscle proteins, and red blood cells, energy production, and much more. Demand for B-Vitamins increases greatly with exercise. Early deficiency symptoms might include:

• Short-term Symptoms: Fatigue, loss of appetite, weakness, increased susceptibility to infection, anemia, moodiness, agitation, and dizziness.

• Long-term Risks: Memory loss, enlargement of the heart, impaired vision, depression, heart disease, and many others.

Iron deficiency is one of the most common deficiencies in the country. It is reported that as many as 80% of exercising women are iron deficient.⁶ Iron is a vital component of red blood cell production. Deficiency symptoms include:

• Short-term Symptoms: Poor stamina, fatigue, irritability, impaired concentration.

• Long-term Risks: Anemia, heart disease, impaired brain function.

Vitamin D deficiency is more prevalent than most people realize. Research shows that up to 24% of adolescents in the U.S. are Vitamin D deficient.7 Early deficiency symptoms include:

• Short-term Symptoms: Joint pain, depression and poor mental focus.

• Long-term Risks: 17 kinds of cancer, autoimmune diseases, chronic pain, heart disease, attention deficit disorder.

Zinc is involved in many aspects of the healing process and hormone production. Because zinc losses increase dramatically with exercise, marginal deficiencies are common among active people. Deficiency symptoms include:

• Short-term Symptoms: Delayed recuperation from exercise, slow wound healing, impaired immune function, poor appetite.

• Long-term Risks: Nerve damage, anemia, sterility (in men), hair loss, glucose intolerance, and atherosclerosis.

If you notice any of these short-term symptoms, chances are you may be suffering some form of marginal vitamin or mineral deficiency. If so, this is the time to catch it and begin using a high-potency multivitamin in order to replenish your depleted stores and avoid the more serious long-term health risks.

Health Benefits of Supplemental Vitamin and Mineral Intake

On the flip side of the coin from the risks of deficiency are the rewards of supplementation. Research has begun to emerge over the past 2 decades regarding some extraordinary health benefits of taking certain vitamins and minerals in doses far exceeding the RDI. This is the type of research that allows us to begin to quantify the truly optimal level of daily vitamin and mineral intake.

Let’s take a look at some of the more recent and poignant research showing how simple supplementation may very well enhance and extend the quality of your life.

B-Vitamins

• Study: "Vitamin requirements for the treatment of hyperhomocysteinemia in humans"

• Background: Elevated homocysteine levels in the blood stream are a well know risk factor for heart disease.

• Procedure: Subjects were supplemented with the following daily dose of B-vitamins:

Folate at 163% the RDI

B-12 at 6,667% the RDI

B-6 at 500% the RDI

• Findings: Researchers stated, "The combination of the three vitamins (Folate, Vitamin B-12, and Vitamin B-6) reduced circulating homocysteine concentrations by 49.8%. Supplementing with B-group vitamins may be effective in reducing cardiovascular risk."⁸

Vitamin E

• Study: "The Women's Health Study (WHS)"

• Background: Vitamin E plays a critical role in the maintenance of nerve health in the eyes.

• Procedure: A randomized, placebo-controlled trial involving nearly 40,000 women, consuming an average of 390 IU (1,300% the RDI) of Vitamin E per day, versus those at significantly lower intake levels.

• Results: Women with the higher intake of Vitamin E experienced a 14% decrease in the risk of cataract development.⁹

Selenium

• Study: "The Nutritional Prevention of Cancer – 400 mcg per day Selenium Treatment"

• Background: Selenium is a potent antioxidant itself, with the added ability to enhance the antioxidant functions of Vitamin C.

• Procedure: Subjects were supplemented with Selenium at 200 mcg/day (286% the RDI) or 400 mcg per day (572% the RDI).

• Results: Supplementation with 200 mcg per day reduced the risk of cancer by 25%, while 400 mcg per day showed no effect.¹⁰

There are numerous additional studies on other vitamins and minerals showing similar positive impact on a variety of health conditions.

The take home message here is optimal intake levels of many essential vitamins and minerals, aimed at producing extraordinary health and vitality, are likely to be far over and above the RDI.

Now let’s take a look at what the optimal intake range for vitamins and minerals may be, according to the latest science.

Optimal Vitamin and Mineral Intake Levels

It is impossible to create a multi-vitamin and mineral supplement that contains the perfect level of nutrients for every individual. Not only do people’s needs vary, so do their intakes of vitamins and minerals through whole foods. Therefore, I am going to provide you with my recommendations for a range of vitamin and mineral intake for healthy individuals. The main variable will be your level of physical activity.

To help you figure out which end of the range you should shoot for here are some guidelines.

You will likely need to use a supplement providing nutrients at the higher end of the intake range if you:

• Perform any type of exercise more than 10 hours per week

• Perform regular strenuous exercise such as mountain biking, long distance running, etc.

• Do not consume more than 6 servings of fruits and veggies per day

• Do not eat dairy products regularly

• Do not regularly use a vitamin and mineral fortified MRP (meal replacement product)

• Are vegetarian

You can get by with a supplement at the lower end of the range if you:

• Exercise less than 10 hours per week

• Exercise at a moderate level

• Regularly consume more than 6 servings of fruits and veggies

• Regularly eat dairy products

• Regularly use a vitamin and mineral fortified MRP

What To Look For in a Multi-Vitamin and Mineral Supplement

When assessing the quality of a multi-vitamin and mineral supplement there are a number of things to keep in mind beside the levels of nutrients mentioned above. These other parameters include, the types of vitamins and minerals used, gender specific formulas, A.M. and P.M. formulas, and the delivery form of the supplement (capsule, tablet, powder, liquid). Knowing what constitutes a good product will allow you to more effectively choose a quality supplement. So let’s check it out.

Delivery Form

• Capsules: This is the best delivery form. They dissolve rapidly in the stomach and don’t require heating or pressing to be made. This form retains and delivers the most active levels of vitamins and minerals.

• Tablets: Tablets are not the best choice because if they are pressed too hard, or the right excipients aren’t used, they may not dissolve completely and thus pass right through the body. Also, the pressing, and the heat created in the process, can destroy sensitive vitamins, thus decreasing the active level in the tablet. If you find a product that looks like it has everything else going for it, but it’s in tablet form, it may be okay. In this case I suggest you call the company that makes the product and ask them if they have done any “dissolution studies” on the tablet. If so ask them if they can send you these studies. If they can’t send them, ask them what the results were. Anything under 10 minutes for total dissolution is good. Anything over 30 minutes is quite bad.

• Powder: Not usually a good choice as the exposure to air and moisture tends to degrade the activity of most vitamins.

• Liquid: Can be a viable alternative for minerals, but most vitamins become unstable in water and will degrade. Plus, liquid products are usually much more expensive and no more effective.

Gender Specific Formulas

• Men and women share much of the same physiological needs, but not all. For this reason it is important to look for a Multivitamin that is gender specific in its design.

• Women, for instance, would benefit from a formula containing higher concentrations of iron, calcium and folic acid in order to help them maintain healthy red blood cell levels, strong bones and prepare them for a healthy pregnancy.

• Men have different needs. Men need more zinc and vitamin E to help support healthy testosterone production. The addition of natural prostate support nutrients, such as saw palmetto and lycopene, could prove helpful as well.

Vitamin Types

• Vitamin A: Beta-carotene is the best choice. Beta-carotene has good antioxidant potential and is converted to vitamin A by the body on demand. There is no toxicity risk (which can be present with high levels of retinol).

• Vitamin C: Plain vitamin C (a.k.a. ascorbic acid) is the best choice. Although bioflavonoids can enhance the absorption of vitamin C, very few (if any) products contain enough bioflavonoids (such as the level found in a fresh orange) to have any effect on absorption. Research indicates that ascorbic acid is quite well absorbed by itself.

• Vitamin D: There are many forms of vitamin D, with D2 (cholecalciferol) being the most common supplemental form. Calcitrol is a prescription drug form, and is 10 times more potent than D2, but is only necessary for those with kidney disease or other digestive disorders. Stick with D2.

• Vitamin E: There are two main forms, there is “natural” vitamin E (also know as d-alpha tocopherol) and there is “synthetic” vitamin E (a.k.a. dl-alpha tocopherol). Chemically these vitamins are VERY similar, but biologically they differ greatly. The natural form of vitamin E contains only one form – the “d” form; while the synthetic form contains a 1:1 blend of the “d” and the “l” forms. The “d” form has the greatest biological activity. The “l” form is less biologically active. Research shows that the natural form of E is utilized about 40% more effectively than the synthetic form.¹¹ So stick with natural E when you can.

• Vitamin K: There are three forms of vitamin K – K1 (phytonadione), K2 (menaquinone), and K3 (menadione) a synthetic derivative. K1 is the preferred form.

• B-Vitamins: There are officially 8 vitamins in the B-vitamin group. They are Thiamin (B1), Riboflavin (B2), Niacin (B3), Pantothenic Acid (B5), Pyridoxine (B6), Biotin, Folic Acid, Cobalamin (B12). Choline and Inositol are two other vitamin-like compounds that are usually included in the B-vitamins group. While some of these B-vitamins do come in different forms, the distinctions regarding their biological activity are not appreciable. So don’t worry too much about what forms of the B-vitamins are contained in you clients supplement of choice.

Mineral Types

While some supplements have a high mineral content, many times those minerals are not readily available for use at the cellular level. Why? Because elemental minerals are not well absorbed. But there is a process called “chelation” which enables minerals to be much more readily absorbed. The term chelation refers to the process of binding a mineral to another substance. This substance is usually an amino acid, creating an “amino acid chelated mineral. Amino acid chelated minerals are absorbed as amino acids rather than minerals, so they have the highest absorption rate possible allowing for increased utilization by the body.

Iron, for instance, once chelated can be absorbed at a rate of up to 80% versus elemental iron which is only absorbed at a rate of approximately 4%.¹²

So when checking out various multi-vitamin and mineral supplements make sure the label shows the minerals to be "amino acid chelated".

A.M. and P.M. Formulas

Intuitively it would seem to make sense that as long as we take enough of the right vitamins and minerals every day that when we take them during the day isn’t really important. Most people believe that even if we take all of our vitamins and minerals in one daily dose our needs will be met. However, if your goal is to truly optimize your health, vitality and physique, then customizing your vitamin and mineral intake to better match your body’s changing needs throughout the day is what really makes sense.

In the morning and during the day for instance our bodies need the nutrients that support energy production, optimal muscle function and high-level neural activity. Many of the B-vitamins are integral in these functions. Thiamin, as an example, is an essential component of the metabolic process that converts carbohydrates into energy.^13,14 Thiamin is also necessary for proper neuro-muscular function – meaning that it aids in the communication between your brain and muscles.¹⁵ Pyridoxine on the other hand is much more involved with the metabolism of proteins – making sure that they are incorporated into muscles and also processed as an energy source.^16,17 Biotin works to convert fats into efficient energy sources for the body.¹⁸ While Vitamin B-12 is a jack of all trades, having a hand in everything from fat and amino acid metabolism to blood formation, and even assisting in enhancing mental function.^19-21 And virtually every B-vitamin is somehow involved in the support of proper cerebral and muscular neural function.^22-27

Now our bodies needs for vitamins and minerals change dramatically as the sun sets and we slow down. In the evenings and while we sleep our bodies require the nutrients that will help them relax, repair, cleanse, refuel, and revitalize. While a variety of vitamins are involved in these tasks, this is where the minerals really shine. Take for instance the multiple roles of zinc. It is not only essential to tissue repair and wound healing (which is what recuperation from exercise really is), but also plays a key role in supporting healthy bone structure, producing plentiful amounts of powerful hormones such as testosterone and growth hormone, and in processing fuels for proper storage in the body.^28-33 Then there is the role magnesium plays in helping out bodies to wind down by relaxing nerve impulses and muscle contractions.³⁴ Also, while we sleep copper acts to help cleanse and repair our systems by acting as a powerful antioxidant and through its necessary function in repair of muscles and other tissues.³⁵

So what does all of this mean? It means that a single daily dose of any vitamin and mineral blend simply isn’t the most efficient and effective way to supply your body with the proper micronutrients (another name for vitamins and minerals) it needs when it needs them most. A split daily dose is what would be most effective. The A.M. formula should include very strong doses of the B-vitamins (some many times the RDI – which is what modern science is showing to be optimal) to help optimize energy production, as well as neural and muscular function when we need them most. While the P.M. formula should rely more heavily on solid doses of vital minerals to help our bodies wind down, recuperate and repair. This is truly the next evolutionary step in the art and science for vitamin and mineral supplementation.

What to Avoid

Now that you know what to look for in a multi-vitamin and mineral supplement, here are a few things to consider when choosing a product.

• “One-a-Day” vitamins: These products are definitely suboptimal. First of all it is impossible to squeeze viable levels of every vitamin and mineral into one tablet. It usually takes between 3 to 6 capsules or tablets to supply optimal doses of all nutrients. Next, these low-cost products typically use low-cost (translated as low-quality) ingredients. Vitamins are usually synthetic and minerals are not chelated.

In summary, it is clear that the foods available to us today are deficient in adequate vitamin and mineral content to provide us with the amounts our bodies require for optimal health. And recent research suggests that the RDI, while able to keep most of us from contracting deficiency diseases, may not offer the best recommendation for optimal health. This makes supplementation a viable and valuable tool. When choosing a multi vitamin and mineral supplement it is important to keep the factors of proper quantity, type and timing well in mind.