Diabetes Self-Management Blog

Thanks to all who commented on last week’s posting. The use of vitamins and minerals is always worthy of a good discussion.

Like many of you, I get frustrated with all of stories that come out about what to take, what not to take, what can cause this or lead to a problem with that. What many of these “studies” tell us is that we still don’t know an awful lot about what vitamins and minerals can do for us above and beyond preventing deficiency-related conditions like scurvy and rickets.

This week, I’m switching from my “true/false” format to more of a “statement” format, with my commentary. And, as many of you did last week, see if you agree!

Taking a multivitamin increases the risk of death. Last fall, a study published in the journal Archives of Internal Medicine indicated that women ages 55 to 69 who took a daily supplement, including a multivitamin, vitamin B6, and folic acid, as well as some minerals, were more likely to die prematurely than those not taking a supplement (a multivitamin increased the risk by 2.4% on average, vitamin B6 by 4.0%, and folic acid by 5.9%). But the researchers were not able to determine the cause of early death, and other researchers feel that the “negative effects” of taking supplements were overstated, while benefits were downplayed.

My take. This was one study. It could be that the women who were taking supplements were taking them because they were concerned about their health and perhaps were ill already. While I don’t believe in taking megadoses of any supplement, it’s a little hard to believe that taking a daily multivitamin is truly harmful. However, if you’re not feeling well and think that a vitamin might help you, talk to your doctor first about your symptoms.

Most people in the US are deficient in vitamin D and should take a supplement. Depending on what you read and who you believe, anywhere from 8% to 90% of Americans are deficient in vitamin D. Last year, the CDC released data from 2001 to 2006 showing that only 8% of Americans are deficient in the sunshine vitamin. But other experts believe a much higher percentage of folks are deficient.

My take. I find it a little hard to believe that only 8% of the population has a shortfall of vitamin D. Maybe not everyone is exactly deficient, but I suspect most people don’t get enough. This vitamin is too important for a number of reasons (promoting bone health and immune health, for example), to not aim to get enough. Getting 600 IU’s per day (or 800 IU’s if you’re older than age 70) is tricky without taking a supplement. But don’t overdo it with vitamin D either; an increased risk of falls and fractures, plus an increase in CRP (a marker of inflammation) are possible consequences.

Vitamin E increases prostate cancer risk. Vitamin E used to be the darling of the supplement world. Now, it seems to have fallen from its pedestal. In a study involving 35,000 men, those who took 400 IU’s of vitamin E each day had a 17% increase in prostate cancer compared to men who took a placebo. Ironically, the study was started on the belief that taking vitamin E would help prevent prostate cancer.

My take. If you’re male, ditch the vitamin E. There’s not too much of a justification for taking this, as you can get what you need from food sources, and why risk the chance of developing prostate cancer? Vitamin E supplements have also been linked with an increase in risk for hemorrhagic stroke (the kind of stroke where a bleed in the brain occurs).

Skip the fruits and vegetables; you’ll get the nutrients you need from supplements. This is a bit of a tough one. Dietitians will tell you to aim for 5 to 9 servings of fruits and vegetables every day. I’m a believer in this, but I know there are days when I fall short. And I admit, I take a multivitamin as somewhat of an “insurance policy,” despite the lack of evidence that they improve health.

However, I know enough about fruits and vegetables to tell you this: a pill, capsule, gummy chew, or powder will not give you 100% of what’s in fruits and vegetables. There’s just no way it’s possible. According to an article in the Nutrition Action Healthletter, there are more than 8000 compounds in fruits and vegetables, including polyphenols (a type of antioxidant). And we need about 46 nutrients each day for health. Can you imagine how many supplements you’d have to swallow to meet your nutrient requirement? Supplements don’t make up for a poor-quality diet (meaning, high in saturated fat, sugar, and sodium, and low in whole grains and fiber).

My take. A diet rich in whole foods (including plenty of fruits and vegetables) is the way to go. Supplements can help fill in the gap, but are not a substitute for food.

If you take a multivitamin, choose one that’s all natural, time-released, and from a natural foods store or company. If you’re a stickler for avoiding added sugars, starches or colorings, there’s nothing wrong with going for an “all natural” supplement. But “natural” doesn’t mean the supplement is well absorbed.

Look for a multi that has the USP (United States Pharmacopeia) seal on the bottle, which is assurance that the product contains what it’s supposed to, that it’s free of contaminants, and that the pill or capsule will dissolve appropriately for absorption. Also, go for a multi that has about 100% of the Daily Value for most nutrients (except for calcium, because it won’t have that much). Avoid multis with added herbs, enzymes, green tea, or amino acids; also, time-release formulations haven’t proven themselves to be any better than the regular version.

My take. Some of the “best” multivitamin/mineral supplements (according to agencies like ConsumerLabs.com and Consumer Reports) can be found right in your neighborhood pharmacy or warehouse store (such as Costco). Do a little research on the Internet and you’ll come across ratings to help you choose.

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Some Hard Facts About Vitamins and Minerals (Part 1)
Some Hard Facts About Vitamins and Minerals (Part 2)


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Nutrition & Meal Planning
Eating to Lower Insulin Needs (12/09/14)
Sugar-Free Labels Can Be Deceptive (12/02/14)
My Battle With the Glycemic Index (11/25/14)
A Short Fast for the Holidays (11/18/14)

 

 

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