Vital Facts About Vitamins
Find out what you're really getting when you take those vitamin supplements. A Bruin expert offers vitamin shoppers some savvy guidelines.
Published Apr 1, 2009 9:00 AM
We know more about the food we eat than ever before. But those pills so many of us pop to get our daily dose of vitamins and minerals, and to lose weight, keep us focused, boost our immunity, or whatever?
Not so much.
Half of all U.S. adults say they take at least one dietary supplement, especially vitamins and minerals. The pills, in fact, are a huge business — $22 billion a year, by some estimates. But none of them are subject to anything near the rigorous testing and safety requirements of prescription and over-the-counter drugs. Their manufacturers' claims aren't always supported by science, and the contents inside the bottles can vary widely.
This is not to suggest that every multivitamin on the shelf is useless. Supplements can be crucial to good health for people with particular needs. Vitamin D, essential for healthy bones, is deficient in many people who get little sunlight and in the elderly. Vitamin B12, important to normal brain function, often isn't well absorbed from food by older people. Childbearing women require daily folic acid supplements to reduce the risk of giving birth to children with neural tube defects. And under medical supervision, even so-called meal replacements — high-protein, low-fat, vitamin- and mineral-rich shakes — can be a safe and effective way to lose weight and reduce the risk of obesity-related diseases.
But many experts argue that for all the appropriate use of supplements, there is at least as much potentially dangerous use. They point to studies indicating that excessive doses of certain vitamins and minerals are associated with increased disease risk. They fret that too many consumers equate "natural" with "safe." If nothing else, they contend, much of the billions spent on supplements is simply money wasted.
Learn more about how nutrition can help you maintain a healthy lifestyle, including natural remedies, vitamins and minerals, weight management and the impact of nutrition on aging and disease. Visit the UCLA Center for Human Nutrition.
While he counsels informed use, Dr. David Heber '69, Ph.D. '78, director of the UCLA Center for Human Nutrition, isn't among the naysay-ers. Outside of his academic roles (the University of California does not endorse specific products or services), in fact, Heber is the author of The L.A. Shape Diet, chairman of the Nutrition Advisory Board for supplement marketer Herbalife, and a frequent guest expert in the media on nutrition issues.
Multivitamins/multiminerals are by far the most widely used supplements; however, among the biomedical establishment the jury is still out on their value. In 2006, an independent panel assembled by the National Institutes of Health concluded after an assessment of available evidence that more studies are needed to determine whether the popular supplements should be used to prevent major chronic illnesses such as cancer and heart disease.
Heber argues that the issue of whether vitamins work has been politicized, with the food and drug industries on one side and the sup-plement industry on the other. "The food industry thinks you get everything you need from the four basic food groups, and the supplement industry thinks the vegetables are washed and all the vitamins are gone," Heber says. "The truth is somewhere in the middle."
For the typical healthy adult, Heber offers the following advice:
Begin with the Basics. Almost everyone can benefit from daily multivitamin/multimineral and calcium/vitamin D supplements. "The levels in a multivitamin/multimineral are there to prevent deficiency diseases," Heber says, pointing out, for example, that iron is deficient among many girls and premenopausal women. Calcium — which, in addition to strengthening bones, has been found to reduce other health risks — also is commonly at too-low levels in many people. Vitamin D recommendations have been going up, and few people are meeting the suggested daily level of about 1,000 IUs per day, particularly with more of us limiting our sun exposure.
Become a Nutrition Expert. Beyond the basics, everyone has different needs depending on their diet, lifestyle and body chemistry. Heber urges people to educate themselves about nutrition, figure out what is optimal for them, and only then determine what else they might need in the way of supplements. In his 2002 book, What Color Is Your Diet?, Heber coded foods into seven colors as a way of helping readers to learn where they were deficient. He recommends at least one serving of a fruit or vegetable from each color each day. "Learn as you go," Heber suggests. "It's like investing in the stock market — if you buy one stock and lose all your money, you don't say the stock market is evil; you educate yourself about mutual funds and 401(k)s and how to invest wisely. You do the same thing with your health."
Buyer Beware. Under the 1994 Dietary Supplement Health and Education Act, nutritional supplements are treated as foods, which means that they receive far less scrutiny than over-the-counter and prescription drugs. The FDA doesn't analyze the content of supple-ments, nor does it require tests to determine their safety before they hit the market. Thus, what appears to be the same type of product may be sold with wide-ranging ingredients, depending on where it is purchased. Heber recommends a close reading of the label to make sure you're getting the doses you want, and purchasing from large manufacturers or retail chains, which are most likely to have adequate controls ensuring that what's in the bottle matches what's on the label.
Supplements are Tune-ups, Not Overhauls. Supplements can fill in gaps in an otherwise well-rounded diet, but should not be used as an excuse to skimp on fruits, veggies and other essential foods. "If you're eating a lot of fast-food burgers and fries and you think that a supplement is going to straighten it out, you're wrong," says Heber, who calls supplements "fine-tuning" the diet. "A supplement is not a medication that makes up for poor eating habits."