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Byline: Mariko Thompson Staff Writer

The aisles of the supermarket have become a vitamin- and mineral-fortified world. There's vitamin D in the milk to ward off rickets, calcium in the orange juice to build strong bones, and folate in breads and cereals to reduce heart disease. Do you really need a daily multivitamin on top of it all?

``I can't think of anyone who doesn't need a multivitamin, whether a kid, teenager, young adult, baby boomer or senior,'' says Dr. Michael Hirt, director of the Center for Integrative Medicine at Encino-Tarzana Regional Medical Center. ``The standard American diet is fairly inconsistent. Even people who say they have a healthy diet don't every day.''

Many doctors and registered dietitians agree with Hirt. But as with so many things in the imperfect world of health, the recommendation to take a daily multivitamin comes with caveats.

``It's probably not a bad idea,'' says Dr. Constantine Gean, clinical director of employee health at Valley Presbyterian Hospital in Van Nuys and lead author of ``The Pocket Drug Guide.'' ``It's more a clinical impression than a proven strategy, with the exceptions of people in (vitamin) deficiency states and pregnant women.''

In other words, a daily multivitamin makes good sense, though strong scientific data for the general public is lacking. In reviewing the results of clinical trials, the U.S. Preventive Services Task Force announced last year that there was ``insufficient evidence'' to show that taking vitamin supplements long-term prevented heart disease or cancer.

Even so, many health experts favor the multivitamin as a disease-prevention tool. Two years ago, the Journal of the American Medical Association came out in favor of taking a daily multivitamin: ``Most people do not consume an optimal amount of all vitamins by diet alone,'' wrote Dr. Robert H. Fletcher and Dr. Kathleen M. Fairfield of Harvard Medical School. ``Pending strong evidence of effectiveness from randomized trials, it appears prudent for all adults to take vitamin supplements.''

For consumers looking to buy a multivitamin, the first thing to do is look at the label and make sure that the amounts don't exceed 100 percent of the recommended daily allowance, says Bettye Nowlin, a Calabasas registered dietitian and spokeswoman for the American Dietetic Association.

Vitamins are either water soluble or fat soluble. Once the body absorbs enough of the water-soluble vitamins - which include all the B vitamins and C - the remainder is excreted through urine. But fat-soluble vitamins - A, D, E and K - dissolve in the fat and are carried into the bloodstream. That's why Nowlin discourages the average person in good health from buying high-potency vitamins, which often contain well beyond 100 percent of the daily recommended allowance.

``If you store these fat-soluble vitamins for too long, you can run into trouble,'' Nowlin says. ``It can be harmful.''

Time-released vitamins are supposed to release the nutrients over an extended period. But Gean says that as the vitamin moves through the gastrointestinal tract, most of the nutrients are absorbed in the small intestine.

``Time release is not that useful for vitamins,'' Gean says. ``It's like buying the undercoating on the new car.''

Hirt says consumers should think about their needs before walking into the store. Adults who don't want to swallow pills might consider taking a children's chewable vitamin. Vitamins also come in liquid form, though not everyone likes the taste.

Women in their child-bearing years should take a vitamin that contains folic acid in case they become pregnant. Folic acid prevents neural tube defects in babies. Since most multivitamins don't contain enough calcium or magnesium, most women likely will need to supplement those minerals as well, Hirt says.

Seniors need a more potent multivitamin formulated for their needs because their bodies don't absorb nutrients as well. They tend to be most deficient in B vitamins and zinc, Hirt says.

``It's good to know a little more about who you are and what you need before you face the dizzying array of vitamins competing for your health- care dollar,'' Hirt says.

Mariko Thompson, (818) 713-3620


A primer on vitamins

The 13 vitamins required by the human body perform a number of functions, which include forming cells, regulating the nervous system and building strong bones. Vitamins A, D, E and K are fat-soluble, meaning they're stored in the body for long periods in the fat tissue. Vitamins B and C are water-soluble, which means the body excretes what it doesn't need. The eight essential B vitamins are biotin, folate, niacin, pantothenic acid, riboflavin, thiamine, B6 and B12. (Twenty-two minerals, including calcium and iron, are considered essential as well.) Parents should discuss with their pediatricians whether to give their children a vitamin supplement.

Vitamin A: Promotes eye health, helps in the development of immune cells and maintains tissues that make up the skin surface and linings of the respiratory and gastrointestinal tracts. Found in organ meats, fish and egg yolks. Recommended daily allowance is 700 micrograms for women and 900 micrograms for men.

Biotin: Helps the body metabolize amino acids and carbohydrates and is involved in the production of digestive enzymes and formation of antibodies. Found in yeast, corn, soybeans, egg yolks, liver, cauliflower, peanut butter and mushrooms. No recommended daily allowance has been established because deficiency is rare. Adequate intake for adults is 30 micrograms.

Folate: Prevents a variety of birth defects, cancer and heart disease. Found in dried beans and peas, leafy greens, oranges, wheat germ, whole grains and fortified grain products. Recommended daily allowance is 400 micrograms for all adults. Women who might become pregnant should make sure to meet the RDA for folate.

Niacin: Important for heart health. Found in meat, poultry, fish, milk, eggs and enriched cereals and breads. Recommended daily allowance is 14 milligrams for women and 16 milligrams for men.

Pantothenic acid: Helps stimulate the release of energy from carbohydrates, fats and proteins. Found in organ meats, poultry, fish, yogurt, whole grains and legumes. No recommended daily allowance has been established because deficiency is rare. Adequate intake for adults is 5 milligrams.

Riboflavin: Helps cells convert carbohydrates into energy and aids in the metabolism of fats and proteins. Found in liver, milk, poultry, fish, eggs and enriched or fortified grain products. Recommended daily allowance is 1.1 milligrams for women and 1.3 milligrams for men.

Thiamine: Important for healthy brain and nerve cells and for heart function. Found in lean pork, whole grains, dried beans, nuts, seeds, fish, and enriched breads or cereals. Recommended daily allowance is 1.1 milligrams for women and 1.2 milligrams for men.

B6: May help prevent heart disease and improve the immune system function in older people. Found in meat, fish, poultry, bananas and avocados. Recommended daily allowance is 50 milligrams for adults through age 50, 1.3 milligrams for women ages 51 and up, and 1.7 milligrams for men ages 51 and up.asking Mariko to confirm numbers ... sr

B12: May be instrumental in preventing heart disease. Found in egg yolks, liver, beef, poultry, fish, shellfish, dairy products, fortified cereals and fortified soy products. Recommended daily allowance for adults is 2.4 micrograms.

Vitamin C: Helps prevent cell damage and is critical in the production of collagen and the proper functioning of the immune system. Found in many fruits and vegetables, particularly citrus fruits, peppers and broccoli. Recommended daily allowance is 75 milligrams for women and 90 milligrams for men.

Vitamin D: Helps to build strong bones and teeth. Primary source is sunlight. Found in fortified milk and fortified cereals, breads and flours. Recommended daily allowance is 200 international units for adults through age 50, 400 IU for adults ages 51 to 70, and 600 IU for adults over the age of 70.

Vitamin E: Promotes heart health and reduces inflammation. Found in green leafy vegetables, whole grains, nuts, vegetable oils and margarine. Recommended daily allowance for adults is 15 milligrams.

Vitamin K: Critical for blood clotting and helps to maintain strong bones. Found in spinach, lettuce, watercress, broccoli and brussels sprouts. Deficiencies are rare. Adequate intake is 90 micrograms for women and 120 micrograms for men.

Source: ``Wellness Foods A to Z,'' by Dr. Sheldon Margen and the editors of the Berkeley Wellness Letter.


3 photos, box


(1 -- cover -- color) Sizing up Multivitamins

(2) A variety of vitamin and mineral supplements are available at many stores, including Follow Your Heart Natural Foods in Canoga Park.

(3) no caption (vitamins)


A primer on vitamins (see text)
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Publication:Daily News (Los Angeles, CA)
Date:Apr 26, 2004
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