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The ultra mega vita guide.

How much of what do I need? That's the toughest question most shoppers face as they squint at the tiny print on multi-vitamin-and-mineral supplement labels.

Don't feel bad if you don't know the answer. No one does. Even the committee that sets the official Recommended Dietary Allowances (RDAs) admits that it doesn't know how much of each nutrient promotes optimal health.

So how could we write this Ultra Mega Guide? Call it educated guessing. While many of our rules are based on incomplete science, that's more than most people have when they face a shelf full of vitamins.

1. Get the most beta-carotene and the least vitamin A palmitate or acetate. "With beta-carotene," says the label on Theragran-M. The question is, how much?

You're better off with a supplement that's rich in beta-carotene. While high doses of vitamin A can be toxic, beta-carotene isn't. The body turns it into vitamin A, but stops when you've got enough.

What's more, only beta-carotene--not vitamin A--is an antioxidant. Studies using 25,000 to 50,000 IU of beta-carotene per day are currently under way to see if it reduces the risk of cancer, heart disease, and cataracts.

The problem is: some labels list the total "International Units" (IU) supplied by vitamin A and beta-carotene together, but don't say how much comes from each.

For example, GNC's Stress Vita-Pak and its Women's Ultra Mega both have 15,000 IU of "vitamin A." But the Vita-Pak gets 10,000 of the 15,000 IU from beta-carotene, while the Ultra Mega gets only 5,000.

You don't need any non-beta-carotene vitamin A (it's listed as "acetate," "palmitate," or "fish oil"). And if your supplement does have any, it shouldn't be more than the USRDA, which is 5,000 IU. That's especially true for a "women's" tablet, since high doses have been linked to birth defects.

2. Ignore high doses of thiamin, riboflavin, and niacin. Think of them as the "three Bs you probably don't need." Thiamin (vitamin B-1), riboflavin (B-2), and niacin (B-3) are plentiful in the food supply, largely because they're added to the "enriched" white flour that goes into bread, pasta, crackers, cereals, and dozens of other grain products.

But judging from "high-potency" supplement labels, you'd think there was a national shortage. In fact, multis load up on these Bs because they're cheap and don't take up much room.

3. Look for extra vitamin C unless it's expensive. Vitamin C is an antioxidant. Whether studies will conclusively show that it reduces the risk of cancer, heart disease, cataracts, and colds is undear.

The USRDA is 60 mg. It's worth taking more--say 250 mg to 500 mg--but it's not worth paying a premium price for a high-potency multi when you can buy your C separately for a few pennies a tab. More than 1,000 mg a day causes diarrhea in some people.

4. Many women should get the USRDA for vitamin D in winter. Postmenopausal women who live in northern latitudes may get too little vitamin D from the sun between October and March.

In one study, postmenopausal women who took 400 IU (the USRDA) in a supplement-along with enough calcium to bring their daily caldum intake to 800 rag--lost less bone than women who took only calcium (or nothing).

Most multis have 400 IU of vitamin D. But several made by Bronson--including its Women's Formula #2--Your Life Daily Pack for Women, Unicap Senior, and AARP Formula #502 have 200 IU or less. (So much for "women's" and "senior" formulas.)

High doses of vitamin D can be toxic, so don't exceed 400 lU a day.

5. Look for 100 10 400 IU of vitamin E. Researchers have reported that supplements containing at least 100 IU of vitamin E are linked to a lower risk of heart disease. In one study, a multi containing 44 IU halved the incidence of infections in older people (see page 4). And in another study, 400 IU of vitamin E a day improved some immune-system functions. The USRDA is only 30 IU.

It's too early to conclude that vitamin E boosts the immune system---or that it reduces the risk of cancer or cataracts, as some studies suggest. Like vitamin C and beta-carotene, it's usually cheaper to take separately than to purchase as part of a high-potency multi.

6. Many women should get the USRDA for folic acid. All females who are capable of becoming pregnant should get 400 micrograms (mcg) of folic acid to reduce the risk of neural tube birth defects, which can occur before a woman finds out that she is pregnant (see NAH, Dec. 1992).

The easiest way to make sure you get enough is to take a multi--that is, unless (and until the government requires companies to add folic acid to foods.

Postmenopausal women and older men might be better off with no more than 50 percent of the USRDA, according to some vitamin B-12 experts, who fear that folic acid will mask B-12 deficiencies.

7. Vegans need vitamin B-12. If you consume no animal or dairy products, take a supplement with the USRDA for B-12. A deficiency can cause irreversible neurological damage, so don't take chances.

Because some older people don't absorb B-12 well, they're more likely to be deficient. Some are even misdiagnosed as having Alzheimer's.

If you're concerned, get a blood test for serum B-12. If it's "low-normal," it may be worth having your methyl malonate and homocysteine checked, according to a not-yet-published study by Ralph Green of the Cleveland Clinic Foundation.

8. Iron shouldn't exceed the USRDA. Can iron harm your heart? According to one recent study, high blood levels of stored iron may increase the risk of heart disease (see NAH, Nov. 1992).

That study needs to be confirmed. But in the meantime, there's no reason to take more than the USRDA for iron. In fact, less is better--unless your doctor says otherwise. That's especially true for men and postmenopausal women, who don't lose iron by menstruating, and who are also at risk for iron overload (hemochromatosis).

Unfortunately, some brands--like Nature's Plus Power-Plex, GNC Women's Vita Pak, and Geritol Complete--supply two to three times the USRDA. Avoid 'em.

9. Don't take high doses of zinc without copper. High doses of zinc can make it harder for your body to absorb copper. Yet some people take extra zinc in addition to a multi that has no copper.

Copper, on the other hand, is an oxidant. What with all the research suggesting that antioxidants promote health, you want the USRDA, but no more.

10. Don't expect to get all your calcium and magnesium in one swallow. Most people assume that a multi provides 100 percent of the USRDA for all nutrients. But you can't squeeze that much calcium or magnesium into a single tablet. So unless each daily dose consists of two or more tablets, you're probably getting no more than 25 percent of the USRDA for either.

Most women don't get enough calcium from food to reach recommended levels --1,200 mg a day until age 25 and 800 mg thereafter. If you don't eat several daily servings of dairy products, canned fish with bones, tofu made with calcium sulfate, or leafy green vegetables like kale, you'll need a supplement.

Calcium is less important for men, but magnesium isn't.

11. Don't forget chromium and selenium. Some studies suggest that too little chromium can lead to glucose intolerance, an early sign of diabetes. And there is sketchy evidence that selenium may reduce the risk of cancer (it's an antioxidant).

The problem is: both selenium and chromium are often left out of multis. A supplement should have at least 50 mcg --but no more than 200 mcg--of each.

12. Don't worry about most other ingredients. Until we know more, you can ignore most other ingredients in multis. Almost all people get enough phosphorus, biotin, chloride, pantothenic acid, manganese, and molybdenum in their diets. Nickel, tin, silicon, vanadium, and inositol are what the RDA committee calls "nutrients essential for some higher animals but not proved to be required by normal humans."

Boron is also on that list, but there is growing evidence that we may need it. The same goes for choline, but there isn't much evidence that anyone gets too little.

13. Don't overpay. If you're paying more than $10 a month for all your supplements, you're paying too much.

Four-A-Days?

Still wondering what to take? The answer depends, among other things, on your sex, age, budget, and "patience index"--that is, whether you like to act now or wait for the results of ongoing research. So here are five options:

Option 1: Take nothing at all Try to get all the nutrients you need from your food. Pay special attention to foods rich in antioxidants (beta-carotene and vitamins E and C) and (if you're female) calcium, folic acid, and vitamin D.

Option 2: Take a standard multi-vitamin-and-mineral. Centrum, Thereran-M, Unicap M, and their "store" brand knock-offs are fairly complete. But they don't supply 100 percent of everything. If you also want what's missing, see Option 3.

Option 3: Take a standard multi plus E, C, beta-carotene,selemium, chromium, and/or calcium and magnesium. Several companies (like Puritan's Pride and Bronson) sell antioxidant formulas with E, C, beta-carotene, and selenium.

Many companies also make calcium-and-magnesium combinations. Look for about 50 percent of the USRDA for both, since most people get the rest from food. The chromium you'll probably have to get separately.

Now you're up to at least four tablets a day. But if you're a man--which means you may not need the calcium--and you're willing to skip the magnesium, you can still get by with one tablet.

Option 4: Take only E, C, and beta-carotene. Even if you eat a terrific diet, it's tough to get the high doses of these antioxidants-especially vitamin E--that are now being studied. So one option is to take just these supplements. The cost: about $4.50 a month if you buy them separately and $6.00 for a mail-order all-in-one formula like Puritan's Pride.

Option 5: Try to get everything from one bottle. some companies do get most nutrients into their multis. The catch is that you have to take four to six tablets a day--and pay a premium. The two most complete ones we found were Twinlab's Dualtabs and Natrol's My Favorite Multiple. To save money, go back to Option 3.
COPYRIGHT 1993 Center for Science in the Public Interest
No portion of this article can be reproduced without the express written permission from the copyright holder.
Copyright 1993, Gale Group. All rights reserved. Gale Group is a Thomson Corporation Company.

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Title Annotation:includes related article; vitamin requirements for optimal health
Author:Liebman, Bonnie
Publication:Nutrition Action Healthletter
Article Type:Cover Story
Date:Jan 1, 1993
Words:1736
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