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Multivitamins and Mineral Supplements
Do you need them?

Most of us try hard to eat a balanced diet. Still, it's hard to know whether your diet meets all of your nutrient needs. Should you take a multivitamin or another supplement?

The only way to know for certain is to have a complete nutritional assessment done. Your doctor or a dietitian can help you analyze your typical diet and your nutrient needs. If this is not possible, simply try to eat a variety of foods each day. Most healthy adults who eat a balanced diet do not need supplements. In fact, using one may give a false sense of security. It may make you think there is no need to pay attention to the nutritional quality of your diet.

Although many people choose to take a low-dose multivitamin or multivitamin and mineral supplement, there is little evidence that this helps the average person. However, there is also little evidence of harm.

Some people supplement because they worry that their diet does not provide adequate vitamins and minerals. If specific nutrients are lacking, concern is justified. Many Canadians do not meet their needs for all the vitamins and minerals. As well, certain groups are at higher risk. For instance, most Canadian women do not get enough of the nutrients folate, calcium, iron and zinc.

Eating a healthy diet is still the best way to meet your nutritional needs. However, it can be challenging to eat well all of the time. Being on the go, dealing with work and family stress, having no time to prepare meals, lack of routine and attempting to lose weight can all interfere. With our hectic lives, it seems much easier to reach for the convenience of refined, processed, and packaged foods. However, meals that involve washing, cutting, and cooking are much more nutritious. It may be wise to take a daily multivitamin and mineral supplement to help round out the days when you don't eat well. Still, keep in mind that a supplement is exactly that – an enhancement to a diet, not a replacement for healthy eating.

Some people simply cannot meet all their nutrient needs through food. Depending on their life stage or lifestyle, they may have higher needs or higher losses. Vitamin and mineral supplements are recommended for vegans, dieters, women of childbearing age, pregnant women, older adults, those with a chronic disease or who smoke or drink alcohol. These groups have increased needs for certain nutrients.

Vegans

A vegan diet does not include any food of animal origin. Vitamin B12 is found almost exclusively in animal products. Vegetarian diets generally tend to be high in micronutrients (small amounts of vitamins and minerals). However, they often lack vitamin B12. Those following a vegan diet must either supplement or meet their needs by including foods fortified with vitamin B12.

Dairy products are the major source of calcium in our North American diet. Vegans may also benefit from calcium supplements if they cannot meet their needs through food.

Restrictive diets

Diets for weight loss often limit energy intake. As a result, micronutrient intake is likely limited as well. It is very difficult to consume all of the recommended amounts of vitamins and minerals on a diet of less than 1200 calories a day, no matter how well planned.

It is also challenging to meet nutrient needs on a diet that excludes or limits a food group. For instance, the Atkins diet limits carbohydrate foods. In either of these cases, a one-a-day multivitamin and mineral formula is a good idea.

Fertile women

Women in their childbearing years benefit from a multivitamin and mineral supplement whether they are pregnant or not. Folic acid supplementation reduces the risk of neural tube defects affecting the brain and spinal cord of a baby. It is recommended that women who are or may become pregnant should take in 0.4 mg of folic acid daily from supplements. This is in addition to the folate that comes from foods in a varied diet.

To ensure that the daily 0.4 mg requirement is met, women should take a complete regular or high-dose multivitamin-mineral supplement, a B-complex supplement or special multivitamin complex for women who are of childbearing age. Other 'just for women' formulas are available, which include specific amounts of certain vitamins and minerals.

Pregnant women

The need for folate remains high when a woman becomes pregnant. Her iron needs also increase. The rise in maternal blood volume and the growth of the baby and other maternal tissues all require iron. Iron deficiency is common among pregnant women. It can lead to premature delivery and greater risk to the mother. While a diet that is well planned can meet the needs of a pregnant woman, it is wise to take additional folate and iron.

To help meet iron needs, a complete regular, high-potency, or prenatal formula can provide a pregnant woman with the recommended levels of folate and iron.

Older adults

Multivitamin and mineral supplements may also benefit older adults. As we age, our ability to absorb or use certain nutrients decreases. For instance, some older adults have a condition called atrophic gastritis. They are less able to absorb the vitamin B12 bound to protein in food. Foods fortified with B12 or supplements are recommended for this age group.

Older adults may also find it hard to get enough vitamin D and calcium. Since production of this vitamin in the skin is decreased and exposure to sunlight (which provides this nutrient) may be limited, vitamin D supplements can help. A calcium supplement is also wise, particularly for older adult women. The risk of osteoporosis, where the bones become less dense, increases with age. It may be difficult to get the recommended calcium from food without exceeding energy needs (which tend to decrease). A pharmacist can help to choose from the calcium and vitamin D combination supplements that are widely available.

Chronic disease

Many people with chronic diseases that affect their body’s ability to use certain nutrients may require vitamin and mineral supplements. This may be caused by the condition itself, or by the medication used to treat the condition. For instance, someone with pernicious anemia requires injections of vitamin B12 or mega doses of oral supplements. Another person using a medication that can cause bone loss should take calcium supplements. Those who take medication regularly should talk to their doctor or pharmacist about the way their food and medications act together and the need for specific vitamin and mineral supplements.

Smokers and drinkers

Smoking cigarettes and drinking alcohol also affect vitamin needs. Heavy cigarette smokers require more vitamin C than non-smokers to maintain the correct concentration of vitamin C in their blood. This extra requirement can be easily met by taking a complete regular multivitamin and mineral formula.

Heavy alcohol consumption prevents the body absorbing some vitamins. Certain minerals are lost through urine. There is also an increased need for certain nutrients to help the body rid itself of alcohol and repair damaged cells. A complete one-a-day formula is recommended for heavy drinkers.

If you choose to supplement

If you decide to take a multivitamin and mineral supplement, choose your product carefully. You want to make sure that it meets the nutrient needs you are aiming for, with a low possibility of toxicity. Some formulas target the special needs of children, women, men, seniors or athletes.

The ingredients list on the product label can help you decide how much of each nutrient is in a daily dose. Check to see whether this amount satisfies your concern. For instance, if you want to increase your calcium intake, does it provide the amount of calcium you want? Or, if you are over 50 or eat a vegan diet, does it provide enough vitamin B12 to meet your needs? Consult your doctor or pharmacist to be sure.

Once you select a product, proper use and safe storage are important. Remember that multivitamin and mineral supplements contain micronutrients (nutrients in ‘micro’ or small amounts). Follow the dosage recommendation, as more is not always better when it comes to supplements. Check the expiry date too, since some vitamins degrade over time.

Multivitamins and other supplements can help those who cannot get everything through diet alone. If you think you may need a supplement, talk to your doctor, pharmacist or dietitian about how to choose one that is right for you.