Multivitamins: do we need them?


The supplement business is burgeoning. Globally, we spend over $132 billion dollars on pills, tinctures are herbal supplements each year, and that number is expected to grow to over $220 billion by 2022. That’s a whole lot of vitamins!

‘Supplements’ is a broad term that covers any pills, tablets or powders that we add to our diet in an effort to enhance health. Popular dietary supplements include vitamins, minerals, herbs, protein powders, fish oils, probiotics and weight loss aids.

Almost 70 percent of Americans say that they take at least one dietary supplement. It may be to support wellness, boost energy, fill nutritional gaps, or to treat a specific health need, such as low bone mass or anemia. This large number of supplement users is not a surprise, since many people rely on physician-prescribed vitamins and minerals for health reasons. The most common supplements are:

  • Calcium for bone health, especially for post-menopausal women, who are at a greater risk of developing osteoporosis
  • Iron for anemia, especially in premenopausal women
  • Vitamin D for bone health and immunity, especially for people who live in cooler climates with less year-round sunshine
  • Omega-3 fats (fish oil), for reducing the risk of cardiovascular disease, especially in people who don’t eat any fish
  • Multivitamins, as an ‘insurance policy’ for anyone who feels they have gaps in their diet

It’s this last supplement – the multivitamin – that we’ll take a closer look at today. The other supplements tend to have a specific therapeutic use for medical conditions, while the multivitamin usage is a bit vague. It begs the question: are multivitamins necessary?

What is a multivitamin?

A multivitamin is a pill that contains a mix of different vitamins and minerals, and sometimes a few herbs are added in too. There is no specific or regulated formula for a multivitamin, so each brand may contain different ingredients in varying amounts.

Health professionals tend to recommend specific individual vitamins or minerals based on medical need, and are less likely to recommend a general multivitamin. Why? Because some people may not require extra amounts of everything that’s found in the pill. The stuff your body doesn’t need will take one of two routes. If it’s excess vitamin A, D, E or K, it gets stored in your fat tissue, which can be toxic at high doses. If it’s excess vitamin C or any B-vitamin, it gets excreted in urine. So if you buy B-vitamins and take more than you need, you are basically flushing your hard-earned money down the toilet.

And what about the multivitamin as an ‘insurance policy’ to cover any nutrients that you miss on a given day? It’s better to get the nutrients you need from food. Taking a multivitamin can’t possibly compensate for poor eating habits. It won’t cause harm to take a low-dose, gender-specific multivitamin on days when you feel that your nutritional intake was sub-par, but daily high dose supplements are not necessary and can’t fill the gap of eating nourishing food. Supplements are designed to ‘supplement’ your diet, not to replace healthy eating.

And, try as they might, chemists are not able to replicate the complex synergistic benefits of eating food. The vitamin and minerals in food can be mimicked in pill form, but the lab cannot recreate the fiber, antioxidants and phytonutrients.

Who needs a multivitamin?

Most people don’t require a daily multivitamin, but there are some populations that benefit from multivitamin use. As described above, it’s best to get nutrients from foods, but this isn’t always possible. People who have very low calorie diets, poor appetite, or who undergo bariatric surgery (which reduces the size of the stomach and the ability to absorb nutrients) may benefit from multivitamins to ensure an adequate nutritional status.  

It’s also common for people with gastrointestinal conditions such as celiac disease or Crohn’s disease to have vitamin deficiencies due to malabsorption. Some may benefit from a multivitamin, while others choose to take individual vitamins and minerals based on their specific deficiencies, which can be discovered by a simple blood test. This target supplementation focuses only on the actual deficiencies that you have. But if there are a whole bunch of deficiencies, it may be more affordable and easier to take one multivitamin rather than a handful of individual pills.  

It’s recommended that pregnant women take a daily multivitamin with adequate amounts of folic acid, which can reduce the risk of neural tube defects. Some physicians also recommend multivitamins to vegetarians and to people over age 65.  

Studies on the long-term use of multivitamins aren’t consistent. Some show lower rates of heart disease or cancer, while others show increased rates or no change of these same conditions. A meta-analysis of multivitamin studies concluded that multivitamin use has no effect on all-cause mortality rates.

The bottom line? Eating can’t be reduced to isolated nutrients, which is why food is a better choice than supplements. But if you really have nutrient deficiencies or can’t meet nutrient needs, a multivitamin can help fill the gaps.

Make eating real food Just Routine

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Cara Rosenbloom is a Registered Dietician, celebrated author and international columnist, active as a food blogger, recipe developer and nutrition educator.

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