Before discussing the decisions that go into purchasing the right multivitamin, let me first answer the basic question of whether multivitamins are even needed at all.
DO I REALLY NEED A MULTIVITAMIN?
Theoretically, most of us can get all the nutrients we need from food. But the reality is very few of us do. This is evident in studies that have been done by the United States Department of Agriculture (USDA) and others. The case where you may not be able to get all of the nutrients you need from food exists if have illnesses, are older, have certain diet preferences, or have certain gender-related conditions. Nevertheless, the fact that the majority of us are not getting all of the nutrients we need from food is the primary reason we all need to take multivitamins daily! But you must understand that a multivitamin DOES NOT REPLACE a a healthy diet. It sits on top of, or supports, a healthy diet. A healthy diet serves as the foundation, and a multivitamin fills in the missing gap....a very critical gap!
But don't take my word for it on the importance of a multivitamin. In 2002, the American Medical Association (AMA), which for decades maintained an anti-vitamin stance, changed its collective mind after a review of 26 years worth of scientific studies relating vitamin levels to the risk of chronic illness. Robert H. Fletcher and Kathleen M. Fairfield, the Harvard-based authors of the study which was published in the June 2002 issue of "The Journal of the American Medical Association (JAMA), stated that while true vitamin-deficiency diseases such as scurvy, beriberi, and pellagra are rare in Western countries, "suboptimal vitamin levels" (meaning slightly less than you need) are a real problem! If "slightly less than you need" sounds slightly less than important, THINK AGAIN!
In the study, the authors concluded that: Suboptimal intake of folic acid and two other B vitamins (B6 and B12) raises your risk of heart disease, colon cancer, breast cancer, and birth defects; Suboptimal vitamin D intake means a higher risk of rickets and osteoporosis; and suboptimal levels of the antioxidant vitamins A, E, and C are linked to a particular form of heart disease and some forms of cancer. Hence the statement by the AMA that "It's prudent for all adults to take vitamin supplements." I want to repeat that. The AMA, which is arguably the most prestigious medical association in the world, reversed its position and stated that all adults need to take vitamin supplements. This should clear up any confusion you might have as to whether you need to be taking vitamin supplements. The answer is
clearly YES!
So now that you understand the importance of vitamin supplements, what levels do you need to be healthy?
UNDERSTANDING THE RDA
According to the Food and Nutrition Board (under the umbrella of the National Institutes of Health): "The Recommended Dietary Allowance (RDA) is the average daily dietary intake level that is sufficient to meet the requirement of nearly all apparently healthy individuals in a particular life stage and gender group." The Food and Nutrition Board further defines "requirement" as: "...the lowest continuing intake level of a nutrient that, for a specified indicator of adequacy, will maintain a defined level of nutriture in an individual."
Basically, the RDA is (by definition) the lowest level of nutrient intake necessary to prevent deficiencies. This is clearly important for helping individuals avoid acute deficiency diseases, but it fails to address the issue of optimal nutrition.
It is wonderful that the RDA's have been so successful in reducing blatant deficient diseases (including scurvy, pellagra, rickets and beriberi) to their lowest levels in recorded history. It is also good that products based on RDA amounts help combat deficiency diseases by providing minimal amounts of important vitamins and minerals.
However, as more and more of the general population is able to meet minimal nutrient requirements, new questions arise. For example, are RDA levels of vitamins and minerals enough to help prevent other degenerative diseases like heart disease and cancer? What about providing protection from oxidative damage?
IS THE RDA ADEQUATE?
For more than 50 years, the general public has been led to believe that RDA nutrient levels are adequate...but adequate for what? Adequate to prevent clinically obvious nutritional deficiencies like scurvy, beriberi, rickets, and pellagra? Indeed that is why they were developed. However, our dietary habits and the kinds of diseases we acquire today are very different than they were 50 years ago. Today we eat more processed food, live in a more polluted environment, and are fighting chronic degenerative diseases like heart disease and cancer, not vitamin deficiencies like scurvy and rickets, which was the case during World War II when the RDA's were created. To put it plainly, the RDA's are outdated, and the periodic modifications made to them are still not adequate.
If you take a closer look, you will find that there are more benefits to nutritional supplementation than merely preventing increasingly rare deficiency diseases.
If you delve into the most current nutritional research, you will find that nutrient levels may or may not have relevance to the RDA's. Rather than just looking to prevent total vitamin deficiencies, we should be concerned with the vast majority of people who are "apparently" healthy. Many degenerative diseases and chronic illnesses develop over a lifetime, striking otherwise healthy individuals when they least expect it. For the millions of "apparently" healthy individuals in the world, minimal nutrient intakes may not be adequate to address modern health challenges.
According to the Centers for Disease Control (CDC), much of the illness, disability, and death associated with chronic disease is avoidable through known prevention measures. Furthermore, recent studies examining the potential economic benefits of vitamin supplementation have concluded that substantial cost reductions can be associated with the use of vitamin supplements, based on principles of preventative nutrition. With the looming healthcare crisis, substantial cost reductions is a good thing!
Here are three examples where RDA levels are not sufficient to protect your health:
(1) Researchers who have looked at the RDA of vitamin C, which is between 60 mg and 90 mg daily, have concluded that you need at least 10 times more (or over 1,000 mg) to receive a health benefit. Incidentally, so that it is clear, the body can’t manufacture vitamin C and it has to get it through diet and supplementation. Vitamin C is critical for proper immune function, prevention of oxidative stress, and prevention of DNA damage.
(2) The RDA for vitamin D is 600 IU's if you are between 1 and 70 years of age. But you need to be supplementing with at least 1,000 to 1,200 IU's of vitamin D to maintain the recommended level of between 50 ng/ml and 60 ng/ml of vitamin D in your body. The RDA would be insufficient in bringing you up to, or maintaining, this level. A report in the Archives of Internal Medicine (June 11,2007) added more evidence in the link of low vitamin D levels and heart disease. These researchers measured the vitamin D levels in over 15,000 women. Those women who had the lowest levels of vitamin D had significantly higher prevalence of hypertension, diabetes, and elevated triglyceride levels (the other fat in the blood other than cholesterol). These are all risk factors for heart disease and strokes. These researchers again pointed out the fact that low vitamin D levels carry a significant risk factor to our health. They concluded that current intake of vitamin D is far too low for optimal health.
(3) The RDA for vitamin E in adults ranges from 15-19 mg/day, but the average adult takes in less than 10 mg per day. To make matters worse, reported therapeutic benefits of vitamin E intake generally require supplementation of 200-800 mg per day. It is clear that the RDA for vitamin E isn't sufficient to help us achieve OPTIMAL health and that most people don't even acheive the RDA level.
While these are solid examples of why the RDA's are inadequate, I want to point out that some doctors still maintain that a multivitamin isn't necessary and that RDA levels are sufficient to provide optimal health. Some of this belief comes from their training which may have been acquired decades ago. Nutrition, and what we know about it, has changed dramatically just over the past couple decades. Remember the about-face by the American Medical Association in June 2002 on the importance of vitamin supplements? One of the greatest sources of confusion among doctors and physicians, and consequently the general population, arises because of reliance on RDA's. The problem is really that the RDA’s have become a guide for optimal nutrition which is not what they were designed to do.
Optimal nutrition are the levels of nutrition required to prevent chronic degenerative diseases, not just combat vitamin deficiencies. New nutritional guidelines are being suggested by scientists and doctors that specialize in nutrition and are describing levels of nutrients far higher than RDA’s for the maintenance of long term health and the prevention of chronic degenerative diseases. I described a few examples of these above.
Well now that you understand the importance of a daily multivitamin, have a better understanding of the term RDA, and understand the reason RDA levels are inadequate, it is now time to discuss how you go about selecting the right multivitamin.
SELECTING THE RIGHT MULTIVITAMIN
This may seem like a daunting process as there are over 2,000 multivitamins on the market in the US and Canada. So how do you go from 2,000 to 1? Well, it turns out that having extensive knowledge around nutrition is helpful! But most people don't have that kind of knowledge, and that is precisely the reason for this section.
Before we talk about selecting the right multivitamin, I want to take a minute to talk about quality. What does quality mean to you? And just how important is it to you? Assume I was a qualified heart surgeon, and I told you that you needed a heart transplant. (NOTE: The average cost of a heart transplant today costs around $700,000.) And let's assume you told me you couldn't afford $700,000 and would need to seek a cheaper option. So you find an unqualified heart surgeon and find a great deal for $150,000 but you have no idea whether the heart is healthy or whether the heart surgeon is knowledgeable. Which option would you take? The majority of people would spend the extra money to ensure the heart transplant was done properly and that they were given a healthy heart.
Yet when it comes to nutritional supplements, such as multivitamins, I see many people consistently sell themselves to the lowest bidder. This is a dangerous game! But I have studied nutrition and the marketplace long enough to know the reason people spend the least amount possible on supplements. The fact is they believe all nutritional supplements are made the same. This couldn't be further from the truth. The quality that goes into making a multivitamin varies GREATLY from one company to the next. The question you should be asking is "Am I getting what I am paying for?" and "Am I getting what I need to be healthy?"
Let's take a look at the first question. "Am I getting what I'm paying for?" Well, what exactly are you paying for? You might conclude that you are paying primarily for the content of what is in the multivitamin. But did you know that what is on the label of a multivitamin is not necessarily what is in the bottle?!? You are probably thinking "How can that be? It must contain what it says on the label!" Unfortunately, that's not the case. You should understand that nutritional supplements are poorly regulated in the U.S. About 92% of the industry meets what are called food-grade standards, which are poor quality standards, and the only standards required by law. These are quality standards that allow what is on the label to be different than what is inside the bottle. The remaining 8% of the industry voluntarily adheres to much higher standards, called pharmaceutical standards, which ensure the quality of the product in numerous ways. While these companies charge a little more, it gives you the assurance that what is on the label is indeed in the bottle. If you can't trust what is on the label, how can you ensure you are getting what you need to be healthy? You can't!....and that is the real problem!...not to mention the fact that you don't know what you are paying for!
Ok so you now should understand that you need to find a company that manufactures to pharmaceutical standards. This is the only real way you as a consumer can guarantee quality. This narrows you down to about 8% of the industry. But how do you narrow a company down even further. Here is where having knowledge in nutrition helps. You must ask key questions. Does the multivitamin contain the full spectrum of nutrients considered essential for optimal health? For each nutrient, is the potency level appropriate? For those minerals included in the formulation, how many are found in a form that is the most absorbable by the body? Does the multivitamin contain the more-useful type of vitamin E? What kind of antioxidant support does the multivitamin have? Does the multivitamin contain the nutrients essential for optimal bone health? Does the multivitamin contain the nutrients necessary for optimal heart health? Does the multivitamin contain the necessary nutrients necessary for optimal liver health (for detoxification)? These, and the answers to several other questions, are important. This information may be outside of your area of knowledge, but it doesn't lessen the importance of the answers.
This doesn't mean you need to be a nutritionist. Just keep this point in mind: With the RIGHT multivitamin, you can greatly increase your chances of achieving optimal health, reducing your risk of chronic degenerative diseases like heart disease and cancer, and feeling great! You owe it to yourself to let your body feel the difference.
Feel free to contact me if you wish to expand your understanding of the criteria that goes into selecting the right multivitamin or if you would like my recommendation of the best multivitamin on the market along with my reasons as to why it's my choice.
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