Multivitamins in the News

April 16, 2009 Written by JP       [Font too small?]

The risk of bone fractures is a very serious danger that faces everyone who reaches their senior years. As we age, bone density typically declines, sometimes dramatically. It’s also generally true that the ability to heal from injuries slows down with advancing age. So it’s important to do what is possible to strengthen one’s skeletal system and sense of balance in order to prevent such bone damage. Taking a daily multivitamin is one of the simplest and least appreciated tools for avoiding bone fractures and the falls that can lead to them.

Multi-Vitamin Ratings and Cost-Per-Day Chart

Rating Cost/Day General Guidelines
1 per day Fair 14C Medium potency.
Low in Calcium and magnesium.
2 per day Good 27C Medium to high potency.
More vitamin A, B, C, D and E.
Low in calcium and magnesium.
3-4 per day Better 50C High potency.
More vitamin B, C and E.
Some calcium and magnesium.
Packets Best 67C Highest potency.
Highest levels of A, B, C, D and E.
Plenty of calcium and magnesium.
May include added antioxidants.

A study that appears in the April 2009 issue of the European Journal of Clinical Nutrition reminds us of the importance of the daily use of multivitamins. A total of 92 senior volunteers participated in this experiment – 49 received a daily multivitamin and 43 were given a placebo that was identical in appearance. The study lasted 6 months and measured several aspects of health, including nutrient status, bone density and balance. Here are some of findings of this scientific trial:

  • Higher levels of Vitamin B12, folic acid and Vitamin D were reported in the multivitamin users.
  • 77% of the multivitamin group had adequate levels of vitamin D in their systems. Only 10% of the non-supplementers were found to have satisfactory levels of vitamin D.
  • There was an increase in bone density (as measured by “quantitative heel ultrasound” in the multivitamin users.
  • Those taking the multivitamins also reported 63% fewer falls during the 6 month evaluation.

The positive changes led the authors of the study to conclude that, “this could contribute to a reduction in fractures“. The most encouraging aspect of this experiment was the speed at which the supplementation brought about an improvement in health. Imagine the amount of suffering that could be spared, not to mention the financial savings involved.

There’s another study from March of 2009 that illustrates another important point. In that research, a group of children recovering from skin burns were also given a daily multivitamin for a period of 6 months. The intent of the experiment was to see if the supplement could restore adequate levels of Vitamin D in these young patients. Damaged skin often cannot produce sufficient levels of Vitamin D, which can lead to deficiencies of this vital nutrient.

The researchers conducting this trial used a different form of Vitamin D than in the senior study. This experiment used Vitamin D2 or ergocalciferol, rather than the Vitamin D3 (cholecalciferol) used in the first experiment. This seemingly subtle difference can have major consequences within the body.

In the study with the young burn victims, the multivitamin did not correct the pre-existing Vitamin D deficiency. It’s not entirely clear whether the form of Vitamin D was at fault here. It could simply be that the dosage used (400 IUs) was not adequate. Still, this is a reminder that not all supplements are created equal. Most experts involved in Vitamin D research suggest opting for the D3 form, which is the variety produced by skin when it’s exposed to sunlight.

Fracture Risk in Seniors

I’m frequently asked to recommend the “best” multivitamin on the market. Because the specific needs of an individual must be taken into account, making such a generalized recommendation is impossible to do. For instance, an ideal multi for a senior woman would not likely be appropriate for an adolescent boy. Viewing everyone “the same” can only lead to very crude and, possibly, even damaging results. Having said that, there are some general recommendations about multivitamins that I think could be helpful for almost everyone:

  1. Take your multivitamin with food. This will assist with the absorption of the fat soluble nutrients and reduce the likelihood of digestive upset.
  2. Look for a multivitamin that requires more than one pill per day. Spreading out the dosage will allow for better distribution of vitamins and minerals throughout the day and night.
  3. Consider using reputable brands commonly found in health food stores. Manufacturers that sell their products mainly in health food stores (retail or online) generally provide more “natural” forms of vitamins. This can make a difference in how the body processes these nutrients. Vitamin D is but one example.
  4. Avoid taking a multivitamin with extra iron if you’re not anemic, still growing or menstruating. Excess iron has been implicated in a variety of health concerns, such cancer and heart disease.
  5. It’s generally advisable to avoid combining medications and supplements at the same time. For instance, certain antibiotics may be impaired by the co-administration of minerals such as calcium and magnesium. Please check with your doctor or pharmacist for more information about any known drug/nutrient interactions.*

* One common supplemental interaction to avoid is taking a multivitamin at the same time as a fiber supplement. Taking these two together may negatively impact the absorption of the nutrients contained in the multi.

I hope this information will serve as a reminder of the importance of taking a quality, daily multivitamin supplement. The information we get on the news often gives us pause concerning the relevance of doing so. But buried deep in the scientific data are studies that continue to support the benefits of such a simple and cost effective way to promote long term health.

Note: Please check out the “Comments & Updates” section of this blog – at the bottom of the page. You can find the latest research about this topic there!

Be well!

JP

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Posted in Bone and Joint Health, Nutrition, Nutritional Supplements

17 Comments & Updates to “Multivitamins in the News”

  1. health advocate Says:

    multivitamins are necessary for our body but there are natural sourse to get them. Wheat Bran, Eggs, Meat, Milk products, Green Vegetables, Liver, Kidneys, Yeast, Bananas, Persimmons,Chard,Yogurt, Fish, and Almonds are a good source of Riboflavin or vitamin B2. it is now used in many baby foods and supplements, breakfast cereals, sauces, cheese, fruit drinks, milk products, and some energy drinks. Egg white and egg yolk contain specialized proteins.

  2. JP Says:

    Good day, Health Advocate.

    I agree that healthy foods should be our first choice for acquiring essential nutrients. Multivitamins are supplements. All supplements should be used to “supplement” a nutritious diet, not to replace healthy foods.

    Be well!

    JP

  3. Sai Says:

    I missed this article before and here i am. I take a B co-enzymate supplement and a B12 (since i am a vegetarian) (not even eggs), But really find it difficult to preferably get a single Multivitamin. Please share if you find a good supplement (Men’s) and (Women’s) and that would be very helpful. Another very good article.

    Best regards

    Sai.

  4. JP Says:

    Sai,

    The multivitamin I currently take comes in individual serving packets. It includes a fish oil supplement as part of each packet. The reason I chose this product is because it combines many of the nutrients and herbal extracts that I prefer not to take separately. If this one is too broad, expensive or inappropriate due to the fish oil part of it … then I’ll suggest a few alternatives.

    What I currently use:

    http://www.vitacost.com/NSI-Synergy-Ultra-Multi-Vitamin-Version-5

    A more basic (and economical version):

    http://www.vitacost.com/NSI-Synergy-3000-Multi-Vitamin-ToCoQ10-Mega-EFA

    A different multi with no fish oil:

    http://www.vitacost.com/NSI-Synergy-3000-Multi-Vitamin-Version-11

    Please note that these products contain quite a few herbal extracts. In general, I believe these are healthful additions. But, if you’re on medications it’s possible that some contraindications may be present.

    I hope this helps. Feel free to let me know if you have any follow up questions.

    Be well!

    JP

  5. Sai Says:

    Sir,

    I really have to salute your pateince and good thoughts. I think taking fish oil is OK and I am OK with the first one. I am taking Janumet (that is the part i need to check and see if it interacts with my medication). Thanks again for guiding me chosse a good product. But just out of curiosity, it says 18 capsules(per serving), so shd we take 18 capsules all at once (meaning 18 pills to swallow?)

    Best Regards

    Sai

  6. Sai Says:

    and i suppose this is for Men and Women – correct?, Thanks again JP.

    Best Regards

    Sai

  7. Sai Says:

    Jp

    The Other concern is the traces of lead on all the multivitamin. I checked vitacost and there is no information regading the lead for this product. Please share with me if you find it.

    Best regards

    Sai

  8. JP Says:

    Sai,

    This isn’t necessarily gender specific. Women (and some men) may need to add some supplemental iron. Supplemental iron is generally not recommended unless blood tests and/or symptoms of anemia dictate it. The reason for this is that excess iron may be harmful.

    re: the serving size

    The product calls for two packets (9 capsules and 2 soft gels in each packet) to be taken a day. Preferably, I think it should be taken with breakfast and dinner or with food early and later in the day.

    re: the lead

    NSI (Vitacost’s product line) states that they have thorough quality control measures in place. These should include testing for heavy metals.

    http://www.vitacost.com/NSI-Synergy/Manufacturing

    I’ll contact them directly and see if they can verify that they test for lead and other heavy metals as part of their standard QC protocol. I shall report back.

    Be well!

    JP

  9. JP Says:

    Sai,

    I just got word from Vitacost. They assured me that they do test for heavy metals, including lead, as part of their standard quality control practice.

    Sorry for the delay in posting this reply. I was disappointed that they (Vitacost customer service) didn’t e-mail me back with an answer to our question. I had to call them to follow up on the matter.

    9/18/09 Update: I just got an e-mail from Vitacost confirming that they do in fact screen for heavy metals.

    Be well!

    JP

  10. Sai Says:

    Thanks a lot JP. That is good news for both of us :) i really like the version 11. Please note that the amount of Vitamin A on the version 5 seems a little too higher. Thanks much again for the useful information and the feedback!

    Best regards

    Sai

  11. JP Says:

    You’re welcome, Sai.

    I believe the only difference between versions 5 & 11 (with regard to vitamin A) is that version 11 has 4,000 IUs of pro-vitamin A and 1,000 IUs of pre-formed A (palmitate). Version 5 has 5,000 IUs of pro-vitamin A only. The total vitamin A activity should be equivalent.

    Be well!

    JP

  12. Pilot Says:

    I have never really been into taking vitamins, but as I started getting older, I wanted to take care of my healthy and keep myself going. Since I am a super healthy guy, I have to make sure I get all of my supplements, and sometimes that can be hard just from food. I found dr max powers multvitamins on sale and they sound easy and safe to use. I have had a bad experience with some vitamin brands because they will upset my stomach, be a bad form to take or not show results.

    I take one in the morning with breakfast and it has really seemed to help me stay healthy and have more energy. I like that they are all natural and not made with gelatin, and they contain both calcium and iron which I need. A bottle is reasonably priced and is a balanced formula that keeps me going and healthy.

  13. JP Says:

    Pilot,

    I’m not sure if you’re female or male. Please note that most older men (and some older women) do not require supplemental iron. This is the reason why multivitamin/mineral formulas for men and seniors omit this nutrient.

    Be well!

    JP

  14. JP Says:

    Update:

    http://stroke.ahajournals.org/content/early/2015/03/30/STROKEAHA.114.008270.abstract

    Stroke. 2015 Mar 31.

    Multivitamin Use and Risk of Stroke Mortality: The Japan Collaborative Cohort Study.

    BACKGROUND AND PURPOSE: An effect of multivitamin supplement on stroke risk is uncertain. We aimed to examine the association between multivitamin use and risk of death from stroke and its subtypes.

    METHODS: A total of 72 180 Japanese men and women free from cardiovascular diseases and cancers at baseline in 1988 to 1990 were followed up until December 31, 2009. Lifestyles including multivitamin use were collected using self-administered questionnaires. Cox proportional hazards regression models were used to estimate hazard ratios (HRs) of total stroke and its subtypes in relation to multivitamin use.

    RESULTS: During a median follow-up of 19.1 years, we identified 2087 deaths from stroke, including 1148 ischemic strokes and 877 hemorrhagic strokes. After adjustment for potential confounders, multivitamin use was associated with lower but borderline significant risk of death from total stroke (HR, 0.87; 95% confidence interval, 0.76-1.01), primarily ischemic stroke (HR, 0.80; 95% confidence interval, 0.63-1.01), but not hemorrhagic stroke (HR, 0.96; 95% confidence interval, 0.78-1.18). In a subgroup analysis, there was a significant association between multivitamin use and lower risk of mortality from total stroke among people with fruit and vegetable intake <3 times/d (HR, 0.80; 95% confidence interval, 0.65-0.98). That association seemed to be more evident among regular users than casual users. Similar results were found for ischemic stroke.

    CONCLUSIONS: Multivitamin use, particularly frequent use, was associated with reduced risk of total and ischemic stroke mortality among Japanese people with lower intake of fruits and vegetables.

    Be well!

    JP

  15. JP Says:

    Update 05/27/15:

    http://www.mdpi.com/2072-6643/7/5/3796/htm

    Nutrients. 2015 May 19;7(5):3796-812.

    Improved blood biomarkers but no cognitive effects from 16 weeks of multivitamin supplementation in healthy older adults.

    Supplementation with vitamins, minerals and phytonutrients may be beneficial for cognition, especially in older adults. The aim of this study was to assess the effects of multivitamin supplementation in older adults on cognitive function and associated blood biomarkers. In a randomised, double blind, placebo-controlled trial, healthy women (n = 68) and men (n = 48) aged 55-65 years were supplemented daily for 16 weeks with women’s and men’s formula multivitamin supplements. Assessments at baseline and post-supplementation included computerised cognitive tasks and blood biomarkers relevant to cognitive aging. No cognitive improvements were observed after supplementation with either formula; however, several significant improvements were observed in blood biomarkers including increased levels of vitamins B6 and B12 in women and men; reduced C-reactive protein in women; reduced homocysteine and marginally reduced oxidative stress in men; as well as improvements to the lipid profile in men. In healthy older people, multivitamin supplementation improved a number of blood biomarkers that are relevant to cognition, but these biomarker changes were not accompanied by improved cognitive function.

    Be well!

    JP

  16. JP Says:

    Updated 11/05/15:

    http://www.ncbi.nlm.nih.gov/pubmed/26529011?dopt=Abstract

    Nutrients. 2015 Oct 30;7(11):9005-17.

    Effects of Four-Week Supplementation with a Multi-Vitamin/Mineral Preparation on Mood and Blood Biomarkers in Young Adults: A Randomised, Double-Blind, Placebo-Controlled Trial.

    This study explored the effects of four-week multi-vitamin and mineral (MVM) supplementation on mood and neurocognitive function in healthy, young adults. Fifty-eight healthy adults, 18-40 years of age (M = 25.82 years, SD = 4.87) participated in this randomised, double-blind, placebo-controlled trial, in which mood and blood biomarkers were assessed at baseline and after four weeks of supplementation. Compared to placebo, MVM supplementation was associated with significantly lowered homocysteine and increased blood B-vitamin levels (p < 0.01). MVM treatment was also associated with significantly improved mood, as measured by reduced scores on the “depression-dejection” subscale of the Profile of Mood States (p = 0.018). These findings suggest that the four weeks of MVM supplementation may have beneficial effects on mood, underpinned by elevated B-vitamins and lowered homocysteine in healthy young adults.

    Be well!

    JP

  17. JP Says:

    Updated 12/18/16:

    https://www.hindawi.com/journals/ecam/2016/3092828/

    Evid Based Complement Alternat Med. 2016;2016:3092828.

    The Effects of Four-Week Multivitamin Supplementation on Mood in Healthy Older Women: A Randomized Controlled Trial.

    Objective. Nutritional deficiencies have been associated with cognitive decline and mood disturbances. Vitamin intake can influence mood and randomized controlled trials have demonstrated that multivitamin supplements are capable of reducing mild symptoms of mood dysfunction. However, few studies have focussed on healthy older women. Methods. This study investigated the effects of four weeks’ multivitamin supplementation on mood in 76 healthy women aged 50-75 years. Mood was assessed before and after intervention in the laboratory using measures of current mood and retrospective experiences of mood over the past week or longer. Mobile phones were used to assess changes in real-time mood ratings, twice weekly in the home. Results. There were no multivitamin-related benefits identified for measures of current mood or reflections of recent mood when measured in the laboratory. In-home assessments, where mood was rated several hours after dose, revealed multivitamin supplementation improved ratings of stress, with a trend to reduce mental fatigue. Conclusions. Over four weeks, subtle changes to stress produced by multivitamin supplementation in healthy older women may not be detected when only pre- and posttreatment mood is captured. In-home mobile phone-based assessments may be more sensitive to the effects of nutritional interventions compared to traditional in-laboratory assessments.

    Be well!

    JP

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