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Should You Be Taking a Vitamin
Supplement?
By Joan Pleuss, R.D., C.D.E.
First, please check any boxes below that
apply to you.
□ I am a woman
of childbearing age
□ I am a
man/woman over 50 years of age
□ I am on a
special diet
□ I don’t eat
well
□ I eat less
than 1,600 calories a day
□ I am a smoker
or I drink alcohol excessively
If you checked any of these boxes, you need
to take a vitamin supplement. Let’s take a
look at the first two categories and what
type of supplement is needed for each
circumstance.
Women of childbearing age
Research has found that certain birth
defects (especially spina bifida) can occur
if there has not been enough folic acid in
the diet. Some foods that provide folic acid
are enriched grains (bread, flour, pasta,
rice and cereal), whole grains, dark-green
leafy vegetables, orange and other citrus
juices, and dried beans. However, because
these birth defects occur in the first days
of a pregnancy—before a woman even knows she
is pregnant and before she may have been
making sure she has been getting 400 mcg of
folic acid in her diet—it is recommended
that she always take a folic acid
supplement.
The other important nutrient for women in
their childbearing years is iron. Iron is
lost in the menses each month. Also, during
pregnancy, the need increases from 18 mg to
27 mg per day. These levels are difficult to
get from food, so it is recommended that
women in this group take a supplement. Foods
that are excellent sources of iron are
fortified cereal, whole-wheat and enriched
breads, dried peas and beans, raisins,
spinach, meat, poultry and fish.
Everyone over 50 years of age
After age 50, the nutrients that need
attention are vitamin B12, calcium and
vitamin D. Vitamin B12 is present in all
animal products. However, after age 50 our
body becomes less efficient at separating
the vitamin B12 from these foods. As a
result, our body is unable to use this
vitamin B12 source. There are two options:
eat foods that are fortified with vitamin
B12 (ready-to-eat cereals are a source), or
take it as a supplement. The amount
recommended is 2.4 micrograms. If these
actions are not taken, the body can become
deficient in vitamin B12. Symptoms of a
deficiency include tingling and numbness in
the arms and legs, impaired balance, and
mental confusion.
Bone loss (or osteoporosis) is a serious
problem. By the time women reach the age of
65, 20% of them will have suffered one or
more broken bones because of that loss.
Getting enough calcium and vitamin D is one
way to slow that loss.
Enough calcium can be obtained from dietary
sources. The recommended daily intake is
1,200 milligrams. See the Calcium Table
below for a listing of excellent sources of
calcium. If you regularly have three
servings of any combination of these foods,
you probably don’t need to take calcium
pills. If getting that amount of calcium
from your diet is difficult, then you should
take a supplement to make up the difference.
To help you figure out the amount of calcium
in a food, just add a zero to the number
before the % on the Nutrition Facts label.
Example: 20% calcium = 200 milligrams. (See
Nutrition Facts figure below.) For best
absorption, do not take your daily
requirement of calcium all at once. Intake
should be spread in separate doses of
approximately 500 milligrams.
Vitamin D allows the body to absorb calcium.
It is recommended that people 50 years or
younger get 200 IU of vitamin D each day,
those between 51 and 70 years get 400 IU,
and those over 70 get 600 IU. The reason for
the increasing amounts with increasing age
is because the skin becomes less efficient
at converting sunlight into vitamin D for
the body’s use. The dietary sources of
vitamin D are fortified milk (100 IU per 8
oz.), salmon, tuna, sardines, egg yolks, cod
liver oil and some fortified foods. Because
it can be difficult after age 50 to get the
recommended amounts of vitamin D in the diet
or from sunshine, a supplement is needed.
Fortunately, the nutrients needed for the
groups discussed above, as well as the
remaining check-the-box groups listed in the
first paragraph, can be met by taking a
multivitamin and a calcium supplement.
Choosing a multivitamin
Select a multivitamin that has 100% Daily
Value (DV) for most vitamins and minerals.
If you are a male or a postmenopausal
female, buy a multivitamin that has no iron
or a very low level of iron. Look for the
USP (United States Pharmacopeia) designation
on the label. Check the expiration date and
store the bottle in a dry, cool place away
from children.
Choosing a calcium supplement
Because most multivitamins average a little
less than 200 mg of calcium (putting more in
makes a pill too large to swallow), it is
necessary to take a separate pill containing
calcium. There are two calcium compounds
that are generally available: calcium
citrate and calcium carbonate. Calcium
citrate is absorbed better and is less
constipating, but costs more because it has
less calcium per pill—thus, requiring more
pills to get the same dose of calcium.
Calcium carbonate should be taken with
meals. However, if you forget, take it
later; it’s better than not taking it at
all.
Most calcium supplements contain vitamin D.
There will also be vitamin D in the
multivitamin. Medical experts believe that
the current recommendation for the amounts
of supplemental vitamin D should be
increased. You will be fine if the
combination of multivitamin and calcium
supplements provides between 1,000 and 2,000
IU of vitamin D.
Vitamin supplements and my diet
Since vitamins do not provide energy,
protein, fiber, phytonutrients, antioxidants
and other unknown beneficial ingredients
that food contains, it is still important to
eat a healthful diet containing lots of
vegetables and fruits, whole grains, lean
protein and low-fat dairy products.
As seen in
TOPS News, Dec-Jan 2010
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