Are multivitamins Worth the Price?

Some individuals may be wondering if multivitamins are worth the cost and the effort. Not surprising when one considers all the bad press multivitamins are getting lately. For instance, in the Harvard Men’s Health Watch, published March of 2008, readers may have gotten the impression that most of the ingredients in multivitamins were not worth buying or ingesting. In the Nutrition Action Health Letter of June 2008, it was suggested that individuals only take multivitamins every two days and not everyday. What brought about this concerned buzz? Folic acid. Or to be more precise, the concern that people were getting too much folic acid because of the use of multivitamins.

So, what to do? Here is a good suggestion. Take a multivitamin on a daily basis, but cut down, or eliminate, consumption of fortified foods that can deliver a lot of folic acid to the body.

The Difference Between Folic Acid and Folate

Folic acid and folate are both in the family of B vitamins. The names they carry come from the Latin word for leaf—folium. Folate can be found naturally in vegetables, fruits, many types of grains, and several other foods. It is in a natural form at this phase. On the other hand, folic acid is the synthetic form. It is only available when it is added to different types of foods or when added to vitamin supplements. The important thing to remember is that folic acid will absorb more quickly but the body will still need to convert it to folate before it actually does any work.

Folate is essential in healthy cell function. It has the job of moving carbon atoms (along with the attached hydrogen and oxygen atoms) from one chemical compound to the next. This transfer is crucial to cell functions and that is why folate is so important. Folate is also crucial for making and repairing DNA. It also assists in the conversion process of amino acids, which are the foundation for proteins. Some of the best ways to get folate is to eat beans, sunflower seeds, various types of greens, fruits, and vegetables.

Starting the late 1990’s, folic acid was added to just about all enriched breads sold in the US. It was also added to rice, pasta, flour, grain products and cornmeal. It was added to these food products as a means of preventing spina bifida as well as anencephaly. These are birth defects caused (in part) when there is not enough folate in the mother at the time of conception. By adding folic acid to food products, folic acid was increased, on average, by 100 micrograms per day. This helped to reduce the number of US children who were born with a neural tube defect by an estimated 25 to 50 percent. Controlled studies also showed that folic acid helps to protect people from strokes. Some studies have also suggested folic acid may reduce the risk of heart disease as well.

The IMO (Institute of Medicine) has recommended that adults receive 400 micrograms of folate or folic acid per day. They recommend that pregnant women get 600 micrograms per day. The IMO often sets guidelines for both vitamins and other nutrients. It should be noted that the IMO also suggested that individuals NOT take more than 1,000 micrograms of folic acid a day if it comes from vitamin supplements or if it comes from fortified food. This limit does not apply to folate that is eaten via food intake.

While it may sound contrary, it has been shown that taking too much folic acid can actually hide B12 vitamin deficiency signs. Older individuals often suffer from this at the rate of about one in six. This is often because the elderly do not get the level of B12 that they need or it is not absorbed efficiently. It has also been shown that excessive folic acid levels can mask the signs of anemia. This is another of the early warning signals of vitamin B12 deficiency. If not treated in a timely manner, it could lead to health issues such as dementia, confusion, and severe damage to the person’s nervous system; some of which may be irreversible.

The above are just a few of the health issues associated with excessive folic acid levels. It is also known that normal levels will often help prevent early tumors, but too much folic acid can actually help tumors grow faster. Some other studies have reported that too much folic acid may be linked to an increased risk for various types of cancer such as breast, colorectal, and prostate cancer. It should be noted, however, that these reports and studies are somewhat limited and many other studies have not found a link between excessive folic acid and cancer.

It is not surprising that many consumers are confused over folic acid. In one major study, it was reported that fortifying with folic acid may cause a minor increase in colon cancer. Another equally major study, suggested that other causes may be at the root of colon cancer. And others debate that more effective detection methods for finding colon cancer are the reasons more cases were noted. It could be argued that since doctors are now more effective in locating colon cancer earlier, it is their work that has brought about the increase in colon cancer reporting and that folic acid has nothing to do with it. In fact, studies have shown that there is a lowered chance of colon cancer, as well as breast cancer, when folic acid or folate levels are increased.

It is known that with higher intakes of folic acid the body cannot convert it all into folate. How this may or may not affect the person’s overall health is not clear at this time.

When is Enough?

It is important that readers understand that getting too much of the folate form is not a problem. This form is found in foods and it is naturally balanced within that food. The body can easily take care of its absorption. Now, folic acid, on the other hand, can become a problem. Here is how that problem occurs:

Many of the foods that we eat everyday such as nutrition bars, breakfast cereals, and forms of fortified foods, can contain as much as 800 micrograms of folic acid. This is more than double what most people need on a day-to-day basis. Consider this: if a person consumes an average size bowl of the breakfast cereal Special K, they will get about 390 micrograms of folic acid. If that same person ingests a Nitro-Tech nutrition bar later in the day, they have addd another 800 micrograms of folic acid. And if they eat just one half cup of pasta later on, they can add another 85 micrograms to the total. As you can see, it doesn’t take much to get to and exceed the daily recommended upper limit of 1000 micrograms. And this is the upper limit as set by the IMO.

It is important to know when enough is enough when it comes to vitamin intake. And this applies to all vitamins and minerals. For instance, too much vitamin A can lead to a weakening of bones which can lead to bone fractures. Likewise, too much folic acid can lead to health issues as well.

On the other hand, it is also important to remember that we often do not get the needed amount of vitamins and folic acid that we require through food alone. Eating foods that are fortified with folic acid is one way to increase intake, but it must be done with common sense. Nothing is better than healthy food, but multivitamins and supplements can play an important role as well. This can be especially true for certain groups of people such as pregnant women, elderly individuals, those who do not have access to healthy food on a regular basis and others.

A sensible idea is to take a multivitamin every day and make it a habit to limit or eliminate foods that have been fortified above 100 to 200 micrograms of folic acid. This is one of the best ways to get the vitamins you need without going overboard.

B Vitamins and Heart Disease

Can B vitamins keep your heart healthy?

Sadly, the death of two young children who had died of massive strokes were the catalyst for a 1968 investigation. The Boston pathologist who investigated the death of the children found that they had extraordinarily high levels of a protein breakdown product in their blood. Both children’s arteries were blocked by cholesterol as well, resembling more closely the arteries of a middle-aged unhealthy person than those of a young child. These discoveries led to the hypothesis that elevated levels of this breakdown product (know as homocysteine) had contributed to the process of hardening of the arteries. This condition is called atherosclerosis. So, what is the connection between B vitamins and heart health?

Folate, vitamin B6 and vitamin B12 are instrumental in the body’s ability to convert homocysteine into methionine. Methionine is one of the 20 substances that help the body to build new proteins. Insufficient levels of any or all of these B vitamins can hamper the conversion process, driving homocysteine levels up. Sufficient levels of these vitamisn, on the other hand, can help to keep homocysteine at a safe level.

Many studies over the last few decades have shown that high levels of homocysteine can be associated with an increase in the risk of heart disease and stroke. Some studies have also shown that there is a causal relationship between high intakes of folate and the lower incidence of cardiovascular disease, hypertension and strokes. There cannot be a direct link made, however, between higher homocysteine levels and lower folate levels to an increased risk of heart disease. In other words, it cannot be definitely stated that lower homocysteine levels by taking more folic acid and other B vitamins will lower one’s risk of having a heart attack, stroke or other heart-related condition.

There have been several randomized trials involving B vitamins and heart health, but they have not conclusively shown any relationship between the two. In the studies adutl participants who had a history of heart conditions or who were in the upper risk categories for heart disease were given either a placebo or a pill that contained high doses of vitamins B6, B12 and folic acid. The result of the study was that taking the high doses of the three B vitamins did lower the levels of homocysteine present in the body, but that that reduction did not lead to a reduction in the number of cardiac events in the participants. There is some suggestion that the participants in this study were already too far gone in terms of heart health for the B vitamins to have an effect.

Recently, analysis of several studies seems to suggest that taking folic acid supplements can reduce the likelihood of a stroke in a person who had never before suffered a stroke. The risk reduction does not occur, however, in people who have already had a stroke. Further, folic acid was most effective in promoting heart health when combined with vitamins B6 and B12 as opposed to when it is consumed in isolation.

In the United States and in Canada, since the governments in those countries have mandated that certain products such as bread and pasta be fortified with folic acid, the rate of death from stroke has fallen dramatically. In the UK, where folic acid fortification is not yet mandated, there has been no significant change in the rate of death from strokes.

The long and the short of it is this: Folic acid supplementation may reduce the risk of heart disease in people who have lower levels of folate in their systems. This will typically include those people living in countries where folic acid fortification of food is not yet the rule. In countries where people already get adequate levels of folic acid from their food, further supplementation, even levels that are much higher than can be found in a standard multivitamin, has not been sufficiently shown to be of any significant benefit and, actually, may cause harm.

Currently, what constitutes a sufficient daily intake of B vitamins isn’t clearly defined. The definition would likely change over time anyway, as more data are collected from randomized trials. Currently in the United States, folic acid fortification of food has led to an increase in the percentage of adults who have adequate levels of folate in their systems. Still, only a small percentage of American adults currently get the recommended daily intake of all B vitamins derived just from their diets alone.

Personal Healthy Guide to Vitamins & Minerals

There is little dispute among the medical and scientific professional communities that the very best way to meet our bodies’ daily nutritional needs is through a healthy diet. Unfortunately, the typical North American diet does not provide all of the vitamins and minerals, in sufficient amounts, for optimal body performance. Even in people who would be considered healthy by most accounts, the incorporation of vitamin and mineral supplements as part of a healthy lifestyle can provide benefits. Doing so can ensure we don’t suffer from vitamin and mineral deficiencies, which can lead to certain diseases.

The trouble is, once we make the decision to incorporate vitamins and minerals into our daily routines, it can be confusing to determine what to take and how much. The following guidelines are meant to help healthy people determine the optimum amounts of each that should be consumed daily. The first category to be discussed are vitamins. From there, we will discuss the optimal.

Folic acid

Although the Food and Drug Administration mandated that certain grain products be fortified with folic acid, a measure that has helped to reduce the deficiency of this B vitamin in the United States, the amounts consumed this way are not sufficient. Folic acid is instrumental in the prevention of conditions such as heart disease. It is recommended that women of childbearing age should take folic acid before conception and throughout their pregnancies to reduce the chances of their children being born with neural tube defections such as hydrocephalus and spina bifida.

Iodine

Iodine deficiency is a concern more in developing countries and less so in the Western world. Typical use of iodized salt and moderate consumption of seafood and sea vegetation such as nori usually provides sufficient levels of iodine. People who stay away from these foods should supplement their iodine intake and those with thyroid conditions should consult their physicians before taking iodine supplements and doing so can be counter-indicated.

Vitamin A

Vitamin A (or beta-carotene) is present in most multivitamins. Caution should be taken by smokers, as synthetic beta-carotene has been shown to put smokers at increased risk for lung cancer. Natural beta-carotene, however, has been shown to aid in the prevention of some cancers.

B Vitamins

The typical Western contains adequate levels of thiamine, riboflavin and niacin. These B vitamins are added to some flour products from which the naturally occurring B vitamins have been removed during processing.

Biotin

Biotin is produced in the intestines in sufficient amounts when in conjunction with a healthy diet.

Vitamin B12

Many elderly people suffer from a deficiency in this vitamin, as do people who follow a vegan diet (a diet that does not include any animal-based products, including dairy and eggs). People who habitually take antacids may also experience a deficiency in this vitamin. Vitamin B12 has been shown to control levels of homocysteine in the blood, which has been shown to reduce the likelihood of some diseases, including hardening of the arteries. In addition, supplementation of B12 may bolster the bones against possible fracture.

Vitamin C

Vitamin C is probably one of the most commonly known vitamins. Associated with the prevention and treatment of a cold, vitamin C is common in the Western diet. Although sever deficiency is rare in Western countries, about 6 percent of healthy adults are lacking in this vitamin to some degree. College students and smokers also typically exhibit a mild level of vitamin C deficiency, which may have to do with the less-than-optimal diet followed by college students and the ability of a smoker’s body to absorb the vitamin.

Vitamin D

Known as the “sunshine vitamin,” Vitamin D is obtained both through diet and from exposure to sunlight. Because sunlight is a primary source of this vitamin, people who live in climates that have long winters (and therefore short sunlight hours during much of the year) often suffer from a deficiency and would benefit from supplementation. Vegans and elderly people are also prone to deficiency in vitamin D. The risks of vitamin D include bone loss and the risk of fracture. Note that very high levels of vitamin D can be very dangerous. Never take more than 2,000 IU per day unless advised by your medical professional.

Vitamin E

Vitamin E has long been valued by the cosmetic industry for its restorative properties, but there are other benefits, too. Diabetics are advised to take vitamin E because it boosts the action of insulin to improve the metabolism of blood glucose. This vitamin has also been shown to reduce the risk of prostate cancer in smokers, although it has not been shown to have the same impact on other kinds of cancers.

Vitamin K

Severe deficiency is rare in healthy adults, but moderately low levels has been associated with an increased risk of getting osteoporosis

Minerals

Calcium

Although calcium is readily available from many common foods such as milk, cheese and yogurt, many American (women especially) do not consume enough of these foods to get adequate levels of calcium. For optimal bone health, it is recommended that adequate amounts of calcium are consumed throughout one’s life. This will help to reduce the risk of bone loss and osteoporosis.

Chromium

Perhaps one of the lesser-known minerals, chromium deficiency is less understood in Western society. Lack of chromium in the system can lead to anomalies with blood sugar and cholesterol levels. These problems are particularly acute in the elderly. Symptoms of chromium deficiency include glucose intolerance, weight loss and mental confusion. Severe deficiency can lead to neuropathy, or damage of the nerves.

Copper

Although there is evidence that many Americans suffer from a deficit in this vitamin, those who do suffer from insufficient levels of copper do not present any obvious symptoms. It has been shown, however, that those who take copper supplements generally experience bone loss less frequently than others. Note: Those who take zinc supplements should also take copper supplements. Zinc can negatively affect the body’s ability to absorb copper.

Iron
Recommended daily dose: Varies by individual. Should be determined by a physician

Iron deficiency can result in a condition known as anemia, which can cause extreme fatigue, among other symptoms. It is very important, however, that one does not take iron supplements unless he has been diagnosed with already having a deficiency. Unlike other supplements that can be taken as a preventative measure, iron should only be taken to address an existing deficiency. This is because high iron levels in the blood can cause some serious diseases. Girls and women of menstruating age, as well as pregnant women, female athletes and vegetarians (particularly vegans) are those most at risk for iron deficiency.

Magnesium

Up to one-quarter of American adult women may have a dietary deficiency of magnesium. The incidence of this may be even higher in elderly Americans (both men and women). The risks of magnesium deficiency include compromised bone health.

Zinc

Zinc encourages proper growth in children and has been shown to boost the functioning of the immune system. Higher-than-normal levels of zinc can be dangerous, causing immune system failure.

Other notable nutrients

Potassium:

Potassium deficiencies are rare among healthy Americans. However, some studies have shown that bolstering the amount of potassium in the system can assist the body in preventing high blood pressure and stroke. In addition to supplementation, potassium can be obtained by ensuring that one’s daily diet includes several servings of fruits and vegetables

Flavonoids

Classified as non-essential nutrients, flavonoids are valuable to our bodies for their antioxidant properties. Like all antioxidants, flavonoids work to repair cell damage that can lead to some cancers.

A note about supplements

Many people think that because they are derived from natural substances, supplements are safer than prescription drugs. This is not necessarily true. Like drugs, herbal and nutritional supplements can have negative interactions with one another and with any prescription or over-the-counter drugs you are taking. In addition, supplements can cause side effects if taken in the wrong amounts. For these reasons, it is absolutely imperative that one consults a doctor before taking any supplements. Always disclose all medications you are taking – including prescription, over-the-counter and supplements – to any doctor, pharmacist or other health care professional to prevent any negative interactions.

Nutritional and herbal supplements are a good way to fill in the holes where our diets may be lacking. They should not be used as a substitute for healthy eating, however. Optimal healthy relies on a healthy diet, proper sleep, adequate amounts of water and daily exercise. Supplements should be used as just that: supplementation.

Do calcium supplements have the same positive effect for your heart?

Yes. There is some evidence that taking just some form of calcium supplement can have the same effect. However, at this point in time, it looks like that actually something about the combination of nutrients in milk has even more effect on helping reduce body fat.

Does cheese fall into this category of calcium or is it just too fatty?

Cheese does fall into that category, but it is high in fat, most types of cheese anyway. You can go for the lower-fat cheeses, like the part-skim mozzarella, but there is still a modest amount of fat in it so you don’t want to overdo it. Some of the types of Jarlsberg and Swiss can be a little lower in fat too, so those would be your better choices in the cheese world.

Is there any food that’s surprising or unique where people might not really think that it could protect your heart?

Titchenal: Probably the ones that come to mind the most are the red meats and the lower-fat milk and yogurt products because they usually just don’t associate those with heart health. Also with meat, I really emphasize the low-fat red meats. The one that I have here is the top round and that’s lean meat. You also can go with pork tenderloin, which is a rather lean red meat as well. The beef tends to be a little higher in iron, but both are good sources of a lot of important nutrients. Both the milk products and the meat products are a good source of vitamin B12, which a lot of people may not be getting enough of. We know the combination of vitamin B12, which is only in animal products, along with folate or folic acid, which is in the fruits and vegetables primarily, and vitamin B6, which is in mostly fruits and vegetables, help reduce the homocystine levels in your blood. So a lot of people are taking supplements with those three B vitamins for that purpose because it’s one of those multiple factors for reducing the risk of heart disease.

If somebody changes his diet and starts an appropriate diet, what kind of impact could that have as far as heart disease is concerned?

Titchenal: If somebody makes the right changes in the direction of heart healthy eating in a balanced fashion, which is what I’m emphasizing here, he can expect to see a pretty big impact at some point down the line. Certainly, it’s one of many factors that play a role, but it’s an extremely important one. So, certainly I think if people cut down on the total fat in their diet, increase the variety of foods that are higher in fiber, and then keep some of these healthy foods, certainly they can see changes in blood cholesterol and things like that within a matter of months.

Source: Ivanhoe Newswire

Label decoder – Specialty multivitamins

Lots of multivitamin labels advertise that they’re specially formulated – for women, men, teenage girls, teenage boys, menopausal women, people who have high cholesterol, or even people who want more energy. Do those multivitamins really give you something different, or is it all just hype? Let’s l. Look at the label decoder at one product, One A Day Women’s Active Metabolism, to see what a special formula really delivers.

Calcium and vitamin D – More calcium than an average unisex multivitamin and a nice dose of vitamin D. But it has 200 fewer milligrams of calcium than you’d get in One A Day’s regular women’s multi, which has more D, too.

B Vitamins – These vitamins help your body to extract energy from food. But taking extra Bs won’t necessarily boost energy. People with vitamin deficiencies due to an underlying condition may need more than a multi can provide.

Caffeine and Guarana Aha – now there’s something that should give you an energy boost. One of these pills has 120 milligrams of caffeine (an 8.4-ounce can of Red Bull has 80 milligrams), plus guarana seed, a natural stimulant that contains caffeine.

Disclaimers – Some dietary supplements include claims that appear next to an “referring to a disclaimer that says the statement hasn’t been evaluated by the Food and Drug Administration and that the product “is not intended to diagnose, treat, cure, or prevent any disease”. That’s because supplement manufacturers don’t have to prove to the FDA that their products are safe or effective before being sold to the public. It is the manufacturer, not the FDA, that is responsible for the accuracy and truthfulness of health or other claims that dietary supplements are allowed to make.

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Supplement Facts
Serving Size: One tablet

Amount Per Serving % Daily Value

Vitamin A
(10% as beta-carotene) 2500 IU 50%
Vitamin C 60 mg 100%
Vitamin D 800 IU 200%
Vitamin E 22.5 IU 75%
Vitamin K 25 mcg 31%
Thiamin (B1) 2.4 mg 160%
Riboflavin (B2) 2.7 mg 159%
Niacin 10 mg 50%
Vitamin B6 3.2 mg 160%
Folic Acid 400 mcg 100%
Vitamin B12 9.5 mcg 158%
Biotin 30 mcg 10%
Pantothenic Acid 5 mg 50%
Calcium (elemental) 300 mg 30%
Iron 18 mg 100%
Magnesium 50 mg 13%
Zinc 15 mg 100%
Selenium 20 mcg 29%
Copper 2 mg 100%
Manganese 2 mg 100%
Chromium 120 mcg 100%

Guarana Seed (powder) 50 mg *
Caffeine 120 mg *

*Daily Value not established.

Depression

Depression is a state of intense sadness, melancholy, or despair that lasts for a prolonged period of time – sometimes for months. In some cases, it does not seriously affect the individual’s ability to function. When it does disrupt function, it is referred to as clinical depression. According to the National Institute of Mental Health, one in ten people suffer from a depressive illness of some type each year.

The symptoms of depression can include sadness, fatigue, irritability, apathy, feelings of isolation, loss of interest in favorite activities, hopelessness, insomnia, significant weight changes, aches and pains, and even thoughts of death or suicide. It has been found that symptoms vary according to age, gender, and culture. For instance, a depressive teen-age boy is more likely to experience irritability and grumpiness, while a grown man who is depressed is more likely to experience sleep problems, fatigue, and loss of interest in work and hobbies. Sometimes, there appears to be a cause of the depression, such as loss of a loved one or declining health. In other cases, no obvious cause can be found.

Nutritional deficiencies are associated with depression, so certain supplements can help treat this disorder. But because depression can not only have a great impact on daily life, but even lead to suicide, it is important to consult a physician if you suspect that you or a loved one suffers from this disorder. A doctor should also be consulted about the nutritional aspect of treatment, as certain medications may contraindicate the use of some supplements.

Nutritional Deficiencies Linked with Depression

• B vitamins, particularly B1 (thiamine), B2 (riboflavin), B6 (pyridoxine), B7 (biotin), B9 (folic acid), and B12 (cobalamin)
• Calcium – USANA Vitamins supplements Active Calcium™ and USANA Body Rox™ Active Calcium™ Chewable are more than calcium supplements. They are carefully formulated, clinically proven bone-building formulas. Both USANA Products contain calcium citrate and carbonate, magnesium, vitamin D, and silicon to optimize bone mineralization and to ensure proper calcium use.
• Copper
• Iron
• Magnesium
• Vanadium
• Zinc

Fatty acid deficiencies can also contribute to depression. Your doctor can have your fatty acid and mineral levels analyzed by a laboratory company. The company, on the other hand, can measure your vitamin levels. When treating depression nutritionally, it is important to see an anti-aging specialist who is fellowship trained. Both this specialist and your conventional doctor must work together to help treat this disease.

Supplements to treat depression

• Alpha-lipoic acid
• Ashwagandha root
• Bacopa monniera
• B-complex vitamins
• Calcium – Although most people are deficient in calcium, there is a danger in taking too much calcium. Do not ingest more than 1,000 to 1,200 mg of calcium a day. USANA’s Active Calcium is enhanced with boron and vitamin K. Boron reduces calcium excretion and increases deposition of calcium in the bone. Vitamin K influences the level of osteocalcin in the bone-forming cells and thus the rate of mineralization of bone.
• Carnitine
• Centella asiatica
• Chromium – Combining with the protein picolinate allows your body to absorb chromium more efficiently. However, some chromium picolinate supplements contain more chromium than necessary. Ask your doctor for a recommendation on chromium consumption.
• Coenzyme Q10
• Copper
• EPA/DHA (fish oil)
• 5-Hydroxy-ryptophan (5-HTP) – Do not take with vitamin B6. Consult your doctor regarding use if you are taking antidepressants. Do not take at the same time as antidepressants or any serotonin-affecting drugs
• Ginseng – Always take with food. Do not take if you are taking a blood thinner. Use with caution if you have high blood pressure
• Inositol – May stimulate uterine contractions. Women who wish to become pregnant should consult their doctor regarding its use
• Magnesium
• Multi-vitamins
• Phosphatidylcholine – Use with caution if you have malabsorption problems, as this could exacerbate them
• Phosphatidylserine
• St. John’s wort – Do not take with antidepressants, indinavir, cyclosporine, theophylline, warfarin, or ehinylestradiol. If you are exposed to the sun, it may cause a skin rash. May lessen effects of birth control
• Selenium
• Tryptophan – Do not take if you are on an antidepressant
• Tyrosine – Do not take if you are taking an MAO inhibitor medication
• Valerian – Do not take if you have liver disease or if you abuse alcohol
• Vitamin A and mixed carotenoids
• Vitamin B9 (folic acid)
• Vitamin B12 (cobalamin)
• Vitamin C
• Zinc