Getting your vitamins

Whenever I speak to groups or patients in my counseling practice, I get more questions about vitamins and minerals than almost any other topic.

Typical questions include “what should I take”, “how much should I take”, “is there any harm in taking them” and of course “food vs supplements.”

So, as we close out nutrition month, I thought I would once again address this popular topic.

Vitamins and minerals are components in food that are essential for our well being. There are many, as most people know, and they all have very specific properties. Most importantly they are all found naturally in a variety of different foods. There are guidelines for how much of each one you need and also — how much is too much.

In general, it’s pretty difficult to overdo it with foods but with supplements there are instances where too much can be a problem.

In a perfect world, under perfect circumstances, diet would give you everything you need and there would be no need for supplements. But, there are times when it’s not possible to get all you need and supplements can help. These times include:

— Women who are pregnant are advised to take a multivitamin with adequate iron to support the demands of pregnancy.

— A multi-supplement with 400 mcg of folic acid is recommended for all women who could become pregnant or who are pregnant or breastfeeding.

— For many menstruating women, getting the required 18 mg of iron can be challenging, even more so if she is on a very low-calorie diet or a strict vegetarian. In these cases, a supplement may be necessary.

— Vegetarians require almost twice as much iron as non-vegetarians and may have difficulty meeting this need with diet alone.

It is recommended that adults over the age of 50 take a supplement of vitamin D as a single supplement or as a component of a multivitamin. And, vitamin D of 600 to 1000 IU or more is being recommended by many health organizations to all Canadians since it is so difficult to get enough in food alone.

Adults over 50 may not be absorbing enough vitamin B12 from foods and are advised to get it from supplements or fortified foods.

People with many food allergies or intolerances, on very restricted diets or those on very low calorie diets may benefit from a multivitamin.

Can you overdo it with supplements? Yes, in some instances you can. Here are a few of those instances:

High doses of vitamin A can be associated with increased risk of fractures and other health issues.

While folate is important, especially to women of childbearing years, too much is not wise. The safe upper limit is 1000 mcg/day. Higher amounts of synthetic folic acid can increase cancer risk in predisposed individuals over time. If you are taking both a multivitamin and a B complex, chances are you are getting too much.

A multivitamin can be a safety net if you feel you are not always eating well. If you are taking a variety of different supplements (for example, vitamin C and B vitamins separately in addition to a multivitamin), it’s a good idea to sit down with your pharmacist or dietitian to evaluate your intake. And, of course, supplements will never take the place of a healthy diet nor will they make up for a diet that’s loaded with unhealthy foods. I’ll write more on this subject in future columns.

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