Vitamin Mineral Supplements Benefits and Risks

Do you take a vitamin and mineral supplement? Maybe you need to, maybe not. Many vitamins and minerals are sold as single supplements—for example, vitamins C and E, beta carotene, calcium, and iron. Some are sold in large doses, perhaps more than you need. Others are "combos," sold as multivitamin/mineral supplements. What's right for you?

Vitamin/Mineral Supplements: For Whom?

Do you consume a varied, balanced diet? With some exceptions, supplements usually aren't necessary—if you're healthy and zf you're able and willing to eat a balanced, varied diet. You probably can get the vitamins and minerals you need from smart food choices. According to national studies, most Americans have enough healthful foods available to do that, yet they may not. Under some circumstances, vitamin/mineral supplements offer benefits and are advised.

Your doctor or a registered dietitian (RD) may recommend a dietary supplement. Are you . . .

  • A woman with heavy menstrual bleeding? You may need an iron supplement to replace iron from blood loss. To enhance absorption, take iron supplements with water or juice on an empty stomach. If nausea or constipation are problems, take iron supplements with food. Absorption may be decreased by as much as 50 percent when taken with a meal or a snack.
  • A woman who's pregnant or breast-feeding? You need more of some nutrients, especially folate and iron—and perhaps calcium if you don't consume enough calcium-rich foods. Check the label's Supplement Facts to make sure you get enough for a healthy pregnancy. Ask about a prenatal vitamin/mineral supplement. See "Before Pregnancy " in chapter 17.
  • A woman capable of becoming pregnant? Consume 400 micrograms of folic acid (the synthetic form of folate) daily from fortified foods, vitamin supplements, or a combination of the two—in addition to folate found naturally in some fruits, vegetables, and legumes. The extra folic acid offers a safeguard against spinal cord defects in a developing fetus. Synthetic folic acid is better absorbed than food folate.

Foods fortified with folic acid include enriched grains such as flour, breads, cereals, pasta, and rice. If you take a supplement, choose one with a dosage of no more than 1,000 micrograms of folic acid daily.

  • A menopausal woman? You'll likely benefit from a calcium supplement with vitamin D, in addition to a calcium-rich diet, to slow calcium loss from bones. See "Calcium Supplements: A Bone Builder" in this chapter. For some older men, a calcium supplement is advised, too.
  • Someone on a restrictive diet (<1,600 calories a day)? You likely won't consume enough food to meet all your nutrient needs. Your doctor or a registered dietitian may recommend a multivitamin/mineral supplement. Caution: Unless under a doctor's supervision, very-low-calorie eating plans aren't advised. See "'Diets'ThatDon't Work!" in chapter 2.

amounts of alcoholic beverages can interfere with the body's use of most nutrients.

  1. Fact: If soil can grow crops, the food produced is nutritious. When soil lacks minerals, plants don't grow properly and may not produce their potential yield. Growing area does affect a food's iodine and selenium contents.
  2. Fact: Usually not. Supplements won't give you instant results. For vitamins and minerals to do their work, they need several hours or several days to interact and do their work in your body. For any benefits from other dietary supplements, you likely need to take them even longer. Read on to unravel the fiction and explore the facts about dietary supplements.
  • A vegetarian? You may need extra calcium, iron, zinc, and vitamins B12 and D—if your regular eating pattern doesn't supply much, if any, meat, dairy, and other animal products. See chapter 20, "The Vegetarian Way."
  • Someone with limited milk intake and sunlight exposure? If you have lactose intolerance, a milk allergy, or simply don't consume enough dairy foods, you may need a calcium supplement for bone health.

You may be advised to take a vitamin D supplement, too. (Older adults often need a vitamin D supplement.) Remember, fortified milk is the best source of vitamin D. Still, you need only a little sunlight for your body to make enough vitamin D: ten to fifteen minutes on your hands, arms, and face without sunscreen, two times a week for most people. See "Vitamin D: The Sunshine Vitamin" in chapter 18.

• Someone with a health condition that affects nutrient use? Doctors often prescribe supplements for those with health problems that affect appetite or eating, or that affect how nutrients are absorbed, used, or excreted—for example, digestive or liver problems. Surgery or injuries may increase the body's need for some nutrients. Some medications, such as antacids, antibiotics, laxatives, and diuretics, may interfere with the way the body uses nutrients. If you have a food allergy, gluten intolerance, or other health problems that restrict what you eat, a supplement may be advised; talk to your healthcare provider.

Ten to 30 percent of adults over age fifty have atrophic gastritis, a condition that causes damage to stomach cells and so reduces the body's ability to absorb vitamin B12. For that reason, adults in this age group are urged to get extra vitamin B12 in its crystalline form from a supplement or from fortified food.

  • Someone unable—or unwilling—to regularly consume a healthful diet? You likely need a dietary supplement to fill in the nutrient gaps. However, eating smarter would be better if you don't have food-related health problems! Take a supplement with the advice of a doctor or a registered dietitian. For example, premenopausal women who don't consume enough calcium from food likely need a calcium supplement—unless they're willing to improve their diet.
  • Some babies after age six months, children, and teens may need a fluoride supplement—and perhaps iron or vitamin D. See "Vitamin and Mineral Supplements forBreast-FedBabies" in chapter 15.

To know ifyou likely consume enough nutrients, see "How Did You Build Your Pyramid?" in chapter 10. If you have any questions about your own nutrient needs—or think you need a supplement—talk to a registered dietitian or your doctor. See "How to Find Nutrition Help..." in chapter 24.

More Isn't Always Better!

A little is good, but a lot may not be healthier. As with other nutrients, such as fat, added sugars, and sodium, moderation is your smart guideline for vitamins and minerals: enough, but not too much.

Supplements carry labeling, showing the amounts of vitamins and minerals in a single dosage. If you already eat a healthful diet, you probably don't need any more than a low-dose supplement. Taking a multivitamin/mineral supplement, with no more than 100 percent of the Daily Values (DVs) as a safety net, is generally considered safe. Most nutrient supplements are produced in low dosages.

Supplements that boast "high potency"—a much higher dosage than you may need—also are sold over the counter in pharmacies, grocery stores, health food stores, and through Internet and mail-order outlets. Either as single-nutrient supplements or vitaminmineral combinations, high-potency supplements (significantly in excess of the Daily Values) can be harmful. Why can they be sold if you don't need so much? Currently no law limits supplement potency, except for potassium. Being prudent is up to you.

Risks. Consumed in excessive amounts, nutrients in some supplements can have undesirable side effects such as fatigue, diarrhea, and hair loss. Others may pose more serious risks—for example, kidney stones, liver or nerve damage, birth defects, or even death.

Because fat-soluble vitamins (A, D, E, K) are stored in the body, taking high levels of some for a prolonged time can be toxic. For example, excess amounts of vitamin D can cause kidney damage and reduced bone density. Too much vitamin A, taken over time, can cause bone and liver damage, headaches, diarrhea, and birth defects.

Supplements with water-soluble vitamins or minerals can be risky if taken in excess, over time. For

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