To Your Health

Q. I have decided that it is prudent to start taking a multivitamin, but it seems like there are hundreds of choices. How do I narrow down the selections?

A. The time may be past, if it ever existed, when we can obtain from our diet alone the amount of each nutrient needed for optimum health. An article found in the July 28, 2002, issue of the Journal of the American Medical Association takes a radical departure from the previous stance of the medical community by recommending that all adults take a multivitamin/mineral as a cost-effective method of preventing disease.

There are hundreds of multivitamin/mineral formulas ("multis") on the market, and since we are each very different from one another it really is a good thing that there are lots of choices. There is probably a product made specifically for your age group and sex, and you may have dozens of good choices. A book by Roger J. Williams, Wonderful World Within You, is a good introduction to the subject.

Assuming you are young and generally healthy at present, you may want to start by looking at the various "insurance" formulas, multis that include "some of everything" in one pill. A good multi does not necessarily contain every single essential nutrient because some nutrients, potassium for instance, are impractical to supplement in reasonable amounts. It is preposterous for a multi to list 5mg of potassium on the label when about 1,200mg are supplied daily by the American diet. There are some "bulky" nutrients such as calcium, magnesium, and vitamin C that usually need to be supplemented separately because a single pill cannot provide enough of these and still have room for the other needed nutrients.

The U.S. Recommended Dietary Allowance prepared by the Food and Drug Administration lists the government-recommended amounts for several, but not all, nutrients. A multi should supply at least these amounts of each nutrient listed, and even more is OK given the safety factor for several of the nutrients. The B-vitamins and vitamin C are considered safe at five to 10 times the RDA levels but the minerals and vitamins A, D, E, and K have a smaller safety factor, so no more than twice the RDA should be used without professional guidance.

Unless you know what you are doing, avoid a multi containing herbs. It's not that herbs are ineffective if used intelligently, but the active ingredient in an herb usually resembles a drug. Also, multis containing amino acids almost never contain the hundreds of milligrams needed to make a significant contribution to your health.

It is prudent to avoid as much as possible the "excipients" contained in most pills. Excipients are the binders, fillers, lubricants, and other non-nutritive substances used in making the pill. Excipient-free multis are available and are especially important for anyone with known allergies.

Remember that food supplements are not a substitute for consuming the best diet you can manage. There are probably still "unknown" nutrients that are supplied by whole foods, and food supplements are just that: supplements to nutrients supplied by your diet. We are learning more and more about the nutrients our bodies need and how to best supply these, but at present we still need the solid base of a prudent diet.