Do I Need a Vitamin?

The supplement section in a store almost always takes up a full aisle. That means it's important to take vitamins, right? 
Listen to Garland County Family and Consumer Sciences Agent, Alison Crane, as she visits with Dr. Jamie Baum, Associate Professor for Food Science at the University of Arkansas and Director of the Center for Human Nutrition at UADA, to find out the facts about multivitamins and whether or not they are actually beneficial. You might be surprised by what you hear.

Transcript

Intro:

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Alison Crane: Welcome everyone to today's podcast. I'm Alison Crane, Family and Consumer Sciences Agent with the Garland County Extension Service in Hot Springs, Arkansas. And we're going to be talking today about a topic of interest to a lot of people.

When you go to the health section in a store, in most stores, there's a lot of space dedicated to the vitamin section. But we find that there's a lot of questions about vitamins and how much or if you should take them. So today we've got a special guest with us, Dr. Jamie Baum, Associate Professor of Food Science and Director of the Center for Human Nutrition at UADA. And she's joining us to clear up some of those misconceptions or questions.

Doctor Baum, welcome. 

Dr. Baum: Thanks, Alison. Thanks for having me. 

Alison Crane: We really appreciate you taking the time to come in and share with us about this topic.

Well, let's first just kind of get everyone on the same page and just kind of define what are vitamins and what role do they actually have in the body.

Dr. Baum: So, vitamins are a class of nutrients called micronutrients. So, I think a lot of people may be familiar with macronutrients, things like carbs, proteins and fat that we hear a lot about on social media. But there's another family called micronutrients. And the reason they're called micro is because they're needed in very tiny amounts by our body.

We need vitamins in our diet because we can't produce them by our bodies, and they're important for growing properly, functioning normally and just staying healthy overall.

They're generally classified in two ways. They can be fat-soluble or water-soluble, and this becomes very important when you're deciding how much of a vitamin you need to take.

So fat soluble vitamins, those are things like vitamins, A, D and K, and those may sound familiar because our milk is fortified with vitamins A and D and being fat-soluble. What that means is you need to consume them with fat in your diet. So, you know, if you're taking your multivitamin in the morning or taking vitamins, often eating them with something like a bagel with cream cheese or, you know, milk, something that has that in it will help them be absorbed better.

But the thing you have to be careful about with fat-soluble vitamins is they can build up in your body, especially in your body, fat tissue and your liver. So, you do have to be careful about taking too much.

And the water-soluble vitamins mean they're soluble in water, so they have to dissolve in the water in your body before your body can use them. And those, when you take them in high amounts, you actually just excrete them in your urine. So sometimes I tell people if they're taking a multivitamin, but they don't need vitamins, they're just having really expensive urine.

Alison Crane: (laughing) Most people probably haven't thought about that before. Is taking a multivitamin beneficial to your health?

Dr. Baum: So, most studies that have been conducted suggest that there's really no effect of taking multivitamins on your health or disease prevention, like cancer, heart disease or even death in normal, healthy people. However, multi-vitamins can help prevent nutrient deficiencies.

So also, a lot of time, especially with older adults or as we age, we may have issues digesting or absorbing certain foods that have vitamins and minerals in them. That's a time when a supplement or multivitamin could be useful.

There's also examples like if you're pregnant, taking folic acid, which is important for lowering the risk of babies, birth defects and brain and spinal health. So, taking prenatal multivitamins has been shown to be healthy for both the mom and the baby.

Also, breastfed babies sometimes need a supplement to ensure they're getting all the nutrients they need. And again, this is to help prevent a deficiency rather than to cure or prevent a chronic disease.

So, for a healthy adult, you're going to get most of your nutrition through what you eat. 

Alison Crane: But then if you were looking at whether to take individual vitamins or a multivitamin, which would be better?

Dr. Baum: Okay. So, I would also like to have a disclaimer that you shouldn't take any multivitamins or supplements without first consenting with your doctor, because some supplements or vitamins may have other things in them besides the vitamin or the nutrient of interest that could interfere with maybe certain medications or other foods or disease risk or things like that. So, it's always important to contact your health care provider if you're thinking about adding a supplement into your diet.

And again, I think it really depends on what you're after. Are you at risk of being deficient in nutrients like vitamin D or vitamin A?  A lot of time when people think about vitamins, they group calcium in there, which is a mineral. But we know that things like calcium supplementation can be beneficial for preventing osteoporosis.

But again, it's just really important to talk to your health care professional before you add anything into your diet.

And another important thing to note is that supplements, including multivitamins, are not really regulated by our government.

So, the Food and Drug Administration or the FDA oversees dietary health supplements. But really, there's no guarantee that what is in the supplement is actually in the supplement, and there's not really an oversight committee for this.

So it's also important to look for labels from NSF International Dietary Supplement Certification or the U.S. Pharmacopeia Dietary Supplement Verification Program, which you may see as USP on the front of your supplement or multivitamin, because these are two companies that screen these multivitamins are supplements to make sure what's in them is actually contained in them.

Alison Crane: Well, that's good to know, knowing that the regulations aren't there, but what to look for for the better benefit?

Well, when you're talking about the quality, then what is the difference between the gummy or chewable vitamins versus the capsules? Are they more effective or less effective? 

Dr. Baum: So what I've read online from organizations like the Mayo Clinic or Harvard Health, it really seems like the gummies are less reliable than the pill format of the supplement.

And this is for a couple reasons, and I was surprised. So gummy vitamins can have some downsides compared to traditional supplements that are in a tablet form. The dose in a gummy vitamin can be unreliable. So, the testing has shown that you may not be getting the same amount of your vitamin in the different gummies within the container and the format of the gummies make it a little less stable on the shelf. So, by the time you get to the bottom of your container, the vitamin or the mineral that is in that gummy may not be in the same form or may be less stable or in a degraded to a lower amount than what it originally was.

And research has found that most gummy vitamins don't have the components they claim to contain inside of them. So, there's not that much proof that they can compete with traditional supplements in terms of nutrition.

And there's other things that have to go into gummies that you have to pay attention to. So, there could be added sugars depending on if it has a sweet taste or maybe there are some artificial sweeteners that people may react to. So, it's really important to look at the ingredient label. If you're eating a gummy, especially maybe if you're a vegetarian or vegan, and if they have gelatin in them, things like that.

Alison Crane: Well, that's good to know because I didn't realize all of the potential differences in them. And I've had a lot of people say, “oh, I like the gummy vitamins much better,” because so many times the regular capsule vitamins are so huge, people don't like trying to swallow them. 

All right. Let's talk a little bit about vitamins that we need, like as you get older. Our audience typically is around 17 to 25, but everybody ages. So how do our needs for vitamins change?

Dr. Baum: That's a great question. As we age, we do tend to have a slowing down of our digestive tract. It happens to everyone. It's just part of the aging process.

But what that means is our bodies are less able to take the nutrients they need from the foods we eat. We're just not as efficient in general, things like vitamin B12 or other B vitamins.

So, B vitamins are really important for movement, muscle function and a lot of other pathways in our body. We may need to get those from a vitamin, especially a lot of up. B vitamins are found in protein based products. So as we age, chewing also can become more difficult and we may steer away from, you know, protein or harder to chew foods like steak or chicken, things like that. So that's where a supplement could come in handy. 

But don't forget, like I mentioned earlier, B, vitamins are one of these water soluble vitamins. So, if we take too much of a supplement, it's just going to come out once our body uses what we need. So again, it would probably be important to talk to your health care provider about what supplement is right for you or if you can change your diet to meet your needs from a variety of health food products.

Alison Crane: Okay, so you look at the multivitamin label and you see all of the vitamins and minerals that are listed on there. What vitamins are least common in a diet that doesn't include a multivitamin? So, what if somebody is just eating food, what's kind of what they miss?

Dr. Baum: So, if we're all eating a healthy, balanced diet, you're really not missing anything. And I would say in. General, because within the United States we do fortify a lot of our food. So, we either add vitamins and minerals to our food. So, like fortifying our milk with vitamins A in D or adding nutrients back to bread or replacing nutrients that might be lost in processing.

We've really eliminated a lot of nutrient deficiencies that we used to see in the past. So, most Americans aren't nutrient deficient. Most healthy Americans and probably do not need a multivitamin.

Again, you know, the data just isn't there to show that in healthy people like 18 and older that multivitamin supplements really give any additional health benefit.

Alison Crane: You referenced a little bit about really there's not a big need to taking multivitamins, but are there any risk then, other than what you've already kind of shared to taking a multivitamin?

Dr. Baum: I think, you know, based on what I've read and what I know from my previous past working in the food industry, the risk really isn't too high for taking, you know, a multivitamin that you would see like on your grocery store or pharmacy shelf. You know, one of the multivitamins that contains all the vitamins and minerals.

However, they are costly or can be costly. So, if you don't need them, you may be spending money that you could use on buying things like fruits and vegetables to supplement your diet.

And it is important to be careful about those fat soluble vitamins and those are vitamins A, D, and K because you can have those build up in your body and have some toxic side effects.

And I think another thing to be careful about is because what goes in supplements is not tightly regulated. You don't know what else could be in your supplement unless it has been certified by one of the companies I mentioned earlier. So again, it just kind of all goes back to eating a variety of foods. Get a healthy diet and you don't have to worry about it.

Alison Crane: Well, during COVID 19, when all of that started, many people started taking vitamin C or elderberry supplements. Is there any research to back up whether those supplements are valuable in improving the immune system?

Dr. Baum: That’s great question, and I think, you know there is some data that shows some of these vitamins and some of these supplements can be beneficial to your immunity, but a lot of it is association. So, when they look, you know, at tens of thousands of people in our population, they may find people who have a high berry intake or high fruit intake that have high levels of a lot of these vitamins may be healthier and live longer lives. Again, that's association because usually if they have high fruit and vegetable intake, they also have healthy lifestyle choices like physical activity and things like that.

I think there has been some research about elderberry, but again, they're not really controlled studies.

Sometimes they're done in animal models. So, I think the better solution is physical activity and a healthy, diverse diet for better immunity rather than relying on sort of a magic pill or a supplement to get us there.

Alison Crane: I will say this because we keep referring back to a healthy diet, we do have some of our episodes that talk about MyPlate and Dr. Baum actually did an episode with us in a previous season about fad diets and some of the dangers and things with that. You can go back to some of our past episodes and get a little more information on just exactly what a healthy diet would look like.

Now let's just talk foods. So, what are some foods that are the richest in the vitamins that we need?

Dr. Baum: Many of you've probably heard the phrase eat the rainbow. So, get over food with a variety of colors in your diet. Those are really things like our fruits and vegetables, carrots, sweet potatoes, spinach, apples, berries. These have a lot of vitamins and minerals that are really good for our health.

They also have something in them called phytonutrients. You may have heard the term functional food, and this kind of falls into that. And it's the phytonutrients are the chemicals within the fruits or vegetables that give them their certain colors. And they also have been shown to have immune effects, anti-cancer effects and things like that in animals and in lab models. But there is an association with people who have high intake of these colorful fruits and vegetables with decreased risk for cancer and things showing that it's really the whole food because these fruits and vegetables also have fiber that's also really important for long term health.

And another thing that often gets overlooked is meat. A lot of our poultry, beef, pork, our meat products are really high in B vitamins. B vitamins are really important for our body and our muscles to function. Specifically, vitamin B12. And I keep bringing in minerals because you kind of can't have one without the other. But things like magnesium, selenium, zinc, things you may hear associated with health are also found in meat products. So, I will say that, you know, if you do follow a vegetarian or vegan diet, these dietary patterns are something you will have to consider the need for a multivitamin supplement in your diet. But after, you know, talking to your doctor or a dietitian to see which nutrients your diet may need.

Alison Crane: I was in a class not too long ago, and one of the things that they referenced was eating the actual foods versus taking a supplement and how in that particular study that we were looking at the foods, the benefits from the foods were so much greater than anything individual vitamin could provide. 

So, I think that's kind of interesting how real food actually works. May also taste better than a vitamin, right? 

Dr. Baum: Yeah. 

Alison Crane: When we're looking at vitamins, though, and you kind of reference this a little bit, too, with the regulations, are there standards or are there regulations that vitamin makers have to follow?

Dr. Baum: The research I did suggest not most multivitamins that you would see like the name brands on the market, they will have less than the dietary reference intake or the recommended dietary allowance for these vitamins and minerals because they don't want to risk like a mega dose of these vitamins and minerals.

If you do take multivitamins, those are name brands on the store are probably pretty safe for you, but there aren't really specific guidelines. That's why it's also important to understand what you need versus the dose that's being sold in the container.

Alison Crane: So, should you avoid vitamins that have amounts above the recommended daily value?

Dr. Baum: I would say yes.

Again, you know, if you're focusing on these water soluble vitamins, when you do consume too much of those, you do lose them in your urine. But I do think we should avoid it. There's no real physical need for it.

You'll spend money on something that your body can't use. Mega doses are the more you eat of these vitamins, doesn’t mean the healthier you are? And you're just paying a lot of money for the nutrients your body can't use?

Alison Crane: You've already mentioned some of the risks that can be associated with taking multivitamins, especially when you don't need them. Are there any other groups who maybe need to be extra careful when considering whether to take a vitamin or not?

Dr. Baum: Yes, smokers and maybe even former smokers are one group that should avoid multivitamins, especially multivitamins with a lot of beta carotene or vitamin A because they may increase the risk for lung cancer if taking to too much. 

Also, if you get too much vitamin A from either supplements or in your diet during pregnancy, it may increase the risk of birth defects for your baby for pregnant women. Beta carotene, which is a form of vitamin A found in plant foods like carrots or other orange colored fruits and vegetables. It doesn't apply to that. It's really specifically about vitamin A, which is found in a lot of animal based products that can increase risk of birth defects for babies.

And then most multivitamins usually don't interact with medication. But there is one really important exception, and I think this applies to many of us, especially as we get older, if we're taking medicine to reduce blood clotting like Warfarin and some brand names might be like Coumadin or Jantoven, you really need to talk to your health care provider before starting a supplement or a vitamin. Especially anything with vitamin K, because vitamin K will lower the effectiveness of these blood clotting drugs.

So, your doctor may warn you against them or maybe be able to recommend a different type of supplement that won't interfere with the blood clotting medicine.

Alison Crane: Well, that's good to know. I knew that some of those particular medicines they recommend, you know, don't eat green beans or some foods and stuff. But I hadn't heard anything about watching for, you know, specific vitamins.

Okay. Let's say, you know, I've listened to all of this, consulted with my doctor, and the doctor does recommend that I need a vitamin and I'm going to the store. Like I mentioned at the very beginning, most stores have almost an entire aisle dedicated to vitamins and minerals and all these supplements. What should I look for if I am going to purchase a multivitamin?

Dr. Baum: If you're really focused just on multivitamins, that will eliminate 95% of your choices in the supplement aisle. And you can really focus on, you know, there's I don't want to promote any one brand is being better than the other, but there's a lot of common brands and your physician may even have a brand, a multivitamin that they prefer to others, but really look for something that is clearly a multivitamin. And it just has, you know, your standard mix of vitamins and minerals.

You'll see things, I guess I can say, like Centrum or One a Day or there's a whole slew of these multivitamins on the market.

Sometimes they say they're geared towards women or men. You do want to check what the extra ingredients are if they are targeting a niche market.

And also, you know, your store brand of the multivitamin is going to be just as effective as the name brand, and they cost a lot less.

And if you are at a place, you know, like a Walmart, CVS, Walgreens, a place with a pharmacy, you can also ask the pharmacist. They should also be able to tell you, especially if you go somewhere where you buy your get your medicines, what may or may not interfere with medicines you're taking, or they may have a brand that they like.

But, you know, when in doubt, look for those certifications that would say NSF or USP on the front and just pretty much skip over everything except the multivitamins.

Alison Crane: Well, that's very good advice. And I really think that you've helped clear up some of the misconceptions or questions that our listeners may have had about vitamins.

And we appreciate you taking the time and joining us today, Dr. Baum. Is there anything else you'd like to share just as a final reference?

Dr. Baum: I would like to share. Get your vitamins and minerals from a healthy, balanced diet with fruit and vegetables. Aim for that first because you will get all the nutrients you need, plus additional benefit from the nutrients found in whole foods that you won't find in a supplement.

And I would just like to thank you for inviting me and giving me the time to talk with you today.

Alison Crane: Again, thank you so much, Dr. Baum. We really do appreciate you coming on.

I know our listeners have lots of questions when it comes to that. In fact, for these questions, I actually had a young person help me write these questions based on what she wanted to know.

Dr. Baum: So, I think if there's something I haven't covered or people come back with more questions, I'm happy just to summarize something in an email, or we can put it in a fact sheet that people can download for free and get the information they need.

Alison Crane: All right. So, listeners do remember that you can visit our website at UAEX.USDA.EDU/GROWNUPU and that's a U. The letter U at the end to reference any factsheets or information that we have.

We also have resources for educators to use in the classrooms or for other programs.

Be sure and come back and listen to next week's episode.

And thank you for joining us today on Grown-Up U Facts for Success.

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