A Dietitian's Guide To Taking Vitamins

All you need to know about vitamin pills from dietitian Dr. Linia Patel

 Given that there is a pill for absolutely everything these days it is not surprising that one of the most common questions dietitians get asked is, “which vitamins should I take?”. Most of us have vitamins in our kitchen or bathroom cabinets as an insurance policy for our health but are none the wiser as to whether we should take them or not. And the big question is shouldn't we get all our nutrition from food? Linia has looked at the research and gives us some guidance on whether we need to take vitamins, who should take them and what we should take if needed.

Food versus vitamins

According to the Food Standards Agency almost one in three people in the UK take a vitamin supplement every day, while 15 per cent of us turn to high-dose supplements for a quick fix. But do vitamin pills really deliver the health and vitality they promise?

Well, I am and will always be a “food-first” dietitian. The reasons for this are simple. Food is a complex balance of hundreds of vitamins, minerals, plant-based compounds and various forms of fibre that all work together to provide multiple health benefits. Therefore common advice from dietitians is that if someone has a good, well balanced, nutritious diet, there should be no need for any supplements.

And yes, in a perfect world we wouldn’t need to pop any pills. However, how perfectly balanced is your diet? I have to confess… despite being a dietitian my diet isn’t always (Shhh! Don’t tell! ). The reality for us all is that we are unlikely to meet optimal nutrient levels of all essential nutrients, 100% of the time. High-speed lifestyles leave many people gulping down pre-made meals and grabbing food-on-the-go. Even if your diet is next to perfect the modern world we live in now has an impact on the nutritional profile of our food. Intensive agriculture, fast-growth crops and food processing means our food is significantly lower in minerals and vitamins than it used to be – not a recipe for perfect nutritional balance.

Vitamins are big business

Vitamins and dietary supplements are big business and it is a multi-billion pound industry. Unfortunately, the industry is also, largely, not regulated and there are many bold health claims promising better health in a pill. Antioxidant supplements like vitamin C and E are the silver bullets against Alzheimer’s, heart disease and even cancer. While taking high-doses of omega-3 whilst you’re pregnant will promote optimal brain development and guarantee that your baby will be a genius. The result is a huge range of “health” pills and powders and lots of confusion about what is really good for us.

Where vitamin pills fall short

Research has shown that isolating individual nutrients found in food and putting these nutrients into a pill or potions doesn’t quite have the same effect on health as eating those nutrients in food.

For example look at the results the Iowa Women’s Health Study. Researchers followed over 38,000 women (between the ages of 55 and older) for a period of 20 years. Results from the study showed that most vitamin and mineral supplements maybe associated with increased total morality risk (2.4%); this association was strongest with supplemental iron. However calcium supplements seemed to be associated with a slightly lower risk of death.

Now what does this mean? It doesn’t mean that iron and other vitamins and minerals are always bad for you. You need to have iron in your diet for you to produce enough red blood cells for example. People who are anaemic need iron supplements. However the study does suggest that for healthy people, taking an extra iron supplement when you don’t need one may actually be detrimental. Other studies have shown that high dose vitamin E supplements may increase your risk of heart failure and too much vitamin A maybe bad for your bones and your heart.
But on the other hand – there are some supplements that have been shown to be good for you. Vitamin D for example was previously only thought to only managing calcium in and out of the bones however in the last decade a whole host of vital functions have been discovered. Adequate vitamin D intake is important for maintenance of healthy bones and teeth but there is also strong evidence to suggest that that it also provides a protective effect against multiple diseases and conditions such as cancer, multiple sclerosis and diabetes.

Nutrition experts believe that vitamin D may protect against type-2 diabetes by reducing insulin resistance, increasing insulin sensitivity and enhancing the function of the cells responsible for producing insulin (the hormone that manages blood sugar levels). Results from two recent reviews showed that people with low blood vitamin D levels have a 55% higher risk of developing type 2 diabetes.

So should we be take supplements?

There is not a straightforward yes or no answer to this question, both because of the range of products available and because an individual’s circumstances will govern whether they would benefit from using a particular supplement.

Who should take a vitamin?

While diet is the key to getting the best vitamins and minerals, supplements can be helpful for certain population groups. Nutrient intakes also vary throughout the lifespan. Very strict diets may also need supplementation. While diet should come first, taking supplements acts as a nutritional safety net especially for:

1. Women who are planning a baby or are pregnant or lactating
2. Children and teenagers with irregular eating habits
3. People over the 50 when absorption of certain nutrients starts to decline
4. Vegetarians or vegans
5. Dieters or people avoiding certain food groups (may be deficient in key nutrients)
6. People with eating disorders or medical conditions (deficiency diseases, absorption problems, lactose intolerance, etc.)

Top tips on taking vitamins

My five tops vitamin and mineral supplement tips are; 

1. Think food-first then supplement the gaps. A supplement should do just that – supplement. It is no replacement for a healthy diet and lifestyle. Supplements can be used to “bridge the gap” when needed, other than that limit supplement use. The supplement industry is sadly not regulated so remember if something sounds too good to be true – be wary!
2. Take stock of your diet habits. Are you avoiding a particular food group? If so, learn about the key nutrients that might be missing as a result and then choose a supplement that helps to bridge that gap. For example it makes sense for anyone who is avoiding diary to talk a calcium and vitamin d supplement to make up for these nutrients.
3. Be well rounded. Multivitamins are often a safer bet than taking a cocktail of individual supplements that exceed the daily recommended intake (RDA). Nutrients all work in synergy in the body and if you take too much of one nutrient for too long you are at risk of becoming deficient in another.
4. Respect the limits. More is not better with supplements. Unless you have blood results that indicate you need high doses – opt for supplements that provide the recommended daily intake. There are some exceptions which a registered Dietitian/nutritionist can talk you through.
5. Find out what’s right for you! How do you know what’s right for you? The best way is to talk to your doctor or registered dietitian/nutritionist before taking dietary supplements. If you are already taking supplements, ask them if it’s a good choice to continue and if you’re taking the right ones in the right quantity at the right time!