Let us be frank. Your whole life has been a lie.
As a child it was Santa and the whole ‘you don’t believe you don’t receive’ ploy. Then, once you started questioning your existence, you were told babies came from storks and Fluffy your childhood dog went to live on a farm to play with his friends.
As you grew older and you realised Fluffy was never coming back and swallowing a watermelon seed will not give rise to a watermelon tree in your stomach, you were made to believe that eating the crusts of your bread will make you grow big and strong and spinach will make you look like Popeye (still waiting). And the lies (or half-truths as your parents would have it) did not stop there.
“Do not swallow your chewing gum or it will stick your insides together”.
“If you make that face and the wind changes it will get stuck like that forever”.
Thankfully, much to our parents’ dismay, most of these exaggerations and fabrications (aka lies) were unveiled early on by the ‘mature’ and ‘experienced’ older kids in the playground. Despite these projected realisations, we are still beguiled by a claim universally accepted as common fact. Instead of coming from the mouths of our (not so) trustworthy parents, this illusion however comes from the mouths of marketers, health ‘professionals’ and health ‘advisors’ – deluding us all. Concealed in bright, multi-coloured packaging brandishing captivating messages promising unlimited energy, flawless skin, pumping muscles and a mansion with a pool, these little fellas are plaguing our supermarket shelves, televisions and newspapers.
Guessed it yet? We’re talking about multivitamins.
“Boost your energy’
Sound familiar? These are just a few promises found on the labels of multivitamins. But can they uphold their promises, or should we add this one to the pile of lies we have already been told?
What are Multivitamins?
Put simply, a multivitamin is a nutritional supplement that includes a combination of vitamins (and often minerals).
Vitamins play a vital role in the maintenance of health and there is a plethora of evidence to show that dietary sources of vitamins have beneficial effects in the prevention of heart-related diseases, bone disease and possibly some cancers.Ball, G.F.M. Vitamin: Their Role in the Human Body [Internet]. Oxford: Blackwell Publishing Ltd; 2004 [cited 2016 Nov 15]. Available from: 10.1002/9780470774571
Although the vitamins and minerals in multivitamins differ in their concentrations from brand to brand, each tablet generally contains the B vitamins, vitamin C, A, E, D2 (or D3), K and minerals such as potassium, iodine, selenium, borate, zinc, calcium, magnesium, manganese, and/or iron. In saying that, multivitamins are typically available in a variety of formulas based on age and sex, or more specific nutritional needs. For example, a multivitamin for men might include less iron than for women, while a multivitamin for seniors might include extra vitamin D.
Like most things in life, vitamins are not created equal. Some are lost easily in the urine (water soluble) and others can store up in the body (fat soluble). Vitamins B and C, for example, are water soluble and need to be replaced frequently to maintain a healthy level within the body. Other vitamins like vitamin A, D, E and K are fat soluble vitamins and do not need to be eaten as regularly.
Due to the multivitamin industry being relatively unregulated, there are enough myths surrounding multivitamins to make an ancient Greek blush.
Despite Australian’s spending more than 1.3 billion dollars a year on these non prescription multivitamins, there is little evidence to suggest that multivitamins actually work.
For example, recent evidence has suggested that multivitamins contribute very little (if at all) to CVD prevention, immune system health and mortality rates. Kendall M.J, Nuttall S.L. The heart protection study: statins for all those at risk? J Clin Pharm Ther [Internet]. 2002 Feb 14 [cited 2016 Nov 15];27(1):1-4. Available from: http://onlinelibrary.wiley.com/doi/10.1046/j.1365-2710.2002.00403.x/abstract Hemilä H, Chalker E. Vitamin C for preventing and treating the common cold. Cochrane Database of Systematic Reviews 2013, Issue 1. Art. No.: CD000980. DOI: 10.1002/14651858.CD000980.pub4
So how can these multivitamin companies innocently make such false claims? Four words: The Therapeutic Goods Administration (TGA). To be listed by The TGA, multivitamins must contain ingredients that are low risk (and you would hope so with the millions of Australian consuming multivitamins every day). What more, the applicant must certify that they hold the evidence to support each indication made related to that medicine. In other words, if you hold the evidence, you can make the claim regardless of whether you can actually show the evidence. These loop holes make it easy for multivitamin companies to sell their products under claims which may not actually be scientifically correct. Check out this short clip from The Checkout for more on the multivitamin industry in Australia.
It is More Than Just a Waste of Money
Consuming anything in excess is bad for you and multivitamins are not an exception. Fat soluble vitamins (A, D, E and K), for example, can build up in the body’s tissue if too much is taken. Taking too much Vitamin A, for example, can increase the risk of osteoporosis and cancer,Penniston K, Tanumihardjo S A. The acute and chronic toxic effects of vitamins A1,2,3,4. Am J Clin. Nutr [Internet]. 2006 Feb [cited 2016 Nov 15];2:191-201. Available from: http://ajcn.nutrition.org/content/83/2/191.full taking too much Vitamin D can damage both the kidneys and blood vessels, and a build up of vitamin E can increase risk of prostate cancer.
On the other end of the spectrum, water soluble vitamins such as C and B vitamins cannot be stored in the body so when consumed in high doses they are simply eliminated from the body through urine. Not so fast though. This is not an excuse to continue popping those sugary orange candies in an ‘attempt’ to prevent that nasty cold from coming back. Although water-soluble vitamins are not stored by the body, you cannot assume that it is safe or effective to take more than the safe upper limit – certain water-soluble vitamins in excess can cause problems as well. For example, too much vitamin B6 can cause nerve problems and excess vitamin C can cause kidney stones.
It is Not All Bad
Despite the debunking of multivitamins, however, we are still tempted to pop these pills like lollies in order to shield us from disease – and it is understandable and in some cases very sensible. Typically, vitamin deficiencies stem from lack of certain vitamins in the diet. Yet although we are exposed to a variety of factors that make it hard to get everything our body needs nutritionally, vitamin deficiency is rare if you are eating a variety of food and are otherwise healthy. For example, ever wondered how much vitamin C you actually need per day? About a small kiwi fruit or orange worth. And yet we still justify spending $50 on a container of those tantalising and addictive orange tablets (lollies).
Nevertheless, there are the small group of people, who may benefit by taking multivitamins. Vegetarians and vegans, for example, often lack B-12 (only bioavailable to us in the form of animal products) and are therefore recommended to take a vitamin supplement. Pregnant women are also recommended to take folic acid supplements of around 400 to 500 micrograms daily to reduce the risk of their child being born with Spina Bifida.National Health and Medical Research Council, Nutrient Reference Values for Australia and New Zealand [Internet]. Canberra: Australian National Health and Medical Research Council and The New Zealand Ministry OF Health. 2014 Folate NRVs. [cited 2016 Nov 19]. Available from: https://www.nrv.gov.au/nutrients/folate A vitamin is the best way to get this amount of folate. Lastly, vitamin D supplements can often be beneficial for older adults and people who do not get enough sunlight.
The Take Home Message:
Although a little bit less obvious than Santa (and quite a bit less disappointing), multivitamins are yet another ‘half-truth’ we are made to believe. Despite their intentions, there is no significant evidence to suggest that multivitamins aid in the prevention of CVD, cancers and all-cause mortality – let alone reduce your wrinkles, help you loose weight, slow ageing and build you a mansion with a pool. Penniston K, Tanumihardjo S A. The acute and chronic toxic effects of vitamins A1,2,3,4. Am J Clin. Nutr [Internet]. 2006 Feb [cited 2016 Nov 15];2:191-201. Available from: http://ajcn.nutrition.org/content/83/2/191.full
If you suspect that you are not getting enough nutrients, consider shifting your focus from supplements to eating a better diet. Whole foods not only contain natural vitamins and minerals, but also fibre and phytochemicals which may help protect against heart disease, diabetes and cancer. According to the Australian Dietary Guidelines, an individual should consume plenty of vegetables including different types and colour, and legumes/beans, fruit, wholegrain foods, lean meats/poultry/fish, eggs, nut and seeds, and mostly reduced fat dairy. Saturated fats, salt, added a sugar and alcohol should also be limited and replaced with polyunsaturated and monounsaturated fats, low salt foods and natural unprocessed foods.
To check the RDI of all macronutrients (protein, fat, carbohydrate, fibre) and micronutrients (vitamins and minerals) for your gender and age, use the Nutrient Reference Values.
If you are one of the few people who may benefit from taking a multivitamin (e.g. vegans/vegetarians, child bearing mothers or the elderly), choose a brand that has the following characteristics:
Contains the most bioavailable forms, including chelated minerals
Contains naturally-sourced nutrients
No preservatives, sugar, artificial flavourings, fillers, dyes, or colourings
So next time you are thinking about taking a multivitamin for your cold, suspected deficiency or just as a safety net, give it a whirl. Who knows what will happen? Maybe Santa will rock up at your door tomorrow with your childhood dog Fluffy and keys to that mansion you have been eying off for years!
But in all seriousness, taking a vitamin supplement can have disastrous effects so it’s a smart idea to have a chat to your GP or APD if you think you may be deficient in a nutrient, and to not self-diagnose. You do not want to end up like Fluffy.
References [ + ]
|1.||⇪||Ball, G.F.M. Vitamin: Their Role in the Human Body [Internet]. Oxford: Blackwell Publishing Ltd; 2004 [cited 2016 Nov 15]. Available from: 10.1002/9780470774571|
|2.||⇪||Kendall M.J, Nuttall S.L. The heart protection study: statins for all those at risk? J Clin Pharm Ther [Internet]. 2002 Feb 14 [cited 2016 Nov 15];27(1):1-4. Available from: http://onlinelibrary.wiley.com/doi/10.1046/j.1365-2710.2002.00403.x/abstract|
|3.||⇪||Hemilä H, Chalker E. Vitamin C for preventing and treating the common cold. Cochrane Database of Systematic Reviews 2013, Issue 1. Art. No.: CD000980. DOI: 10.1002/14651858.CD000980.pub4|
|4.||⇪ab||Penniston K, Tanumihardjo S A. The acute and chronic toxic effects of vitamins A1,2,3,4. Am J Clin. Nutr [Internet]. 2006 Feb [cited 2016 Nov 15];2:191-201. Available from: http://ajcn.nutrition.org/content/83/2/191.full|
|5.||⇪||National Health and Medical Research Council, Nutrient Reference Values for Australia and New Zealand [Internet]. Canberra: Australian National Health and Medical Research Council and The New Zealand Ministry OF Health. 2014 Folate NRVs. [cited 2016 Nov 19]. Available from: https://www.nrv.gov.au/nutrients/folate|