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Test Your Supplements Savvy (part 1)

How much do you know about your vitamin pill?

By Patricia Malouf, MPH, RD, LD

Should you or shouldn't you pop one, two, or 10 pills full of vitamins, minerals,
and/or other hard-to-pronounce dietary additives?

The decision about whether to take dietary supplements -- and, if so, which
ones to choose -- gets harder all the time. It seems like nearly every day
brings a new study that adds to the confusion about the role of supplements in
our health.

Once a Day

Though people with certain illnesses or conditions may need extra
supplements, experts agree that nearly everyone can benefit from a once-daily
multivitamin that includes minerals. Even the best eating plans can fall short of
meeting all of the 40-plus nutrients we need each day.

"Most Americans fall short of meeting nutrient needs," says vitamin researcher
and Tufts University nutrition professor Jeffrey Blumberg, PhD. "It is estimated
that only 3% meet the new dietary guidelines, and clearly we can improve the
overall nutrient composition of most diets with a simple, once-daily
multivitamin/multi-mineral pill."

There's no need to spring for an expensive brand, says Katherine Tallmadge,
RD, author of Diet Simple.

"A generic brand is just as good as the best-selling brands," advises
Tallmadge, also a spokeswoman for the American Dietetic Association.
"Compare label ingredients and look for multis that include up to 100% [of the
Recommended Dietary Allowances] of most vitamins and minerals."

Too Much of a Good Thing

When it comes to vitamins and minerals, there is such a thing as too much of a
good thing. Dietitians have long warned of the dangers of excess vitamins and
minerals, especially the fat-soluble types (vitamins A, D, E and K) ones that are
not easily eliminated from the body.

"Individuals who start the day with a vitamin drink, eat energy bars throughout
the day along with fortified foods, and [take] a cocktail of individual
supplements risk developing serious vitamin or mineral toxicities," warns
Tallmadge.

While illnesses resulting from mega-does of vitamins and minerals are rare, it's
better to be safe than sorry, Tallmadge says. "The scientific research is lacking
on the long-term safety of large doses of supplements," she warns.

Taking a daily multivitamin, on the other hand, won't put you at risk of overdoing
it, says Blumberg. "The risk of dietary deficiencies is far greater than the risk of
overdosing on vitamin and mineral supplements," he says.

Food First

Experts say it's important to keep in mind that supplements are intended to
enhance, not take the place of, a healthy diet. That's because food offers so
much more than vitamins and minerals.

"It is safer to get nutrients from foods than supplements because of the
disease-fighting, interactive compounds; fiber; and phytochemicals that occur
in food and do not exist in a pill," says Tallmadge.

New health benefits from various substances found in food are being
discovered all the time. For example, in a just-published study in the American
Journal of Clinical Nutrition, researchers found that antioxidants found in certain
brightly colored fruits and vegetables may offer protection against arthritis.

Test Your Supplement IQ

Take this quiz to test your supplement knowledge.

1. Which of the following conditions calls for taking a vitamin and/or mineral
supplement?

a. Pregnancy
b. Nursing
c. Smoking
d. Dieting
e. Having a chronic disease
f. Eating a vegetarian diet

Answer: All of the conditions warrant taking a supplement.

For pregnant or nursing women, a prenatal vitamin ensures adequate nutrients
for the developing fetus or nursing baby. Folic acid is very important, both
before and during pregnancy, to prevent birth defects.

Smokers need extra vitamin C. This requirement can be satisfied by a
supplement, or by eating more vitamin C-rich foods like citrus fruits, red
peppers, strawberries, broccoli, and tomatoes.

Dieters can fall short of meeting their nutritional needs if they choose the wrong
foods. The best strategy is to eat at least three meals a day and choose
nutrient-rich foods like fruits, vegetables, whole grains, and low-fat dairy. To fill
in the nutritional gaps, a daily multivitamin is the smartest approach.

If you have a chronic disease, a multivitamin is usually a safe bet. Check with
your doctor to be sure that all your nutritional needs are being met.

If you're a vegetarian, your particular diet determines what supplements you
may need. Vegans, who eat no animal products, should pay special attention
to protein, iron, zinc, calcium, riboflavin, vitamins D, B-12, and A, and iodine.
According to an American Dietetic Association position paper, a well-planned
eating plan -- which may include supplements -- can meet your requirements
for these nutrients. Seek the services of a registered dietitian to ensure your
vegetarian diet is adequate.

2. True or false: Everyone can benefit from a once-daily
multivitamin/multi-mineral supplement.

Answer: True.  A basic multivitamin, selected for your age and sex, provides
an array of vitamins and minerals to fill in any nutritional gaps in your diet. Most
multivitamin pills provide up to 100% of the Daily Value for the nutrients they
include. But there are exceptions: calcium and magnesium are too bulky to
include 100% in a multivitamin.

If you don't eat three daily servings of dairy or use calcium-fortified foods, you
probably need to take additional calcium. But most healthy diets that include
spinach, legumes, fish, and nuts provide enough magnesium.

3. True or false: Supplementing your diet with a daily multivitamin and eating
enriched or fortified foods is safe.

Answer: True. The choice is yours. Very few enriched or fortified foods on the
market contain 100% of the Daily Value for nutrients. "There is a margin of
safety built into vitamin and mineral requirements, and most safe upper limits
allow for consumers to take a multi and enjoy fortified foods," says Blumberg.
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