Your Ultimate Multivitamin Guide – A Checklist Before You Buy Any Multivitamin


MultivitaminsA healthy diet must of course always be based on foods. Taking a multivitamin can however be a useful top-up, giving you a boost of anything you may need in extra amounts, or as an ‘insurance’ policy just in case you are missing anything. After all, with more than 40 essential nutrients, that we need every day, even the healthiest diet can sometimes fall short.1,2

In fact, USDA nutrition surveys have found that 75% of Americans are not meeting the daily requirements for one or more nutrients (USDA).3 Although, the evidence is inconclusive regarding multi-vitamins extending life-spans of healthy people, there is evidence that they can reduce the risks of several specific diseases.

For example, multivitamin use was associated with a 75 percent lower risk of colon cancer, in a study of 80,000 U.S. nurses.4 There is also evidence that increased intakes of vitamins A, C, E, and selenium reduce the risk of other forms of cancer.5,6 Daily multivitamin supplements have been found to cut fetal deaths, low birth weight, and pre-term births.7 They have also been found to boost immune response by up to 60%, reduce the rate of infectious diseases and delay the onset of cataracts in the elderly.8,9

Multivitamins are the most commonly used supplement, with 40% of men and women reporting they take a daily multivitamin.10 However, with thousands of different formulas available, choosing the right one can feel like a bit of a minefield.

Do not fear! The following article is your comprehensive guide to choosing the best multivitamin for you.

Think About Why You Want To Take It

The first thing to think about is why you want to take a multivitamin and whether you have any special requirements in terms of your sex, age, stage of life or health. For example, men and women have different requirements and the nutrients we need change throughout the lifespan. You may therefore wish to choose a multi, designed especially for your age and sex.

Formulas for women of childbearing age should contain iron, to replace the iron lost each month during menstruation. They also contain higher quantities of folic acid to prevent the possibility of birth defects in women capable of becoming pregnant. Men’s formulas on the other hand, contain higher doses of different nutrients, such as zinc and selenium to support healthy sperm production. They do not contain iron, due to reduced requirements and higher risk of iron overload in men.

Pregnancy is a time when requirements change considerably, so taking a supplement designed especially for this time is wise. A pregnancy formula meets the increased demands of both you and the developing baby. For example, higher levels of calcium and magnesium for healthy bone development and higher zinc, which is required for cell division, and foetal development.

Around the time of the menopause women’s needs change again, so changing your multi at this time is beneficial. A particular issue at this age is bone health, so a formula containing bone protecting nutrients (calcium, magnesium, Vitamin D, boron and vitamin K2) is advisable. Older people in general are at risk of becoming deficient in Vitamin D, B12 and zinc.11,12 Absorption of certain nutrients also slows down with age, so formulas for seniors should take this into account, providing these nutrients in adequate amount and in easy-to-absorb forms.

Another consideration is why you want to take the vitamin? Is it simply for general health or is it to address anything specific? For example, if you want to improve your energy levels, look for one with higher doses of the B vitamins and magnesium. If you suffer with acne, a supplement with good levels of zinc, B5 and vitamin A may help. If you do have a particular health concern, do your research and make sure your multi contains good levels of the ones you need.

Do Your Research

With supplements, like most things in life, you get what you pay for.

There is a huge variation in the quality, with the lower quality ones tending to contain less vitamins, in forms that are less well used by the body. It is a good idea to research the company before you buy, and buy the best you can afford. If you buy from a store, ask a trained advisor. If you are buying on-line, call and talk to someone. A reputable company should have a customer service team, and preferably a qualified nutritionist you can talk to.

The United States Pharmacopeia (USP) has a voluntary testing program called the Dietary Supplement Verification Program. The USP Dietary Supplement Verification mark shows that the supplement has passed tests to ensure that it contains the ingredients listed on the label, does not contain harmful contaminants, and was manufactured using safe and sanitary procedures. Look out for the USP verification as an extra assurance of quality.

Read The Label

You need to check out for 3 things:

  • All essential nutrients are present in correct amounts
  • The types of nutrients used in the formula (see below)
  • Unwanted extras, such as synthetic colourings or sugar.

The essential vitamins and minerals that should be included are vitamin C, B1, B2, B3, B6, folic acid, B12, B5, biotin, A, E, D, K, potassium, iodine, selenium, borate, zinc, calcium, magnesium, manganese, molybdenum, beta-carotene, and iron. Check that the majority meet 100% of the Daily Value, (the recommended amount for each nutrient) – this should be shown on the label beside each nutrient. Calcium and Magnesium are exceptions to this, and will not be present in 100% of the DV as they are too bulky, so would make the pill too large.

The quality of a multivitamin depends on both the quantity of nutrients and the quality – specifically, how bioavailable they are. Bioavailability refers to the amount of a nutrient that can be absorbed by the digestive system and used by the body to give you a health benefit. But how on earth does the average person work out the difference between magnesium amino acid chelate and magnesium citrate? (and that’s only 2 possibilities out of more than ten possible forms of magnesium!).

You don’t need to research or learn all the different chemical names of nutrients, but there are some that are especially important and worth checking. These are shown in the table below. You don’t need to check them all, but if you check that at least some of them are in the recommended forms, you can be fairly confident that the supplement is good quality and that the other nutrients will be ok too.

Nutrient Good Forms Not As Good
Calcium Calcium citrate-malate
Calcium pantothenate
Calcium Orotate
Calcium Carbonate (chalk!)
Calcium citrate
Oyster Shell Calcium
Calcium Gluconate
Magnesium Magnesium Orotate
Magnesium Amino Acid Chelates Magnesium Glycinate
Magnesium Citrate
Magnesium Oxide
Magnesium Sulphate
Magnesium Chloride
Magnesium Carbonate
Zinc Zinc Citrate
Amino Acid Chelates
Zinc Gluconate
Zinc Picolinate
Zinc Sulphate
Selenium Selenomethionine
Selenium Yeast
Selenite
Selenate
Chromium Picolinate
Polynicotinate
Chromium Chloride
Iron Bisglycinate
Ferrous fumarate
Ferrous Gluconate
Iron glycine amino acid chelate

Ferrous Sulphate (can cause intestinal symptoms)

Vitamin A Beta-Carotene (plant form) Retinol (animal form)
Vitamin D D3 (cholecalciferol) D2 (ergocalciferol)
Vitamin E D-Alpha Tocopherol (natural) Dl-Alpha Tocopherol (synthetic)


Added Extras

As well as the right forms of nutrients, you should check that the formula contains no unwanted extras. Many people prefer using products with all-natural ingredients and no added sugar, starch, animal products etc. Again this should be specified on the label. If you are vegetarian or vegan, check that the vitamin is suitable for you, likewise if you have any allergies. If you have any religious dietary requirements, also check for these.

A final decision is what form you prefer to take your supplement in. Multivitamins are available as capsules, tablets, powders, chewables and liquids. There is not much difference between these, other than the rate at which your body absorbs the supplement. If you have trouble swallowing, you will probably find a liquid or gel-coated capsule easier than a tablet. Many people prefer to take just one tablet, so ‘one-a-day’ formulas are popular.

By Daisy Whitbread BSc (Hons) MSc DipION
Nutritionist

References

1. Pao EM, Mickle SJ. Problem nutrients in the United States. Food Technology 1981;35:58–79.

2. Pennington JA, Young BE, Wilson DB. Nutritional elements in U.S. diets: results from the Total Diet Study, 1982 to 1986. J Am Diet Assoc 1989;89:659–64.

3. United States Department of Agriculture survey, 1987-88.

4. Giovannucci, E, et al. Multivitamin use, folate, and colon cancer in women in the Nurses’ Health Study. Annals of Internal Medicine, 1998;129:517-524.

5. Clark LC, Combs GF Jr, Turnbull BW, et al. Effects of selenium supplementation for cancer prevention in patients with carcinoma of the skin. JAMA 1996;276:1957–63.

6. Bonn D. Vitamin E may reduce prostate-cancer incidence. Lancet 1998 Mar 28;351(9107):961.

7. Locksmith GJ, Duff P. Preventing neural tube defects: the importance of periconceptional folic acid supplements. Obstet Gynecol 1998 Jun;91(6):1027-34.
Losonczy, K.G., et al. Vitamin E and vitamin C supplement use. American Journal of Clinical Nutrition, 1996.

8. Pike J, Chandra RK. Effect of vitamin and trace element supplementation on immune indices in healthy elderly. Int J Vitam Nutr Res 1995;65:117–21.

9. Robertson, J., et al. A possible role for vitamins C and E in cataract prevention. American Journal of Clinical Nutrition, 1991 supplement.

10. Pennington JA. Intakes of minerals from diets and foods: is there a need for concern? J Nutr 1996;126(9 Suppl):2304S–8S.

11. Ryan AS, Craig LD, Finn SC. Nutrient intakes and dietary patterns of older Americans: a national study. J Gerontol 1992;47:M145–50.

12. Zheng JJ, Rosenberg IH. What is the nutritional status of the elderly? Geriatrics 1989;44:57–8, 60, 63–4 [review].

13. Classen HG. Magnesium orotate–experimental and clinical evidence. Rom J Intern Med. 2004;42(3):491-501. Review.

Photo by  CreativeCommons @ http://www.flickr.com/photos/detroitsunrise/3524151027/

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