What's in Your Multi?
by Wyn Snow, Managing Editor
it comes to vitamins and other nutrients, experts agree on only
one thing: Insofar as possible, it's best to get them from food.
Foods contain a wealth of nutrients, all bundled together the way
that evolution has shaped our bodies to use them. In addition to
protein and carbohydrates plus essential fats and vitamins and minerals . . .
vegetables, fruits, beans and whole grainscontain fiber
and important phytochemicals
contains vital omega-3 essential fatty acids
contain healthful unsaturated fats and other nutrients
. . . all
of which help our bodies fight off cancer and heart disease and
diabetes, the major killers of the 21st century in industrialized
it is sometimes difficult to obtain enough of a particular nutrient
from food. Processing can destroy nutrients. Lifestyle choices can
lead to inadequate intake of some nutrients. Special circumstances,
such as pregnancy or reduced absorption by older people, can lead
to higher needs for various nutrients.
though fortification of foods has done its best to close these gaps,
taking a multi-vitamin can be a wise strategy to ensure getting
enough. And many Americans do. Multivitamin/mineral formulas are
the most widely purchased supplement in the marketplace.
variety of multi is best? Here again, a pendulum of opinion ranges
from the "minimalist" to the "optimal" approach.
RDA minimalist approach
health professionals, such as the American Medical Association and
many nutritionists, now recommend that all Americans take a multivitamin
supplement every day. The strategic thinking behind this advice
is to ensure that everyone gets enough of these essential nutrients
every day, even if one's food choices are less than ideal.
aid Americans who wish to follow this approach, we have assembled
two charts covering the nutritional needs of healthy men and women
of various ages from the Institute of Medicine (IoM) of the National
charts also include information on IoM's recommended not-to-exceed
maximums. For children ages 9-13, a good rule of thumb is that they
need roughly half of the recommended levels for adults; for children
younger than 9, consult a nutritionist.
recommended intake levels have gone up for only two nutrients: vitamins
C and K. Others have either remained the same or, for nine vitamins
and eight minerals, gone down. These new recommended intake levels
are not yet reflected in the daily value (DV) column on labels of
dietary supplements, so you may want to compare the specific amounts
shown in these charts with supplement bottles on store shelves.
most nutrients, there is a comfortably wide gap between the minimum
recommended daily intake level and the recommended maximum upper
intake level. Ironically, for the nutrient magnesium, which is vital
for cardiac health, recommended minimums for men are 420 mg/day,
higher than the recommended maximum of 350 mg/day.
for the RDA minimalist approach
we discussed in our previous article entitled RDAs
And Safe Upper Levels: Solid Science Versus Bureaucratic Bias,
more than a few of the recommended minimums, especially for children,
are based on small research populations, extrapolations and guestimates
rather than extensive scientific evidence. Also, scientific data
for the recommended maximums is especially sparse. Furthermore,
these recommended daily intake levels are intended only for healthy
individuals and are designed to maintain health for only 95% of
the population, meaning that one in twenty healthy individuals might
need more than the recommended minimum in order to maintain health.
factsplus scientific research indicating that much higher
levels of some nutrients appears to reduce the risk of contracting
heart disease, cancer, and/or diabeteshas led some experts
to espouse the "optimal" approach to nutritional supplementation.
point of view is best exemplified by the Life Extension Foundation
and analyzes all research that affects long-term health and
longevity (and reports on this research to the public and their
some research on health issues affecting longevity, and
dietary supplement products based on all of these research results.
ConsumerLab.com compares supplement products to formulas shown to
be effective in clinical (human) research, LEF creates formulas
based on such research.
result? Their Life Extension Mix of vitamins-plus-minerals-plus-phytochemicals
contains so many nutrients that the daily "dose" consists of 14
capsules or 9 tablets or 3 rounded scoops of powder. That's quite
a lot to swalloweven when divided up among three or four meals
also makes products with 2 tablets/day and 1 tablet/day that have
a more modest, RDA-like formulation, for those of their members
who prefer this.)
a multi include herbs or phytochemical nutrients?
includes extracts from broccoli and raspberries and tomatoes in
their Life Extension Mix, which makes sense for people who are restricting
their caloric intake as a method of living longeror as a method
of dieting. (Caloric restriction has been proven to lead to longer
lives in several mammals as well as other species, both vertebrate
and invertebrate.) For many of the rest of us, however, eating actual
broccoli and raspberries and tomatoes is a tastier method of gleaning
LEF's credit, however, their formulas include the full dosage amount
shown to be valuable in clinical research. Some supplement companies
add only a small amount of an herb or other nutrient (such as saw
palmetto or ginseng or ginkgo biloba), far less than the amount
used in research studies, and then claim the full benefits of the
research for their product. For most people following the minimalist
approach, it makes more sense to take only the plain multiplus
a separate supplement in a full-strength formulation for the additional
health benefits sought.
tablet or time release?
again, opinions vary. A regular tablet discharges all its nutrients
into the stomach in a single burst, while time-release formulas
are intended to produce more of a steady-stream effect over the
course of a day.
scientist recommends the time-release formulation, because any nutrients
that the body cannot use within a few hours goes to waste, and are
excreted through the urine or perspiration or stool.
scientist points out that the human gut is designed to absorb specific
nutrients in particular "sweet spots" along its length. Any nutrients
that are released "downstream" of those absorption points are simply
the best strategy for the minimalist approach is to cut a single
tablet into halves or thirds or quarters, and take one with each
main meal of the day. Our bodies are designed to absorb vitamins
and minerals together with the foods that normally contain them.
vitamins are made now syntheticallywhich means they are assembled
in state-of-the-art chemical laboratories. This process ensures
that they are identical both to one another and to the "naturally
occurring" forms made by plants and animals.
main exception where the "naturally occurring" nutrient is superior
to the synthetic is vitamin E, which consists of eight forms in
nature and is better absorbed by the body.
essential minerals are all atomic elements (in other words, like
hydrogen and oxygen), and their natural forms are usually some variety
of rocky ore. Plants absorb these minerals from the earth and water
where they grow, and use them in many different ways.
multi-mineral formulas, the minerals are supplied in a variety of
different molecular forms. Questions about which molecular forms
are better absorbed by the body could fill an entire article in
itself, and will not be addressed here. We recommend that you ask
a nutritionist to review any claims about absorption that you wish
to know more about.
speaking, the labels of multi-mineral formulas are required to say
how much of the mineral is supplied and in what form. For example,
"500 mg calcium (as calcium carbonate)" should mean that your body
will be supplied with 500 mg of calcium, and that the source is
calcium carbonate. Alternatively, "500 mg calcium carbonate" would
mean 500 mg of the entire mineralwhich means getting considerably
less calcium because it is only part of that mineral! Unscrupulous
manufacturers have been known to use misleading language, so read
labels carefully and compare brands.
your multi-vitamin dissolve properly?
manufacturers claim that many brands of vitamin tablets are so hard
that they go through the body undissolved, and quote nurses who
find vitamin pills in the bedpans of their patients. While this
can happen, here's a simple "acid test" you can apply to find out
if your multior any other pill!dissolves properly:
Place approximately one cup of white vinegar in a small bowl and
warm it to 98 degrees or so by placing it inside a larger bowl
of water that you "top up" several times with warm water from
the tap. (The goal is to keep the vinegar reasonably close to
98 degrees for half an hour.)
Drop your multi-vitamin (or other pill) into the vinegar, and
jostle it about every five minutes or so by gently shaking or
swirling the cup. While you can also stir the mix with a wooden
stick or toothpick, be careful not to touch the tablet itself.
The tablet should dissolve within 30 minutes. (This is the USP
standard for all pharmaceutical tablets.) If it doesn't dissolve
within a full hour, it's not doing you much good. Get another
about all those "inactive" ingredients on the label?
ingredients in vitamin tabletstechnically called excipientsserve
Sometimes the active ingredients in a tablet would result in a pill
too small to hold. Or as in multi-vitamins, the formula can include
"oil and water" ingredients that don't mix with one another. In
these cases, the manufacturer adds one or more filler ingredients
to the brew so it can be formed into a tablet either big enough
or stable enough to hold.
can be a problem for people who are allergic to them. Read the ingredient
and "does not contain" lists for substances you are concerned about.
Common fillers include lactose (milk sugar), microcrystalline cellulose,
corn starch, sugars (including sucrose, mannitol, sorbitol, fructose,
dextrose), whey and yeast.
These do exactly what the term implies: They are sticky or gluey
substances that hold the pill together. Commonly used binders can
include povidone, xanthan gum and Carbopol (an acrylic resin). Some
fillers may also act as binding agents.
These help hold the tablet together so it doesn't break apart in
the mouth. They also mask any unpleasant tastes, and often contain
colorants. If you prefer to avoid dyes, these should appear in the
list of ingredients.
These assist the manufacturing process in releasing tablets from
the tablet-forming machines. Commonly used lubricants include magnesium
stearate, stearic acid, sodium stearyl fumarate, polyethylene glycol,
and hydrogenated vegetable oil.
excipients used must be listed in the US Pharmacopeia or National
Formulary (for products sold in the USA), and are usually either
food products and thus digested normally, or chemically inert so
that they pass through the body and are not absorbed.
and no. When the formulas for two brands are essentially the same,
purchase the cheaper one unless:
wish to avoid specific excipients
tablet does not dissolve in the "acid test" described above
brand has not passed GMP inspections
manufacturing practice (GMP) procedures establish methods of ensuring
that raw materials are indeed what they are supposed to be, and
that the final product contains the ingredients and potencies listed
on the label. Inspections are crucial because they ensure that the
manufacturer actually follows these GMPs. (For details about GMP
inspections, see our article Four
Websites List Quality Products and Companies.)
the past 10 years since the passage of the Dietary Supplement Health
and Education Act (DSHEA), the FDA has been developing GMP regulations
especially designed for supplements. Before DSHEA and until these
regulations are finalized, supplement manufacturers have been and
still are required to follow GMP regulations for foods. Some have
chosen to follow GMP regulations for pharmaceutical drugs, which
are far more stringent than those for foods.
addition to any brands of multivitamins listed at ConsumerLab.com,
we have great confidence in the quality of all Life
Extension products, including their multivitamins.
LEF's commitment to research and product testing makes them
one of the industry leaders.
experience with products at Our
Health Co-op demonstrates that their multivitamin
products are also of high quality. They not only test every
completed batch of supplements through an independent laboratory,
they also publish those test results on their website.
bottom line on multivitamin quality
following approaches are ways to find a multivitamin/mineral product
of high quality.
current product evaluations, ConsumerLab.com
is an independent laboratory that tests supplement products that
it purchases off the shelf. If a product passes their tests, this
is a good indication that the brand is high qualitymeaning
that it contains therapeutic levels of the ingredients listed on
the label, at the potency levels shown, and does not contain unwanted
contaminants. At this writing (July 2004), the annual fee for seeing
the names of all brands that passand fail!ConsumerLab's
testing information is less than $20.
other organizations are involved in inspecting manufacturing plants
to determine if they are adhering to GMP standards. See our article
Four Websites List Quality
Products and Companies. These organizations list the names
of passing brands on their websites.
the product dissolves in 30 minutes of the "acid
test" described above, the body will be able to absorb the
active ingredients. If it doesn't dissolve within 60 minutes, choose
a different brand.
products that contain additional herbs or phytochemicalssuch
as lycopene or saw palmettodo not contain as much as of these
ingredients as was used in the clinical trials that demonstrated
health benefits. If you want to use supplements containing these
kinds of ingredients, consult an herbalist or nutritionist to find
out the therapeutic levels shown to be effective in the research.
Websites that can help you find an herbalist or nutritionist are
shown in our listing of Healthcare
Practitioners and Alternative Medicine.
you prefer the minimalist or the optimal approach to supplementation,
the more you know, the better your chances of making a decision
conducive to your good health. That said, the best source of vitamins
and minerals is still food.
the old saying goes: You are what you
eat! So eat wisely and well!
Forman, MS, RD. "Multis Deliver Nutrition Insurance: EN Helps
You Make the Best Choice." Environmental
Nutrition, 2004. (www.environmentalnutrition.com).
Manufacturing International, Ltd. "How
are pills, tablets, and caplets made?" 2000.
in this pill? - inactive ingredients in vitamins and other
pills; includes a tip on finding out if a food supplement pill is
vegetarian and a glossary of inactive materials in pills." Vegetarian
Times, March 1998.
M. Scarmoutzos, PhD. President, MVS
Solutions, Inc. (www.mvssolutions.com).
Private communication, June 2004.
Thomas, EdD, RD. "Multivitamin-mineral Supplements." The Dietary
Supplement, No. 13, September-December 2002.
Tuttle. "Setting the Standard for Quality: The Life
Extension Foundation continues to lead the industry in quality
control and research." Life Extension Foundation website. (www.lef.org).