Good Food with Evan Kleiman: Vitamins and Your Diet

If you're a bit delinquent about taking vitamins on a regular basis, there's some good news - those vitamins may not be making a difference anyway. Evan Kleinman's special guest Will Clower was on Good Food a few weeks ago to explain how this can be.

Will Clower says that one of the biggest problems is that vitamins and other dietary supplements often get on the market before they've been fully tested, particularly in the area of long-term effects. He explains that several long-term studies have been completed in the past few years showing that many of the main vitamins we've been told to take since childhood have very little or no effect on overall health.

Not only this, but taking these raw vitamins has actually been shown to have a negative affect on health in some cases. One study showed that people taking vitamin E were 75% more likely to have a stroke while another showed that men taking selenium and vitamin E are more likely to get prostate cancer.

Clower admits that this issue can get very confusing, especially since it seems like studies with conflicting claims seem to come out every other day. As someone who has spent his career studying studies, his recommendation is to pay careful attention to who is providing the funding and how the study has been conducted. Clower believes that "if you look at the most reliable studies, the bottom line is that we probably should not be taking vitamin supplements."

Evan Kleiman responds by saying that she's not entirely surprised by these findings, and we agree. It makes sense that eating the whole food would be a more effective way of ingesting vitamins than taking the raw vitamin. After all, humans have been been eating carrots for centuries and beta carotene has only become a dietary supplement in the past fifty years.

What do you think about these findings? Do you take vitamins?

• Listen to Evan Kleiman's full interview with Will Clower, and all the other great segments from this episode, on the Good Food website!

(Image: Flickr member House of Sims licensed under Creative Commons)

Comments (20)

I take them, but I don't take a lot, and I avoid super-everything multivitamins. I take calcium with D, under doctor's orders, because of medical calcium issues. When I don't take it, I get signs of hypocalcimia, namely tingles in my fingers. I take a fish oil capsule to boost good cholesterol, as suggested by my doctor. Also suggested by my doctor -- one Flintstones chewable daily.

Other than what my doctor tells me? I take zinc if I've been exposed to germs or feel as if I'm getting a cold. Nothing else.

I take vitamin C because it's been proven to lessen symptoms of a cold. Calcium because my doctor suggests it for my bones, and E because the doctor suggested it for my skin. Is there a link to the study that says Vitamin E causes strokes in men?

I take Flinstones Complete because I can't stomach any other vitamin pill. My doctor said I need 400mcg of Folic Acid since I'm an of birthing age lady person.

I take calcium w/ magnesium and Vitamin D because osteoporosis runs in my family. I tend towards anemic so I also take an iron pill with a vitamin C supplement (to aide with absorption).

I used to take a daily multi until the most recent study came out about how it doesn't do squat. I've been off it since January and haven't noticed any difference.

It takes a bit of digging, but here's a link to the NY Times article mentioned in the Good Food podcast:

http://www.nytimes.com/2009/02/17/health/17well.html

And here's a link to the study about Vitamin E and prostate cancer from the NY Times article:

http://jama.ama-assn.org/cgi/content/full/301/1/39

Also, here's the one about vitamin supplements and cardiovascular disease in women:

http://archinte.ama-assn.org/cgi/content/abstract/169/3/294

One problem with most of the popular vitamin studies is that they make no distinction between subjects taking naturally derived vitamins vs. synthetically produced vitamins.

This is all extremely confusing.

After I went through cancer treatment in 2007, I got an overwhelming amount of often conflicting information about the role of vitamins and other supplements in preventing cancer and other diseases.

At this point, I only take Vitamin D and calcium. I try to eat a balanced diet.

Most of all, I try to keep my stress level low and exercise every day. I think those last two things are more important to my overall health than any vitamin.

I disagree that eating a good diet gives you everything you need. I'm a nutritionist, don't eat any processed or fast food, and only eat fresh, whole foods with lots and lots of vegetables. Given that, when I run a dietary analysis on my own diet, I always come up deficient in about half a dozen vitamins and minerals. When I do this for patients, they always fall short on things (often, they fall short on everything).

So, I think it's good to take a multi to cover your bases.

As for the studies mentioned, as Arin pointed out, these studies -- be they primary or review articles -- don't differentiate between natural and synthetic forms of a vitamin, or the bioavailability of various minerals. For example, in the Vitamin E Selenium article linked to JAMA above, they used alpha tocopheryl Vitamin E. While this form has the greatest bioavailability, it's function in the body is not identical to beta, gamma and delta tocopherol. So, to imply that all Vitamin E is worthless and possibly dangerous is an exaggeration of the study findings.

In this JAMA study, there was a 5% increased risk of prostate cancer in the vitamin E selenium group. While this result was statistically significant, 5% is a very small risk increase and could be attributed to other things. This study didn't look at family history, diet, or other important factors that contributed to stroke. (That doesn't mean this was a bad study -- studies only look at very specific things because you can't look at everything) So, while the data is interesting and a very small piece of a much larger picture, I wouldn't recommend people avoid Vitamin E and Se based on these results.

This is the problem with studies in general -- they are only a very small part of a very large picture, yet these small pieces are reported on in the media, and people and doctors make changes based on them.

As for me... I take magnesium (400 mg), iron (60 mg), and Vitamin D3 (4000 IU) to treat deficiencies. I also take 8g Vitamin C (for reasons too long to post here ;) ), along with a smattering of botanicals.

Oh I forgot, I also take 3g flax seed oil along with 400 IU vitamin E (to prevent the omega-3 from going rancid int he body), and a vitamin B complex (for carpal tunnel and andrenal insufficiency).

Very interesting reading!

In my adult life, I shied away from taking vitamins until a couple years ago. I began taking whole food prenatal vitamins for about a year prior to my pregnancy. Certainly this isn't scientific proof, as someone who had the flimsiest fingernails and super fine hair, after a bit of taking the vitamins my nails and hair grow faster and are much, much stronger. I HAVE nails now! My skin was better also. As far as my diet goes, I have always tried to eat healthy and well balanced, so it wasn't a change there. I can't say what's happening internally though!

I think using vitamins to help with particular ills just as you would use any drugstore medicine is a good thing versus the multivitamin route. I take wellness formula vitamins whenever i feel sick. Lysine pills for cold sores and cranberry pills when i feel a UTI coming on (possible overshare. sorry). I think it helps!

My doctor here in Switzerland took me off my prenatal vitamins while I was still exclusively breastfeeding because "I should be getting all the vitamins I need from the food I eat".

Since here in Switzerland there is no such thing as a family doctor, she didn't give a thought to the welfare of my child, and when my underweight baby was diagnosed as anemic due to iron deficiency, none of the pediatricians gave a thought to checking his mother.

Consequently, over the course of the pst 2 years, I've suffered extreme fatigue, heart palpitations and dizzy spells while my doctor sent me cardiologists. It was my gastroenterologist who discovered I was anemic due to iron deficiency (I had almost no iron!!). My son was probably born underweight (5 pounds 13 ounces at 37 weeks) because I most likely became iron deficient with the birth of my first child.

So I guess besides not being impressed by the very compartmentalized medicine practiced here, my story only serves to support ilovebutter's key point: hell no, you can't get everything you need from what you need!

I'm back on Omega-3s and vitamin D, which I give both my kids. They also get a multivitamin and my son gets extra iron. I'll probably look into vitamin Bs too.

oops!

hell no, you can't get everything you need from what you EAT!

@mschatelaine -- if you like, I could run a dietary analysis for you and/or your kids. You'd need to keep a very detailed and accurate food diary for 3-7 days and e-mail it to me. If you're interested, post your e-mail address and I'll e-mail you.

Oh, and I would like to add as a general comment -- anyone who eats enriched grains, fortified cereals and drinks store-bought milk is consuming supplements. It's funny how doctors seem to forget that when they make these "you can get everything from eating a balanced diet" statements.

Humans have been roaming the earth for 100,000 years so yes, obviously you can get everything you need from diet alone otherwise we would have been extinct long ago. However, they ate a diet of meat and plant foods (leaves, berries, fruits, roots, nuts). If you ate this way, yes, you would be getting "everything you need." Modern diets have a lot of grains and dairy which offsets vegetable consumption and leads to lack of nutrients. (I know, that's contrary to what you hear from the food pyramid people -- eats lots of grains and dairy for health! But, that's a crock IMHO.)

Ilovebutter: What brand of Vitamin D do you take? I take cod liver oil now, but I am looking for something else. I am looking into iodine too. Also, what botanicals? Im interested, hehe.

Currently I take a multi, MSM, cod liver oil and if I feel down Ill throw in extra D and C. Sometimes Iron... eh.

I'm curious how you know if something is naturally versus synthetically derived. I was looking online for some gummy vitamin D (I have a hard time swallowing pills) and couldn't figure it out! Anyone have a good resource?

Currently I just take an Emergen-c when I think about it or when I'm getting sick.

@ Taratootie42: I take either Carlson or Vital Nutrients vitamin D3. For iodine, try a kelp extract.

As for botanicals... New Chapter Zyflammend for general inflammatory stuff, New Chapter Stress Advantage, Vital Nutrients Adrenal Support, Natrol glucosamine, MSM and hyaluronic acid, and dandelion. These were prescribed by my naturopath.

@ mizrobot: It depends on the vitamin. Some vitamins have just one molecule, whereas others are for a whole family of molecules.

Vitamin C is just one compound (ascorbic acid or ascorbate -- in water they are basically the same) so synthetic is fine. Emergen'C is an excellent brand.

Vitamin D has several different forms -- D1, D2, D3. D3 is the active form and is what you should take. Synthetic is fine, as is naturally derived like in cod liver oil.

Vitamin E is a family of compounds of tocopherol and tocopheryl -- dl-alpha, d-alpha, dl-beta, d-beta, etc. The "d" form is natural, and "dl" is synthetic. Your body can't use the "dl" form very well. You want "d" (not "dl"), and a mix of alpha, beta, delta and gamma. Look for a label that says "mixed tocopherols" or lists out these different ones (ie, "contains d-alpha, d-beta, d-delta and d-gamma tocopherol").

Vitamin A is also a family of compounds -- retinol, retinal, carotenes, etc. Taking carotenes in supplemental form is fine whether synthetic or natural. I would only take retinol/retinal in small quantities in a naturally occurring form like cod liver oil.

As for minerals... I'm not even going to go there. There's so many different mineral compounds. But I will say, the best for of calcium is calcium apetite or calcium triphosphate. Calcium carbonate is garbage -- don't waste your money. Calcium citrate is ok.

For Vitamin D, try Sunny Gummies: http://www.drugstore.com/products/prod.asp?pid=199120&catid=32480

Also, Vitamin D supplements are really small, so you might be able to swallow them ok. Get your blood levels checked too. Here in New England nearly everyone I see if deficient.

Oh wow! Thank you ilovebutter!

Here is my email: goodfellowatbluewindotch

Thank you ilovebutter! That is such awesome, useful info and I appreciate you taking the time to type it out and to even find some gummies for me. :)

I actually did just get my D levels checked--my doctor suggested it. I haven't gotten the results in the mail yet but most everyone in Seattle is deficient too so I'm expecting it!