Assuming I eat a rather varied/balanced diet (and knowing nothing else about me), how likely is it that I am deficient in one or more of the vitamins and minerals listed on the side of many food products sold in the US? Is it difficult to get the US Recommended Daily Allowance of all of those vitamins/minerals without deliberately seeking out unusual quantities of obscure food items?
If I am in fact not suffering from any particular deficiency, is there any benefit to be gained by taking an over-the-counter supplement (e.g. Centrum, Once-A-Day, etc.) so that I am, in total, receiving far more than the US Recommended Daily Allowance of some/all of those vitamins and minerals?
In the “Western World,” vitamin deficiencies are uncommon. And when they do occur it’s usually with small children under 5 and seniors who are dependant on others to provide them food.
Still I take a good multi-vitamin once a day. I can find them at Walmart, usually a whole year’s supply goes on sale for like $7.00. So for about 2¢ a day, I figure why not. Probably a waste of 2¢ but I’ll waste it
What Marxxx said. Most true vitamin and mineral deficiencies are very uncommon in the US and western europe, for healthy adults.
One exception is Vitamin D (which isn’t really a vitamin anyway). Lack of adequate sunshine is leading to epidemic levels of deficiency here. 1000 units of this a day isn’t a bad idea, and runs about 2 cents a pill. I’d spend your money here rather than on a multivitamin. Unless you’re a sun worshipper.
You raise an interesting point. My elderly father was recently diagnosed with a vitamin D deficiency, as was my sister’s daughter. My sister was diagnosed with MS a couple of years ago, and Vitamin D deficiencies have been implicated by some studies as a causative factor.
As it happens, I am visiting the doc for a physical next Monday (my first full physical in a couple of decades); I will ask about being tested for D deficiency.
If you have any chance of getting pregnant, you are likely not getting as much folic acid as you need–not because you need it, but because having plenty in your system (well in excess of your own system’s needs) halves the chance of neural tube defects in a baby–but only if taken in the weeks right around conception, before most people even suspect a pregnancy.
I’ll second the call for vitamin D. I don’t get much sun and mine tested out to be very low - even with a daily supplement of 500IU’s. Definitely get tested. It’s very important for your natural immunity. One role it plays is in helping to manufacture cathelicidins.
There are a few other things that most people are likely to be deficient in but the only one I can think of off hand is magnesium and maybe zinc. Zinc is also important for a healthy immune response but I don’t remember the mechanism.
If you eat a balanced diet (containing animal products) I don’t think you have to worry much about anything but vitamin D. Even 1000-5000 IU of D orally isn’t enough to keep many people in the proper ranges (above 30 to avoid deficiency, ideal range 50-70), and 400 IU daily is all that’s currently recommended and contained in multivitamins. Get a decent amount of unprotected sun exposure, and supplement with an oil-based D3 capsule or drops on days you don’t. It’s incredibly important for general health.
I’m not sure that the OP was about straight malnutrition due to inadequate stores of a certain nutrients in the body. Most people here in America fall far short of the RDA of most nutrients and have good general health. But even if you’re not ‘deficient’ in a particular nutrient to the point that you are symptomatic, you can suffer many effects of inadequate nutrition just eating kinda crappy like most people do.
A multivitamin is a good precaution but of course it’s better to be aware of the nutrition in the foods you’re eating.This is something I’ve been interested in for a while and I often track my intake so I know that even eating a high-calorie composed of only fresh, whole foods with high amount of nutrients - I fall short of the RDA in quite a few things. So every 2-3 days I make a special effort to eat large servings of foods I know contain high amounts of these nutrients (FWIW the nutrients I find it challenging to get enough of are vitamin E, potassium, magnesium, zinc, and of course dietary D).
I know you are a doctor, so I hesitate to ask, but … is this the result of thorough research, or just a “everbody knows” assumption?
Because when I think about, several things come to my mind that we don’t really know about how well people are fed in US Western Europe:
the normal check-up at the general doctor doesn’t look for vitamin levels; furthermore, not everbody does these check-ups (in the US with its private health system, even less than in Europe)
connected with rising obesity, the general consensus is that most people eat unhealthy junk food, fast food, frozen TV dinners, that kind of stuff. Now, one slice of tomato on a hamburger won’t fill your 5-portion-a-day ratio of veggies, and I doubt it fills the vitamin requirments.
in the University study of vegetarians and vegans, dangerous low levels of vitamin and other mineral deficiencies were discovered. However, these were well-educated people who made conscious choices to eat healthy. I don’t believe that somebody who eats hamburgers and french fries is healthier than a vegetarian just for eating meat; rather, if a vegetarian paying attention is low on minerals and vitamins, the meat-eater will be even worse, only nobody has looked.
statistics show that vitamin and mineral pills are mostly bought by middle-class people with a higher income and education level, who already know more than average about nutrition than the normal burger-eating lower class person. Partly the supplements are taken from over-caution by people who don’t need them, partly by people with an unhealthy lifestyle (they know they have too much stress, too little movement, too little veggies), who can’t change their lifestyle right now, so take pills instead to tide them over.
How are the vitamin levels for the lower class, with little nutrition knowledge, and no disposable income for pills? I think we simply don’t know.
Vitamin D is a case in point - only recently evidence came in that it’s important not only for bones in children and elderly, but for general health, and that the previous levels are not enough (I think the factor is 10 or 100), so then levels were measured for the first time.
The only obvious vitamin deficiency that is easy to see is Vitamin C, where scurvy leads to bleeding gums. But not only do most people know about that, vitamin C is easy to get, just a glass of orange juice is enough for some time. But what about all the other vitamins, minerals etc.?
I mean, when I look at the chart that x is found only in broccoli and in traces in certain nuts, and I don’t eat broccoli (blergh), and nuts only occasionally, is my level of x high enough? Well, I don’t know, and my general doctor can’t even measure my vitamins, because his lab doesn’t have the special quick-freeze to keep them from disappearing from my blood sample. (His lab only draws the blood, then it’s stored until a driver takes it to the real lab.)
IAMNAD or dietician, but going by those charts- which foods contain what vitamins etc. - I say it’s very difficult. Some stuff is only found in a few foods. The sort of food (apple, carrot etc.), the kind of growth (organic vs. agro-industry), the ground itself (rich vs. poor in minerals), all that together can vary the vitamin / mineral content of one carrot to the next. Added to that is: how long has the carrot been stored, transported (fresh vs. 1 week old), prepared (sliced and stored, cooked for 30 min. vs. steamed etc.), and just eating one carrot can provide you ample Vitamin A or hardly any at all.
So you don’t know how much you are getting. You also don’t know how many miligrams you need today vs. how much is still stored and how much Vitamins you have used up today because you are fighting a cold so your immune system is using up 3 times as much vitamins as on a normal day.
Unless you have access to a good lab and can measure daily levels over a longer period, I don’t really see how anybody could know.
Would be an interesting experiment, though, I think.
The general recommendation by doctors over here is not to take the shot-gun approach of general tablets, but rather change your lifestyle (though that is much easier said than done!), because general tablets with general doses can result in over-dosing some vitamins and still deficiency in other areas (like minerals or rarer stuff).
I think Vitamin E, which was touted as being anti-cancer several years ago, was shown in studies to result in more cancer when smokers took them to supplement and combat their cancer risk.
That Vitamin E study was flawed as it was tested on people who were already not in good health. I found Vitamin E to be very helpful for my leg muscle cramps.
I think one of the problems with Western medicine is that we don’t recognize sub-clinical symptoms of disease. You need to have a raging case of a deficiency before anyone will even consider that as a possibility. But there are consequences to having a marginal deficiency - as we’ve learned regarding Vitamin D - and the medical profession is still behind the curve on this. I used to get sick 2 or 3 times a year but did any of the doctors I saw even consider testing for Vitamin D? No. I had to ask for the test. And guess what - that’s right, I was well below the bottom of the range even with taking 400 or 500Iu’s a day.
