Healthy Eating Tip:
Cut through the supplement industry confusion and select a multivitamin!
The last time we discussed vitamins two weeks ago, I reminded you that we tend towards obsession with specific physiological details or what is called reductionism. I used the example presented by T. Colin Campbell in his book Whole: Rethinking the Science of Nutrition. “Six blind men are asked to describe an elephant. Each feels a different body part: leg, tusk, trunk, tail, ear, and belly. Predictably, each offers a vastly different assessment: pillar, pipe, tree branch, rope, fan, and wall. They argue vigorously, each sure that their experience alone is the correct one.” You only get the full picture of the nature of an elephant when you back away and look at the entire animal. Nutrition and health are no different, and vitamins are an excellent example.
We have our heads faced downward, looking into the details, the nutrients involved, and the minutia of metabolism, trying to identify all the variables involved in the exceptionally complicated choreography of elements and systems that make up our physiology. But health isn’t in the details; we need to look upward towards the general principles derived from the details. Health isn’t found in an individual tree; it’s found in the way all the trees interact as a forest!
I’m often asked what I think about the latest phytochemical or “nutrient de jour” as it relates to a specific condition, and my response is almost always: “I don’t think about it at all, and neither should you!” If we eat following some simple guidelines, those concerns about individual nutrients go away.
Every effective diet is built on general macronutrient principles. I call them the “pillars of health; eat less salt, fat, and sugar, reduce meat (especially high-fat meat), reduce dairy (especially high-fat dairy), reduce all processed food, and increase “whole foods” like fruits, vegetables, beans, legumes and whole grains. All effective diets on the healthy diet spectrum, from the moderate DASH diet on one side to the more rigorous plant-based whole foods diet on the other side of the spectrum, all follow those same general guidelines. No matter what diet you choose on the healthy diet spectrum, you will find health by viewing the general principles from 30,000 feet rather than the details of nutrition at ground level! The real fact is that if eating was rocket science, we would have never made it to 2020!
The United States Food and Drug Administration’s version of the pillars of health is embodied in these two recommendations:
- “Consume a variety of nutrient-dense foods and beverages within and among the basic food groups. At the same time, choose foods that limit the intake of saturated and trans fats, cholesterol, added sugars, salt, and alcohol.”
- “Meet recommended nutrient intakes within energy needs by adopting a balanced eating pattern, such as one of those recommended in the USDA Food Guide or the National Institute of Health’s Dietary Approaches to Stop Hypertension (DASH) eating plan.”
There are two problems with following these guidelines:
- First, for the most part, Americans do not follow these very simple guidelines. We consume far too much salt, fat, sugar, meat (especially high-fat meat), dairy (especially high-fat dairy), processed food and we eat too few fruits, vegetables, beans, legumes and whole grains.
- Second, even when we follow these guidelines, many of the fruits, vegetables, beans, legumes and whole grains we consume are not what they used to be even just 50 years ago. Most fruits and vegetables we purchase in grocery stores are grown in soil that is overworked and deficient in the nutrients that supply the food we eat with what our bodies need to ensure our health.
This is where a multivitamin comes in. If the fruits, vegetables, beans, legumes and whole grains we eat in America are nutritionally deficient, the need for supplementation is obvious.
At the Coconut Grove Restaurant on the West Indian island of Nevis, where I was the Executive Chef for nine years just before coming to Smith Center, the items that received the most comments from visiting Americans were the vegetables. I imported absolutely no fruits or vegetables, so carrots, celery, onions, peppers, lettuce, tomatoes, spinach, oranges, lemons, limes, pineapple, melons, papaya, mango, bananas, pumpkin, potatoes, and sweet potatoes were all grown on Nevis and came from tiny family farms and back yard gardens all over the island. I was called out to tables a half dozen times a week for guests to ask me what kind of special variety the tomatoes or carrots were. The answer was that they weren’t special at all. What was special was the soil they were grown in was not depleted, and it was packed with the nutrients that made them taste amazing, and the nutrient density exceptional! You can experience that very same thing here in Smith Center. Taste a tomato or butternut squash that you buy from Megan Zimmerman at In The Garden side by side with one from any grocery store around here, and you will see what I mean!
People on Nevis and those very few Americans that eat organic vegetables not grown in depleted soil every single day don’t need a multivitamin. They only need to follow the FDA’s recommendation to adopt a balanced eating pattern, but the rest of us need to take a multivitamin every day because the nutrients we need to make our bodies healthy are not in the foods we eat.
Our bodies operate in concert with the environmental context our bodies developed in. One of the problems with the present health of Americans is that the physical environment our bodies developed in doesn’t exist anymore. We now live a “life out of context,” and the foods that we relied on to maintain our health are not available to everyone anymore. Hence, the need for a multivitamin.
Vitamins come in two forms; water-soluble and fat-soluble. Water-soluble vitamins are easily obtained from many fruits and vegetables that are readily available and have always been a significant part of our regular daily diet. They are not stored by the body, and what is not needed is excreted. Toxicity is rare except in people that completely ignore healthy eating. Fat-soluble vitamins come from food sources like meat, nuts, and seeds that have only been available on a daily basis to a very small segment of the human population until the 19th century. They are stored by the body, and toxicity is not common but does occur in people that megadose because of a reductionist belief.
So, what multivitamin is the best?
If you don’t know where to look, that is an impossible question to answer because vitamins, herbs, and supplements are not regulated at all. One would guess that vitamins would be regulated as a drug by the FDA, but the FDA views vitamins, herbs, and supplements as food and only provides oversight. “Regulation” is self-imposed by the industry. There isn’t even a governing body that sets standards for identity and quality. Ascertaining if the product is what it says it is and if it contains what the label says is in every serving is impossible. One thing the FDA does do is report on safety and adverse events, but that is after the fact. MedWatch is the FDA medical product safety reporting program for health professionals, patients, and consumers. The problem is that when people megadose, they are using these “foods” as drugs, and many herbs and supplements have drug interactions and even vitamins have toxicity issues. Taking a multivitamin is safe in every regard, but when you megadose, it can be very dangerous, especially when you are not sure what you are taking!
Thankfully there are companies that supply very reliable independent testing services. The one I use and arguably, the leader in the industry, is ConsumerLab.com. If you are interested in having access to the same information that medical professionals use, then you can join and get the same information we do for a little less than $50 a year, but you will have to be able to read the same peer-reviewed journal articles that we do. In some cases, ConsumerLab will condense information for you, but not always. The introduction to the ConsumerLab multivitamin reviews is extensive and very detailed. They test many products in 10 different multivitamin categories. I suggest that you not worry about any specific category of multivitamins like men or women 50+. I believe that this encourages reductionist thinking all over again. Ever since I stopped thinking in reductionist terms sometime in 2005, I have been taking the same multivitamin every single day. It has been the ConsumerLab top pick for a general multivitamin since 2005, and it is also the cheapest one they test at just three cents a day! This morning I double-checked, and it is still their top pick. I scrolled down the test results and noticed more than a dozen multivitamins priced at over 30 cents a day and more that were listed as not approved because they contained too much or too little of a particular vitamin, took too long to digest, or were contaminated in some way. One was found to have 257.1% of the vitamin A than it claimed on the label. Vitamin A is a fat-soluble vitamin that the body stores so it can build up over time to toxic levels. Toxicity can cause dizziness, nausea, headaches, and even coma and is especially dangerous for pregnant women. This particular product costs $37 for 60 tablets. That’s 61 cents a day; price is no guarantee of quality! The one I use is Costco’s Kirkland brand, available on Amazon at $17.49 for 500 tablets with free shipping. That’s three cents a day! At that price, there isn’t a reason not to use a multivitamin!
See you next time; have a healthy week!
Here are the references for today’s Healthy Eating Tip:
Campbell, T. Colin, Jacobson, Howard. Whole: Rethinking the Science of Nutrition. BenBella Books, 2014.
United States Food & Drug Administration. Consumers. Updates. Fortify-your-knowledge-about-vitamins. (Accessed 9/10/2020).
United States Food & Drug Administration. Safety. MedWatch: The FDA Safety Information and Adverse Event Reporting Program. https://www.fda.gov/safety/medwatch-fda-safety-information-and-adverse-event-reporting-program. (Accessed 9/10/2020).
ConsumerLab LLC. https://www.consumerlab.com/.