Should You Take A Multivitamin?

Healthy Eating Tip:

Unless you consistently eat a plant-based whole foods diet and have done so for a while, you should take a multivitamin every day!

If I added up all of the questions I get about vitamins and herbs, together they would represent the issue I am most asked about as a dietitian. People are interested in a vitamin or supplement and how it will affect a specific disease or symptom. Is taking vitamin D or vitamin E good for heart disease? How much vitamin C should I take to cure my cold? Will garlic pills help lower my cholesterol? It does happen, but I really can’t remember the last time I was asked about a multivitamin.

Americans think about medical intervention in terms of either medication or a procedure. Medical procedures and medication can and do save lives. People that have been prescribed medications need to follow their doctor’s recommendations and take them. I would never say anything different, but in many cases waiting until you require medication or a procedure to save your life is like purchasing lottery tickets to fix your retirement plan. Health requires investment over time, just like retirement planning does! Changing your lifestyle and making sure that your body has what it needs to function properly is another medical intervention that can save your life, but it is an investment you need to participate in over time. It will not work as a last-minute hail Mary! I see many people in the hospital that have finally realized that they need to change the way that they eat, but it is too late for that to make a real difference, and that breaks my heart. Lifestyle modification is an extremely powerful tool, but the time to start thinking about your health is when you are healthy, not when you are facing a health crisis. Taking a multivitamin once a day is a quick and painless way to make sure that your body has what it needs to function properly and help ensure health down the road.

The first thing we need to do is step back from looking at physiological minutia and stop thinking about vitamins and how they affect a specific condition. I often say that health is found in the big picture and not the details. This is a perfect example.

The fancy word for an obsession with the physiological minutia is “reductionism.” Although details of physiological functions are crucial for all of us in healthcare to be familiar with, it is a very poor way to derive meal-to-meal advice on what to eat. That is, nevertheless, what many nutrition experts use as a basis for the advice they give, and just about every media piece or institution tries to extrapolate daily nutrition advice from new nutrition research. This is one of the reasons that dietary advice is so confusing these days. In his book Whole: Rethinking the Science of Nutrition. T. Colin Campbell describes reductionism using a metaphor. “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.” In terms of nutrition research, we make the problem even larger. “Modern science tasks 60,000 researchers to examine the elephant, each through a different lens.”

What those of us that are not researchers see are dietitians, researchers and doctors divided into different camps arguing, and the takeaway message is just confusion. I experienced this confusion myself first hand. When I was starting my personal lifestyle modification journey, one of the things that confused and frustrated me was all the controversy surrounding the details of nutrition. Some doctors and scientists thought one thing and argued with others that thought something different. So, I decided to back up, look at the whole picture, and see what all of these people agreed on. They all agree that Americans consume far too much salt, fat, sugar, meat (especially high-fat meat), dairy (especially high-fat dairy), and we eat too few fruits, vegetables and whole grains. I don’t know any self-respecting nutrition expert, dietitian, medical practitioner or public health official that would disagree with that statement. Frankly, it would just be irresponsible to say anything different! If that is what we are doing wrong, might we not find health in doing the opposite? I researched every kind of diet out there and found out that every effective well-studied diet is built on these general macronutrient principles; eat less salt, fat, and sugar, reduce fat – especially saturated fat and cholesterol, reduce all processed food and increase fruits, vegetables and whole grains. All effective diets on the healthy diet spectrum, from the moderate DASH diet to the more rigorous plant-based whole food diet, all follow those same general guidelines.

The takeaway for ordinary folks like you and I is that we don’t need to pay attention to how much vitamin A and E we are getting. We need to make sure that we get a wide variety of fruits and vegetables in our diet with a minimum of processed food, less salt, fat, and sugar and let the nutrition details take care of themselves! If you find yourself listening to a researcher espousing the latest research on eggs or cholesterol, stop listening and find a nutrition expert that can see the whole elephant and listen to what they say. They will all be saying the same thing; eat less salt, fat, and sugar, reduce fat – especially saturated fat and cholesterol, reduce all processed food and increase fruits, vegetables and whole grains!

People that don’t want to take medication because they don’t want to deal with side effects or want a more “natural” or “healthy” approach need to realize that when you take vitamins in the large doses that are talked about in the news, they also come with side effects and many times they are harmful. This practice is called “megadosing,” and it is dangerous. Megadosing is reductionism in practice.

If you are like me then getting a wide variety of fruits and vegetables to make sure that my body has what it needs to function properly is not always easy. It takes a real effort to do that. That is where a multivitamin comes in.

Next week we will take a look at how to choose a multivitamin, and I will give you a specific multivitamin recommendation supported by science! Until then, have a great week and try to start thinking about your health before you are in a health crisis!

Here is the reference for today’s Healthy Eating Tip:

Campbell, T. Colin, Jacobson, Howard. Whole: Rethinking the Science of Nutrition. BenBella Books, 2014.