The nutritional safety net
‘Vitamins and minerals are nutrients your body needs in small amounts to work properly and stay healthy,’ is how the NHS Choices website explains what these nutrients do.3 And the best place to find them is, unsurprisingly, in your food. Ideally we should be able to get all the vitamins and minerals we need from what is on plates but, in the real world, often we just don’t. Figures from the government’s UK National Diet & Nutrition Surveys have shown a sizeable proportion of us are getting below the levels we need to ward off nutritional deficiency diseases. Over one in 10 gets below the recommended nutritional intake levels for the minerals magnesium, selenium and potassium. Around a quarter of women don’t get enough iron. Even relatively minor shortfalls of some vitamins and minerals can potentially lead to health problems like anaemia or osteoporosis. A multivitamin is not a substitute for eating healthily but it can to cover all nutritional bases by giving you a complete spectrum of what your body needs so you get a near perfect balance of vitamins and minerals on a daily basis.
Who needs them?
The Department of Health recommends certain supplements for some groups of people at risk of deficiency including folic acid for pregnant women, vitamin D from April to October and children aged six months to five should take a supplement containing vitamins A, C and D. 4 Other people could also have a greater need for certain nutrients - the over 50s, for example, find it harder to absorb vitamin B12 from food; 5 the over 60s often find their appetite decreases so they are not getting as wide a range of nutrients; vegetarians and vegans may be low in iron as the most readily absorbable form of it comes from red meat, they might also be low in vitamin B12; women with heavy periods can also become iron-deficient. Those who are convalescing and/or on very low-calorie weight loss diets could all be missing out on vital nutrients. A multivitamin can also help if you are a regular exerciser as you can use up vital vitamin and mineral stores through sweating and those extra nutrients can also help speed up recovery after physical exertion.
Overall, the evidence to show how taking a multivitamin can improve health is promising but mixed. One study involving around 100 elderly people showed those who had taken a multivitamin for a year had improved immune function and 50 per cent fewer days ill than those not taking one. The Physicians’ Health Study II involving over 14,000 middle-aged male doctors took either a multivitamin or a placebo for over a decade and the end result showed they were eight percent less likely to be diagnosed with cancer (this protective effect was greater in those with a history of cancer) and had a lower risk of developing cataracts but offered no protective effects against cardiovascular disease or cognitive decline. These appear to be compelling reasons to justify taking a multivitamin for eye disease and potentially some cancers. A 2015 study also found that among women, but not men, taking a multivitamin for at least three years was linked to a 35 per cent lower risk of dying from heart disease. 6 Another study involving 88,000 women as part of the Nurses’ Health Study at the Harvard School of Public Health showed those who had taken a multivitamin for 15 years or more significantly reduced their risk of colon cancer (compared to those who had taken them for less time). There have been calls for more expansive studies into their role but as things stand Harvard Medical School in the US have weighed up the available data and concluded: ‘Looking at all the evidence – from epidemiological studies on diet and health, to biochemical studies on the minute mechanisms of disease – the potential benefits appear to outweigh the potential risks for most people’. 7 As to whether ‘they work’ or not, yes in the sense that they will help you avoid vitamin and mineral deficiency but there is, as yet, no evidence to show they ward off chronic diseases or increase your lifespan. Which isn’t to say they can’t, just that there no one really knows yet.
The best one for you
If you feel you are not getting the nutrients you need from your food take a multivitamin once a day. Take them with food (this increases your body’s ability to absorb many nutrients) and ideally with your evening meal when your body can help utilise them more effectively: ‘The repair processes your body undergoes are greatest at night when growth hormone is secreted,’ explains Medical Director Dr Sarah Brewer. Try to avoid taking any other supplements at the same time (if you are taking others, take them in the morning), given the multi should supply you with plenty much all your recommended daily allowance of vitamins and minerals swallowing more could potentially push you over the safe threshold of some and vitamin E, beta-carotene and calcium can be harmful in high doses). And don’t assume all multivitamins are the same: there are versions tailored specifically for certain groups including men and women; the over 70s; the over 50s, ones for vegetarians and vegans or you can even find ones without iron if you are supplementing with this mineral separately. And if you are not very good at swallowing capsules you can get yours in more palatable forms like fruit flavoured powders, a yogurt drink or chewy gummies these days.