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It’s become popular to shun supplements and rely strictly on food to fulfill nutritional needs. It would be great if we could get all of our nutrition from food, but this approach can cause more problems than it solves.

According to the National Health and Nutrition Examination Survey, over 40 percent of Americans (more than 100 million people) do not meet the recommended levels for vitamin D, calcium, vitamin A, vitamin C, vitamin E, thiamine, folate, and magnesium. Other nutrients that are commonly insufficient include choline, vitamin K2, omega-3 fatty acids, zinc, and potassium. Surveys from Europe show similar nutritional deficits.

How Do Lack of Nutrients Impact Wellbeing?

One of the most common complaints associated with a poor quality diet is fatigue. The energy to power the body’s metabolic processes is derived from the food we eat. The body takes carbohydrates, fat, and protein and produces ATP, which is the energy currency to power all of our actions. The process of producing ATP requires an ample supply of micronutrients that act as coenzymes and cofactors for reactions. When nutrients are absent, it affects the central nervous system, increasing fatigue and lowering cognitive function.

Depression and imbalances between neurotransmitters and hormones are other side effects of low nutritional status. Lack of these essential nutrients may also compromise the immune system and increase risk of chronic diseases. Here is a snapshot of how specific vitamins and minerals impact well-being:

The eight B vitamins are necessary for the body to breakdown glucose from carbohydrates and transform it into ATP.

Vitamin C is necessary for the synthesis of the energizing neurotransmitters dopamine and noradrenaline.

Magnesium affects hormone release and the breakdown of glucose for energy.

Zinc affects neurons and hormones that regulate brain activity.

Who Is At Risk of A Deficiency?

Scientists have identified two categories that increase risk of a nutritional deficiency:

1. Lifestyle factors are behaviors that lead to deficiency. These can be countered by changing habits, improving the composition of the diet, and supplementation. Actions that increase risk of deficiency include:

  • Restrictive diets, especially low calorie diets or those that limit macronutrients.
  • Regular high-volume athletic training.
  • Chronic work and family stress combined with unhealthy food choices.
  • Excessive coffee consumption.
  • Smoking or excessive alcohol use.

2. Lifestage factors are related to changing physiological needs that either increase nutrient requirements, reduce absorption of nutrients, or both. These can be countered with dietary changes and supplementation. They include being elderly, pregnant or nursing, or in a childhood growth stage.

A third category of individuals at risk of deficiency is those with chronic illness. Individuals with underlying diseases tend to have higher levels of inflammation and may take medications that deplete nutrients. They may also suffer from reduced absorption of nutrients in the GI tract. In particular, people with gastrointestinal disorders (celiac disease, Crohn’s disease, IBS) are at high risk of nutrient depletion that can exacerbate other health conditions.

Can A Multi-Nutrient Supplement Help?

The proper use of multi-nutrient formulas has been shown to help fill common nutritional gaps and ease symptoms linked to low nutritional status (1). For example, a study of young men who were given a multivitamin found improvement on behavioral and mental performance tests compared to a placebo (2, 3).

A second study of 136 individuals suffering from stress found that after 28 days of treatment with a multivitamin, subjects reported a 66 percent improvement in concentration, a 67 percent decrease in depression, and an 82 percent decrease in tiredness (4). The authors conclude that a multivitamin is an important part of treatment for psychological and stress-related symptoms.

Multivitamins have been shown to support the immune system and reduce duration of illness. A recent placebo-controlled study of older adults found that taking a multi-nutrient supplement improved immunity and reduced the severity of symptoms (5). Although the same percentage of participants in both groups got sick during the study, days of sickness in the supplement group averaged fewer than three compared to more than six in the placebo group.

The longer term effects of multivitamins on illness, such as cancer, are less clear. A large trial of male doctors found that multivitamin supplementation led to a small decrease in cancer over 11 years (6). A trial that tested the effect of multivitamins on cardiovascular disease reported no benefit of supplementation, likely because heart disease is a multifactorial issue influenced by many aspects of diet and lifestyle (7).

How To Choose A Multi

Choosing a multi is not as simple as going to your local store and picking the cheapest option. Multivitamins are unique from single nutrient supplements because they require fitting many different nutrients into a single capsule. This is a complicated chemical process and many supplement manufacturers cut corners, using cheap, inactive nutrients that are poorly absorbed and end up being eliminated from the body via the urine.

Instead, you want a product that provides stabilized nutrients in a bioavailable form that the body can use. For example, folic acid is a synthetic form of vitamin B9 that must be turned into the active methylfolate form in the liver. However, people with a MTHFR polymorphism are unable to efficiently make this transition. A high-quality multivitamin will supply vitamin B9 in the active methylfolate form, which has superior absorption and can be easily used by the 40 percent of the population that have an MTHFR genetic mutation.

References

1. Fulgoni, V., et al. Foods, fortificants, and supplements: Where do Americans get their nutrients? Journal of Nutrition. 2011. 141(10): 1847-54.

2. Carroll, D., et al. The effects of an oral multivitamin combination with calcium, magnesium, and zinc on psychological well-being in healthy young male volunteers: a double-blind placebo-controlled trial. Psychopharmacology (Berl). 2000. 150(2): 220-225.

3. Heseker, H., et al. Interaction of vitamins with mental performance. Bibliotheca Nutritio et Dieta. 1995. 52: 43-55.

4. Schlebusch, L., et al. A double-blind, placebo-controlled, double-centre study of the effects of an oral multivitamin-mineral combination on stress. South African Medical Journal. 2000. 90(12): 1216-1223.

5. Fantacone, M., et al. The Effect of a Multivitamin and Mineral Supplement on Immune Function in Healthy Older Adults: A Double-Blind, Randomized, Controlled Trial. Nutrients. 2020. 12 (8): 2447.

6. Gaziano, J., et al. Multivitamins in the prevention of cancer in men: the Physicians’ Health Study II. Journal of the American Medical Association. 2012. 308(18):1871-1880.

7. Kim, J., et al. Association of Multivitamin and Mineral Supplementation and Risk of Cardiovascular Disease. Circulation. 2018. 11.