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  • Joanna Injore

Vitamin supplements do I need them?

Do you take any vitamin supplements? What are your reasons for taking them? Do you feel you are not getting the right balance of vitamins and minerals from your diet? Or do you feel like you should you be taking supplements but are not? This article will examine supplements use and how to choose the right type from the wide selection that's available.


Different types of vitamins


Vitamins are needed for lots of different processes in the body and most vitamins cannot be created (with the exception on vitamin D) so you need to consume them via your diet.

Vitamins are classed as either ‘fat-soluble’ or ‘water-soluble’:

Fat soluble vitamins are: Vitamin A, D, E and K

Water soluble are: The B vitamins (Thiamin, riboflavin, niacin, Vitamin B12, folate and vitamin C)


Do you need supplements?


Vitamins and minerals are only actually needed very small amounts. We are talking about milligrams (mg) which is 1 thousand’s of a gram or micrograms (µg or Mcg) 1 millionth of a gram! So, you should be able to achieve this with following a varied balanced diet including all the food groups such as starchy carbohydrates (cereal, rice pasta, potatoes), dairy or dairy-free alternatives, protein foods (meat, fish, eggs, pulses or beans) and lots of fruit and vegetables.

However, there are certain groups of people that require supplements as they are at a higher risk of deficiency (low levels). Below are The Department of Health and Social care recommendation for particular at-risk groups:





CHILDREN

6 months to 5 years: should take Vitamin A, C and D *

*except babies who are having 500mls or more infant formula which is already fortified with vitamins.

This can be provided by Healthy start Vitamins (check with your doctor, midwife or health visitor for more information and if you can apply) or their alternatives.


Breastfed babies from birth to 12 months: 8.5-10 µg (micrograms) Vitamin D in vitamin drops daily

This is needed as babies are rapidly growing and may not obtain enough vitamins from their diet particularly Vitamin D


PREGNANT AND BREASTFEEDING WOMEN

FOLIC ACID

Women trying to conceive and within first 12 weeks of pregnancy should have 400µg (micrograms) of folic acid to reduce the risk of the baby being born with a neural tube defects (NTD)

The recommendations are 5mg in pregnant ladies with diabetes or had a previous pregnancy affected by NTD or partner with an NTD


CALCIUM

Women exclusively breastfeeding and following a dairy free diet should take 1000mg of calcium



VITAMIN D


From October to March in the UK when the sunlight is less strong 10µg (microgram) of Vitamin D is recommended from all children over 4 years and adults. This is because sunlight generates our main source of vitamin D as we obtain very little from our diet.

The following groups of people may benefit from having a vitamin D supplement ALL YEAR ROUND:

  1. Those with little or no sun exposure

  2. People who cover up when going outside

  3. People from BAME groups (Black, Asian and minority ethnic groups) who may have darker skin tones

FOLLOWING A RESTRICTED DIET?


If you are following a restrictive diet due to allergy or intolerances or choose to follow a very strict vegan or plant-based diet your diet may not contain all your vitamin/mineral needs. You should discuss your individual requirements with your doctor or dietitian who as assess whether you need any supplements. You can read more about plant-based diets here.


What is the evidence for supplements to improve health or prevent disease?


When we look to scientific evidence we want to review the best quality evidence available and studies conducted in humans not just animals or lab based cell studies. Often pooling lots of randomised controlled trials (when you test a new treatment or drug with a group of people and measure this new method against those that do not receive what you are testing) can provide you with reliable information as you can observe the effect in lots of people.

So, what does the evidence say about vitamins and minerals? A review1 of 179 randomized controlled trials in 2018 analyzed the effect of 14 vitamins and minerals on cardiovascular disease, coronary heart disease, heart attack and stroke and did not find any benefit.

In addition a large Cochrane review2 in 2012 of 78 randomized controlled trials showed antioxidant supplements (beta-carotene, vitamin A, vitamin C, vitamin E, and selenium) had no benefit in the general population or those with different chronic diseases.

What about supplements for cancer? Research into specific vitamins and minerals and cancer outcomes has shown little effect on cancer risk. For example, a high-quality Cochrane review3 of selenium  supplements found that it did not reduce cancer risk. In fact, there was an association with selenium supplements and high-grade prostate cancer.

So what can we take away from this studies? The answer is that unfortunately the evidence does not support using vitamins to prevent cardiovascular disease, cancer, or mortality from other causes.


What about high doses of Vitamins?




Some vitamin and mineral supplements are available in high doses, but more does not mean better!


As mentioned above you only need very small amounts and taking high amounts can be harmful or even just wasteful.


Water soluble Vitamins (Thiamin, riboflavin, niacin, Vitamin B12, folate and vitamin C) will not be absorbed in the body so will just end up in your wee! The fat-soluble Vitamins (Vitamin A, D, E and K) on the other hand can build up in the body and could be harmful, for example high doses of Vitamin A in pregnancy is toxic and can increase the risk of birth defects and high doses of Vitamin E can have a negative impact on other fat-soluble vitamin absorption.


So how do I choose a vitamin supplement?


If you are still thinking about trying a vitamin supplement below are my top tips to consider:


Top tips when choosing a supplement


  1. Buy from a reputable company at your local chemist, supermarket or high street shop rather than an unknown company or online. This will ensure they meet the UK requirements for safety

  2. Check the Vitamin supplements do not exceed the recommended daily amount known NRV’s (Nutrient Reference Values) i.e. should not exceed 100%

  3. Avoid taking lots of different types of supplements as you may be doubling up on the same Vitamins unknowingly, for example Fish liver oil supplements often contain Vitamin A

  4. Always read the label and check for the expiry dates

  5. Only choose supplements for your age group (particularly for children) as the NRV will be vary depending on age

  6. Always check the supplements you are taking with you doctor or pharmacist if you are taking other medication, in case of negative interactions

  7. Don’t take vitamin/mineral supplements with caffeine containing drinks (tea/coffee) as this can reduce their absorption

  8. Fizzy effervescent vitamin supplements contain 1g of salt per tablet! So not a good idea if you are trying to limit your salt intake!

  9. And finally check with your dietitian to see if you actually need!


Special mention about vitamin/mineral deficiencies


If you are concerned that you are not eating the right diet and you may be deficient in something, the only valid method of identifying nutritional deficiencies is to have a blood test. A blood test can to check your blood levels of the particularly vitamin or mineral to assess whether you are deficient. This is commonly performed to check you iron levels, B vitamins, calcium or vitamin D. If you GP or doctor identifies your blood levels are low in a particular vitamin or mineral, they may prescribe a vitamin/mineral supplement. Sometime this may be a higher dose then you buy in the shops because a higher level is often needed to correct a deficiency. However, this is usually short term and under guidance and monitoring from your doctor so always follow the advice you have been given.

Take home message


Having a detailed nutritional assessment with a dietitian is the best way of checking if your diet is meeting your daily nutritional requirements and to see if you need any supplements. Included in all my packages are a comprehensive dietary report https://www.jinutrition.co.uk/post/diet-analysis-what-are-my-daily-nutrition-needs link and you will receive expert advice on how to meet your needs with diet.


If you want to find out more book your call to find out how I can support you

References:

  1. https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD007176.pub2/full

  2. https://www.sciencedirect.com/science/article/pii/S0735109718345601

  3. https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD005195.pub4/full?highlightAbstract=nutrition%7Ccancer%7Cdiet%7Cnutrit

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