Making the most out of multivitamins

Millions of people take multivitamins in the hope of staying healthy. The evidence that these dietary supplements can mitigate the risk of chronic conditions is at best equivocal, yet some health experts continue to recommend daily multivitamins for almost everyone.

Others, though, see multivitamins as little more than comfort products, arguing that most people can get all the nutrients they need from a healthy balanced diet - especially if they follow the recommendations on fruit and vegetable intake in the Department of Health’s ‘5 A Day’ campaign.

To give a flavour of the debate, here are two somewhat conflicting viewpoints on the need for dietary supplements. One comes from the British Nutrition Foundation (BNF), a registered charity with funding from a variety of sources including the government, the food sector, trusts and other charities. The other is from the Health Supplements Information Service (HSIS), which is coordinated by the Proprietary Association of Great Britain, the trade group for over-the-counter medicines and supplements in the UK.  

In the BNF’s view,healthy adults who consume a healthy, balanced diet incorporating a variety of foods and at least five portions of fruit and vegetables a day “should be able to get all the nutrients they need from their diet”.  

Specific dietary supplements may, however, be of benefit to certain population groups, such as pregnant women, older adults and children. They may also help maintain health for people whose dietary intake is likely to be poor - for example, if they are following a restrictive diet or recovering from an illness. 

The BNF cites vitamin D supplements, at a recommended dose of 10 micrograms per day, for people aged 65 and over, especially if they are housebound.  And women of childbearing age are advised to take a folic acid supplement (400 micrograms per day) to reduce the risk of neural tube defects in babies. Calcium supplements may benefit people at high risk of osteoporosis, the BNF says.

Dietary supplements “cannot be used, however, to replace a healthy, balanced diet and supplements containing high doses of individual nutrients should generally be avoided”, it warns. The HSIS also acknowledges “many people do get enough nutrients from their diet - as defined by the Recommended Daily Allowance [RDA]”. Nonetheless, the HSIS adds, there “will always be some people who are either deficient in one or more nutrients or who have special nutritional or medical needs for particular nutrients at certain times in their lives”

These populations include young children and adolescents, pregnant and breastfeeding women, immobile, housebound or institutionalised elderly people, vegans and some vegetarians, smokers, heavy drinkers, people with chronic illnesses and anyone on a restrictive diet, including “long-term slimmers”.

But the HSIS goes further in seeing an everyday, consumer-oriented rationale for food supplements - at least as an optional alternative to more fundamental changes in diet and lifestyle.