Multivitamins: Now Recommended for All Adults

By:
Sophia Cariati

All adults should take a daily multivitamin to help stave off heart disease, cancer and osteoporosis, according to the Journal of American Medical Association in a complete reversal of the prestigious journal's policy on nutritional supplements. What's more, these new recommendations published in June 2002 suggest that women in their childbearing years should consider adding folate, and the elderly might add vitamins B12 and D to their daily multivitamin.

Drs. Kathleen Fairfield and Robert Fletcher of Harvard Medical School in Boston Massachusetts wrote the new guidelines for JAMA in two separate articles. In the first, the researchers reviewed studies examining the connection between vitamin intake and disease published between 1996 and 2002. In the second, the experts reviewed all available data and concluded that everyone, regardless of age or health status, needs a daily multivitamin.

The last time the journal made a recommendation on the subject was approximately two decades ago when little was known about the role of vitamins in disease. At that time JAMA advised healthy people against taking multivitamins concluding there was no evidence to suggest significant benefits in this group of patients.

But times have changed. In their current examination of the subject, Drs. Fairfield and Fletcher write that, "insufficient vitamin intake is apparently a cause of chronic diseases." While the researchers note that the diet of most Americans is sufficient to prevent diseases associated with extreme vitamin deficiency such as scurvy, studies do suggest that a large proportion of people fail to get the optimal levels of vitamins in the foods they eat. In fact, a recent survey revealed that only 20 to 30 percent of the population eats the government's recommended daily minimum of five servings of fruits and vegetables, the main dietary source of vitamins and minerals.

The researchers' review of studies on vitamins and disease revealed that insufficient levels of folic acid increases a person's risk for neural tube defects. A low intake of Vitamins B6 and B12 raise the risk for cardiovascular disease and colon and breast cancer. In addition, a shortage of vitamin D boosts the chance of osteoporosis and bone fractures, while evidence suggests that suboptimal intake of vitamins A, E and C may increase the risk of several other chronic diseases.

The experts do stress that vitamin supplements are no substitute for eating right. Instead, people should strive to eat at least five servings of fruits and vegetables daily as part of a low-fat, fiber-rich diet. Foods, unlike supplements, contain thousands of chemicals that may promote health, the researchers write. As a result they recommend multivitamins be taken in addition to, not in place of, a well balanced diet.

Before You Take a Multivitamin People that already take a multivitamin and those contemplating adding one to their routine should talk to their doctors, warn researchers. Some vitamins can interfere with the effectiveness of certain medications, while excessive doses of others can have serious side effects. For example, women who are trying to conceive should avoid taking too much vitamin A, and need more folate than other individuals.

Most good multivitamins contain approximately 100 percent of the daily-recommended value of all vitamins and minerals.

References: Fairfield KM Fletcher RH. Vitamins for chronic disease prevention in adults: scientific review. JAMA 2002; 287:3116-3126.
Fletcher RH Fairfield KM. Vitamins for chronic disease prevention in adults: clinical applications. JAMA 2002; 287:3127-3129.