Vitamins are everywhere. You can’t walk into a pharmacy, stroll through a big box store or scroll Instagram without being bombarded by pills and potions promising to cure every manner of problem, from thinning hair to digestive issues and even cognitive decline.
That’s because vitamins are a big business, raking in more than $12 billion every year. Harvard School of Public Health reports that half of all American adults—including 70 percent of those age 65 and older—take a multivitamin or another vitamin or mineral supplement regularly. But nutrition researchers at Johns Hopkins suggest that most vitamins aren’t all they’re cracked up to be. Instead, they suggest getting your vitamins and minerals the old-fashioned way, through nutrient-packed foods like fruit, vegetables, whole grains and low-fat dairy products. That is, most of the time. Here is what we found.
Do vitamins work?
The reviews are mixed. Researchers at Johns Hopkins concluded that multivitamins do not reduce the risk for:
- heart disease
- cognitive decline (such as memory loss and slowed-down thinking)
- or an early death
However, researchers at Penn Medicine found several supplements worth considering for their proven positive effects:
- Vitamin B12 – can make DNA, help prevent anemia and keep nerve and blood cells healthy
- Folic acid can help reduce birth defects when taken by pregnant women
- Vitamin D can help strengthen bones
- Calcium can help improve bone health
- Vitamins C and E help prevent cell damage
- Vitamin A can help slow down vision loss with age
- Zinc can promote skin health
- Melatonin can help counteract jet lag
- Fish oil may improve heart health
A lot of research has gone into studying vitamins (the National Institutes of Health has spent more than $2.4 billion since 1999) and the evidence still isn’t completely clear. As stated above, most studies suggest that multivitamins cannot lower your chances of disease (or death). It’s actually illegal for companies to claim that their supplements will treat, diagnose, prevent or cure diseases, so be wary of ads that try to do just that. Plus, what you’re buying in stores or online might be different doses or combinations from the vitamins used in studies.
Specific supplements can help – in some cases.
Studies show that some supplements, rather than a multivitamin, can be very beneficial for specific groups of people. These include:
Women in child bearing years: Folic acid
For women who are pregnant or of childbearing years, folic acid (which is a B vitamin), helps prevent birth defects in fetuses, and is best absorbed in supplement form. To be effective though, folic acid needs to be taken within the first few weeks of gestation, and since many pregnancies begin without a birthing person’s knowledge, researchers suggest that women of child bearing years take a multivitamin with the daily average amount of folate.
Difficulty chewing and swallowing, or experiencing taste changes due to medications, makes elderly people at risk for poor nutrition from food alone. Seniors can have trouble absorbing vitamin B12 specifically, and it starts earlier than you think. The National Academy of Medicine recommends that people over the age of 50 eat foods fortified with vitamin B12 (like some cereals and bread) or take vitamin B12 pills because they’re actually easier for your body to absorb than from food.
People with malabsorption conditions: B Vitamins & Vitamin C
Conditions that disrupt digestion can make it hard for your body to absorb nutrients. This includes but isn’t limited to:
- Ulcerative colitis, cystic fibrosis, and celiac
- Gastric bypass or any surgery to remove parts of your digestive organs
- Vomiting or diarrhea from recent (or ongoing) illnesses
- Alcoholism, which specifically wreaks havoc on your body’s absorption of several B vitamins and vitamin C
Everyone: Vitamin D
Nine out of 10 of Americans don’t get their Estimated Average Requirement for Vitamin D and Vitamin E from food alone. Vitamin D, however, is unique because taking it in pill form is actually easier for our bodies to absorb than through food. That’s because our bodies are best at absorbing the kind of Vitamin D from the sun, which is replicated in vitamins.
People on medications: ask your doctor.
Prescription medications and even some OTC products can affect your body’s ability to absorb nutrients from even the healthiest diet. For example, diuretics commonly prescribed to lower blood pressure might lower your body’s level of magnesium, potassium, and calcium. If your doctor prescribes proton pump inhibitors for acid reflux and heartburn, you might have trouble absorbing vitamin B12, and sometimes calcium and magnesium. Parkinson’s disease meds, including levodopa and carbidopa, can reduce your body’s ability to absorb B vitamins including folate, B6, and B12.
Who needs a multivitamin?
Multivitamins are the most popular form of supplements, and generally claim to add a comprehensive array of benefits for your body. However, as we’ve learned from researchers at Harvard and Johns Hopkins, to only name two, many people don’t really need a multivitamin, and should rather focus on getting their vitamins and minerals through nutrient-packed foods like fruits and vegetables. Consider this checklist:
- I’m too busy to eat a balanced diet every day.
- I’m temporarily limiting my diet to lose weight or prep for surgery.
- I am pregnant, have celiac disease, ulcerative colitis, or have had gastric bypass surgery, Whipple procedure, etc.
Advertisers appeal to many common issues with claims to help through supplements but experts say these issues might not be a good cause for taking a multivitamin:
- Feeling tired all the time, even though I eat well
- I want to improve my health as much as possible, so any extra nutrition is good, right?
- I have osteoporosis and need more calcium or iron-deficiency anemia. (In these cases, specific supplements would be more useful than a multivitamin.)
Always discuss taking any kind of vitamin or supplement with your doctor. For a deeper dive into the best mix of foods and supplements, also consider consulting a registered dietitian. But again, do keep your doctor in the loop about new supplements because of potential interactions with medications.
What’s the best way to get my vitamins through food?
Sometimes simpler is better. “Pills are not a shortcut to better health and the prevention of chronic diseases,” says Larry Appel, M.D., director of the Johns Hopkins Welch Center for Prevention, Epidemiology and Clinical Research. “Other nutrition recommendations have much stronger evidence of benefits—eating a healthy diet, maintaining a healthy weight, and reducing the amount of saturated fat, trans fat, sodium and sugar you eat.”
Appel goes on to suggest that he eats three healthy meals a day to get the vitamins, minerals and other nutrients he needs. Here is his gameplan:
- Plenty of produce. “I aim for two or more servings of fruits or vegetables at every meal,” he says. “I enjoy salads and have one for lunch or dinner several times a week.”
- Low-fat dairy and whole grains. “Low-fat or fat-free milk and yogurt provide calcium, magnesium, potassium and other nutrients,” he says. “I have cereal with milk for breakfast a few times a week. And I have yogurt sometimes too.”
- Protein. “At home we usually have fish or chicken for dinner. I am not a vegetarian; rather, I eat minimal meat,” Appel says. Some fish, such as salmon, are a good source of healthful omega-3 fatty acids.
How do I know if my supplements are any good?
From tablets to liquids, powders and capsules, there’s no end to the forms, or brands, of supplements available. Here are a few tips to choose wisely:
- Look for supplements that contain the Recommended Daily Allowance amounts.
- Choose supplements with the United States Pharmacopeia (USP) seal of approval on the label. This seal ensures that the ingredients and amounts of that ingredient listed on the label are contained in the pill. The USP also runs several tests that confirm the pill to be free of contaminants like heavy metals and pesticides and has been manufactured under sanitary and regulated conditions.
- Don’t underestimate generic. An expensive brand name is not necessary as even standard generic brands will deliver results.
- Use caution with vitamins that contain extras, like herbs and botanicals, because they’re usually not well researched for long-term effects.