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A vitamin examination, from A to K

Chris Swingle Rochester (N.Y.) Democrat and Chronicle

Are vitamins a sound investment in your health? Or are they a waste of money or potentially hazardous?

The answer from physicians, registered dietitians and clinical studies: It depends on who you are, what you take and how much. Any vitamins – like any medication – should be reviewed with your health care provider and be appropriate for your diet and your medical and family history.

Our bodies need small amounts of 13 micronutrients, from vitamin A to vitamin K, most of which the body can’t make on its own. (One exception is vitamin D, which our skin can make from sunlight.)

For the average person, the best source of vitamins is food – where they naturally exist – not pills. That’s because fruits, vegetables and whole grains include not just vitamins, but fiber and a mix of nutrients that may protect against disease.

Review your needs

But many Americans don’t eat healthfully. A daily multivitamin can be a nutritional safety net for them and for the following groups who tend not to meet their nutritional requirements by diet alone: strict vegetarians, teenagers, people eating fewer than 1,200 calories a day, people older than 60, women of childbearing age (who may not yet know they’re pregnant) and pregnant women, says Christina Krueger, a registered dietitian at ViaHealth’s Diabetes Care and Resource Center in Rochester, N.Y. A registered dietitian – who’s gone through schooling, clinical hours and passed a nationally accredited exam – can meet with clients individually to evaluate eating patterns and needs.

At times they recommend supplements of individual vitamins. Women older than 50, for example, tend to be short on calcium, needed for strong bones.

But, Krueger stresses, supplements don’t erase the need for a healthy diet.

Too much can hurt

Clinical studies find little evidence that vitamins prevent chronic disease and raise cautions about excess doses of vitamins, especially the fat-soluble ones – A, D, E and K – that can accumulate in the body. A National Cancer Institute study published in May found that men who take more than one multivitamin a day may be increasing their risk of developing advanced prostate cancer and dying from the disease.

People are wrong if they think that “if one is good, two must be better” when it comes to vitamins, says Grace Ricci, a registered dietitian and clinical nutrition manager for Unity Health System.

Krueger has seen clients inappropriately taking large doses of B vitamins or vitamin E or take bad combinations, such as vitamin E and garlic with prescribed Coumadin (warfarin) and aspirin - all blood thinners.

Some vitamins lose luster

Some science on vitamins has changed over time. A decade ago, vitamin E seemed a superstar, an antioxidant thought to protect against cell damage caused by rogue molecules. But a number of large studies in recent years have found that vitamin E pills don’t slow diseases. A 2004 review of 19 medical studies involving nearly 136,000 people taking varying doses of vitamin E, found that people taking high doses (400 international units or more a day) seemed to die sooner than people who had not.

Supplement industry groups dispute such studies.

So does Les Moore, director of integrative medicine at Clifton Springs Hospital in Ontario County. He says vitamins made synthetically – the ones typically studied - aren’t the same as vitamins made from naturally occurring nutrients.

Moore, a doctor of naturopathy, believes patients need the help of a naturopath, clinical nutritionist, registered dietitian or holistic physician to help navigate the maze of information and misinformation.

No study shows benefit

At least half of Americans take a dietary supplement, mostly multivitamin-multimineral supplements, and they can be a touchy subject to discuss, says Dr. Geoffrey Morris, an internist at Pulsifer Medical Associates in Brighton, N.Y. Patients like to feel they’re taking some control over health, on their own. But Morris says there’s never been a study showing that healthy people benefit from vitamins. (People who have a disease or can’t digest foods normally are in another category.)

On the other hand, as long as people aren’t taking harmful levels, he tries not to argue.

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