Dr. Zorba Paster: Make sure you get enough vitamins A, D and E – even if it means a supplement

I’ve written about vitamins and supplements many times. My bottom line has always been that we get these essential micronutrients from food – colorful fruits and veggies.

The more variety, the better; the more colorful, the better. It’s the best way to stay healthy.

OK, but now it’s winter. Fresh produce is more difficult to find, more expensive and requires many people to visit the grocery store more than once a week because perishables are perishable.

What if you don’t have the time, transport or money to do this? What should you do? Is vitamin supplementation a way to go – and, more important, does it do anything?

The coronavirus pandemic has led to questions about vitamins in preventing serious complications from the infection. That might be especially important for Black people, who have been affected at higher rates by COVID-19.

African Americans have lower levels of vitamin D due to skin pigment and how the vitamin is metabolized. They are more likely to become seriously ill. Is vitamin D the culprit? And what about other vitamins?

Nutrition plays a key role in reducing the risk of when you get sick and just how sick you get. We know that micronutrient intake boosts immunity, but exactly how it works is not clear.

Vitamin A is thought to help by supporting mucosal tissues to defend against respiratory pathogens. Vitamin E, being a fat soluble vitamin, enables it to accumulate in fat membranes, neutralizing free radicals and triggering the production of pro-inflammatory cytokines essential in fighting infections.

Vitamin C supports white blood cells metabolism. Where vitamin D plays a role is still a mystery.

The European Union was interested in whether increasing vitamin intake through pills might be good. A recent study from the British Medical Journal gives us clues.

Investigators looked at more than 6,000 adults in the U.K. who completed food and nutrition diaries, looking at what they ate, drank and whether they took vitamins A, E, C or D over more than a 10-year period from 2008 to 2016.

Then they looked at whether they saw a clinician for an upper-respiratory infection, bronchitis, exacerbation of COPD, asthma or pneumonia. The U.K. has a national health system so their data is robust and complete.

Researchers controlled for age, gender, weight, smoking, household intake and how much people exercised. They found that higher intake of vitamins A, E and D was linked to fewer respiratory complaints, while vitamin C was a nonfactor.

Foods rich in vitamin A include carrots, dark green leafy vegetables and orange-colored fruits, while major dietary sources of vitamin E include vegetable oils, nuts and seeds.

It’s easy to get vitamins A and E from your diet, but vitamin D is a different issue. It’s difficult to go out in the sun on that winter day, strip down to your skivvies and soak up the sun.

The study’s conclusion was, “Despite this, micronutrient deficiencies are often overlooked as a key contributor to the burden of malnutrition and poor health, presenting an additional layer of challenge during the COVID-19 pandemic.”

My spin: I go back and forth on vitamins – maybe, maybe not. Maybe, maybe not. But the landscape has changed.

We’re in the middle of a pandemic that’s not going anywhere soon. What’s the downside of swallowing a pill – simply the cost? That might not be an issue if you shop right.

It’s about a dime a day for a multivitamin. Add an extra 2,000 IU of vitamin D, and you’re up to 13 cents. As for vitamin E, get it from nuts because we know how good they are for cardiovascular health.

When it comes to vitamins, the pandemic has shaped my opinion, too. Stay well.

Dr. Zorba Paster is a family physician and host of the public radio program “Zorba Paster on Your Health.” He can be reached at askzorba@doctorzorba.com.