FDA promotes Multivitamin
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Fortify Your Knowledge About
Vitamins
Vitamins are essential
nutrients that contribute to a healthy life. Although most people get all the
vitamins they need from the foods they eat, millions of people worldwide take
supplemental vitamins as part of their health regimen.
Why Buy
Vitamins?
There are many good reasons
to consider taking vitamin supplements, such as over-the-counter multivitamins.
According to the
• for certain health
problems
• if you eat a vegetarian
or vegan diet
• if you are pregnant or
breastfeeding
Vitamin
Facts
Your body uses vitamins for
a variety of biological processes, including growth, digestion, and nerve
function. There are 13 vitamins that the body absolutely needs: vitamins A, C,
D, E, K, and the B vitamins (thiamine, riboflavin, niacin, pantothenic acid,
biotin, vitamin B-6, vitamin B-12 and folate). AAFP cites two categories of
vitamins.
• Water-soluble vitamins
are easily absorbed by the body, which doesn’t store large amounts. The kidneys
remove those vitamins that are not needed.
• Fat-soluble vitamins are
absorbed into the body with the use of bile acids, which are fluids used to
absorb fat. The body stores these for use as needed.
Develop a
Vitamin Strategy
It is important for
consumers to have an overall strategy for how they will
achieve adequate vitamin
intakes. The 2005 Dietary Guidelines for Americans
advises that nutrient needs
be met primarily through consuming foods, with
supplementation suggested
for certain sensitive populations. These guidelines, published by the
Department of Health and Human Services and the U.S. Department of Agriculture
(USDA), provide science-based advice to promote health and to reduce risk for
chronic diseases through diet and physical activity. They form the basis for federal
food, nutrition education, and information programs.
Barbara Schneeman, Ph.D.,
Director of FDA’s Office of Nutritional Products, Labeling, and Dietary
Supplements, says, “The Guidelines emphasize that supplements may be useful
when they fill a specific identified nutrient gap that cannot or is not
otherwise being met by the individual’s intake of food.” She adds, “An
important point made in the guidelines is that nutrient supplements are not a
substitute for a healthful diet.”
Special
Nutrient Needs
According to the Dietary
Guidelines for Americans, many people consume more calories than they need
without taking in recommended amounts of a number of nutrients. The Guidelines
warn that there are numerous nutrients—including vitamins—for which low dietary
intake may be a cause of concern. These nutrients are:
• calcium, potassium,
fiber, magnesium, and vitamins A (as carotenoids), C, and E (for adults)
• calcium, potassium,
fiber, magnesium, and vitamin E (for children and adolescents)
• vitamin B-12, iron, folic
acid, and vitamins E and D (for specific population groups).
Regarding the use of
vitamin supplements, the Dietary guidelines include the following:
• Consume a variety of
nutrient-dense foods and beverages within and among the basic food groups. At
the same time, choose foods that limit the intake of saturated and trans fats,
cholesterol, added sugars, salt, and alcohol.
• Meet recommended nutrient
intakes within energy needs by adopting a balanced eating pattern, such as one
of those recommended in the USDA Food Guide or the National Institute of
Health’s Dietary Approaches to Stop Hypertension (DASH) eating plan.
• If you’re over age 50,
consume vitamin B-12 in its crystalline form, which is found in fortified foods
or supplements.
• If you’re a woman of
childbearing age who may become pregnant, eat foods high in heme-iron and/or
consume iron-rich plant foods or iron-fortified foods with an iron-absorption
enhancer, such as foods high in vitamin C.
• If you’re a woman of
childbearing age who may become pregnant or is in the first trimester of
pregnancy, consume adequate synthetic folic acid daily (from fortified foods
“Do not self-diagnose any
health condition. Work with your health care providers to determine how best to
achieve optimal health.”
Practice
Safety with Dietary Supplements
When it comes to purchasing
dietary supplements, Vasilios Frankos, Ph.D., Director of FDA’s Division of
Dietary Supplement Programs, offers this advice: “Be savvy!”
Today’s dietary supplements
are not only vitamins and minerals. “They also include other less familiar
substances such as herbals, botanicals, amino acids, and enzymes,” Frankos
says. “Check with your health care providers before combining or substituting
them with other foods or medicines.” Frankos adds, “Do not self-diagnose any
health condition. Work with your health care providers to determine how best to
achieve optimal health.”
Consider
the following tips before buying a dietary supplement:
• Think twice about chasing
the latest headline. Sound health advice is generally based on research over
time, not a single study touted by the media. Be wary of results claiming a
“quick fix” that departs from scientific research and established dietary
guidance.
• More may not be better.
Some products can be harmful when consumed in high amounts, for a long time, or
in combination with certain other substances.
• Learn to spot false
claims. If something sounds too good to be true,
it probably is. Examples of
false claims on product labels include:
· Quick and effective
“cure-all”
· Can treat or cure disease
· “Totally safe,” “all
natural,” and has “definitely no side effects”
Other red flags include
claims about limited availability, offers of “no-risk, money-back guarantees,”
and requirements for advance payment.
“Also ask yourself, ‘Is the
product worth the money?’” Frankos advises. “Resist the pressure to buy a
product or treatment on the spot. Some supplement products may be expensive or
may not provide the benefit you expect. For example, excessive amounts of
water-soluble vitamins, like vitamins C and B, are not used by the body and are
eliminated in the urine.” or supplements) in addition to food forms of folate
from a varied diet.
• If you are an older
adult, have dark skin, or are exposed to insufficient ultraviolet band
radiation (such as sunlight), consume extra vitamin D from vitamin D-fortified
foods and/or supplements.
How
Vitamins are Regulated
Vitamin products are
regulated by FDA as “Dietary Supplements.” The law defines dietary supplements,
in part, as products taken by mouth that contain a “dietary ingredient”
intended to supplement the diet.
Listed in the “dietary
ingredient” category are not only vitamins, but minerals, botanicals products,
amino acids, and substances such as enzymes, microbial probiotics, and
metabolites. Dietary supplements can also be extracts or concentrates, and may
be found in many forms. The Dietary Supplement Health and Education Act of 1994
requires that all such products be labeled as dietary supplements.
In June 2007, FDA
established dietary supplement “current Good Manufacturing
Practice” (cGMP)
regulations requiring that manufacturers evaluate their products through
testing identity, purity, strength, and composition.
Risks of
Overdoing It
As is the case with all
dietary supplements, the decision to use supplemental vitamins should not be
taken lightly, says Vasilios Frankos, Ph.D., Director of FDA’s Division of
Dietary Supplement Programs.
“Vitamins are not dangerous
unless you get too much of them,” he says. “More is not necessarily better with
supplements, especially if you take fat-soluble vitamins.” For some vitamins
and minerals, the National Academy of Sciences has established upper limits of
intake (ULs) that it recommends not be exceeded during any given day.
For more information
www.nap.edu/catalog.php?record_id=6432#toc
Also, the AAFP lists the
following side effects that are sometimes associated with taking too much of a
vitamin.
Fat-soluble
Vitamins
• A (retinol, retinal,
retinoic acid): Nausea, vomiting, headache, dizziness, blurred vision,
clumsiness, birth defects, liver problems, possible risk of osteoporosis. You
may be at greater risk of these effects if you drink high amounts of alcohol or
you have liver problems, high cholesterol levels or don’t get enough protein.
• D (calciferol): Nausea,
vomiting, poor appetite, constipation, weakness, weight loss, confusion, heart
rhythm problems, deposits of calcium and phosphate in soft tissues.
If you take blood thinners,
talk to your doctor before taking vitamin E or vitamin K pills.
Water-soluble
Vitamins
• B-3 (niacin): flushing,
redness of the skin, upset stomach.
• B-6 (pyridoxine,
pyridoxal, and pyridoxamine): Nerve damage to the limbs, which may cause
numbness, trouble walking, and pain.
• C (ascorbic acid): Upset
stomach, kidney stones, increased iron absorption.
• Folic Acid (folate): High
levels may, especially in older adults, hide signs of B-12 deficiency, a
condition that can cause nerve damage.
Taking too much of a
vitamin can also cause problems with some medical tests or interfere with how
some drugs work.
Report
Problems
If you believe that you are
experiencing an adverse response to taking a vitamin or any dietary supplement,
Frankos advises reporting it to your health care provider, as well as to the
manufacturer whose name or phone number appears on the label.
You can also report
directly to FDA through its MedWatch program at
1-800-FDA-1088 or online at
www.fda.gov/medwatch
Starting December 22, 2007,
any serious adverse events reported to a dietary supplement manufacturer must
be reported to FDA within 15 days of the manufacturer receiving the adverse
event report.
For More Information
Dietary
Supplements
www.cfsan.fda.gov/~dms/supplmnt.html
What
Dietary Supplements Are You Taking?
www.cfsan.fda.gov/~dms/ds-take.html
Dietary
Guidelines for Americans, 2005
www.health.gov/dietaryguidelines/dga2005/document/default.htm
National
Institutes of Health Office of Dietary Supplements
http://dietary-supplements.info.nih.gov/
Dietary
Reference Intakes: A Risk Assessment Model for Establishing Upper Intake Levels
for Nutrients
www.nap.edu/catalog.php?record_id=6432
Vitamin products are
regulated by FDA as “Dietary Supplements.”
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