Do I Really Need To Take Vitamins? An intelligent answer to a common question

How many times has a customer asked you, “Do I really need to take vitamins? Can’t I get what I need by just eating a good diet?” Or perhaps even, “My doctor says I don’t need to take vitamins, just eat a good diet.” How do you respond to this? Are you successful in overcoming these objections? If you’d like to provide such customers with an intelligent, convincing answer, you need to consider two key issues: The adequacy of vitamins and minerals in our food supply and the dietary habits and nutrient intakes of Americans.

An examination of our food supply over a 90-year period does show the nutrient level of foods in general has improved, albeit only modestly. However, it is also true that despite improvements in agricultural techniques that have improved crop yield, from 1909 to 1994 a decrease in the levels of key nutrients has occurred. The vitamin B12 levels in foods decreased about 5 percent, magnesium decreased about 3 percent, zinc decreased about 3 percent, and potassium decreased about 7 percent.¹ Of course on the face of it, a 3 percent to 7 percent decrease of key nutrients doesn’t sound too bad. On the other hand, this is a decrease of nutrients across the whole food supply. An examination of individual crops reveals more severe declines. For example, growing conditions have caused certain crops to experience a 20 percent decrease in vitamin E and the essential unsaturated fatty acid linoleic acid.² Other studies have shown growing conditions can affect the calcium level of some crops by as much as 300 percent.3 Likewise, certain agriculture technologies decreased vitamin C and E levels in some crops by 2 percent and 13 percent, respectively;⁴ the content of seven minerals decreased in those same crops.

Aside from growing conditions and agricultural technologies, there is the simple fact that the nutrient content of foods can be directly related to the nutrient content of the soil in which they were grown. For example, the selenium content of plants, in particular cereal grains, is strongly influenced by the quantity of biologically available selenium in the soil in which they grow, that is, by their geographical origin.⁵ As a result, it should not be too much of a surprise that, according to the U.S. Department of Agriculture (USDA), the selenium content of fruits and vegetables is normally very low.⁶

In addition to the aforementioned issues, research has also shown food preparation may decrease the activity of some vitamins. Keeping food hot for more than two hours, for example, results in more than 10 percent losses of vitamin C, folate and vitamin B6.⁷ Vitamins are also lost during chilling, storage and reheating, including more than 30 percent of vitamin C and folate.⁸

The fact that the food supply may not be providing us with adequate levels of all of the nutrients is compounded by Americans’ generally poor dietary habits. Despite the fact that many individuals indicate they try to eat a good diet, USDA has reported only 10 percent of Americans actually eat a good diet. For example, only 17 percent of people consume the recommended number of servings of fruit per day.⁹

Of course with such a poor dietary report card, it shouldn’t be a surprise that USDA’s Continuing Survey of Food Intakes by Individuals (CSFII) revealed adult females failed to meet the recommended daily intake (RDA) for five nutrients—calcium, vitamin E, vitamin B6, magnesium and zinc; adult males fell short of the RDA for vitamin E, magnesium and zinc.¹⁰ The same USDA survey indicated only 6 percent of female adults over 60 met the recommended calcium intake. When you consider that postmenopausal women are most susceptible to osteoporosis, this last nutrient inadequacy is particularly alarming.

Other research has shown similar results. For example, in an article entitled “The Great American Nutrient Gap,” Dr. Melvin Werbach cites research from various scientific journals demonstrating that more than half of all Americans consume significantly less than the recommended intake for calcium, chromium, copper, folic acid, vitamin B6 and vitamin E.¹¹

Since people are clearly not getting an adequate amount of nutrients from their diet, this would seem to make a strong case for using dietary supplements as a “nutrition insurance policy.” In fact, in the Journal of the American Medical Association (JAMA), the association noted: “Most people do not consume an optimal amount of all vitamins by diet alone. Pending strong evidence of effectiveness from randomized trials, it appears prudent for all adults to take vitamin supplements.”¹²

Considering the AMA has not traditionally been in favor of the routine use of dietary supplements, this is truly a landmark recommendation. Another statement made in the same JAMA study, helps to shed some light on why the change of position. “Vitamin deficiency syndromes such as scurvy and beri beri are uncommon in Western societies. However, suboptimal intake of some vitamins, above levels causing classic vitamin deficiency, is a risk factor for chronic diseases and common in the general population, especially the elderly.”¹³

Apparently, the suboptimal intake of nutrients was significant enough to lead the AMA to the conclusion that supplementation is recommended for the general population. In fact, in the United States, between 5 percent and 10 percent of people over 60 have clinical findings associated with vitamin deficiency.¹⁴ Moreover, overt nutrient deficiencies are only the tip of the iceberg. Marginal deficiencies appear to be far more widespread and can cause a variety of nonspecific symptoms while they weaken the body’s defenses against serious illnesses.¹⁵

The customer question about the need to take vitamins versus just eating a good diet has an intelligent answer. In a nutshell, research shows our food supply doesn’t necessarily provide all of the nutrients we need, most people don’t eat a good diet, and most people aren’t getting adequate amounts of key nutrients. Clearly, we do need to take supplements. Perhaps The Council for Responsible Nutrition said it best: “The regular use of multivitamins and a few other nutritional supplements can measurably improve the nutritional status and lifelong health of the American public. Adoption of the concept of supplementation as a part of personal lifestyles, health care practices, and public policy would benefit individuals, would improve the health profile of the nation as a whole, and could significantly reduce health care costs.”

Gene Bruno, B.S., M.H.S., R.H.(AHG), is the dean of academics and professor of dietary supplement science with the American Academy of Nutrition (AAN) College of Nutrition & Integrative Health Sciences. Art Presser, Pharm.D., D.H.Ph., is a professor of alternative medicine and president of AAN. AAN is an accredited distance learning institution offering undergraduate and graduate degrees as well as a diploma program in nutrition. Visit www.aan.edu or call (865) 524-8079 to learn more.

1. Gerrior S, Bente L. "Nutrient Content of the U.S. Food Supply, 1909-94." U.S. Department of Agriculture, Center for Nutrition Policy and Promotion. Home Economics Report No. 53. 1997.

2. Alpaslan M, Gunduz H. "The effects of growing conditions on oil content, fatty acid composition and tocopherol content of some sunflower varieties produced in Turkey." Die Nahrung (Germany). 44, 6:434-7, 2000.

3. Barta DJ, Tibbitts TW, Barta DJ. "Calcium localization and tipburn development in lettuce leaves during early enlargement." J Am Soc Horticult Sci. 125, 3:294-8, 2000.

4. Hou TZ, Mooneyham RE. "Applied studies of plant meridian system: I. The effect of agri-wave technology on yield and quality of tomato." Am J Chinese Med. 27, 1:1-10, 1999.