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Dr. Robert D. Fusco, Medical Director    
Should You Take Vitamins?

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No question about it. Vitamins are hot. Just about every week there seems to be another disease that some vitamin helps prevent. You cannot walk past the newsstand any longer without seeing a magazine cover claiming good health through vitamin therapy. Surveys estimate that over 85 million Americans now take vitamin supplements on a regular basis. What is all the fuss about? Should you be taking vitamin supplements? And if you should, which ones should you take?

That is a good question and not that easy to answer. Check out the vitamin section of your local drugstore and you'll find the pickings are anything but slim. There are name brands, generic store brands, tablets for men, tablets for women, stress formulas, advanced formulas, antioxidant formulas, and so on. To make matters worse, some companies take advantage of your fear of aging by giving their products misleading names like "Memory" or "Manpower." They are trying to cash in on the general confusion over vitamins.

Lately, many of our patients have expressed frustration and confusion about this whole vitamin question. They ask, "How much of what do I really need?" Hopefully this information will help you sort through all the hype and make you a savvy supplement shopper.

What Is A Vitamin?

First of all, vitamins are not food. Not in the sense that food provides fats, carbohydrates, and proteins which serve both as sources of energy and building blocks for body growth and repair. On the contrary, vitamins contain no calories and have no nutritional value. They can't make you gain weight. In fact, a typical vitamin tablet contains less than 5 calories. They can't help you lose weight, nor can they cure baldness, increase your brain power, reduce emotional stress, or improve your social skills. Vitamins are merely "cofactors" that help your body function normally by controlling the millions of chemical reactions within your cells. Just like a copilot, they help keep your metabolism on course. In this way, vitamins do play an important role in the health and vigor of every organ in your body, from skin and bones to the brain and immune system. But, they are not food, nor are they magic. Getting The Minimum For the most part, vitamins' main role is to prevent deficiency diseases. Many years ago, government scientists established the minimum daily amount of vitamins needed to prevent deficiency diseases like scurvy, beriberi, and pellagra. This Recommended Daily Allowance, or RDA, has been established for most of the essential vitamins and minerals. The percentage number you see on a vitamin bottle label tells you what percentage of your daily minimum needs are contained in one tablet. For example, if a pill contains 50% RDA for Vitamin C, it provides half of your daily minimum needs to prevent scurvy.

Our abundant diet is easily capable of obtaining these minimum levels. Except for special cases of malnutrition and malabsorptive digestive diseases, almost all Americans can obtain the adequate nutrients needed to prevent these now-rare disorders from diet alone.

Going Beyond the Basics

But, is "adequate" all you want to be? The RDA of a vitamin is the minimum necessary to function - not what you need to perform optimally. The real question is: Do doses which exceed this minimum RDA level have any value? For most vitamins, the minimum RDA is all you really need. A balanced diet can provide that, but all vitamins are not created equal. After years of nutritional research, science is beginning to confirm the special role that two specific vitamins play in safeguarding health and fending off disease - vitamin C and vitamin E. There is a growing body of evidence that suggests when these two vitamins are taken in amounts which exceed the RDA minimum, they help protect against many chronic diseases such as cancer and heart disease.

"Rustproofing" Your Body

How is it possible that simply taking vitamin pills each morning can help prevent such serious ailments as cancer and heart disease? It sounds a little too good to be true. To understand this, you must first learn about free radicals and their role in disease.

Your body is made up of billions of small cells. Each has a special job to do. Bone cells lend support. Muscle cells allow motion and provide strength. Intestinal cells digest and absorb nutrients from your food. Blood cells carry oxygen and fight infection. And so on....

Like tiny engines, these cells must consume fuel (usually as the sugar, glucose) to function properly. Just as your automobile engine generates unwanted exhaust fumes when it burns gasoline, each of your cells creates harmful by-products as it burns energy. These destructive molecules are called cell oxidizers or "free radicals." It is estimated that your internal organs generate about 10 billion "free radical" molecules every day. Other free radicals enter your body in the polluted air you breathe, the water you drink, the additives and preservatives in processed foods, and even cigarette smoke.

Regardless, of their source, these molecular terrorists roam your body stealing electrons from body cells in a process called oxidation. Much like rust attacking an old car, these pirates attack and damage almost any cell surface. This cellular damage accelerates the aging process and can lead later in life to a variety of diseases. When you are young, your body produces the equivalent of "rust proofing" to protect your cells. But as you age, this protection fades and your cells are overwhelmed.

This is where two special vitamins enter the picture - vitamin C and vitamin E. They are antioxidants, or molecules which destroy free radicals. They destroy the destroyers and thus protect your cells from the aging effects of free radicals.

What Are The Benefits?

Some of the most exciting new nutritional research centers on the health-protective powers of vitamin C and vitamin E. Over the past few decades good scientific studies have shown that extra doses of these vitamins above the RDA may help lessen the risk of heart attack, stroke, some forms of cancer, and cataracts. Vitamins may improve immune function in the elderly. There is even some early evidence that Alzhiemers's disease may be benefited as well. Every day more evidence is accumulating to validate the beneficial effects of extra vitamin supplements.

A Balanced Diet Is Still Important

This is not to say that you should lessen your efforts to eat a better diet. Eating a balanced diet is still important. The new US Dept. of Agriculture guidelines stress the importance of eating more grains, fruits, vegetables, and low fat dairy products with little dabs of meat, fat, and sugar. A wide variety of foods is best.

We should all strive to get as much benefit from our diet as possible. Cut back on fat and protein. Stress whole grain foods and eat plenty of green leafy vegetables and deep-orange foods such as squash, apricots, peaches, carrots, and sweet potatoes. Remember when it comes to fruits and vegetables, deeper color usually means more vitamins.

But the sad fact is that few of us eat the ideal "balanced diet." Despite our best intentions, the typical American diet is still laden with too much fat and protein, and not enough fiber, vitamins and minerals. Nutritional surveys consistently show that less than 10 percent of adults consume the three or more daily servings of vegetables and two or more servings of fruit recommended for a healthy nutrient-packed diet. In fact, on any given day, half of us eat no vegetables at all. All those missing servings of fruits and vegetables are the major sources of the protective antioxidant nutrients. When you consider that this poor showing comes after a major push towards healthy eating, it is hard not to conclude that the goal of achieving protective levels of vitamins from our diet is at present beyond the grasp of most of us. So, in today's fast paced world, We believe that supplements are the only practical way to make sure that you are getting all the vitamins and minerals that you need. Because of this most physicians make vitamin supplements part of their daily routine and now recommend them to their patients.

What Are The Risks?

The risk of side effects from vitamin pills is extremely small and such cases usually involve truly massive doses, or "megadoses", which you should avoid. As with all other things in life, it is possible to get too much of a good thing. Don't exceed the doses below without consulting with your doctor.

What We Suggest
    1. Eat defensively with a balanced, nutritious diet. Your diet should stress high fiber and low fat.

    2. Supplement your diet with RDA quantities of all the basic vitamins using a general multivitamin tablet daily. Centrum, Theragram-M, and Unicap-M and their store brand "knock-offs" are fairly complete. Higher priced supplements are not necessarily better. If you want to save money by purchasing a cheaper store brand, just make sure you stick to a large national retailer or a store with a reputation for quality.

    3. Add extra amounts of two antioxidants. A reasonable amount would be 400 IU of vitamin E, and 1000 mg. of vitamin C daily. These levels are felt to be generally safe for adults. (To obtain these levels of antioxidants from diet alone, you would have to eat 12 carrots, one whole head of broccoli, and 7 oranges each day.)

    4. Women of childbearing age have special needs and should be sure that their supplement has 400 mcg of folic acid and 18 mg. of iron. In addition, both men and women need at least 1000 mg of calcium to prevent osteoporosis later in life, but both fall short in their diet. The best source of calcium is 4 daily servings of low-fat dairy products. If you have problems digesting dairy products, two Tums-Ex tablets twice daily with meals also provide plenty of calcium.
The Best Advice...

The best advice is to adopt a healthy lifestyle. Don't smoke and try to make some form of regular exercise a part of your normal routine. Good health habits and eating the right foods should be your number one priority....less fat and more fiber. In addition, we suggest you hedge your bet by taking daily vitamin supplements in moderation. Just consider it a little "nutrient insurance." While there's no way to guarantee that vitamins can prevent disease in any one individual, they may reduce your overall risk.

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