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Dollars and Sense

Vitamins: How to Shop Wisely

June 24, 2002|BOB ROSENBLATT | SPECIAL TO THE TIMES

Momma said, "Eat your vegetables." She was right, of course, but we often ignored her as kids, and we are failing to listen as adults. Very few of us eat the recommended five to nine servings daily of fruits and vegetables, and many are eating three or fewer servings. And that's why many scientists and medical researchers believe most Americans could benefit from taking a vitamin pill.

Consumers need to know what vitamins and minerals they need every day, and the cheapest way to get them. A single daily pill, called a multivitamin, is the best way to get your supplemental nutrition, especially if you don't regularly consume the recommended amounts of fruits, vegetables and other vitamin-rich foods. But you've got to know how to shop wisely.

Unlike prescription drugs, vitamins (and other dietary supplements, such as herbal products) aren't regulated for safety and efficacy by the Food and Drug Administration. The government does not assure you that a bottle of vitamins is safe, that the pills inside work to give you the nutrients you need or that the product is manufactured under strict standards. Typically, the government steps in only when something goes wrong--for example, when consumers who have used a particular product get sick or die.

So you have to be your own inspector. First, check the label on the bottle to be sure the contents are what you need. There are FDA-approved daily values, which tell you what a healthy adult needs in a typical day. The vitamin is never a substitute for eating properly. But it can assure that you get the basic things you need. The multivitamin should contain 100% of the daily values of vitamins A, B-6, B-12, C, D and E, as well as riboflavin, niacin and folic acid. The pill also should contain calcium, copper, magnesium, zinc, iron and iodine. Next, you have to be sure the product will dissolve in your bloodstream, so that you actually get the benefit of the vitamins. If the pill is compacted too tightly when it is manufactured, or if the coating is too thick, it will pass through your system without dissolving.

Here is an easy home test. Drop the multivitamin in a glass of vinegar, which represents the acid content of your stomach in this experiment. The pill should dissolve within 45 minutes. If it doesn't, look for another product. Or you can look for the USP label on the bottle. This means the vitamin product has been approved by the U.S. Pharmacopoeia, an independent organization that performs laboratory tests on the pills.

And don't be impressed by any extravagant language on the bottle that goes beyond a simple listing of the basic vitamins inside and their percentage of recommended daily value. The UC Berkeley Wellness Letter gives a selection of "words you don't need to see listed" on a vitamin bottle. These include "stress formula," "sugar-free," "starch-free," "natural," "super-potency," "senior formula," "slow-release," "enzymes" and "amino acids," as well as the addition of herbal ingredients such as ginseng. These serve no purpose and add to the price, according to the newsletter. If you want to buy an herbal supplement, purchase it separately. Talk to your doctor because herbs sometimes counteract the medicines you might be taking. And the quality and quantity of herbs in a given bottle of supplement is uncertain, some health professionals caution.

While virtually all adults can benefit from a multivitamin, for some groups it may be essential. Women of childbearing age need folic acid because it prevents birth defects. It is needed in the first trimester of pregnancy, often before a woman may discover she is pregnant. But 70% of women between 18 and 45 aren't taking a multivitamin with folic acid, according to a series of public opinion surveys for the March of Dimes.

Others at high risk of vitamin deficiency are those who consume at least one or two alcoholic drinks daily; persons over 65; and poor people, who may be unable to afford adequate supplies of fresh vegetables and fruits. Vegans--individuals who eat no animal products--also are at risk of suffering vitamin deficiencies. Also, many women nearing menopause don't have enough iron in their diets, and a multivitamin can help.

How much should you pay for vitamins? A 2001 report in the New England Journal of Medicine said adults can get a multivitamin at a typical cost of $20 to $40 a year. Because the price is so reasonable, it makes sense to give a general endorsement to the idea of vitamins for most people, rather than spending the money for blood tests to determine who has vitamin deficiencies, according to the Harvard School of Public Health researchers who wrote the article.

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