Choosing a quality multivitamin is easier with a few guidelines
Choosing a multivitamin-mineral supplement can be puzzling. Conflicting messages abound in the marketplace, especially on the Internet. And, as expected, the confusion is not helped by reports from the media that tend to overemphasize observational studies that confirm bias against supplementation. The reality is that the quality of multivitamin-mineral supplements ranges widely.
The highest quality dietary supplements are those designed according to current science and technologiesâ€”they use the most stable and efficacious forms of vitamins and minerals, have optimal solubility rates, are third-party tested for potency and shelf life, and provide optimal vitamin-and-mineral dosages that are divided over the course of the day for best absorption.
On the other end of the quality spectrum are the popular â€œone-a-dayâ€ supplements, which claim to provide all that the body needs in a single tablet; they may provide adequate amounts of many nutrients, but severely neglect others. Other supplements use synthetic vitamins when science demonstrates the bodyâ€™s preference for the natural forms. Finally, some supplement companies claim higher absorption or bioavailability because their nutrients come directly from, or are paired with, â€œwhole foodsâ€; such claims are misleading because they are not presented with data. These vitamins do not actually come from whole foods, but are simply combined with botanicals that may even inhibit absorption.
Far be it for all marketers to paint a clear picture of the science, or for the media to do a little homework before lumping all dietary supplements in the same category of low quality and worthless. The fact is though, that there have been well-designed studies showing clear benefits from taking supplements in forms appropriate and in dosages that assist in meeting dietary recommendations for optimal health. If this werenâ€™t true, or if multivitamins were somehow â€œdangerousâ€, then why do most medical doctors continue prescribing prenatal multivitamins to women who are expecting?
A proper review and critique of multivitamin-mineral supplements should be based on how well it reflects positions of scientific consensus on dosage, forms, and delivery. A few of the things to look for in a supplement are these:
- Quality â€“ According to a recent Consumer Labs report, one in three supplements either contained fewer nutrients than promised on the label, provided far more nutrients than claimed, had incorrect labeling of ingredients, or simply failed to disintegrate in the allotted time for proper absorption. If uncertain about whether or not a supplement really provides what it claims to, itâ€™s probably a supplement to avoid. Take a multivitamin-mineral only if it comes from a reputable company that tests label claims through an independent laboratory.
- Efficacy â€“ Itâ€™s well-known that some forms of vitamins or minerals are more stable, or more bioavailable, than others. For example, natural vitamin D3 exhibits greater retention in the body compared to synthetic vitamin D2 (1). Likewise, vitamin E in its natural form of d-alpha tocopherol provides greater activity than its synthetic mixture counterpart, dl-alpha tocopherol, which contains only a small percentage of the natural form (2). Another example is vitamin B12 as cyanocobalamin, which is more stable than other forms of vitamin B12, thus allowing for greater shelf life.
- Optimal dosages â€“ Multivitamin-mineral supplement makers will often add a mineral such as calcium or an antioxidant such as coenzyme Q10 (CoQ10) to help it sell better in the marketplace, but not in high enough doses to really strengthen bones or support the heart. Such supplements should be avoided in favor of others that actually supply enough of each nutrient to truly be effective. Similarly, should a supplement contain omega-3 fatty acids, it should contain a high enough concentration of both DHA and EPA for heart health. In short, dosages should reflect the latest that science has to offer as recommendations for health and longevity.
- Solubility â€“ Have you heard of â€œbed pan bulletsâ€? Thatâ€™s what doctors used to call tableted multivitamin pills that passed through the body unabsorbed. Science has come a long way to provide technologies for better solubility, but there still are a few multivitamins on the market that donâ€™t disintegrate appropriately enough to be absorbed properly. The standard for a quality multivitamin-mineral tablet is to disintegrate within 60 minutes or less in an acidic solution mimicking the environment in the stomachâ€”even better is if it can disintegrate easily in plain water or rice vinegar.
- Absorption and bioavailability â€“ Companies make misleading claims when they market their supplements as more highly absorbed or bioavailable because they are from, or combined with, â€œwhole foodâ€ or â€œvegetable components.â€ For one thing, the source of their vitamins is really not different than anyone elseâ€™s, which is obtained through yeast fermentation. The â€œwhole-foodâ€ source supplements also seldom meet label claims or stability for shelf life. In addition, they donâ€™t account for anti-nutrient components; for example, a supplement containing leafy green vegetables such as spinach may also contain anti-nutrient compounds called oxalates that inhibit absorption of other minerals in the supplement through chelation (thatâ€™s not to say people should avoid eating spinach, but that improved absorption and bioavailability from a spinach supplement is false) (3). There are also supplements on the market (obviously not designed by nutritionists familiar with the science) that completely disregard well-known absorption problems when dosages of minerals such as calcium are too high, or when mineral competitiveness occurs between iron, calcium, zinc, and copper (3 & 4). A quality supplement will use forms of minerals without absorption-inhibiting anti-nutrients and have an appropriate amount of minerals in each tablet to be taken in divided doses over the course of the day.
Before ever venturing out to choose a multivitamin-mineral, each of the five points presented above should be considered by those looking to achieve the greatest value from their supplements. All things considered, my choice for a great vitamin is the Ageless Essentials Daily Pack, which comes in convenient A.M. and P.M. packets. Over the course of the day, the pack provides optimal dosages of essential vitamins and minerals such as vitamin D3 (2000 IU), calcium (800 mg for men, 900 mg for women), vitamin E as mixed tocopherols and d-alpha tocopheryl succinate (90 IU), and vitamin K2 (80 mcg).
The pack also includes a potent combination of bioactive compounds that support optimal health and longevity. These include patented, lipid-soluble CoQ10 (100 mg) backed by studies showing eight times greater bioavailability, maximum concentrations of ultra-purified DHAand EPA omega-3 fatty acids (600 mg EPA, 440 mg DHA), trans-resveratrol (250 mg), and more.
Food and Nutrition Board. Institute of Medicine. Dietary Reference intakes. Washington, DC: National Academy Press, 2000, pp. 186-283.
Heaney R et al. Vitamin D3 is More Potent Than Vitamin D2 in Humans. J Clin Endocrin & Metab. 2011;96(3):E477 doi: 10.1210/jc.2010-2230
Gropper SS, Smith JL, Groff JL. Advanced Nutrition and Human Metabolism. Belmont, CA: Thomson Wadsworth, 2009.
Hoffman H et al. Zinc-induced copper deficiency. Gastroenterology 1988; [94:50]8-12.