I think it is fairly obvious that a healthy balanced diet,
which is carefully balanced to provide the nutrients our body
needs is highly preferable.
This the composition of needed nutrients can vary greatly
for person to person. But in general, a good diet is the
way to go. On that is also adapted to change conditions.
For instance, the lack of sunlight in Scandinavian countries
during the winter, which makes consuming foods rich in Vitamin D
is important.
However, a lot of people are not motivated and/or privileged¹ enough
to do so.
A question that then must be asked, if you are not able to compose
and consume a healthy diet does a multivitamin have a positive effect?
¹ Using this term may seem controversial but I think it is accurate.
If a person is poor and does not have food safety the fight
is to find enough food. Not finding the exact food needed for a
balanced diet. In general, the food that food banks give out
will not be able to provide a proper balance.
Add to that though that multivitamins can be expensive and is also
out of reach. I have never heard of a food bank providing
multivitamins. (even though it would probably be a good idea)
Then some people will feel that they do not have the time.
Some people have not learned to cook well.
Eating healthy was a lot easier when I lived in the US the
availability of a broad selection of fruits, vegetables and
nuts is great.
Norway has in general a small selection of all of the above.
I think part of the problem is that a 'balanced diet' is also pretty poor in micro nutrients/vitamins/etc because modern farming techniques mean the soil itself is pretty exhausted, with just the bare minimum being added back to yield the next crop.
I get the sentiment but this is very much an exaggeration. Vegetables might have 5% to 30% less micronutrients than 100 years ago if you believe in the accuracy of micronutrient measurements from 1940 (you shouldn't). But there's good evidence that the soil isn't to blame. Rather, we have switched to varietals which grow quicker and have less time to pull good stuff up from the ground.
In any case, vegetables are now many times cheaper and more accessible than before. As a species we have hundredfold better access to nutrition than a century ago.
The fact is most people feed themselves mostly on flour and oil. That's what's causing a malnutrition epidemic, not poorer vegetables.
Or if someone has some need other than the average. Someone diagnosed with low iron can change thier diet to encorporate lots of red meat, kilos of it, or just pop an iron pill once a week.
About 20 years ago, after I'd been vegan for a while, I bought a software package that would analyze my hippy diet to see where I was coming up short.
Predictably, my "lazy bachelor vegan" lifestyle wasn't quite hitting the RDI for everything but as soon as I keyed in a multivitamin I had plenty of slack (at least according to this software).
Apart from dispelling my concerns about my diet choices it made me realize the number of things that are fortified with vitamin additives: [soy] milk, flour, salt, to say nothing of processed foods like breakfast cereals.
So maybe for most omnivores a vitamin supplement is harmlessly redundant given the way modern food is processed?
Vegan diets are a slightly special situation. If you're vegan you at least need to supplement B12 and you might be more likely to be deficient in other vitamins as well compared to non-vegans, regardless of whether they are consuming processed foods that are fortified with vitamins.
I think when people are saying that vitamin supplementation isn't necessary in general, they are not talking about vegans.
I wonder, though -- my own experience is my only data-point -- but I got pretty close as a lazy bachelor presumably because of the vitamins that are added to so many things.
For example: the Silk soy milk I buy includes the following ingredients: Calcium Carbonate, Vitamin A Palmitate, Vitamin D2, Riboflavin [B2], Vitamin B12. Do they juice it with extra 12 because they know dirty hippies like me aren't eating eggs? I'd believe it.
So do I really need a separate B12 supplement? Now that I'm a [just as lazy] middle-aged vegan with better access to groceries and a partner that loves to cook I really wonder.
I'm sorry but it was so long ago I've long since forgotten; I don't know that my lazy bachelorhood diet is a good example anyway (cooking for one with less emphasis on fresh vegetables and more on what I could fit in my backpack to carry home).
Vitamin D is the only one the NHS (i.e. the UK authority) recommends adults 'consider' taking, especially in winter months. It suggests year round could be beneficial for certain groups, such as darker skin (less production of it from the limited sun we get than lighter skin) and those working/spending most time indoors.
For everything else its guidance (for non-pregnant adults) is that you should be able to get it from your diet.
Not that it says don't or that it's really bad, or especially if you have some inherent deficiency (or you're a menstruating vegetarian, etc.) it could be a very good idea to take the relevant supplement to make it easier than getting it from food, I just thought it was interesting when I was looking through recently that the language is very consistent for all of them, except vit D which has the relatively strong 'should consider taking it'.
> Vitamin D is the only one the NHS (i.e. the UK authority) recommends adults 'consider' taking, especially in winter months
I have had two doctors in Canada tell me that the government health plan does not cover Vitamin D testing because everyone at our latitude is expected to be vitamin D deficient and should be on a supplement.
If they really believe that everyone is deficient they should probably cover testing.
There is a lot of argument about the appropriate dosage for vitamin d supplementation, so repeated testing might actually be the only way to make sure you're taking the right amount.
Well per the NHS you should consider taking 10ug (400IU) daily, but up to 100ug (4,000IU) as a supplement would be safe. (Risk of hypercalcæmia if too high.) (As a supplement too, so that's presumably saying ok maybe the person's not deficient, they're naturally at 20ug or whatever, they take a 100ug supplement, add some margin, and it's still safe.)
So basically what the doctors/gov health plan say in Canada according to GP makes sense to me wrt that in the sense that you almost certainly are deficient, 10ug is enough, an order of magnitude more than that is still safe; so just take it.
(I don't know about the cost to the Canadian government if they wanted to provide it obviously, but to me as an individual it's cheaper to get 365x 10ug supplements than it is to get 1x test to see if I'm deficient.)
Technically, people vary so much we can't even tell you your needs. E.g. the RDA is sth like a 2 sigma excess. It's not enough for 4% or so of ppl.
And even if we could know out needs from day to day, the food varies quite a bit, by varietal, location and season.
There's still more wiggle room, bc if we get excesses or shortages, our responses may vary unpredictably. With extra calories, we might suddenly decide to clean the garage.
We are not precise machines in a precise environment. Our sexual reproduction and mutations -and that of our food- constantly reshuffle the deck, guaranteeing we can only make broad predictions.
The best we can do is accumulate knowledge, observe and create feedback.
I'd be happy with them just specifying a sample daily diet that provides 100% of the RDA for everything in a given calorie budget. Does something like that exist?
Exactly. Taking a few vitamins including multis and D is a very cheap insurance policy.
People overestimate how much sun someone in Australia is exposed to on a daily basis for one, especially if I want to protect my skin from dangerous UV radiation. And throw in some very regular WFH on top of that...
tdeecalculator.com and eatthismuch.com may go some way towards what you want. Eatthismuch will make you up a meal plan and give you all the micro- and macro-nutrient info, although anything fancy requires paying.
I usually find that a lot of multivitamins are quite underdosed. Athletic multi-vitamins are better dosed but are stupidly expensive compared to just buying separate.
As others have noted, you just need few main vitamins/supplements to cover your most likely deficiencies (Vitamin D, Zinc, Magnesium, Omega, etc.)
If you really care about this then find and do a simple general blood test for your micros/vitamins. It will show you where you are deficient and can focus on supplementing on only those. No not much point supplementing micros that are already OK.
>If you really care about this then find and do a simple general blood test for your micros/vitamins. It will show you where you are deficient and can focus on supplementing on only those.
Presumably this will only show what you are deficient in based on the previous few days diet, right? So to have a decent measurement you should already have a very stable diet. If you eat like I do, random things from day to day, then your vitamin levels should differ from week to week, or are they much longer lasting?
> If you really care about this then find and do a simple general blood test for your micros/vitamins.
I wish they were cheaper (a broad set is >£100) - would love to do it say weekly, and be able to really see it against the food I've been eating (maybe keep a rough note of that, or just be able to think about it in terms of seasonally what I've been eating).
Magnesium is almost always grossly under dosed because the actually daily dose is quite substantial. I take a multivitamin and a supplemental magnesium and to get the daily recommendation I need to take two magnesium capsules as supplement. If they had included it in the multivitamin it would be a horse pill.
If one can afford to buy extra supplements to eat everyday, probably can also afford to buy a car to drive around and die more often in car accident than who don't drive.
Exactly. Like how does it effect sleep, feeling of well-being, strength, etc. There are many better metrics. We wouldn't be here if not taking multivitamins killed.
If multivitamins are really improving things like sleep and strength why is that not showing up in mortality? Isn't there evidence that sleep quality and strength in later life are negatively correlated with mortality?
Feelings of well-being have also been shown to be negatively correlated with morality.
Things like sleep, sense of well-being, and strength are inversely correlated with mortality.
If this is a causal relationship, and vitamins cause these things to improve, then mortality should also improve. The fact that this is not the case therefore suggests that either 1) the relationship between these things and mortality isn't causal, 2) vitamins are not improving these things (or I suppose, 3) the relationship is causal and vitamins are decreasing mortality by improving these things but also increasing mortality by other effects in a way that balances out).
While it is theoretically possible that none of these things have a causal relationship with mortality and it would therefore be be possible to improve them without decreasing mortality, I'm not sure it's likely.
It just seems pretty improbable to me that multivitamins are having all these wide-ranging health benefits that people are claiming and none of these benefits are having even the slightest effect on mortality.
For this reason, I think evidence that vitamins don't decrease mortality is actually pretty strong evidence that they are not having these other effects.
You've made a major mistake. It may be that vitamins do improve all of those things and would improve mortality as a consequence but something else keeps mortality the same, for example heart disease and cancer.
> It may be that vitamins do improve all of those things and would improve mortality as a consequence but something else keeps mortality the same, for example heart disease and cancer.
Are you saying that vitamins have improved mortality over time but increasing heart disease and cancer rates have balanced that out over time? If so, that's not what's being talked about here. The study in the article is comparing people who take multivitamins with people who don't, not looking at the overall rate in multivitamin usage compared to mortality over time in the entire population.
Or are you saying that people who take vitamins are more likely to have heart disease and cancer? That can be an issue in this type of study but there's no reason to think that's true. If anything, I think there is a concern that the confounding factors go in the opposite direction, where people who take vitamins are more likely to do other things that improve their health like exercise more. However, the study in the article also controlled for various potential confounding factors like BMI and physical activity.
I think I was clear, but I'll spell it out for you:
Imagine this possibility. Everyone gets cancer and dies at 65 years old. Everyone starts taking vitamins and therefore starts sleeping better, getting stronger, etc. They all still die at 65 years old though because of cancer. Suddenly, cancer is cured. All those people now live to 85, except the ones who still don't take vitamins. They only live to 66. Vitamins caused a 20 year increase in lifespan, but this was undetectable because cancer was killing everyone at 65. In all cases though, everyone slept better and were stronger after taking vitamins.
Mortality is a terrible measure of whether people are sleeping better and stronger after taking vitamins. It would be better to measure sleep and strength directly if that's what one wants to know about. I hope your mistake is clear to you now.
> Imagine this possibility. Everyone gets cancer and dies at 65 years old. Everyone starts taking vitamins and therefore starts sleeping better, getting stronger, etc. They all still die at 65 years old though because of cancer. Suddenly, cancer is cured. All those people now live to 85, except the ones who still don't take vitamins. They only live to 66. Vitamins caused a 20 year increase in lifespan, but this was undetectable because cancer was killing everyone at 65. In all cases though, everyone slept better and were stronger after taking vitamins.
Cancer isn't killing everyone at 65 years old. Not everyone dies of cancer at all. Even if you assume that vitamins have no effect on cancer rates, if they decrease mortality due to other causes, people who take vitamins should have lower overall morality than people people who don't take vitamins.
So again, you would have to have a situation where vitamins are improving sleep and strength, which are both inversely correlated with mortality, but somehow not decreasing mortality, as I said in my previous comment.
...as a mortality benefit for ordinary people. If you are going through various diseases it is absolutely something that a doctor will order, and there's plenty papers to prove positive effects versus sham therapy. Right now I am taking B12 to help with neuropathy and anosmia after a horrible bout of Covid for example.
What I still don't understand is why everyone is talking in 'servings' of vegetables and fruit, instead of cups or ounces.
(I believe this one and the imperial one (which definitely is) both make some sort of sense in being the same as half a pint. For whatever reason that's consistent, but the US needed to reinvent the pint (and gallon, ton[ne], ...).)
You may be saying this, but it's fine until it's not.
A good example of where it's not is baking. Cup works for the wet stuff but will ruin your baking if you use it with flour. Because of flour's ability to compact, 1 cup is a wildly different amount. That really impacts how dry or mushy your bread turns out.
Show me a recipe that uses cups for volumetric measurements and also has any mass measurements. They're rare.
Cups makes it either very old or very American, and from what I've seen American recipes tend not to measure anything by mass. (Even butter is measured by the 'sticks' that it's sold in there. They're obviously some standard weight, but if you're not American (and so did not buy your butter in a stick) you'll have to try to look that up.) And in a vicious circle, as I understand it most American home kitchens don't have scales?
Personally I think cups (or call it anything, doesn't matter) are nice when absolutely everything is going to be described in a volumetric ratio. That works nicely, it's easy to scale, and it doesn't matter at all what a 'cup' is, everything's just relative to everything else. But even then, especially with wet & dry ingredients, you probably want multiple 'cups' of the same size, it's not completely convenient.
Yeah - I started getting food boxes with picked ingredients that I cook every week a few years ago ... to add to the "cup" situation there's also the tablespoons/teaspoons situation they like to go nuts on their smaller ones.
My favourite was seeing "half" a tablespoon of something.. not having a full derivative of measurement devices for this unit, thankfully with 3 teaspoons to a tablespoon that was merely 1.5 teaspoon.
And then they have eg "sprinkle", "dash" and "pinch". As in "add a dash of water". Grr, those are _not_ beginner friendly units. I've destroyed a dish by adding a "big pinch" of salt (my fingers probably much bigger than theirs).
I find measuring with grams and millilitres much easier.
Salt is the worst because a pinch of kosher salt is wildly different from a pinch of granulated salt.
That said, one key part of cooking is knowing when the measurements matter. Most herbs and spices will flavor a dish exactly the same if you add a teaspoon or a tablespoon.
Those measurements matter the most when there's a chemical reaction that's strongly influenced by the ratios. For example, having enough emulsifier in a cheese sauce.
Yep - it was indeed a teaching moment for me. :-)
Dealing with a bit of high blood pressure as well, I'm learning to err on the side of caution when it comes to salt.
The imperial system is fine for intuitive everyday human operations such as serving one's family greens. One cup does not have to be the same size as everyone else's. It's not as good when preparing rocket fuel or chemical reagents and scaling orders of magnitude or mingling measurement systems.
It would be interesting to see a decade by decade breakdown of the loss of nutrients and vitamins due in fruits and veg due to intensive farming caused by greedy business
Every time I'm traveling I take vitamins supplements. I know my diet is gonna consist of very poor nutrients foods so I feel it's a good safety measure.
> Other things like [...] vitamin D might be beneficial for specific people with deficiencies but realistically you'll get more health benefit by just fixing your diet
If you're from a sunny place in November~February, please package me some sunlight for breakfast!
The linked site has no search results for either D or vitamin D, I guess search is broken. I'm not aware that any regular diet typically comes with sufficient vitamin D, hence people in higher latitudes (like most of Europe) with indoor jobs being commonly deficient and using supplements rather than "just" fixing their diet
My doctor prescribed vitamin D after blood work for unrelated reasons, which I take in months where I don't think I'm getting enough sunlight on my skin. This is most of the year, since even if you were outside for 6 hours in winter, you were probably still wrapped in jackets, hats, shoes, gloves, etc.
There is very little evidence for vitamin D supplementation unless tests show you are severely deficient. If you’re replete they do nothing. Getting outside is significantly more beneficial.
Unless a test shows you’re on the rickets train it’s not going to do much or anything. Basically the same as any other vitamin, if you’re deficient correct the deficiency. If you’re not don’t waste your time.
[edit] also note that in the sun UVB rays cause production of vitamin D while UVA rays cause the release of nitric oxide which lowers blood pressure and improves cardiovascular health. That’s likely a real benefit of going outside separate from the D pathway.
I'm sorry but I'm not sure how this relates to what I wrote. You write "unless tests show" when I already mentioned having a prescription based on blood tests, that taking supplements unnecessarily does no harm (so if you have a similar lifestyle/situation to those who were tested and are known to need it, you might as well right?), and that sunlight generates a second beneficial chemical and so one really should just be going outside when my comment explained there is simply not enough sunlight hitting the skin during the cold months to generate much of anything. I'm genuinely confused how this advice is suppose to be used
Vitamin D is worth taking for most people in Northern north America a above southern Europe in the Internet, absolutely. Specially people who work indoors.
> there are only 3 supplements that are really worth taking
Well, that's pretty far from true. For example, creatine supplementation is very well supported for a majority of strength trainers; obviously protein supplementation is as well if necessary.
Whoa there! That is a little assertive and this is a big problem with diet and nutrition. Everyone has an opinion and a little bit of Dunning Kruger goes on.
The article hints that it is maybe vegetables that we need to be eating. Supplementation is rarely that, it is usually substitution. If you do eat your greens, nuts and legumes then you will get everything except B12 and D.
People that consume animal products get their B12 from the B12 supplement that is fed to the animals, so you can cut out the middle-cow and just stick to a plant based diet, substituting the B12 that you would get through bacteria in soil for a supplement. Or you could grow your vegetables in manure and not wash them, just to get the full B12 experience that our ancestors enjoyed. Plants have no need for cobalt, so bacteria are the only way, and animals don't make B12 themselves, they get it from dirt or supplements.
Vitamin D means sun exposure. The body can't overdose on D (D3) because too much sunlight destroys the D that is generated. But then people are a bit funny about being in the sun since there is a lot of 'must wear suncream' propaganda and very little 'heliotherapy' propaganda.
You can just hide in the dark and supplement vitamin D.
As for fish oil, as a former employee of a government marine science laboratory, I have had time to think about this. I am in favour of giving the fish a break and not eating them just because of some old wives tale about needing to eat fish oil. We are primates and our ancestors survived just fine without trawling the oceans for some toxin-laced fish to heavily market as fish, or is it snake, oil. I don't honestly believe the proponents of 'you must eat your fish oil like a good boy or die' have the slightest clue as to how the body works.
I am substituting dirt for B12, doing my physical activity outdoors for vitamin D and getting every other vitamin by making every calorie count by eating leafy greens, legumes, fruit, grains, herbs, spices and starchy vegetables, with everything home cooked with no added sugar or any animal products.
So I am in broad agreement with you that you just have to fix your diet, but taking creatine just because you don't bother with eating animal products is in the realm of body dysmorphia. People that lift weights in fitness industry cults do that sort of thing. It is a slippery slope of never being 'big enough' and doing 'meal prep' instead of enjoying really good food.
If you eat vegetables that are in season, or at least available in a normal supermarket, then you get all the vitamins and nutrients during the course of the year. Right now I notice that there are no 'spring greens' (it is summer), so, whatever goodness they came with will not be around until next spring. However, there is a new type of cabbage taking its slot, with a similar but different nutrient profile.
The liver can store many vitamins and nutrients for a long time, so, if you get enough of all of the vegetables, cook them at low temperatures, then, over the course of a year, you should have enough of everything, just by focusing on cooking really good food with whatever new vegetables are in season. It is not difficult.
As for lithium, isn't that the one they give to depressed people in lunatic asylums so they don't experience the full range of emotions? I am just a person with a stomach, and therefore an opinion, so I have no idea.
What I do know is that no life form has come with an operators manual in billions of years and most animals seem to do better than us humans when it comes to staying in shape, without taking supplements. A lot of them live longer than us, with parrots, tortoises, elephants and plenty of other notable creatures doing just great without fish or snake oil.
This the composition of needed nutrients can vary greatly for person to person. But in general, a good diet is the way to go. On that is also adapted to change conditions.
For instance, the lack of sunlight in Scandinavian countries during the winter, which makes consuming foods rich in Vitamin D is important.
However, a lot of people are not motivated and/or privileged¹ enough to do so.
A question that then must be asked, if you are not able to compose and consume a healthy diet does a multivitamin have a positive effect?
¹ Using this term may seem controversial but I think it is accurate.
If a person is poor and does not have food safety the fight is to find enough food. Not finding the exact food needed for a balanced diet. In general, the food that food banks give out will not be able to provide a proper balance. Add to that though that multivitamins can be expensive and is also out of reach. I have never heard of a food bank providing multivitamins. (even though it would probably be a good idea)
Then some people will feel that they do not have the time. Some people have not learned to cook well.
Eating healthy was a lot easier when I lived in the US the availability of a broad selection of fruits, vegetables and nuts is great. Norway has in general a small selection of all of the above.