Myths and Truths About Multivitamins

According to the Council for Responsible Nutrition, a leading trade association for the dietary supplement industry, 76 percent of U.S. adults take nutritional supplements. Of these individuals, 73 percent take a multivitamin.¹ In recent years, media outlets have generated controversy about multivitamins with bold headlines such as "vitamins and supplements are a waste of money" and "dietary supplements do nothing for your health."^2,3 Should we take these statements at face value and toss our multivitamins in the trash?

Unfortunately, misinformation abounds about multivitamins. Let's debunk several big myths about multivitamins and discuss how the right one can be an asset to your health, filling critical nutritional gaps in your diet and supporting whole-body wellbeing.

What are Multivitamins?

The definition of a “multivitamin” differs widely throughout the dietary supplement industry and scientific community. However, the general consensus is that a multivitamin contains three or more vitamins and minerals required by the body for normal physiological function. The nutrients in multivitamins aid enzymatic reactions, act as signaling molecules, serve as structural elements within the body, and regulate many metabolic and developmental processes.

While dozens of products available on the market are labeled as multivitamins, they are not all equivalent. Let’s discuss three myths and three truths surrounding multivitamins, and how to select a high-quality multi to support your health.

3 Myths and 3 Truths About Multivitamins

Myth #1: You Don’t Need a Multivitamin If You Eat a Healthy Diet

A common myth in the nutritional community is that if you eat a healthy, balanced diet, you don’t need a multivitamin.

Truth: Nutrient Deficiencies are Possible Even on a Balanced Diet

A balanced, varied diet is essential for promoting optimal health. However, a growing body of research indicates that nutrient deficiencies are possible even on a balanced diet for several important reasons:

Industrial agriculture has depleted the nutrient content of soil: Soil nutrient depletion results in less nutritious vegetables, fruits, and other plant foods.⁴

Food starts to lose nutrients as soon as it is harvested. The long distances that most produce travels before reaching our plates causes significant declines in nutrient levels. Spinach loses 47 percent of its folate content 8 days after harvest, even when stored at standard refrigerator temperatures.⁵ Furthermore, when produce is picked out of season, the nutrient content is significantly decreased compared to in-season produce.^6,7

Nutrient deficiencies are common in the U.S.: Concerning research indicates that one-third of Americans are at risk for at least one vitamin deficiency or anemia, despite our bountiful food supply.^8,9 One of the reasons for nutrient deficiencies in the U.S. is the widespread consumption of the nutrient-poor, processed Standard American Diet. Beyond the effects of a processed diet and the lower nutrient contents of modern-day foods, vitamin deficiencies can also be caused by impaired digestive function, abnormal nutrient metabolism (such as variations in the MTHFR genes), inadequate sun exposure (in the case of vitamin D), chronic stress, and medications.

For example, B12 deficiency is far more common than previously believed, with even mild deficiency found to cause neurological consequences such as memory impairment.^10,11,12 Vitamin D deficiency is also exceedingly common, afflicting 40 percent of U.S. adults.¹³

Throughout a lifetime, vitamin deficiencies can contribute to serious health issues. Vitamin D deficiency is associated with immune dysfunction, metabolic syndrome, and cardiovascular disease. Vitamin K2 deficiency is correlated with heart disease, while vitamin C deficiency promotes chronic inflammation and high blood pressure.

Multiple factors conspire to adversely impact our nutrient status. While a multivitamin can’t compensate for poor eating habits, it can serve as valuable "nutritional insurance," protecting your body from nutrient deficiencies and supporting your long-term health.

Myth #2: Multivitamins Are All the Same

The media would like us to believe that all multivitamins are essentially the same. This couldn’t be further from the truth!

Truth: Many Multivitamins Have Misleading Labels and Missing Nutrients

Multivitamins are not all created equal. Research by independent quality assurance organizations indicates that the quality of multivitamins varies widely between various brands. Many multivitamins contain higher or lower levels of nutrients than what is stated on the label, a phenomenon referred to as “label fraud” that results in an inferior product.¹⁴

Another problem with multivitamins is that they often contain excesses of certain nutrients, such as iron, and insufficient amounts of other nutrients, such as vitamin K2. These nutrient imbalances may result in detrimental health outcomes and explain some of the conflicting research on the efficacy of multivitamins. Conversely, research indicates that a high-quality multivitamin containing bioavailable forms of vitamins can be a powerful ally in your pursuit of optimal health.

Myth #3: Multivitamins Have No Health Benefits

Few dietary supplements have suffered more disdain from the medical community than the multivitamin. While some multivitamins are not worth your money, the right one can offer valuable “nutritional insurance” and can support your long-term health.

Truth: The Right Multivitamin Can Significantly Boost Your Health

A strong body of evidence indicates that multivitamins can fill small but critical nutritional gaps in the average person’s diet and may reduce the risk of chronic diseases. Multivitamin use is associated with a reduced risk of colon cancer and total cancer, improved memory in older adults, improved mood and wellbeing in young adults, and enhanced cognition in the general population. ^{15,16,17,18,19} Taking a multivitamin may also support eye health, reduce cardiovascular disease mortality, and slow the aging process.^20,21,22

Studies that have not found any benefit from multivitamins often failed to control for confounding variables, including the presence of poorly-absorbed forms of vitamins and insufficient levels of nutrients such as vitamin K2. While isolated synthetic vitamins may have harmful effects on the body, synergistic combinations of vitamins in their naturally-occurring forms are not associated with adverse health effects.²³

Many supplement manufacturers use cheap forms of vitamins with low bioavailability or ones that are incompatible with the human body. For example, folic acid has been used in multivitamins for decades yet cannot be metabolized by the 30 to 40 percent of the U.S. population who have variants in MTHFR, a gene that regulates folate metabolism.²⁴ Excessive intake of folic acid, a form of folate that does not occur in nature, is also associated with health risks such as cancer.²⁵

Conversely, superior forms of vitamins to look for in a multivitamin include:

• Folinic acid: This form of folate is highly-bioavailable and supports methylation without causing hypermethylation.

• Sodium ascorbate: Compared to ascorbic acid, the form of vitamin C used in most multivitamins, sodium ascorbate is more bioavailable and does not cause digestive distress.

• Tocotrienols: Tocotrienols are naturally-occurring compounds in the vitamin E family with distinct health benefits compared to tocopherols, the form of vitamin E most commonly used in supplements. They have superior antioxidant properties and support brain health.²⁶

• Phytochemicals: Plant-based nutrients such as lutein, zeaxanthin, and lycopene bolster the antioxidant health benefits of multivitamins. They may be especially beneficial for people who do not eat enough fruits and vegetables.^27,28

According to the medical community, several groups of people are most likely to benefit from a multivitamin:

• Older adults: Digestive processes weaken with age, leading to reduced absorption of vitamins. Supporting your body with a multivitamin can make up for these nutritional losses and can support healthy aging.²⁹

• Vegans and vegetarians: People following vegan and vegetarian dietary patterns have low intakes of many nutrients, including iron, vitamin B12, vitamin A, vitamin D, and choline. They may thus benefit significantly from a multivitamin.^30,31

• Pregnant and breastfeeding women: Higher levels of many nutrients are required during pregnancy and breastfeeding to support the growth of a healthy baby and maternal wellbeing.

• People taking medications: Many medications deplete vitamins; the birth control pill depletes B vitamins, vitamin C, and vitamin E, while proton pump inhibitors decrease B12 and vitamin C.^32,33

Liposomal Delivery Enhances Vitamin Bioavailability

The dietary supplement industry lacks a standardized scientific and regulatory definition for multivitamins. As a result, there are no rules for assessing the bioavailability and efficacy of multivitamins. Many manufacturers use forms of vitamins that have extremely low bioavailability, simply because the ingredients are cheaper. The gastrointestinal system already has strict absorption constraints in place for vitamins, so this means that many multivitamins are failing to deliver meaningful concentrations of vitamins altogether.

Liposomal systems offer a superior alternative for the oral delivery of vitamins.³⁴ Liposomal vitamin A is more effective and safer than non-liposomal forms because it facilitates controlled release of the vitamin.³⁵ Nanocarrier delivery systems also significantly enhance the bioavailability of vitamin B12 and vitamin C.^36,37

When combined with a nutritious diet and a healthy lifestyle, a high-quality multivitamin is a wise investment that offers valuable “nutritional insurance” and supports your long-term health.

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References

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1. Tan ZX, et al. Global soil nutrient depletion and yield reduction. J Sustain Agric. 2005; 26(1): 123-146.

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1. Wunderlich SM, et al. Nutritional quality of organic, conventional, and seasonally grown broccoli using vitamin C as a marker. Int J Food Sci Nutr. 2008; 59(1): 34-45.

1. Bird JK, et al. Risk of deficiency in multiple concurrent micronutrients in children and adults in the United States. Nutrients. 2017; 9(7): 655.

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1. McBride J. B12 deficiency may be more widespread than thought. US Department of Agriculture. 2 Aug 2000. https://www.ars.usda.gov/news-events/news/research-news/2000/b12-deficiency-may-be-more-widespread-than-thought/.

1. Parva NR, et al. Prevalence of vitamin D deficiency and associated risk factors in the US population (2011-2012). Cureus. 2018; 10(6): e2741.

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1. Evans JR, Lawrenson JG. Antioxidant vitamin and mineral supplements for slowing the progression of age-related macular degeneration. Cochrane Database Syst Rev. 2017; 7: CD000254.

1. Bailey RL, et al. Multivitamin-mineral use is associated with reduced risk of cardiovascular disease mortality among women in the United States. J Nutr. 2015; 145(3): 572-578.

1. Xu Q, et al. Multivitamin use and telomere length in women. Am J Clin Nutr. 2009; 89(6): 1857-1863.

1. Klein EA, et al. Vitamin E and the risk of prostate cancer: The Selenium and Vitamin E Cancer Prevention Trial (SELECT). JAMA. 2011; 306(14): 1549-1556.

1. “MTHFR gene variant.” NIH: National Center for Advancing Translational Sciences. https://rarediseases.info.nih.gov/diseases/10953/mthfr-gene-mutation.

1. Boyles AL, et al. Safe use of high intakes of folic acid: research challenges and paths forward. Nutr Rev. 2016; 74(7): 469-474.

1. Peh HY, et al. Vitamin E therapy beyond cancer: Tocopherol versus tocotrienol. Pharmacol Ther. 2016; 162: 152-169.

1. Kang S, et al. Multivitamin and mineral supplementation containing phytonutrients scavenges reactive oxygen species in healthy subjects: A randomized, double-blinded, placebo-controlled trial. Nutrients. 2019; 11(1): pii: E101.

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