We all know we need to have vitamins and minerals, so our bodies function properly, but what else is there to know?
According to the National Institute of Health, the vitamins we need include vitamins A, C, D, E and K, along with the B vitamins. The B vitamins include thiamin (B1), riboflavin (B2), niacin (B3), pantothenic acid (B5), pyridoxal (B6), cobalamin (B12), biotin, and folate or folic acid. Plus, there are a plethora of essential minerals we need such as calcium, chloride, cobalt, copper, iodine, iron, fluoride, magnesium, manganese, phosphorus, potassium, selenium, sodium, sulfur and zinc.
Sarah Yandow, the campus registered dietitian at SUNY Plattsburgh, who aids students, athletes and employees alike, gave us some insight into her vast knowledge of vitamins and minerals.
Without a well-balanced diet, you may not be getting all the vitamins and minerals you need. For instance, Yandow said some of the common ones you may be lacking include vitamin D, which she said is surprising for some people to hear.
“Vitamin D we can obtain from both food sources and from the sunlight, but because we are either inside most of the day and/or wearing clothing or sunscreen when we are outside, we’re not getting a lot of vitamin D from the sunlight,” she said.
As well, women, vegetarians and vegans are commonly seen to fall short on their iron consumption. “That’s a big one for the female population,” Yandow said.
Similarly, vitamin B12 is another vitamin vegetarians and vegans are more likely to not get enough of through their diets, as Yandow said B12 usually comes from animal sources.
As well, calcium is mineral people are typically not getting enough of, and generational differences seem to emphasize this. “The older generation kind of grew up drinking milk more regularly, and now that we have an expanded array of different beverage options, people aren’t getting as much calcium from cow’s milk,” Yandow said.
Of course, she notes there are other ways to get calcium, but it’s necessary to get it in our diets. “Calcium is so important to help maintain strong bones, both now and later in life,” she said.
Getting Your Nutrients In
To make sure you’re not missing out on any of the vitamins and minerals you need, Yandow suggests diversifying your diet and having a variety of foods every single day. Yet, “sometimes we can get caught up in different habits,” she said.
For example, she mentioned if you enjoy having a sandwich for lunch everyday, that’s OK, but you should vary what goes on the sandwich. The vegetables, types of protein you’re using and other add-ons or condiments is something to think about switching up, so you can continuously add variation into your diet.
“Like they always say, eat the rainbow. The more colors you visually see on your plate, you’re most likely getting more vitamins and minerals,” she said.
She also noted being intentional about the foods you chose to eat. If you know you’re the type of person who hates drinking milk, try to find some other alternatives to get calcium in your diet more often.
Additionally, having a varied diet doesn’t just provide you with the vitamins and minerals you need and prevent deficiencies, but may also prevent health conditions. “Dietary supplements can help prevent, improve or in some circumstances correct a certain medical condition if a deficiency is present,” Yandow said.
“We know proper calcium and vitamin D intake will prevent osteomalacia or osteoporosis, which is weakening or softening of the bones later in life,” she said. Intentional intake of calcium and vitamin D is especially important for children, adolescents and young adults.
“Even with something like fluoride, we know fluoride prevents cavities, so being mindful and using a toothpaste with fluoride is important,” she said.
Vitamin and Mineral Deficiencies & Supplementation
If you’re wondering if you have a vitamin or mineral deficiency, Yandow said it’s hard to determine. Changing factors in your daily life will probably not be much help, as each vitamin and mineral deficiency has unique symptoms. However, some have more characteristic symptoms than others.
For example, “If someone’s iron deficient, a lot of times they might notice fatigue or be tired all of the time,” she said. “If someone is vitamin A deficient we see people that all of the sudden they have vision problems and we notice different things with their skin.”
Yandow also notes you’ll never truly know if you’re deficient in a vitamin or mineral unless you see your primary care provider.
“You won’t know you’re deficient in something unless you have lab work to confirm it, so before you self diagnose, I always recommend talking to your provider to get that blood work done to confirm it,” she said. “There’s no use spending money on a supplement you don’t need.”
So, before you go buy a bunch of supplements, make sure you actually need them. “We don’t want to be taking a supplement until there’s an actual deficiency,” she said.
If getting your blood work done is something you’d like to look into, Yandow said it can be ordered by a primary care physician and can be as simple as a blood draw, where you get your results back in just a couple days. “At that point, your provider can determine the next steps and hopefully refer you to a dietitian,” she said.
Yandow mentioned there are some deficiencies or circumstances where supplementation is necessary. In some cases injections of vitamins and minerals must be prescribed to the individual with the deficiency.
In general though, these deficiencies do not appear overnight. Yandow noted this can take weeks or months to develop, from continuously not getting enough of a certain vitamin or mineral.
“People that we see that are the most at risk for different deficiencies are these specific populations of people: pregnant women or women who are breastfeeding, infants or young children, especially if they’re picky eaters,” she said.
She also mentions those who have had bariatric surgery or really any surgery that alters the gastrointestinal tract are other populations at risk for a vitamin or mineral deficiency, as they may have difficulty absorbing certain nutrients. As well, those with an eating disorder or distorted eating patterns, she said, are not getting enough energy in the form of calories and thus most likely not getting a good variety of foods either.
Vegans and vegetarians are also another population at risk for a vitamin or mineral deficiency. “There’s fewer foods available to them, and we know that a lot of vitamins and minerals can be found in animal based products,” she said. “Again, it just comes to being a little more intentional with food choices for vegans and vegetarians.”
The elderly, Yandow said, are another one of these populations most at risk for a deficiency, as there can be taste and hunger changes and a decrease in food intake as we age.
Lastly, food insecurity may aid in developing a vitamin or mineral deficiency, with these individuals having limited access to fresh foods.
These are the groups, Yandow said, where vitamin and mineral deficiencies are most prevalent.
For vegans and vegetarians, Yandow specifically recommends working with your primary care provider if you plan to make this lifestyle change. As well, “a dietitian is a great resource because you can review your typical or current food intake, and we’re able to point out holes or gaps where we see areas of improvement within the diet,” she said.
From there the dietitian can create a plan with you to add other food options in and also work with the primary care provider to make sure proper supplementation is recommended, if necessary.
So, before you look to supplements to solve your problems, Yandow suggests another method.
Foods First Approach
“In general, if someone wants to take what I call the food’s first approach, a lot of times we look right to fruits and vegetables,” she said. They also don’t have to be fresh, they can also be frozen or canned, she mentioned. Except, she doesn’t usually recommend fruit juices because of the amount of added sugar in them.
“You’re going to get a huge increase in your vitamin and mineral intake just by having more fruits and vegetables,” she said. For instance, she recommended berries for their fiber content and bananas as a great source of potassium, but there’s going to be a benefit for any fruit or vegetable you add to your diet.
“Depending on the level of deficiency or the lab values that come back, most people are going to want to go with foods first, unless it’s a severe deficiency, then supplements may be necessary to correct levels faster than what foods can do on their own,” she said.
“But if we’re able to, I’d love to see someone make changes to their diet first before they start taking anything extra,” she said. “That being said, supplements do serve a purpose, a time and a place and I think it’s about making sure you choose the best supplement using the information that you have.”
However, Yandow highlights the importance of enjoying the foods we eat too. “It’s just about finding things that the individual will like and will continue to eat,” she said. “One of my biggest things as a dietitian is that I don’t want to tell people to eat something they don’t like.”
Certainly, it’s wonderful to up your intake of fruits and vegetables, but with the rise in the cost of food, expenses also play a role. “It comes to meeting people where they’re at in terms of their financial resources,” she said.
Caution Toward Supplements
Another reason to be cautious of supplementation is because of how they are regulated.
“Dietary supplements are regulated by the FDA or the Food and Drug Administration, but the FDA doesn’t review products before they make it onto a store shelf, meaning the product hasn’t been evaluated for effectiveness or safety or quality before it’s sold to the consumer,” she said.
“A lot of the time what we end up hearing is things in the news, people reporting different adverse effects for a supplement, before it’s actually then removed from the store shelf.”
Thus, we as the consumers need to pay extra attention, as supplements are not as closely monitored as food and can lead to issues. “People may be thinking of taking a peer reviewed product, but don’t really know everything that’s in these supplements or the potency or strength of these because they aren’t as well-regulated,” she noted.
However, one thing to look out for is if the supplement is third party tested. “That’s a voluntary process by the manufacturer, so it’s not required. You know if you see a product that has a third party seal on it, that manufacturer has willingly gone through that process to get their product verified,” she said.
If you’d like to look further into this, Yandow recommends using consumerlab.com. She said this website is great to learn a bit more about the supplement you may be interested in purchasing.
“I think knowledge is power in this case, and the more knowledge you can have on certain products the better, and you can make the best informed decision for yourself.”
“You can always ask your provider, if they recommend supplements, what specific product they recommend. The pharmacist may also have a good recommendation too,” she said. “I would say just make sure you are looking at all the options and doing your homework before you pick.”
This “homework” Yandow mentions, will include ensuring the product is third party tested, looking at the ingredients list, and what’s written on the bottle. As well, it’s important to know which vitamin supplements may give you more trouble than others.
“Water soluble vitamins include vitamin C and the different B vitamins. We don’t worry so much about toxicity or too high of a level because those can easily be eliminated through the urine,” she said. “With the fat soluble vitamins, that’s a little bit of a different story.”
The fat soluble vitamins include vitamins A, D, E and K. Yandow said these are absorbed with dietary fats that you consume, getting stored in the body’s fat and liver tissue.
“If you’re taking in an excess amount of these continuously over time, that’s where we can see adverse effects,” she said. “We don’t usually see these toxicity levels present from consuming too much of the food product, it’s when people are getting too much from a dietary supplement.”
“People say ‘Oh I have expensive urine,’” she said. This occurs when you take a supplement you don’t actually need, and most of it gets excreted through the urine. Don’t waste your precious money, she said, unless you’ve come to the conclusion you need these supplements with your healthcare provider.
What’s the Hype About Multivitamins?
Also, most people know what a multivitamin is, but is it worth taking?
“You can think of a multivitamin as like an insurance policy,” she said. “It’s nice to have as a backup, but most people, if they’re consuming a balanced, varied diet, are getting what they need from their food choices.”
She continued saying a multivitamin may be beneficial, but is it worth buying? Is it something you really need? You’ll only be able to find out from your healthcare provider or dietitian.
Getting the Lingo
Also, there’s a lot of terminology regarding the amount of food we intake like RDA, DV and UL, but what do these all mean, especially in terms of getting in the vitamins and minerals you need?
“The RDA is the Recommended Dietary Allowance, so this would be the best place to start if you’re curious to know how much of a certain vitamin or mineral you need,” she said. “This is going to tell you the average daily dietary intake level, which is sufficient to meet the nutrient requirements of almost all healthy individuals.”
RDA’s are also then broken down by age and sex, to ensure the individual is getting the required amount of a particular nutrient for the stage of life they’re in. “It should serve as a goal for intake for healthy populations,” she said.
The DV, according to the National Institutes of Health, is known as the Daily Value and was developed by the FDA “to help consumers determine the level of various nutrients in a standard serving of food in relation to their approximate requirement for it.” As well, often, the DV is similar to the RDA for a certain nutrient, but the DV is a single value for each nutrient selected for food labels and dietary supplement labels.
UL represents the Tolerable Upper Intake Level. She said that this standard was established for nutrients to reduce the risk of any adverse or toxic effects from consuming too much of a nutrient in a very concentrated form. “Most of the time, again, we see this with the people who are taking supplements,” she said. “It can be hard to do with food unless you’re really trying.”
There’s so much to learn about vitamins and minerals, but take this as a starting point. If you’d like to learn more, please see your primary care physician or a dietitian. You can also see the National Institutes of Health’s website, a credible source for nutrition information.