Best Food Sources for Vitamins

Here is a simple rule of thumb for getting your vitamin requirements from your diet: Eat whole grains for B complex, fresh fruits and vegetables for vitamins A (as beta-carotene), C, E, and K. Apricots, mangoes, citrus, bananas, melons, and dried fruits are all excellent. The vegetables with the highest vitamin content are always the most colorful ones: a few examples are dark green leafy vegetables such as spinach, chard, collards, mustard, and kale, and carrots, tomatoes, and colorful peppers. All members of the cabbage family such as broccoli, cauliflower, Brussels sprouts, and cabbage itself, along with carrots and winter squash, are also vitamin-rich. Research has clearly linked a high intake of these foods rich in C, E, beta-carotene, and other antioxidants with a markedly reduced risk of some cancers and cardiovascular disease. Diabetes and arthritis are other common diseases with a strong association between incidence and lack of vitamin-rich foods.

All B-complex vitamins are included in whole-grain products except for B-12, which is found naturally only in milk, eggs, and meat, fish, and poultry. Vegetarian and any reduced-meat diets need a reliable source of B-12, such as a multivitamin supplement and fortified breakfast cereal or soy milk. Eggs supply most of the other B-complex vitamins, as do many fruits and vegetables. Vitamin D is added to milk and is formed on the skin by sunlight.

Best Food Sources for Minerals

Iron is found in high amounts in beef and pork, and in moderate amounts in prunes, apricots, spinach, beans, tofu, blackstrap molasses, nutritional yeast, and wheat germ. However, the iron content of fortified cereals dwarfs all sources. For example, a serving of Total brand cereal contains 18 mg of iron, which is 100% of the recommended daily intake. Younger people, especially premenopausal women, need the full amount of iron, but older men and women should be okay with 10 mg or less daily. Vegetarians need to be sure to include these iron-rich foods and to use a multivitamin mineral supplement with iron. However, more isn’t better; you do not want too much iron. Iron is a powerful oxidizer that can damage vitamin E, and possibly even oxidize LDL cholesterol, which may damage arteries.

Zinc is needed for growth and development, but is much more difficult to obtain, with only beef, pork, and shellfish being good sources. Wheat germ, garbanzo beans, and lentils are the best of the rest, but in order to get the recommended 15 mg, you would need to eat nearly 1 1/2 cups of wheat germ. A mineral supplement supplying the recommended amount of zinc makes good sense, and most multivitamin/mineral supplements include the recommended amount.

Calcium is highest in dairy foods: milk, yogurt, and cheese. Include plenty of low-fat and fat-free varieties in your diet. Other good sources include tofu (if processed with calcium sulfate; read the label), fortified soymilk, and some dark green leafy vegetables (especially turnip and mustard greens, kale, and Chinese cabbage). Vegetarians absorb more calcium from foods, perhaps due to the lower dietary fat levels or to higher levels of vitamin C in the gut. Unless you commit to eating at least four servings per day of high-calcium nonfat dairy foods (1 serving = 1 cup milk, 1 cup yogurt, 1 oz natural cheese), take a calcium supplement in place of each missing high-calcium serving.

Magnesium is an important part of calcium metabolism, affecting nerves and muscles in the artery walls, and also reducing the risk of diabetes. Many studies indicate that Americans get too little. Whole grains and beans are the best sources, especially if they were grown in magnesium-rich soils. I take a calcium supplement that includes magnesium (about 1:3 or 1:2 magnesium-to-calcium ratio) for convenience, as the amount of magnesium in most multivitamin/mineral supplements is inadequate, and I have no way of knowing the magnesium content of the soil in which my food is grown.

Trace minerals are difficult to track and should be sufficient in a diet that includes a wide variety of unrefined foods such as whole grains and fresh fruits and vegetables. The single exception is selenium. Add 200 mcg (micrograms, not milligrams) selenium to your supplement list for protection from prostate, lung, and colon cancers as well as antioxidant protection for your arteries. Most multivitamin/mineral supplements contain this amount.

Who Should Supplement?

• We feel there is sufficient evidence of widespread inadequacy to recommend that everyone take a supplement with 200 mcg selenium, 25 micrograms of B-12, and 400 mcg of folic acid. Our recommended multivitamins include these amounts.
• Dieters: Given that the majority of Americans are overweight, it may seem that everyone you meet is dieting. If you seriously restrict calories in order to lose weight, vitamins and minerals may well be lacking in your diet. Even a well-balanced diet can be lacking in adequate amounts because of restricted quantity and portion size. Generally, if you tend to skip meals or diet often, supplements are a reasonable course.
• Those at risk for heart disease: Many experts believe that the body’s ability to safely process cholesterol is overwhelmed by a diet too high in cholesterol and saturated fats. All aspects of diet affecting the body’s ability to repair damaged arteries, to lower circulating levels of cholesterol and triglycerides, and to protect healthy artery tissue are important, and safe and effective nutritional supplements are an important part of this strategy.
• Those at risk for gastric cancer: Not surprisingly, the alimentary canal, which is in direct contact with food, is most affected by our dietary choices. Supplementing with vitamins C, E, beta-carotene, and calcium may reduce the risk of oral, esophageal, stomach, and bladder cancer, and extra calcium reduces the risk for colon and rectal cancer. Isoflavones, found in soy products, stimulate natural killer cells throughout the body to resist cancer growth. In fact, vegetarians have reduced risk for developing cancer at all major sites.
• Those at risk for arthritis: The common antioxidants — vitamins A, C, and E — and the trace mineral selenium are low in the fluid of arthritic joints, possibly impairing the regeneration of healthy tissue. Some people in this group also benefit from the B vitamins, especially niacin, pantothenic acid, B-6, and folic acid. Glucosamine and chondroitin have been shown to be safe and effective, and are helping many people relieve symptoms of arthritis.
• Older people: The older population most at risk for arthritis, cancer, CVD, hypertension, and diabetes is also most likely to be overweight. It is never too late to strive for a more reasonable weight; even a 10% reduction helps reduce blood pressure. I urge all those who are overweight to restrict fat and sugar calorie intake to lose weight. Older people often have irregular eating habits and do not eat a well-balanced diet, whether they are dieting or not. Depression, loneliness, lack of appetite, loss of taste and smell, and denture problems can all contribute to a poor, inconsistent diet. Absorption of vitamins and minerals can be impaired in older people. Older women often need extra vitamin D and calcium for protection from osteoporosis. Calcium supplements should usually total 900 to 1,000 mg (three 300 mg tablets or two 500 mg tablets daily) for older people, since absorption decreases as we age.
• Women: Women have special nutritional needs throughout life, starting with calcium and vitamin D to prevent osteoporosis. Lower levels of these nutrients increase the risk of developing arthritis, a condition that affects twice as many older women as men. Women of child-bearing years usually do not get enough folic acid, which increases the risk of neurological birth defects and increases homocysteine levels damaging to the arteries. Physicians usually prescribe vitamin and mineral supplements for pregnant and lactating women, whose nutritional requirements are higher during this time.
• Strict vegetarians: Vegans, vegetarians who eat absolutely no animal products, are unlikely to get adequate amounts of vitamins D, B-2, and B-12, or calcium, iron, or zinc. They should consider supplementation.
  

Select a Well-balanced Multi-vitamin/mineral Supplement

We feel that everyone should consider taking a complete multivitamin/mineral supplement daily as nutritional insurance, and we have provided a list of good choices valid at this time. Look for those that provide at least 100% of the daily value for A, B-1, B-2, niacin, B-6, B-12, C, D, E, and folic acid. Limit beta carotene to no more than 15,000 IU, iron to 10 mg, phosphorous to 100 mg, and B-6 to 200 mg. The supplement should also provide at least 25 mcg of vitamin K, 120 mcg of chromium, 100 mg magnesium, 2 mg copper, and 15 mg zinc. Iron requirements vary with gender and age: Women under 50 need 8 to 18 mg of iron, men under 50 need under 10 mg, and men and women over 50 need no more than 10 mg iron. Everyone over 50 needs at least 24 mcg of B-12, because of generally poor absorption in older bodies. Everyone should have plenty of the antioxidant selenium, so make sure there is at least 200 mcg included.

Supplement Quality and Dosages

A comprehensive multivitamin/mineral is a simple and relatively inexpensive choice. You do not need to spend a lot of money on a supplement. The cheapest "store" brands are often as well balanced and effective as the premium brands. I usually go to large retailers where the price is lowest, such as Wal-Mart or Kmart. The basic multivitamin/mineral supplement can cost as little as 10 cents or less per day, or as high as 50 cents or even higher for designer brands, yet there is no discernable advantage to the higher priced choices.

The vitamin and mineral compounds in all supplements are manufactured by a small group of multinational corporations such as ADM. "Natural" vitamins are no better in quality than other choices you will see shelved next to them. Many supplements include additives such as herbs and enzymes, but they contain these compounds in such tiny amounts that they can do you no real good. The only quality issues for supplements are (a) nutrient content (does the tablet contain the labeled amount?), (2) whether the tablet will dissolve properly, and (3) purity. Although there are no federal standards for vitamins, you can help insure quality by sticking to major brands and by looking for the letters "USP" on the bottle, which indicates voluntary compliance with U. S. Pharmacopoeia.

When I was eliminating artificial colors from my diet to relieve symptoms of rheumatoid arthritis, I learned to buy uncolored brands if possible. If none were available, I rinsed the outer colored coating off, leaving the hard white shell on the tablets, before swallowing.

I usually take vitamin/mineral supplements after a meal for better absorption, and I take E and calcium at a different time of day than the basic multivitamin that includes iron. Calcium interferes with iron absorption, and iron may rapidly oxidize the vitamin E. Some experts suggest not taking vitamins and minerals at the same time as any prescription medications, so wait a few hours between to reduce the risk of interference.

The following name brand recommendations for multivitamin and mineral supplements are adapted from Nutrition Action Healthletter [see Resources], April 2000 issue.

FOR WOMEN - Centrum, Dr. Art Ulene Nutrition Boost formula for Men & Women, Kroger Complete Extra, OneSource, Rite Aid Whole Source, Safeway Select Omnisource, Spring Valley Advantage, Summit Complete, Twinlab Dualtabs, Walgreens Ultra Choice, YourLife Super Multi-Vitamin.

FOR MEN - Dr. Art Ulene Nutrition Boost Formula for Men & Women, Eckerd Daily Impact Senior, Rite Aid Whole Source Mature Adult, Safeway Select Omnisource Senior, Shaklee Vita-Lea without iron, Twinlab Dualtabs, YourLife Super Multi-vitamin.

FOR OLDER MEN AND WOMEN (OVER 50) - Dr. Art Ulene Nutrition Boost Formula for Men & Women, Eckerd Daily Impact Senior, Rite Aid Whole Source Mature Adult, Safeway Select Omnisource Senior, Twinlab Dualtabs.

Supplemental Antioxidants and Minerals

The tablet size of the recommended multivitamin/mineral supplements is too small to include adequate amounts of several important nutrients, so please consider adding them separately. Extra amounts of the vitamins E, C, and beta-carotene, along with calcium and magnesium, are useful to almost everyone, and countless studies have demonstrated their safety and effectiveness.

• For vitamin A, it’s best to depend on a diet rich in beta-carotene containing fruits and vegetables such as apricots, mangoes, cantaloupe, carrots, and sweet potatoes, and limit supplements to a total daily amount of 15,000 IU of vitamin A and beta-carotene combined. All good-quality multivitamin/mineral supplements contain 5,000 IU of vitamin A, so add 10,000 IU of beta-carotene daily to achieve the 15,000 suggested amount on days when you do not eat darkly colored fruits and vegetables.
  
• Vitamin C needs to be supplied up to 500 to 1,000 mg daily in order to saturate all the tissues. More than this is simply excreted. The best plan is to take 500 mg twice daily. Multivitamins usually contain only a small fraction of this amount.
  
• Vitamin E benefits seem to increase with daily amounts in capsule form up to 400 IU, but more isn’t better. Multivitamins usually contain 30 to 60 IU.
  
• Calcium, magnesium, and vitamin D are all critical for bone health and often need to be supplemented: 1,000 to 1,200 mg daily (300 mg per dose) from citrate for calcium and 1/3 to 1/2 that for magnesium. You may skip a dose for every meal that includes a serving of high calcium dairy products, tofu, or vegetables. Vitamin D is included in most multivitamins and added to many dairy products, so an additional supplement is not advisable.
  
• With the above exceptions in mind, it is a good idea to limit your intake of vitamins and minerals to no more than 150% of the RDA. Large amounts of some vitamins and minerals can be toxic (especially vitamins A, D, and niacin, and minerals selenium, iron, and zinc).
  

The following table suggests how to take supplements throughout the day for best absorption.