The real value of popping pills

Yet, like many of us, you are likely not to be consuming the correct amounts of nutrients through the food you eat. Like many people, you may feel you need vitamin and mineral supplementation. But the wide variety of products and claims on the market can make that difficult and confusing.

A scientific review published in the Journal of the American Medical Association in 2002, says "most people do not consume an optimal amount of vitamins by diet alone. Pending strong evidence of effectiveness from randomised trials, it appears prudent for all adults to take vitamin supplements."

Various factors may contribute to these dietary gaps in vitamin and mineral intake.

In recent times, the world has experienced dramatic surges in food prices, including staple foods on which many countries depend.

This has made eating a nutritiously adequate diet more challenging. In addition, the move to intensive farming methods has resulted in some foods having a lower nutritional value. In other words, the food you eat may not be as nutritious as that eaten by your great-grandparents.

Our lifestyles are fast-paced, and meals often rushed and not planned, which may result in poor food choices and the failure to include nutrient-dense foods.

Furthermore, our modern lifestyles are characterised by stress, too little exercise and unhealthy diets, all of which can affect the way the body absorbs and uses vitamins and minerals.

In order to overcome real or perceived deficiencies, many people choose to use vitamin and mineral supplements, and the supplement industry has grown into a multibillion-rand industry.

Whether supplements improve health - and how - is a matter of ongoing scientific inquiry and debate. New studies emerge regularly.

So should you just swallow a multivitamin and mineral pill?

The American Dietetic Association says that the best nutrition-based strategy for promoting optimal health and reducing the risk of chronic disease is to choose a wide variety of foods wisely.

"Additional nutrients from supplements can help some people meet their nutrition needs as specified by science-based nutrition standards, such as the Dietary Reference Intakes," the association says.

It also says that the US Council for Responsible Nutrition advocates that the best solution for most people is "to eat the best diet possible, adopt other healthy habits, and use a rational assortment of nutritional dietary supplements, most notably a multivitamin, to ensure adequate intakes or to try to approach levels that may be considered optimal".

A report in the New England Journal of Medicine in 2001, says that a daily multivitamin "makes sense for most adults".

Dr Walter Willett reiterated this advice in a chapter on preventive nutrition in his book Eat, Drink and Be Healthy, The Harvard Medical School Guide to Healthy Eating (Harvard Medical School Book). It features a modified food guide pyramid, with a side bar recommending "multivitamins for most."

But just how safe are vitamin and mineral supplements?

Vitamin and mineral supplements are generally regarded as very safe. Upper safe levels (UL) have been established for the protection of consumers and manufacturers are expected to keep within these limits.

The UL for a particular nutrient is an estimate of the highest level of total chronic intake judged to be unlikely to pose a risk of adverse health effects to humans.

It is worth remembering that as far as vitamins are concerned, the fat-soluble vitamins - vitamin A, D, E and K - are more likely to cause adverse side effects if taken in large amounts, than water soluble vitamins, vitamin B and C.

Provided the directions on the labels are followed, there should be no safety issues. Remember not to apply the principle that if one tablet is good then five are five times better.

Potential areas of benefit from vitamins and minerals are:

• Protection of cell constituents from oxidative damage from vitamin C, vitamin E, copper, selenium, zinc
  
• Immune benefits from vitamin A (including beta-carotene), vitamin D, vitamin B6, vitamin B12, vitamin C, folic acid (folate), iron, copper, selenium, zinc
  
• Bone health from calcium, vitamin D
  
• Wound healing from vitamin C, and zinc
  
• Energy: release and energy metabolism from thiamin, riboflavin, niacin, vitamin B12, biotin, pantothenic acid, vitamin C, copper, iron, magnesium
  
• Cognitive function from biotin, vitamin B6, vitamin C, niacin, vitamin B12, iron, calcium, phosopholipids, and omega 3 fatty acids.

When taking multivatimins, there are some simple questions you should ask yourself before buying a supplement. The obvious one is: "Do I really need it?" Another: "Can I possibly get what I need from my diet or by including certain foods?"

Other points to keep in mind when supplementing:

• Don't self diagnose. Consult a registered dietician or health professional for advice;
  
• Don't mega dose with a single-nutrient supplement. Rather choose a multivitamin and multi-mineral supplement - unless an informed doctor uses this type of therapeutic intervention;
  
• Stick with a reputable manufacturer/well-known brand because there are unfortunately "cowboys" in the industry who will make products in a backyard garage with no quality control, then package and sell to the unsuspecting consumer;
  
• Take responsibility for your own health. Find out if any claims made by a product are backed up by credible scientific research. Is there solid evidence suggesting it will work?
  
• Check if the claims made are valid. If something sounds too good to be true, it usually is. Watch out for false statements such as: "a quick and effective cure-all"; "can treat or cure disease"; "totally safe"; or, "has no side effects".

Before making decisions about whether to take a supplement, see your doctor and/or a registered dietitian.

They can help you to achieve a balance between the foods and nutrients you personally need, as well as the medications and other supplements that you may be taking.

In a capsule: remember that good health should not be a set of tablets to take, but rather a set of responsibilities to meet - eating more fruits and vegetables, regular exercise, moderation in alcohol intake, not smoking and the prevention of obesity.

While you may continue to take your, daily just-in-case dose of vitamins and minerals, you should always remember there is more science behind another way of getting your vitamins - eating right.