Office Talk: Multivitamins

**I'm going to include posts where I'll answer a question that I frequently get asked by my patient's. If you have any questions you'd like to see answered, comment or send me an email. I can't guarantee they'll get answered right away, but I'll keep them in mind. :)**




Question: Should I be taking a multivitamin?

When people admit to me that they aren't taking a multivitamin, they have a look of guilt that is probably similar to the look on my face when I admit to my denist that I don't floss as religiously as I should. But while my dentist always (appropriately) reinforces my guilt upon such a confession, this is one area where I can let people off the hook.

I don't care if you take a multivitamin. Ha!

But. There is a caveat.

I don't care if you take a multivitamin as long as you are doing the more important thing: trying to get the nutrients through a diet rich in fruits, vegetables and whole grains.

It's funny that we're all on the multivitamin bandwagon. Did you know that there's no real evidence that taking a multivitamin does anything important for you at all? Which is not to say that we don't have good reason to recommend certain supplements: Folic acid is critical for pregnant women. Vitamin D can prevent osteoporosis (and possibly a whole host of other things...jury is still out). Vitamin B2 might prevent migraines in high doses. Fish oils can reduce cholesterol and may promote healthy brain development in babies. There are others that I believe strongly in, but that is a post for another day.

This is about most of our nutrients for the day being wrapped up in a convenient little tablet. Easy? Certainly. Efficacious? I'm not convinced.

We all know that the national recommendations are for 5 servings of fruits/veggies daily. I think I've talked to one patient in the last few weeks who is even coming close to that guideline. Some of them ARE taking a multivitamin. And I think it's giving them a false sense of security.

We know nutrition works (heck, Johns Hopkins recently published a report about how we need to get back to a focus on the power of nutrition in health). Replacing something central to our health with an untested substitute, seems less than an ideal proposition.

I believe we'd all do a lot better by our bodies if we focused on getting our nutrients through our diet. A pill can't reproduce the fiber, the anti-oxidants, the minerals, the absorptive process of whole food.

I will be the first to say that my diet is NOT perfect. But I really try to keep up with the fresh foods. Here's what I aim for and what I recommend to patients:

1)Eat a piece of fruit with breakfast. A banana or berries on your cereal, an orange, whatever. This comes naturally to a lot of people.

2)Eat 2-3 servings of fruit and veggies during your day. This does NOT come naturally to a lot of people. But it can be so simple. Maybe pack a bag of baby carrots, a small apple and a pear. Or a small serving of sunsweet prunes. Or a clementine. You get it. :) If you bring them (or keep them in your fridge), you'll snack on them. If you have a Trader Joes by you, buy their bags of organic apples or pears. They are super well-priced, well-sized, and easy to stock up on. If you're a salad person at lunch, all the better!

3)Eat a vegetable with dinner. Again, this usually comes pretty easily to people. If you don't like to get creative with vegetables, stock your freezer with some peas or green beans or roasted corn. They are SO easy to defrost. And I'm all about easy. Rockstar likes to buy unusual vegetables and put them in our fridge. When I'm cooking, I mostly avoid them. He, on the other hand, knows that his drive to let nothing go unused is strong. So having it there motivates him to find recipes that revolve around them, and then--wammo!--more vegetables.

4)Ever get munchy while watching 'The Office'? Me too. I grab another apple. Now, I might wash it down with a small(ish) handful of guittard chocolate chips, but by golly, I ate my apple! And Heavens to Betsy, if I do that--I'm now at SIX servings/day. Now if that's not overachieving, I don't know what is.

5)Switch white for whole wheat. I think we all mostly know this by now, but the nutritional superiority of whole wheat over white is vast. Switching to whole wheat pasta can add nutritional benefit to a meal that otherwise has next to none! I still reserve my right to flour tortillas, though. Just sayin'.

Life is busy, and sometimes it's hard to focus on things like 5 servings of fruits and vegetables when we're just trying to get ONE serving into the mouth of a stubborn toddler. But I believe that it matters. That it really does add up to something in the longterm. My mom always told me: if you don't make deposits in your 'health bank account' as you go, when you someday try to withdraw, you're going to come up short.

Amen, sister. Or, you know, Mother.

So, here's to getting Fresh! (sorry...I couldn't resist).

*Feel free to share any tips you have on working fresh foods or whole grains into your diet!*