Take care supplementing with vitamins and minerals

Eat a wide variety of foods

The best way to get vitamins and minerals for optimal health and reducing the risk of chronic disease is to eat a wide variety of foods. Many of us are worried we don’t get enough vitamins and minerals, so we buy supplements to provide extra amounts – especially in winter when we stock up on vitamin C.

However, if you eat a variety of foods, take vitamin or mineral supplements, and include fortified foods, like some breakfast cereals, in your diet, you could be getting much more than you need for good health. Remember, eating well (including all the recommended food groups each day) ensures you get the best possible spread of nutrients.

But, generally speaking, that does not equate to eating poorly and taking vitamin and mineral supplements to make up for it! This isn't a guaranteed way to ensure bad eating turns into a good nutrient intake. In addition, evidence mostly does not support taking extra vitamin C to prevent a cold or help you recover more quickly from one.

Some vitamin and mineral supplements, however, might be very useful for some people.

• Iron – adolescent females and women during childbearing years may well benefit from iron supplements, especially if they don’t eat much meat, fish or chicken.
• Folic acid – adolescent females and women during childbearing years if a pregnancy is planned.
• Vitamin B12;– for older people and people who are vegan (do not eat any food of animal origin).
• Vitamin D – older people, people with darker skins and people who don’t go outside much or wear clothing that covers most of the body.

Folic acid and pregnancy

Folic acid is a vitamin needed for the formation of blood cells and new tissue. During pregnancy, a woman's need for folic acid is higher. Lack of folic acid has been linked with birth defects, such as spina bifida. The risk of having a child with these birth defects is low and can be reduced by taking a folic acid tablet - strating befrore you get pregnant.

Take a folic acid tablet daily

Take a folic acid tablet (0.8mg) daily for 4 weeks before you might become pregnant through to 12 weeks after actually becoming pregnant. If you find out you are pregnant and haven’t been taking a folic acid tablet, start taking tablets straight away. This tablet is available from pharmacies. Make sure to ask your pharmacist or LMC which folic acid tablet is best for you. As well you are reminded to choose foods naturally high in folate or fortified with folic acid, such as :

• well-washed, fresh, raw or lightly cooked vegetables
• raw fruit, well-washed or peeled (citrus is especially high in folate)
• bread and cereals, especially whole grain
• cooked dried beans and peas
• yeast extracts
• freshly cooked liver and kidney (no more than one serving a week)
• folic acid-fortified breakfast cereals, bread or fruit juice.

Remember: eat at least 6 servings of vegetables and fruit per day, aiming for 10 servings per day.

Source: Ministry of Health Eating for Healthy Pregnant Women 2008

Concerns about vitamin and minerals supplements

Many vitamin or mineral supplements taken as medication are simply excreted in urine. The good thing is that they do little harm, on the other hand there is no evidence they will do much good. Sometimes, however, intakes of supplements can be excessive and place people at risk of adverse effects. This generally only occurs from high dose vitamin and mineral supplement pills or when people exceed the recommended dosage.

Take note of safe upper levels

The Nutrient Reference Values for Australia and New Zealand include tables that give safe ‘Upper Levels of Intake’ for vitamins and minerals. If you choose to take vitamin and minerals supplement pills, check the dose against the table and make sure you are not exceeding it. Remember to take into account your food as well.

Article supplied by Auckland Dietetics Service

Take care with calcium supplements

At menopause women will experience a decline in calcium absorption and/or an increase in calcium excretion – putting them at increased risk of osteoporosis and bone fracture. The Nutritional Reference Values for Australia and New Zealand 1997 says in post menopausal women, a high calcium intake will slow the rate of bone loss and may reduce the risk of fracture.

However, it is not proven that getting your calcium from supplements will have this effect, and recent studies have begun to show there may be an upward trend in heart attacks and other cardiovascular problems in postmenopausal women taking calcium supplements.

We need calcium for healthy bones and teeth, but it may be safest to get yours from what you eat and drink, rather than from taking a supplement. New Zealand osteoporosis researcher Professor Ian Reid advises against calcium supplementation in people over the age of 70 years and in those known to have coronary heart disease.

In younger people who may be wishing to avoid osteoporosis, he says it may be sensible to aim for a smaller dose, say 500mg/day.