Chew on this

Nutritional supplements not a black and white issue

Before jumping on my soapbox, I offer two disclosures. The first is that I love food. In fact, I just came from teaching medical students about the healing powers of whole, natural foods. The second is that I do not sell supplements in my practice, have no financial stake in a supplement company and have never been sponsored to speak by a supplement company.

Last week’s headlines proclaimed that multivitamins are a waste of money. With so much spent on vitamins — $28 billion in 2010 — I understand the logic behind looking at supplements, but I disagree with the questions the researchers did and did not ask.

The studies in the Annals of Internal Medicine reported only on supplement use, and said nothing about food intake. Supplements are meant to fill in gaps left by less-than-nutritious food consumption. The position of the Academy of Nutrition and Dietetics is that choosing a wide variety of foods is optimal for health and disease reduction, but it also states that nutrient supplementation may be necessary in special circumstances.

When I do a nutritional analysis for a client and the diet is low in specific nutrients, I recommend foods that will fill the gaps. If there is hesitation or resistance, I would suggest a multivitamin supplement until the client has initiated dietary changes.

Some medications change nutritional status. A recent study showed that patients who were on certain reflux medications were 65 percent more likely to have a vitamin B12 deficiency. A multivitamin with folic acid is insurance that even with an unplanned pregnancy, a woman is guarding against a baby with neural tube defects. Vitamin supplementation is not a black and white issue.

The bottom line is this: Fill your plate with plant-based foods, and if you have concerns about nutritional deficiencies because of diet, medications or medical conditions, see a registered dietitian who can sort through the science and develop a personalized plan for your needs.

Sheah Rarback is a registered dietitian on the faculty of the University of Miami Leonard M. Miller School of Medicine. Follow her on Twitter @sheahrarback.

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