Designing a Multivitamin That's Right For You
By Jason Jensen, NMD.
Multivitamin preparations are the most common dietary supplement taken by at least one-third of all adults in the US. 
Yet many people continue to struggle with health issues related to optimal nutrition needs. Here's a quick overview of issues to consider when pinpointing the optimal intake amounts of "essential" vitamins, and micronutrients.
Who's At Risk?
Malnutrition is common in older people, especially for older women. 
The malnutrition risks children face around the world are noteworthy. It's been estimated that common micronutrient deficiencies including iron, iodine, vitamin A, and zinc, are responsible for more than 50% of the deaths of all children under the age of five. 
This leaves middle-aged folks who often rely on a "western-type" diet. Although we're not sure about specific micronutrient depletion in all food crops, we do know that when analyzing 43 foods, using USDA nutrient data from 1950 to 1999, scientists found reliable declines for 6 key nutrients:
|Protein -6%||Calcium -16%|
|Phosphorus -9%||Iron -15%|
|Riboflavin -38%||Vitamin C -15%|
Researchers from this study suggest replacing these known depletions with more nutrient-dense whole foods . But which food nutrients do we need, and how much? First lets consider how malnutrition is associated with a host of adverse health effects.
An independent meta study published in the March 2013 Food Nutrition Research reports how diets based on dietary recommendations are associated with important health benefits. 
Not only are some food staples nutritionally depleted, they can also contain the risk of toxin exposure. Researchers studying "chlorpyrifos" neurotoxin residue in potatoes admit, "Industrialized nations, people, infants and the aged in particular, are even more exposed to neurotoxic drugs as a consequence of the increased quantity of pesticide residues in food." 
Wheat, another popular food stable, has estimates showing 22 milligrams to 2 grams of pesticides per kilo-gram of processed wheat are ingested by humans. 
Safety and Side Effects
Do you take a multivitamin? Are you sure it provides the right nutrients your body needs? More importantly, getting to much of certain nutrients can raise issues, such as excess B12 and foliate that's been shown to increase the risk of prostate cancer. 
Many people work at improving their health, yet many continue to struggle with deficiencies that prevent them from reaching their full potential. This can be due to a number of different factors:
- Biochemical Individuality – We’re all different, so the nutritional requirements for you can be very different compared to everyone else. 
- Absorption – You may have a great diet, but if you can’t absorb the vitamins, minerals, antioxidants and micronutrients you need, then chances are you will have one or more nutritional deficiencies. 
- Chronic Illness – Health conditions such as arthritis, cardiovascular disease, diabetes and fatigues, to name a few, can drastically affect what you can absorb. 
- Medications – Antacid can deprive your body of zinc, however, zinc helps us ward off cold and flu viruses. 
- Taking a cholesterol drug can deplete your stores of Co-Q10, which is a nutrient used in every muscle in your body, especially your heart. 
- Many different medications, both over the counter and prescription can keep our body from getting what it needs. 
- Age – What your body needs at age 30 is different than what it needs at age 45, 55 and beyond. Absorption difficulties typically increase with age. 
Benefits: What Can Vitamins Do?
- Daily multivitamin supplementation has been found to "modestly but significantly reduced the risk of total cancers." 
- Antioxidants preventing cancer. 
- Multivitamin intake enhances immediate free recall memory. 
- Vitamins, minerals, amino acids, and metabolites have been shown to prevent and treat mental health disorders. 
- Higher omega-3 (DHA) percentages in blood plasma is associated with a reduction of cardiovascular disease risks. 
- Decreased cardiovascular risks are associated with the intake of essential fatty acids contained in fish oils. 
- Nutrition impairment commonly occurs in patients with heart failure, affecting disease progression. 
Finding Your Needs: Which Nutrients and How Much?
Finding out exactly what nutrients your body needs with a blood test will show where to focus your supplement regimen, eliminating time and money spent on unnecessary nutrition.
Naturopathic doctors are uniquely qualified to help guide patients through the interpretation of lab results, as well as, accounting for other related health makers.
Applications for prescriptive nutrition include:
- Disease Therapy and Management
- Family History and Risk Groups
- Proactive Risk Assessment
- Challenging Cases
Interpreting Test Results
Lab reports are easy-to-read numerical and graphic representations that include information about the function of each nutrient found to be deficient. These reports help us identify deficiency symptoms, nutrient sources, and daily intake standards.
Here's an beginning sample of the nutrients that you and your naturopathic doctor should be looking for
|Vitamin B1, B2, B3, B6, B12||Magnesium|
|Vitamin K||Coenzyme Q10|
Advances in testing technology allow affordable results from state certified laboratories. Micronutrient tests are covered by most health insurance policies, because disease prevention is cost-effective for everyone.
2. Journal Nutritional Health Aging. 2013;17(4):310-4. doi: 10.1007/s12603-013-0033-8. Nutritional Screening Strategy in Nonagenarians: The Value of the MNA-SF (Mini Nutritional Assessment Short Form) in NutriAction.
3. Annual Nutrition Metabolism. 2012;61 Suppl 1:8-17. doi: 10.1159/000345165. Global burden of maternal and child under-nutrition and micronutrient deficiencies.
4. Changes in USDA Food Composition Data for 43 Garden Crops, 1950 to 1999 Donald R. Davis, PhD, FACN, Melvin D. Epp, PhD and Hugh D. Riordan, MD Biochemical Institute, The University of Texas, Austin Tx. American College of Nutrition
5. Food Nutrition Research 2013;57. doi: 10.3402/fnr.v57i0.20523. Mar 4. What do review papers conclude about food and dietary patterns?
6. Chemosphere. 2013 Feb;90(7):2115-22. doi: 10.1016/j.chemosphere.2012.11.005. Effects of the neurotoxic thionophosphate pesticide chlorpyrifos on differentiating alternative models. Amaroli A, Aluigi MG, Falugi C, Chessa MG. Laboratorio di Protozoologia, Dipartimento di Scienze della Terra, dell'Ambiente e della Vita, Università degli Studi di Genova, Genova, Italy. PMID:23211320
7. Chemosphere. 2011 Nov;85(10):1639-47. doi: 10.1016/j.chemosphere.2011.08.030. Plant uptake of pesticides and human health: dynamic modeling of residues in wheat and ingestion intake. Fantke P, Charles R, de Alencastro LF, Friedrich R, Jolliet O. Institute of Energy Economics and the Rational Use of Energy, Universität Stuttgart, Hessbrühlstr. 49a, 70565 Stuttgart, Germany.
8. Cancer Epidemiology Bio-markers Prevention. 2010 Jun;19(6):1632-42. doi: 10.1158/1055-9965.EPI-10-0180. May 25. Circulating folate, vitamin B12, homocysteine, vitamin B12 transport proteins, and risk of prostate cancer: a case-control study, systematic review, and meta-analysis.
9. Genes Nutrition. 2013 Mar 15. Food and health: individual, cultural, or scientific matters? Nordström K, Coff C, Jönsson H, Nordenfelt L, Görman U. School of Education and Communication, Jönköping University, Jönköping, Sweden PMID:23494484
10. Digest Disease. 2012;30 Suppl 3:73-80. doi: 10.1159/000342609. Intestinal absorption and vitamin levels: is a new focus needed? Vavricka SR, Rogler G. Division of Gastroenterology and Hepatology, Department of Internal Medicine, Stadtspital Triemli, Zurich, Switzerland. PMID:23295695
11. Amino Acids. 2013 Apr 6. Protein and amino acid supplementation in older humans. Fukagawa NK. Department of Medicine, University of Vermont, Colchester Research Facility, 208 South Park Dr., Room 173, Colchester, VT
12. British Journal Clinical Pharmacology. 1992 Jan;33(1):115-6. Norfloxacin interaction with antacids and minerals. Campbell NR, Kara M, Hasinoff BB, Haddara WM, McKay DW. Faculty of Medicine, Memorial University of Newfoundland, St John's, Canada.
13 Reference forthcoming.
14. Nutrition. 2013 Apr;29(4):605-10. doi: 10.1016/j.nut.2012.11.011. Effects of widely used drugs on micronutrients: A story rarely told. Samaras D, Samaras N, Lang PO, Genton L, Frangos E, Pichard C. Clinical Nutrition, Department of Medical Specialties, Geneva University Hospital, Geneva, Switzerland.
15. Digest Liver Disease. 2002 Sep;34 Suppl 2:S12-8. Variation in human intestinal microbiota with age. Hopkins MJ, Sharp R, Macfarlane GT. MRC Microbiology and Gut Biology Group, University of Dundee Medical School, Dundee, UK.
16. Journal American Medical Association. 2012 Nov 14;308(18):1871-80. Multivitamins in the prevention of cancer in men: the Physicians' Health Study II randomized controlled trial.
17. Nutrition Neuroscience. 2012 May;15(3):134-49. doi: 10.1179/1476830512Y.0000000006. Role of polyphenols in cell death control. Giovannini C, Masella R. Department of Veterinary Public Health and Food Safety, Italian National Institutes of Health, Rome, Italy. ECGC pathway mapping. PMID:21300025 ECGC
18. Journal Alzheimer's Disease. 2012;29(3):561-9. doi: 10.3233/JAD-2011-111751. The effects of multivitamins on cognitive performance: a systematic review and meta-analysis. Full text: http://iospress.metapress.com/openurl.asp?genre=article&issn=1387-2877&volume=29&issue=3&spage=561
19. Psychiatry Clinical North Amercian. 2013 Mar;36(1):25-36. doi: 10.1016/j.psc.2012.12.003. Nutrients for prevention and treatment of mental health disorders.
20. Applied Physiology Nutrition Metabolism. 2013 Mar;38(3):243-8. doi: 10.1139/apnm-2012-0238. Association between plasma omega-3 fatty acids and cardiovascular disease risk factors.
21. Mozaffarian D, Lemaitre RN, King IB, et al. Plasma phospholipid long-chain omega-3 fatty acids and total and cause-specific mortality in older adults. A cohort study. Ann Intern Med 2013; 158:515-525.
22. Nutrition Clinical Practice. 2009 Feb-Mar;24(1):60-75. doi: 10.1177/0884533608329299. Nutrition and heart failure: impact of drug therapies and management strategies. Dunn SP, Bleske B, Dorsch M, Macaulay T, Van Tassell B, Vardeny O. Department of Pharmacy Services, University of Kentucky, 800 Rose Street, Rm H-112B, Lexington, KY
Author Jason Jensen is a licensed naturopathic medical physician in the state of Arizona.
Selecting a Multivitamin. by Dr. Barker