By Brittany Schmidt, DC

Multivitamins are our supplement of the month for January! Read on to learn more.

Should you take a daily multivitamin?
My answer to this question is almost always, YES! The reason why is pretty simple: most individuals do not get enough fruits and vegetables in their daily diet. Fruits and vegetables provide necessary vitamins, minerals, and anti-oxidants that our bodies both desire and need. Personally, I prefer my patients get their essential nutrients from whole foods; meaning I’d rather you eat the recommended 6-13 servings of fruits and vegetables a day than take supplements to compensate. In a perfect world we would be able to eat a nutritious and balanced diet every day and not need supplementation, however, this is challenging to do consistently as we all lead busy lives! I consider myself to be pretty health conscientious, and I love my fruits and vegetables, but even I struggle to get in 6-13 servings of fruits and vegetables a day. A multivitamin can help you “fill in the gaps,” nutritionally, which can be key in maintaining health.

What does the research say about multivitamins?
I think it is necessary to know what the literature says about any supplement before suggesting it to patients. Although research is important, it is not everything. In chiropractic school we are taught to have an Evidence Informed approach to practice. This means that as doctors it is important to not only consider the research, but to consider anecdotal evidence (clinical expertise/experience), as well as what the patient values. In my opinion, research on multivitamin usage is lacking and mixed. However, there are many studies supporting multivitamin use. A 2017 birth cohort study found that those who used multivitamins during pregnancy had a reduced risk of hyperkinetic disorders (similar to ADHD) in their offspring (Virk, et al 2017). A brand new study found that those who took multivitamins before and during pregnancy had a reduced risk of Autism Spectrum Disorders in their offspring (Levine, et al 2018). These studies support the fact that it is important for women of child bearing years to take a multivitamin, as a multivitamin will also contain folic acid or folate which is critical for a developing fetus during the first 25 days of conception. Another added benefit for women is that most multivitamins for women contain iron, which is often needed due to the blood loss experienced monthly during a menstrual cycle. Wo

men are not the only ones that would benefit from multivitamins; it has been shown that vitamins (especially vitamin D and B vitamins) may have an effect on mood and stress (Long, et al 2013). In the winter months vitamin D is especially important for Minnesotans, as we do not get enough sun to produce vitamin D naturally. Vitamin D has a wide range of benefits and can be found in most multivitamin supplements. Finally, a study conducted in Japan found that multivitamin use was associated with a lower risk of ischemic stroke mortality (Dong, et al 2013). According to strokecenter.org, stroke is the third cause of death in the United States, which highlights the fact that we need to work towards reducing our overall risk of stroke.

Are all multivitamins created equally?
The answer is no, and this goes for all supplements on the market, not just multivitamins. There is a difference between synthetic and natural vitamins. Synthetic vitamins are manufactured with chemicals while natural vitamins are derived from straight from the source (usually a fruit or vegetable). There are also concerns with fillers and additives in certain vitamin supplements. Finally, the biochemistry of vitamin break down in the body is complex, and some synthetic nutrients cannot be metabolized and utilized by the body because of their structure. In short, it is important to choose a high quality multivitamin.

Tips for getting more fruits and veggies!
As mentioned earlier, I believe it is important to have an abundance of fruits and veggies in your daily diet. Here are some easy tips to help increase your fruit and vegetable intake:

• Have a serving of vegetables in each meal—better yet, double it!
• Try going vegetarian one day a week, if you’re religious Fridays may be a good day to choose, or another option that seems to be trending is Monday, hashtag it #MeatlessMondays
• Pre-cut fruits and vegetables and place them on the top shelf of the fridge for easy access.
• Drink your veggies! Putting spinach or kale in your smoothie is easy and many don’t believe me, but you can barely taste it! Or ask about our Dynamic Greens to add to your beverage!
• Bell pepper, carrots, celery, radishes, and other veggies are great to dip into hummus or guacamole for a nutritious snack.
• Add lots of veggies to soups, stews, casseroles, and other meals.

References

Association of Maternal Use of Folic Acid and Multivitamin Supplements in the Periods Before and During Pregnancy With the Risk of Autism Spectrum Disorder in Offspring

Stephen Levine-Arad Kodesh-Alexander Viktorin-Lauren Smith-Rudolf Uher-Abraham Reichenberg-Sven Sandin – JAMA Psychiatry – 2018

Canadian Chiropractic Guideline Initiative (CCGI) Evidence-Informed Practice: Introduction and implications for clinicians, patients, and the chiropractic profession. Patrick Norris. http://slideplayer.com/slide/10818663/ Image found on slide 7/30, originally found on Google Images. Accessed on January 8, 2018.

Effects of vitamin and mineral supplementation on stress, mild psychiatric symptoms, and mood in nonclinical samples: a meta-analysis. Long SJ, Benton D. Psychosomatic Medicine. 2013

Multivitamin Use and Risk of Stroke Mortality: The Japan Collaborative Cohort Study. J.-Y. Dong-H. Iso-A. Kitamura-A. Tamakoshi- – Stroke – 2015

Pre-conceptual and prenatal supplementary folic acid and multivitamin intake, behavioral problems, and hyperkinetic disorders: A study based on the Danish National Birth Cohort (DNBC). Jasveer Virk-Zeyan Liew-Jørn Olsen-Ellen Nohr-Janet Catov-Beate Ritz – Nutritional Neuroscience – 2017

The Internet Stroke Center. <http://www.strokecenter.org/patients/about-stroke/stroke-statistics/>. Accessed on January 8, 2018.