Getting Your Vitamins?

November 3, 2011

Like most health information these days, there seems to be a great amount of confusion when it comes to vitamins. And rightly so — it can be challenging to know what to take, how to take them and why. Personally, it seems as though it’s a guessing game for most people and in turn, some people are taking full cocktails of pills daily, while others are skeptical to take any.

Why the confusion? True for any scientific matter, as we gain more evidence, what we believe changes. Take vitamin E, for example. In the ’90s vitamin E was touted as a miracle antioxidant that was protective against cardiovascular diseases and cancer and health experts advised everyone to take additional vitamin e along with their daily multivitamin. Recently, this information has been rescinded and the medical community has denounced any benefit of supplementing with vitamin e aside from the DRI (Daily Reference Intake) set by the Institutes of Medicine, even suggesting potential detrimental effects of extra supplementation. The latest information recommends focusing on naturally occurring vitamin E from foods such as nuts, seeds and vegetable oils, which has shown to be safe, effective and without the potential risks supplementation with vitamin E provide.

Another question about supplementation concerns the multivitamin. Is it a good or bad thing? While it’s generally accepted a multivitamin can have its place in everyone’s diet, by no means should it be insurance for healthy nutrition (no, you cannot eat a diet of fast food and revive yourself each day by taking a multi). There can be many ways a multivitamin can fall short. The first is in absorption. If you find a multivitamin with 100 percent of the DRIs, it does not necessarily mean you will be absorbing 100 percent of each vitamin.

There are a couple factors at work in absorption. When we look at vitamins, we basically break them down into two groups: the fat-soluble vitamins — A, D, E and K — and the water-soluble vitamins B and C. In order for the fat-soluble vitamins to be absorbed, bile, which is excreted from the liver, is needed to help absorb and store these vitamins. To initiate this process, some fat is needed to be eaten when these vitamins are taken to signal to the liver to excrete bile. Water-soluble vitamins are much more easily absorbed, but can just as easily be lost through excretion in the urine.

Then then we get to problems with competition for absorption. Think of it like a perfect situation for each vitamin: to be properly escorted and absorbed though the body, vitamin D and calcium need one another. That’s why milk is fortified with vitamin D. However, calcium hinders the absorption of iron. Assuming you are taking a multivitamin with minerals as well, some vitamins aren’t going to be absorbed fully. (If you are taking extra iron, you may want to note that iron needs vitamin C to be absorbed, so taking it with a glass of OJ can help). The bottom line here is to note proper nutrition can’t be found in a pill, even if what you take says it will provide you with 100 percent of the RDI. Quality, whole foods are needed to ensure your body gets enough of the essential vitamins and minerals. But as a back up, a multivitamin should always be taken with some food, preferably something with a little protein and fat, and a full glass of water.

The latest in dietary research brings attention to vitamin D. In 2007, Time magazine declared vitamin D one of the top 10 medical breakthroughs of 2007. An abundance of studies bringing forth the vital properties of vitamin D since then have surfaced. From nearly every type of cancer to common colds, autoimmune diseases, diabetes and heart disease, vitamin D seems to play a role in prevention, survival and recovery. It almost seems too good to be true, except in this case, the numerous amount of research backs this vitamin up. The Vitamin D Research Council ( does a great job linking published scholarly studies to the numerous diseases vitamin D has been studied with. The major problem with vitamin D, often referred to as the sunshine vitamin (since our skin can produce it from the sun), is that many, if not most of us, aren’t getting enough.

“Its an evolving science,” says Washington Center for Weight Management’s Jan Gagen, a nurse practitioner who has had her vitamin D levels tested and believes in supplementation. “Basically everyone is in agreement that most Americans are deficient.”

The evolving question is: by how much? In light of strikingly convincing research supporting vitamin D, new standards are needed, as most scientists and practitioners believe the requirement currently set at 400 IUDs is significantly too low. Gagen currently takes between 4-5,000 IUDs daily.

“Looking at vitamin D and cancer research, it is ideal to stay above 50 ng/mL [of circulating vitamin D, known as serum 25-hydroxyvitamin D] to prevent against cancer and the reoccurrence of cancer,” says Gagen. While normal ranges can start as low as 25-30 ng/mL and can be indicated through a simple blood test, it all depends on where you and your physician feel comfortable your level should be. In the meantime, supplementing your multivitamin with extra vitamin D seems to be the general consensus of the medical community. The Canadian Cancer Society was one of the first to issue a recommendation to all of its citizens in 2007 to take 1000 IUDs daily. The Institute of Medicine’s Food and Nutrition Board has been reviewing the convincing data on vitamin D and plans to come with a report on vitamin D in summer 2010.

With all this new information, it is important to tell your primary care physician what you are taking and ask what you should be taking. Be sure to list off everything you take, even if you only take it occasionally. Supplements can powerfully influence nutrition and because we get them over the counter, we often think they can do little harm — this couldn’t be further from the truth! There are a variety of biochemical reactions that occur with each supplement you take and it can be easy to unknowingly take a supplement that acts against a medication. Certain vitamins like vitamin K should be limited and monitored to people on a blood thinner like coumadin (warfarin) due to its blood thinning properties. Other supplements like gingko can block absorption of certain medications, especially blood pressure medication, thus hindering their effects. Be cautious for every new supplement you take and check with your health care provider.

Looking to eat better? Check out our [vitamin guide](

Eating Right


-While it’s not always advised to supplement with individual vitamins, it is important to eat a diet rich in quality whole, unprocessed foods. Choose a variety of fruits, vegetables, and whole grains to ensure you are getting an ample supply of vitamins and minerals. Here’s a quick glance at vitamins:

Vitamin A:
Promotes vision and eye health, healthy maintenance of cells in the body’s inter-surface linings (intestinal tract, respiratory linings, etc.) and skin. It also functions in both cellular and embryonic development and reproduction, immune function and bone growth. Note: there are two sources of vitamin A, the active source that comes from animals, and the inactive source, known as beta-carotene, which comes from plants.

Best sources (Active): liver, milk, eggs
(Inactive): look for colorful fruits and vegetables such as carrots, cantaloupe, sweet potatoes and spinach

Vitamin Bs:
The B vitamins are what we call coenzymes. They function as catalysts activating chemical reactions. They consist of thiamin, riboflavin, niacin, vitamin B6, folate, pantothenic acid, biotin and vitamin B12.

B vitamins work in every cell and have many different functions to make chemical processes occur. They have major roles in energy metabolism (thiamin, riboflavin, niacin, pantothenic acid, and biotin work with carbohydrates, fats and proteins to release energy). Folate and vitamin B12 are necessary for new cell production and working with cellular DNA. Vitamin B6 is essential for protein production.
Best sources:
Thiamin: seeds and legumes (especially sunflower seeds, black beans and peas), tuna, asparagus, mushrooms, spinach
Riboflavin: calf’s liver, mushrooms, venison, mushrooms, spinach
Niacin: mushrooms, tuna, chicken breast, asparagus, salmon
Vitamin B6: bell peppers, spinach, bananas, tuna
Folate: dark leafy vegetables (especially romaine lettuce, spinach, collard greens), asparagus, broccoli, cauliflower and lentils
Pantothenic Acid: mushrooms, cauliflower, broccoli
Biotin: found in a wide range of foods, and produced intestinally, greatest sources can be found in swiss chard and egg yolks (supplementation not recommended and deficiency is rare).
Vitamin B12: animal products, specifically calf’s liver, snapper, venison, shrimp, eggs, milk, poultry

Vitamin C:
Helps to protect against cellular damage, formation and maintenance of tissue protein (collagen), supports immune system function.
Best sources: Papaya, bell peppers, broccoli, strawberries and oranges

Vitamin K:
Fuctions to promote blood clotting and bone health
Best sources: green leafy vegetables especially spinach, kale collards, brussels sprouts, broccoli, asparagus

In Good Company

When we were little, our friends and social network influenced our choices, thoughts and behaviors. If Dave played basketball then so did Colin. If Marie wore her hair in pigtails, Andrea thought it was cool. When we grow up, we look at our friends and those who construct our social network much differently. We are led to believe who you know can lead you to opportunity and success. The number of names and phone numbers in our Blackberries are supposed to grow, especially in our nation’s capital, where building one’s social network is not only an event, pastime or lecture topic, but a way of life. We’ve all been told that “who you know” can get you in the door to a job, inside information or get you into a sold-out event. But studies say who you know and how well you know them can make a much more remarkable impact on one’s life than having an “in” with backstage security.

In recent years, sociologists, psychologists, scientists and physicians alike have shifted their attention and broadened their focus of study subjects by examining the relationships and characteristics of those closely connected to them. While an individual’s social networks have not unveiled connections resulting in lucrative jobs or insider information, they have instead revealed a profound influence and vital effect over many facets of one’s health and wellness. The characteristics of those who run in a person’s social circle and how closely connected they are to that person have proven to play a factoring role in matters diverse as belt size to coping ability.

So just how much are we influenced by our relationships? Let’s start with behaviors. It may sound rudimentary to assume that if the people you associate with are drinkers, you’ll likely follow suit. After assessing the social networks of 12,000 people from 1971 to 2003 — the subjects of the famous Framingham Heart Study — researchers from Harvard and the University of California, San Diego concluded in the Annals of Internal Medicine last month that not only do those in your social network affect your alcohol consumption, so do those in your social network’s network — this relationship held through three degrees of separation. If the people you surround yourself are heavy drinkers, it is 50 percent more likely that you will also drink heavily. If a friend of a friend is a heavy drinker, you would be 36 percent as likely to be one as well. And if that friend’s friend — the third degree of separation — is a heavy drinker, your chances of drinking heavily increases 15 percent.

It may be easy to enjoy another cocktail among your friends or share ideas of social acceptance when it comes to alcohol consumption, but what about body size? Could obesity spread from one to another just like the tendency to drink within a social circle? Take the people in your life, your friends, significant other, colleagues and family. Look at your body size in comparison to theirs, taking extra note of your closest friends. Do you find any parallels? Researchers from the Harvard/UCSD study found that it may not just be about diet and exercise, but that obesity is spread through relationships. The most statistically significant (and shocking) relationship influences were with close friendships of the same sex. A person’s chances of becoming obese increased by 57 percent if he or she had a close friend who became obese throughout the study. In pairs of people who each named one another as a close friend, the likeliness that both would gain weight if one became obese jumped to 171 percent. It didn’t matter how near or far the friends were from one another geographically, as long as the person being named was a close friend. This correlation has proved to be stronger than genetics and marriage. Between adult siblings, the likeliness that one would become obese after their brother or sister had increased by 40 percent; for spouses they found a 37 percent increased risk.

Don’t get upset just yet, not all relationships increase negative outcome. But if you are unhappy, perhaps you should find a new group of happy friends, hopefully ones with their own happy friends. Analyzing over 50,000 social ties of nearly 5,000 Framingham participants from 1983-2003, researchers concluded a key determinant of a person’s happiness lies in the happiness with whom they are connected. The degree of closeness to one’s friends and family also ascertained the likeliness of happiness in the future. In the study, happiness was found to be dependent on a person’s social connections extending (again) to three degrees of separation. What this means is that your close friends, siblings, spouse and neighbors all can impact your happiness, and if they are happy (and their friends, and their friends’ friends), there is a greater probability that you will also be happy. Luckily, happiness seems to spread much more consistently through a social web then does unhappiness. By mapping out a network of social connections, it was found that happy people are found in clusters, and the more central one is in the network of relationships, the more likely they are to be happy and stay happy in the future.

Need more reasons to embrace friendships? Want to live longer? Keep your friends, make new ones and continue your relationships in your old age. While having a spouse had little impact on survival, a study of 3,000 nurses with breast cancer published in the Journal of Oncology found that women without close friendships were four times as likely to die then women with 10 or more friends. Another study, this time focused on longevity, found that when people aged 70 and above maintained close friendships and social ties, they had a 22 percent higher survival time. Australian researchers in this study also found no correlation between relationships with their children and relatives, just the friendships the subjects maintained.

Maybe it is all about who you know in life that makes a difference when it comes to attaining health and happiness. It’s not just a mind and body connection we need to be aware of. There is a third component, a person’s social ties, which can play a major role in one’s wellness, thus unveiling the mind-body-social network connection. It turns out, in one way or another, we are all influencing one another, spreading cheer or weight gain, and not only is it important to choose friends wisely and rekindle old friendships, it’s never too late to make new friends. It’s also important to remember you are part of larger phenomenon, influencing and leaving your mark in others’ lives.