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Nutrition

Your Commitment: Start Taking a Daily Multivitamin with Folic Acid.

As past president and consultant for the Council for Responsible Nutrition (CRN), the leading trade association for the dietary supplement industry, Annette Dickinson, Ph.D. has been actively involved with encouraging people to take a daily multivitamin since she started working with CRN in 1973. A recognized nutrition expert and author with expertise in vitamins and minerals as well as regulatory, legal, and technical aspects of marketing dietary supplements, Dr. Dickinson has previously served on the U.S. Food and Drug Administration’s Food Advisory Committee and was appointed by President Clinton to the Commission on Dietary Supplement Labels. She is the author of two highly regarded industry reference books, The Benefits of Nutritional Supplements, a comprehensive compilation of information about the health benefits of vitamins and minerals, and Before and After DSHEA, a guide to the Food and Drug Administration’s regulation of the dietary supplement industry. We recently had an opportunity to speak with Dr. Dickinson about the role of multivitamins in a healthy lifestyle and why they are particularly important for women of childbearing age.

Q. How long have multivitamins been around?

A. Vitamins have been widely used and highly valued by American consumers ever since being discovered and commercialized, beginning in the early decades of the 1900s. Combinations known as “multivitamins” were well established in the U.S. by the 1940s. According to the National Health and Nutrition Examination Survey (NHANES), the most commonly used dietary supplement is the multivitamin.

Q. What are the benefits of taking a multivitamin?

A. Multivitamins are a safe, reliable and affordable way to bridge the gap between what we should eat and what we actually eat. Many nutrition experts urge all adults to use a multivitamin, to be sure that they are getting adequate nutrients. Multivitamin users tend to adopt other healthy habits (such as eating a healthy diet, getting adequate exercise and seeing their doctor regularly) and studies have shown that multivitamin users tend have a reduced risk of some chronic diseases. 

Q. Why should women in particular take a multivitamin?

A. Virtually all women can benefit from taking a multivitamin to ensure they are getting all of the nutrients they need. In particular, women of childbearing age, not just pregnant women (as people often think), should make sure they are taking a daily multivitamin containing 400 micrograms of folic acid, which helps reduce the risk of having a baby born with neural tube birth defects, such as spina bifida. 

Q.  How do I decide which multivitamin is right for me?

A. When choosing between brands of multivitamins or any supplements, it is best to buy from sources or companies that you know and trust—a simple rule is that if the claim on the bottle sounds too good to be true, then it probably is. Look at the label to be sure that the multivitamin you’re taking contains 100 percent of the daily value (%DV) for the following vitamins and minerals: vitamins C, D, E, K, B-6 and B-12 and folic acid, iron and zinc. You may want to consider taking a separate calcium supplement since your multivitamin doesn’t have room for the amount you need (1,000 to 1,300 milligrams per day, depending on your age and gender). It is particularly important for all women of childbearing age to make sure that they are getting enough (400 micrograms) of folic acid to help prevent neural tube birth defects. Women capable of becoming pregnant also need to be sure that they are getting enough iron (18 milligrams). Many foods and beverages today are being fortified with vitamins and minerals, so try to be cognizant of the nutrients you are getting from fortified foods and supplements combined. The best advice is to adopt a healthy diet and add a simple multivitamin with folic acid for nutritional insurance.

Q. Why is folic acid so important?

A. Folic acid is one of the only proven ways to help prevent neural tube birth defects. There is a solid body of scientific support behind folic acid supplementation, including numerous studies that have been published in peer reviewed journals. FDA has approved a health claim about folic acid and birth defects. The U.S. Public Health Service has formally recommended that all women of childbearing age take a daily multivitamin containing 400 micrograms of folic acid daily to help protect against having a baby with a neural tube birth defect such as spina bifida and a recent scientific statement from the American Heart Association and the American Academy of Pediatrics endorses the same multivitamin supplementation with folic acid to help protect against heart defects in the fetus. Since the government began its mandatory food fortification program in 1998 and public/private partnerships have been urging women to take a multivitamin with folic acid, there has been a 27 percent decline in the number of neural tube birth defects in the United States. Folic acid plus vitamins B-6 and B-12 may also reduce cardiovascular disease in the general population. Recent studies also have shown that folic acid may reduce the risk of stroke by 18 to 25 percent and may improve domains of cognitive function that tend to decline with age. Women who are at the age to become pregnant should talk to their doctor about the importance of taking a daily multivitamin with folic acid. 

Q. How are multivitamins regulated?

A. Multivitamins, like other dietary supplements, are regulated by the Food and Drug Administration (FDA) as a category of food.  

Q. Who should I talk to about taking a multivitamin or other supplements?

A. You should talk to your doctor or other healthcare professional (nurse, pharmacist, dietitian, etc.) about your use of all dietary supplements. Your doctor or other health advisor should be aware of your health habits and the things you put into your body. Additionally, they can assist you in making sure that you are choosing the right supplements for your specific health needs. Some prescription medications have potential interactions with supplements and some drugs can lead to nutrient depletions. It is always a good idea to have an open conversation with your healthcare professional about your supplement habits.

Q. What can partners and friends of Healthy Mothers, Healthy Babies do?

A. It is critical that healthcare professionals, educators, associations and industry stakeholders continue to encourage all women of childbearing age to take a daily multivitamin with 400 micrograms of folic acid every day – before, during and after pregnancy. This can help ensure that every baby born has a healthy start in life.

Q. Where can I go for more information on multivitamins and other dietary supplements?

A. If you’re looking for more information on dietary supplements and the role that they play in an overall healthy lifestyle, visit www.crnusa.org or its affiliated consumer website, www.lifesupplemented.org. The “Life…supplemented” website is consumer-friendly and will give you plenty of information about vitamins, minerals and other dietary supplements. You can even take a fun, interactive real-time quiz, “My Wellness Scorecard” to find out where you fall on the wellness scale and how you can improve your healthy habits. For specific information on folic acid and birth defects, see the Centers for Disease Control and Prevention (CDC) webpage on folic acid at http://cdc.gov/ncbddd/folicacid.