Get the Nutrients You Need

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You may not be getting enough of some essential nutrients, and the right multivitamin can help make up the difference.

By Walter C. Willett, M.D.

Once upon a time, vitamins were thought of only as nutrients needed in small amounts to prevent diseases with exotic-sounding names such as beriberi, pellagra, scurvy and rickets. Because these diseases were becoming rarer, it seemed that most Americans were getting enough vitamins.

New findings suggest that some people—probably many people—don’t get enough of the essential micronutrients. Vitamins are playing newly recognized, or suspected, roles in preventing many diseases. By increasing the amount of vitamins and minerals we get, mostly from food, but maybe from supplements as well, we could substantially improve our long-term health.

THE THREE B'S

The five vitamins that most people don’t get enough of in their diets are folic acid, vitamin B6, vitamin B12, vitamin D and vitamin E. Three of these are B vitamins—B6, B12 and folic acid. There are a total of eight B vitamins, but new evidence suggests that these three may play pivotal roles in reducing heart disease and cancer.

High levels of the amino acid homocysteine are being studied as a risk factor for heart disease, and B6, B12 and folic acid help recycle homocysteine into harmless amino acids. The Physicians’ Health Study, a long-term study of 22,000 men, found that high homocysteine levels tripled the chances of having a heart attack. The Nurses’ Health Study, which recorded data from 121,000 female nurses, found that those with the highest intakes of vitamin B6 and folic acid were about half as likely to have heart attacks or die from heart disease as women with the lowest intakes.

Folic acid, or folate, also helps guide the development of the embryonic spinal cord. Pregnant women who get too little folic acid increase the chances that their babies will be born with neural tube defects such as spina bifida and anencephaly. Folic acid also may temper the increase in breast cancer seen in women who average more than one alcoholic drink per day. The same is true for colon cancer, another disease that is more common among alcohol drinkers than nondrinkers.

Getting enough of these vitamins doesn’t mean taking megadoses. For most people, it means just reaching the current recommended daily intakes of 400 micrograms for folic acid, 1.3 to 1.7 milligrams for vitamin B6—depending on your age and gender—and 2.4 micrograms of vitamin B12. Good sources of B6 include meat, nuts and beans. Liver is the most efficient food source of B12 and is rich in folic acid. Unfortunately, only a small fraction of U.S. adults achieve the recommended levels of these B vitamins through diet alone.

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