Different colored pillsBefore you buy your next multivitamin, think about how you can improve your overall diet first.  According to the CDC, 53% of Americans are taking some type of vitamin or supplement everyday but only 32% of Americans meet the recommended dietary guidelines of 2 or more servings of fruits and 3 or more servings of vegetables a day.

Supplements can’t take the place of a nutritious diet nor has it been shown to prevent chronic disease in healthy individuals.  Fruits, vegetables, whole grains and legumes contain more than just isolated nutrients found in vitamin pills but they also contain a variety of other healthful nutrients, such as phytochemicals, fiber and minerals.  These nutrients interact with each other and cannot be isolated into a single pill. Therefore think food first and supplement only when your diet is less than optimal and you need to fulfill nutrient gaps.

The Requirements are based on the National Academy of Sciences Food & Nutrition Board, DRI, which has the latest information of nutrient requirements.  The Daily Values listed on vitamin bottles have not been updated since 1970’s, therefore requirements listed here are the updated requirements and may vary from the DV.

Here is what you should look for:

1. 100% of Daily Value for:

thiamin (B1)

riboflavin (B2)

niacin (B3)

vitamin B6

vitamin B12

vitamin D (if you are deficient you made need more,  see post “Vitamin D“)

vitamin E

folic acid

2.  Vitamin CFor men: 90 mg 

For women: 75 mg

3.  Vitamin A of 2500 IU or 5000IU of which at least 50% comes from beta carotene.   Long-term intake of retinol has been associated with a higher risk of hip fractures in women and decreased bone mineral density in older women and men.

4. Chromium:  35 mcg/day for young men and 25 mcg/day for young women

5.  Copper:  0.9mg (900mcg)

6. Selenium:  55mcg

7. Zinc:    11 mg for men

8 mg for women

8.  Calcium:  best absorbed in 500mg amounts, see Calcium post)

Adults 19-50 years old: 1000mg

Women 50 yrs and older: 1200mg

Men 71 yrs older: 1000mg

9. Magnesium:  100mg and get the rest through food, women AI:  320mg, men AI:  420mg

10. Iron:  women:  18 mg, men & postmenopausal women none to 8 mg

11. Vitamin E:  15 mg, take a natural source such as RRR-alpha-tocopherol or d-alpha-tocopherol, it is the most bioavailable .  Synthetic alpha tocopherol, or all-racalpha tocopherol,  is less bioavailable and therefore less potent. 



The following independent organizations offer quality testing, meaning they provide assurance that what is listed on the label is actually in the product and that it doesn’t contain harmful levels of contaminants.  They do not test for safety or effectiveness.

U.S. Pharmacopeia


NSF International

Natural Products Association

Always check with your doctor when adding new supplements and/or vitamins. Prescription drugs can interact with dietary supplements and cause a reduction or increase in the effectiveness of the medication.  For example Vitamin C and E can reduce the effectiveness of certain types of cancer therapy.  St Johns Wort can speed the breakdown of antidepressants and birth control pills and reduce their effectiveness.





1. CDC. State indicator report on fruits and vegetables, 2009. US Department of Health and Human Services, CDC; 2009. Available at http://www.fruitsandveggiesmatter.gov/indicatorreportExternal Web Site Icon.

2. Dietary Reference Intakes: Recommended Intakes for Individuals. National Academy of Sciences. Institute of Medicine. Food and Nutrition Board. Accessed May 13, 2011.

3. Linus Pauling Institute at Oregon State University. http://lpi.oregonstate.edu/infocenter/minerals/calcium/

4. Historical comparisons with RDA: Dietary Guidance: Food and Nutrition Information Center. http://fnic.nal.usda.gov/nal_display/index.php?info_center=4&tax_level=3&tax_subject=256&topic_id=1342&level3_id=5142&level4_id=0&level5_id=0&placement_default=0

5. FDA Food and Drug Administration. US Department of Health and Human Services. http://www.fda.gov/Food/GuidanceComplianceRegulatoryInformation/GuidanceDocuments/FoodLabelingNutrition/FoodLabelingGuide/ucm064928.htm


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Sun shining down through tree branchesVitamin D, also called the “Sunshine Vitamin”, because it can be made by the body with the help of sunlight, is a fat-soluble vitamin.  That means it’s  absorbed in fat and can be stored in the body for months.

The American Academy of Dermatology has found it unsafe to be in the sun without protection for any amount of time, therefore it has recommended to get vitamin D solely through food and supplement sources.

Other sources such as the vitamin D council and other health experts believe that some sun exposure is an effective and preferred choice for obtaining vitamin D.

Whether your choice is supplementation or sunlight, it’s important to correct for vitamin D deficiency.

Vitamin D absorbs and maintain calcium and phosphorus levels which helps build strong bones, it prevents fractures and boosts immune function. But Vitamin D has been also found to be protective in a variety of other illnesses, such as: heart disease, osteoporosis, hypertension, some cancers and diabetes.

There has been some disagreements with the recommended guidelines of vitamin D but the IOM has established the guidelines to be as follows:

The Recommended Dietary Allowance (RDA) for Vitamin D:

ages 1 -70 yrs old = 600 IU/day

> 70 yrs of age = 800 IU/day

“At risk” individuals (see below) should get vitamin D levels checked by the doctor and consider increasing  vitamin D intake through food or supplements.

At Risk Individuals are:

  • People that are overweight or obese.
  • People with darker skin tone.
  • People who spend most time indoors.
  • People who use sunscreen daily.
  • People who live in areas with little sunlight (northern hemisphere).
  • People diagnosed with osteoporosis.
  • People who suffer from malabsorption syndrome or inflammatory bowel disease.
  • People on seizure medication.

Other institutions, such as Harvard School of Public, has found these recommendations to be too conservative and has found that the evidence shows optimal intake to be, 800-1000 IU/per day.  In addition, individuals with darker skin, little exposure to sunlight or people living in the northern US during winter season may even need 2000 IU/per day, but before you increase your vitamin D intake to these higher levels have your doctor check your blood levels first.

Good Food Sources of Vitamin D:

There are only a few foods that naturally contain vitamin D, such as certain types of fish, but there are many fortified foods that can also provide you with the recommended amounts of vitamin D, such as dairy and breakfast cereals.  Here are some food choices with their respective vitamin D levels:

Cod liver oil (1360 IU’s per serving) Salmon (447 IU), mackerel (388 IU), tuna (154 IU), milk (115-124 IU), Orange Juice (100 IU), yogurt (80 IU), Sardines (46 IU), Egg (41 IU) Ready to eat Cereal ( 40 IU),


Since only few foods contain vitamin D you may have to supplement your diet with supplements. Here is what you should know:

There are two forms of vitamin D, vitamin D2 or ergocalciferol, is a plant-based form and vitamin D3 ,or cholecalciferol, is an animal-based form. If you are a strict vegan ergocalciferol, or vitamin D2, would be your best choice.  Everyone else has a choice between either one.  Some studies have found cholecalciferol to be more effective in raising vitamin D levels, and chemically it looks exactly like the vitamin D your body produces, but other studies have found them to be equally effective. Until more studies find more conclusive evidence, the choice is yours.



Institute of Medicine. Dietary Reference Intakes for Calcium and Vitamin D. Washington, D.C.: National Academies Press, 2010.

U.S. Department of Agriculture, Agricultural Research Service.USDA Nutrient Database for Standard Reference, Release 23, 2011.

American Academy of Dermatology. Position statement on vitamin D. November 14, 2009.

Harvard School of Public Health. The Nutrition Source: Vitamin D and Health. Accessed, April 11, 2011.






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Calcium pills on a spoon.Calcium Benefits

Calcium is one of the most abundant minerals in the body.  Most of the calcium is stored in bones and teeth. This mineral is tightly regulated, if not enough calcium is available through your diet or supplements, calcium is pulled from the bones or teeth, not what you want to happen.

We need calcium throughout our lifetime and for different reasons.   During childhood and adolescents we need calcium to help build and form bone and start a reservoir for later years, breakdown occurs at a much lesser rate.  As adults the build-up and breakdown of bones is about equal, so we need calcium to help maintain this balance.  When we reach our 40’s the breakdown of bones exceeds the build-up, which can result in osteopenia or osteoporosis.    Therefore, regardless of age it’s important you are getting enough calcium either through your diet or by taking supplements.   Besides bone growth, calcium is needed to help build and maintain teeth, it helps regulate the heartbeat, it helps blood vessels move blood throughout your body, it helps contract muscles, it transmits nerve messages of the brain throughout the body and it helps release hormones and enzymes.

The Institute of Medicine makes the following RDA for calcium:

1-3 yrs old         700 mg/day

4-8 yrs old        1000 mg/day

9-18 yrs old      1,300 mg/day

19-51 yrs old    1,000 mg/day

51yrs                  1,200 mg/day

Good food sources of calcium

Plant-based Sources:

Beans, tofu (made with calcium sulfate), spinach, kale, rhubarb, bok choy, sardines, Black-strap molasses, Almonds, Orange juice (calcium fortified)

Animal-based Sources:

Milk, yogurt, cheese, cottage cheese, ricotta cheese, buttermilk

What to look for when supplementing for calcium

There are two forms of calcium supplements:

  1. Calcium Carbonate
  2. Calcium Citrate

Calcium Carbonate is best absorbed with food, whereas calcium citrate can be taken with or without food. They both vary in the amount of elemental calcium they contain, calcium carbonate has 40% calcium by weight and calcium citrate has 21%.  These amounts will effect how much calcium is absorbed at one time.  The higher the amount of calcium the less calcium is absorbed.  So, in this case more is not better.  Calcium is best absorbed in amounts less or equal to 500 mg.  For example, if you need 1000mg, take one 500mg supplement at breakfast and another 500 mg at lunch or dinner.

The Role of Exercise

Exercise, especially weight bearing exercises, help maintain and retain bone density.  The stress on the bone signals cells in the bones to respond by making the bone denser and stronger. 

Weight bearing exercises include strength training, running, walking, stair climbing and racquet sports. 

Vitamin D

In order to effectively absorb calcium, vitamin D needs to be present.  If you are low in Vitamin D you are most likely deficient in calcium as well.


Estrogen helps absorb calcium, if estrogen levels are low, which is what happens after menopause,  calcium absorption drops as well.

Foods that inhibit calcium absorption:

Oxalic acid also called oxalate, is one of the strongest inhibitors of  calcium absorption, it can be found in spinach, rhubarb, and in lesser amounts in sweet potatoes and dried beans.  Another inhibitor but somewhat less potent is Phytic acid which can be found in fiber containing whole grains, wheat bean, beans,seeds, nuts, and soy isolaes, the yeast used in baked goods contains phytase which helps break down the phytic acid.

Calcium also decreases iron absorption from non-heme sources such as plant foods and supplement and should be taken 2 hours apart.

Tannins which can be found in tea can bind with calcium in the intestine and can inhibit its absorption.


Long-term use of corticosteroids and anti-convulsants can affect bone health. 




Linus Pauling Institute Micronutrient Research for Optimum Health. http://lpi.oregonstate.edu/infocenter/minerals/calcium/

Office of Dietary Supplements:  National Institute of Health. http://ods.od.nih.gov/factsheets/calcium/

Harvard School of Public Health.  Then Nutrition Source: Calcium and Milk:  What’s the Best for Your Bones and Health.  Accessed April 29, 2011.  http://www.hsph.harvard.edu/nutritionsource/what-should-you-eat/calcium-full-story/index.html



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