Episode 83 - Do You Need to Take a Multivitamin?

Do You Need to Take a Multivitamin?

A question I get asked all the time - Should I be taking a multivitamin supplement as a triathlete?

As overachieving endurance athletes, we have a higher need for many vitamins and minerals compared to someone that’s more sedentary. But do we need to supplement? Or can we get everything we need from our diet?

In this episode I talk about:

• The 13 essential vitamins our body needs for normal, healthy functioning
• What happens if certain vitamins are missing from our diet?
• Are there any adverse effects if we get too much?
• Water soluble vs fat soluble vitamins
• When would vitamin supplements be useful?
• My simple answer for the question - Do you need to take a multivitamin supplement?

Tune in to learn more!

Links:

Paper Referenced: Paranjpe et al. 2020. Self-reported health without clinically measurable benefits among adult users of multivitamin and multimineral supplements: a cross-sectional study. BMJ Open. Available from: bmjopen.bmj.com/content/10/11/e039119

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Episode Transcription

Episode 83: Do You Need to Take a Multivitamin?

Taryn Richardson  00:00

Welcome to the Triathlon Nutrition Academy podcast. The show designed to serve you up evidence-based sports nutrition advice from the experts. Hi, I'm your host Taryn, Accredited Practicing Dietitian, Advanced Sports Dietitian and founder of Dietitian Approved. Listen as I break down the latest evidence to give you practical, easy-to-digest strategies to train hard, recover faster and perform at your best. You have so much potential, and I want to help you unlock that with the power of nutrition. Let's get into it.

Taryn Richardson  00:42

Welcome to Episode 83. Today, I'm going to answer a question that I get asked all the time, - do you need to take a multivitamin, particularly as an endurance athlete? So we're gonna dive into a little bit of background and then I'm going to give you my hard and fast answer. So we know that vitamins play lots of important roles in our body - there are 13 essential vitamins that our body needs for just normal healthy functioning. We can't make them ourselves, or we can't make enough of them, so we have to get them through our diet. When vitamins are missing from our diet, it leads to poor health outcomes and illness can occur. So think things like vitamin C deficiency, which was the cause of scurvy. Vitamin D deficiency leads to rickets. And things like being deficient in calcium leads to porous, weak bones and teeth. So not having enough of these things is definitely bad. But vitamins, in particular, are usually only needed in small, small amounts, and too much of some of them can actually cause symptoms of toxicity.

Taryn Richardson  01:49

So we've got 13 vitamins, they're A, all of our B complex - B1, B2, B3,  B5, B6, B7, B9 and B12, vitamin C, vitamin D, vitamin E and vitamin K. Now, if you're wondering what on earth happened to those missing letters of the alphabet, they did name them, like, A, B, C, D, E all the way to K. But what happened is, later on, they discovered that some weren't vitamins or others were related to the B complex. So they then got a B with a number attached to it. So if you've ever wondered what happened there, that's what happened, they did get a letter things like F and G, but were later renamed.

Taryn Richardson  02:32

So out of those 13 vitamins, we have nine water soluble vitamins, they are the eight B vitamins and vitamin C. And what that means is that they dissolve in water and, as a result, they're actually really easily excreted from the body. So we get rid of them very easily. So what we need with these types of vitamins is a steady intake rather than a whole heap at once that we can't use and store. And ideally, we want to get them from our diet - that's really important. Now the four that are classified as fat soluble vitamins are vitamin A, D, E, and K. And to absorb those effectively, we do need to consume them with some healthy fats. So think olive oil on your veggies or in salad dressings, or things like avocado to help our fat soluble vitamins absorb. We also store them in fatty tissues and the liver. And as a result of that they can accumulate. And if levels become too high, then that causes symptoms of toxicity, which is also not a good thing.

Taryn Richardson  03:32

So they have lots of varying roles in the body. I'm not going to get into it here - it's a little bit too nerdy for the podcast. But we need them for things like extracting energy from our food to use just at rest, in our daily functions and for exercise, for transporting oxygen around the body, for building strong bones. There are loads of different roles. So because they're so important, it's kind of led to people thinking that we need to supplement with them to make sure we're getting everything that we need. But do you need to take a supplement? Short answer, not unless you're deficient.

Taryn Richardson  04:10

I know a lot of athletes take a multivitamin as, like, a safety blanket or because it makes them feel healthy. And there was actually a study in the placebo effect of taking a multivitamin. It was massive - in the 2012 National Health Survey of Americans 21,603 people were involved in this study, multivitamin users and non multivitamin users. And the multi users reported 30% better overall health compared to the non multivitamin takers. But there was no clinical difference in measurable health outcomes. They just felt better because they were taking a multivitamin and that is, my friend, the placebo effect. So if you take your multivitamin and it makes you feel healthy, it's not necessarily doing anything.

Taryn Richardson  05:02

We know that vitamins from food actually work better than the vitamins that are manufactured in something like a multi - even when they've manufactured that vitamin to be the exact same structure as the real food vitamin structure - the chemical structure. Folate is the only exception to that. The manufactured form of folate is absorbed by the body better than folate from food. There are loads of chemicals in food like enzymes, other minerals, phytochemicals - so things like plant chemicals - that are really good for our health, that work together with vitamins in these complicated ways to help our body. Also, don't forget that food food contains fiber, which you can't get from a magic pill. And that's really good for our gut bacteria - keeps our gut microbes happy and keeps our whole body working more effectively. Phytochemicals, in particular, are really important as part of a healthy diet and may help to actually reduce some diseases like cancer and heart disease. And you can't get that from a vitamin supplement. We don't have those complicated food chemicals when we're taking pills and potions.

Taryn Richardson  06:16

Think of a multivitamin like a general practitioner, your GP - they know a little bit about everything, but they're not specialists in one particular thing. A multivitamin is like that it has a little bit of lots of things in there but it doesn't have a high enough dose to fix a deficiency or a problem if there is one. So as an example, something like a Centrum, which is a common multivitamin here in Australia, for adults - it contains five milligrams of iron, and 90 milligrams of vitamin C. Now if you're struggling with iron deficiency, and your iron levels are low, and your sports dietitian or your GP or your sports physician has suggested you take an iron supplement, you're likely to take something called FerroGrad(umet) C, which contains 105 milligrams of elemental iron, and 500 milligrams of vitamin C. So can you see the huge disparity of a multi versus a supplement that is designed to actually fix a deficiency? You would really struggle to fix that with a Centrum, if your iron levels are low. It would probably be impossible to get there. So keep that in mind. If you are deficient in something, then a multivitamin is not going to cut it. You will need a specialist supplement to correct that deficiency. And you don't need a multivitamin to ward off deficiency as long as you're eating properly.

Taryn Richardson  07:47

It's not rocket science, not sexy. But if you have a huge variety of foods - you're eating all your fruits and vegetables and all those types of things, then you don't need to take a multivitamin to be a safety blanket for any of that sort of stuff. You will literally just break it down and pee it out, particularly the water soluble ones. And so you're just making expensive pee.

Taryn Richardson  08:09

So when would a vitamin supplement be useful? Like I just said, if you're deficient in something like iron or vitamin D, you would need something to correct that deficiency, potentially. But that's something that your GP or whoever is testing your bloods can help guide you on - please don't take this as individual advice from a podcast. The other time might be in preconception or early pregnancy, where something like folic acid supplementation can be useful to reduce the risk of neural tube defects. And iodine is also something that seems to be lacking in our diets. And that for some people can be supplemented in the preconception and for the first trimester as well. Iron in particular, through pregnancy or before, is something that is commonly supplemented with because your iron requirements are so high through pregnancy and some people really struggle to maintain that.

Taryn Richardson  09:01

Vegetarians and vegans may also need to supplement with something like a B12 or an iron. Our animal sources are really rich in both of those two things. So if somebody avoids them altogether, for whatever reason, then they are two key nutrients to be on top of that may or may not need some supplementation in a vegan diet. Older adults, maybe sometimes they need some calcium and vitamin D supplementation to maintain their bone health if they're not able to meet the requirements from their day to day diet.

Taryn Richardson  09:32

And another instance might be really incredibly fussy, little people - fussy kids - and that's something that a medical professional would recommend. It's not something that you should throw your kid on if, you know, they're not eating their vegetables at dinner. Definitely seek advice on that one, rather than giving kids a safety blanket. So the summary of all that is you don't need to take a multivitamin, unless you're deficient in something and then, if you are deficient, then you should be taking the thing that you're deficient in and fixing it properly rather than just like throwing spaghetti at the wall and hoping something sticks. If you think it's a good safety blanket, or you feel healthier, taking a multivitamin, remember that vitamins from food are better than manufactured ones in ALL instances except for folate. So consult your GP, your general practitioner, if you're not sure, and get a blood test before buying a supplement. There's no point taking something unless you have some data to know what's actually going on. So if you're taking a multi save your money, put it in a separate bank account, call that bank account TNA and put it towards your education next time we open the door to the Triathlon Nutrition Academy. In the meantime, check out my new Triathlon Nutrition Kickstart course at triathlonnutritionkickstarter.com.

Taryn Richardson  10:59

Thanks for joining me for this episode of the Triathlon Nutrition Academy podcast. I would love to hear from you. If you have any questions or want to share with me what you've learned, email me at [email protected]. You can also spread the word by leaving me a review and taking a screenshot of you listening to the show. Don't forget to tag me on social media, @dietitian.approved, so I can give you a shout out, too. If you want to learn more about what we do, head to dietitianapproved.com. And if you want to learn more about the Triathlon Nutrition Academy program, head to dietitianapproved.com/academy. Thanks for joining me and I look forward to helping you smashed in the fourth leg - nutrition!