Are multivitamins vital for good health – or a waste of money?

WE’RE a nation of vitamin pill poppers: around half of the UK population takes a supplement once a week or more. But which are worth buying, and which are just like flushing money down the drain? In this unique series, starting today and continuing tomorrow in The Mail on Sunday, we take a critical look at supplements — from single vitamins and herbal remedies, to ‘superfood’ powders to stir into smoothies — to give you the information you need to make up your own mind. Today we focus on multivitamins and minerals, and ask: is this what YOU need?

MANY people start their day by swallowing a multivitamin in the hope that this ‘one-pill wonder’ offers just the right amount of important nutrients to act as health insurance against illness.

These pack a wide range of nutrients into a convenient capsule and are one of the UK’s favourite supplements. In 2022, 38 per cent of Britons took vitamins, minerals or supplements daily.

The official NHS line is that most of us can get all the nutrients we need by eating a healthy, balanced diet. The exceptions are vitamin D in the winter months ( adults are advised to take 10mcg between October and March); vitamin B12 if you’re a vegan (adults need 1.5mcg a day); and folic acid for women trying for a baby, to protect against birth defects.

Then there is research, such as a review of 84 studies by the U. S. Preventive Services Task Force, published last year, which found little evidence to suggest supplements could help prevent heart disease or cancer, for instance.

The report stated that for otherwise healthy people, multivitamins are a waste of money. ‘ We should all [just] be following the evidence-based practices of eating healthily and exercising,’ said the lead researcher, Dr Jeffrey Linder, head of general internal medicine at Northwestern University Feinberg School of Medicine. Yet the fact is that the recommended daily vitamin intakes are based on the level needed to prevent a deficiency in that nutrient, rather than the amount needed to achieve optimal health.

And while a good diet should — in theory — be able to protect you from deficiency symptoms (such as scurvy if you are lacking in vitamin C), very few of us are eating enough of the good stuff.

NHS studies show only 28 per cent of UK adults eat five portions of fruit and veg a day — many struggle to meet that target in even a week — while an estimated 51 per cent of the UK diet is based on highly processed and nutritionally depleted foods, according to a study in the journal Public Health Nutrition.

Aidan Goggins, a pharmacist and an independent adviser to the supplement industry, says that even if we believe we are eating exemplary diets, they are in fact ‘ nowhere near as good as we think’.

He uses the term ‘ hidden hunger’ to describe the effect of the declining amount of nutrients in plants over recent decades, as a result of intense farming.

This nutrient deficiency is compounded by the fact that we tend to eat such a narrow range of foods, he says. ‘Of the 30,000 edible crops available to us, only 150 varieties are grown on a large scale and 95 per cent of the world’s calories come from just 30 plants,’ he adds.

‘Almost half of global calorie demand is supplied by three crops — maize, rice and wheat — and what little micronutrients [i.e. vitamins and minerals] there are in these grains are mostly lost in the intensive processing they undergo.’

‘Overall, there is not a chance that our diets today provide sufficient nutrients even if we are “eating well”,’ he says.

There is further evidence, too, such as the analysis of official UK diet surveys in 2018 by public health nutritionist emma Derbyshire. Published in the journal Frontiers in Nutrition, this showed that many women have lower than optimal levels of key nutrients, including B vitamins, magnesium, selenium, calcium, iron, potassium and iodine.

We’re also not doing enough exercise: Sport england has found that most of us fall short of even the most basic NHS recommended activity targets.

Is it any wonder so many of us reach for a daily tablet or capsule just in case? emma Derbyshire, who is also a spokesperson for the industry body, the Health and Food Supplements Information Service, believes supplements can play a role for some people.

‘Studies show that supplements can help to boost vitamin and mineral intakes, and that British adults who take supplements are more likely to meet nutrient recommendations than those who don’t,’ she says.

‘But supplements should be seen as a means to top up the regular diet — not to replace the role of food.’

Margaret Rayman, a professor of nutritional medicine at the University of Surrey, agrees, saying that if you’re one of the many whose vegetable repertoire is limited to peas and sweetcorn, who prefers white bread to brown, enjoys a drink ( or two) and watches more sport on TV than you play, then ‘a multivitamin might help replace some of what you are missing’.

She adds that topping up key nutrients to recommended levels is ‘probably a good idea if you know your diet leaves a lot to be desired’.

Aidan Goggins isn’t convinced about squeezing any number of vitamin and mineral compounds into a capsule, though. ‘So many [ multivitamins] contain a hotchpotch of junk — the wrong doses of nutrients, the wrong forms which offer poor

absorption,’ he says. ‘That’s why study outcomes for many supplements have been so terrible. For instance, research shows we absorb around 99 per cent of vitamin C taken as a single supplement but less than 50 per cent of it from a multivitamin.’

A major issue with multivitamins is the different compounds can compete with each other for absorption.

‘you always get an element of tradeoff with multinutrient supplements,’ says Aidan Goggins.

‘Fa t-soluble vitamins such as A,D,e and K are better taken with other food — specifically fat — to aid absorption.

‘Meanwhile, water-soluble vitamins such as Bs and C get absorbed in the small intestine, so they are actually best taken on an empty stomach, which allows the compounds to travel through the stomach unencumbered.’

But a key advantage of a broadspectrum multivitamin is the fact that they rarely contain more than the minimum recommended levels of nutrients and, according to Professor rayman, are unlikely to cause harm.

And if you do decide a multivitamin is for you, use this guide to help you.