$64,000 question: do you need supplemental vitamins in diet?

I was startled to find four huge containers of vitamin and mineral supplements on Laura's kitchen counter. She takes some of each every day. In total, they achieved levels that could eventually have negative side effects. Their saving grace is that they are very expensive, so she probably won't go on taking these quantities for long.

Thirty-five percent of American adults reported they took vitamin or mineral supplements in 1990, according to the annual survey of the Vitamin Nutrition Information Service of supplement manufacturer Hoffmann-LaRoche, Inc. But only 28 percent took them almost every day.


Of those who take supplements, most take either one (57 percent) or two (21 percent) different types daily. A large majority (94 percent) take a multivitamin. Very few reported taking dangerous amounts, and many recognized excessive amounts of vitamins A and D could be dangerous.

Does this mean supplements are a good idea?



The age-old party line is that healthy children and adults can get all the nutrition they need by eating a well-balanced diet. But who eats a well-balanced diet?

Do you eat at least two fruits and three vegetables most days? Is at least one of them high in vitamin C? Is one of them high in vitamin A? Do you eat at least six servings of whole grain breads or cereals most days? Do you eat two servings of milk, yogurt or cheese daily? How about 4 to 6 ounces of lean meat, poultry or seafood, or a couple of servings of beans, legumes and rice daily?

Now for the $64,000 question -- if you don't eat well most of the time, will a vitamin/mineral supplement save you?

The $64,000 answer -- probably not.

Although a supplement will add nutrients missing from your diet (except for fiber), it can't subtract the elements you're overdoing, like fat, saturated fat, cholesterol and sodium.

For most people, the only way to improve your diet is to improve your diet.

There are a few normal, healthy people, however, who can benefit from supplementing their diets -- sometimes even above normal levels. The American Dietetic Association and the American Medical Association agree:


* Women with excessive menstrual bleeding may need to take iron supplements.

* Women who are pregnant or breast-feeding need more iron, folic acid and calcium.

* People with very low calorie intakes often fail to meet nutrient needs in general.

* Some vegetarians may need additional calcium, iron, zinc and vitamin B-12.

* People who take medications that interfere with nutrient intake, digestion, absorption, metabolism or excretion may have different requirements.

If you fall into one of these categories, discuss your situation with your doctor or dietitian to plan a course of action suitable for you.


If you wish to take a supplement, the least expensive vitamin-mineral tablet that meets 100 percent of the RDA for all nutrients will do just fine -- you don't need the larger doses offered by "stress" or "therapeutic" supplements. There are no demonstrated benefits to self supplementation beyond 100 percent of the RDA levels.

Colleen Pierre, a registered dietitian, is the nutrition consultant to the Union Memorial Sports Medicine Center in Baltimore and national spokesperson for the American Dietetic Association.