Should You Take a Multivitamin?

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More than half of Americans take multivitamins. But can a daily pill really make up for a poor diet?
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“So many of my patients tell me they know their diet is not great but that I should not worry because ‘at least’ they take a multivitamin,” says dietitian Anna Taylor, RD . “But multivitamins aren’t a surefire way to get what you need.”
Here’s what you need to know about vitamins and supplements .
Is it good to take a multivitamin every day?
Experts are at odds over the effectiveness of multivitamins. While some think they supply missing nutrients, others say they’re nothing more than an expensive crutch.
Internist Raul Seballos, MD , notes that two large studies have finally shed some light on the subject:
The Physicians’ Health Study II: Tracked multivitamin use in 14,500 male physicians, aged 50 and above, over an 11-year period.
The Iowa Women’s Health study: Tracked multivitamin and supplement use in 38,772 women over an 18-year period. The average age at the study’s start was 61.
Dr. Seballos says these studies found that:
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Multivitamins won’t prevent heart attacks or strokes. If you’re a healthy adult, taking a multivitamin won’t lower your risk of heart attack, stroke or death from cardiovascular disease. In fact, in 2014, the U.S. Preventive Services Task Force concluded that there is insufficient evidence to support any benefit from vitamin and mineral supplementation for the prevention of cancer or cardiovascular disease.
For men, multivitamins won’t prevent common cancers. Taking a multivitamin won’t lower your risks for the most common male cancers: prostate, colon and lung cancer. And taking a multivitamin will not lower your risk of dying from cancer.
For men aged 65 years or older, multivitamins do not provide cognitive benefits. Nearly 6,000 male physicians over 65 years were evaluated for cognitive function in the Physician Health Study II. Memory loss and cognitive performance were similar in men who took a multivitamin and those who did not.
For women, multivitamins won’t help you live longer. The women’s study found that those who took multivitamins actually had a higher risk of early death. 
Taking a multivitamin won’t replace healthy habits. “Taking a multivitamin is no substitute for healthy lifestyle choices, such as exercising and eating a balanced diet,” says Dr. Seballos.
Multivitamins vs. whole foods
When it comes to the essential nutrients our bodies need to thrive, it’s hard to beat what nature provides. That’s because most of the vitamins, minerals and phytochemicals (which are plant compounds that serve as immunity-boosters, antioxidants, anti-cancer agents and anti-inflammatories) that you get from whole foods are superior to the same nutrients delivered in a pill , notes Taylor.
Studies offer proof that a multivitamin will not give you the same health benefits as food:
Eat your broccoli. Broccoli and other cruciferous vegetables contain components that provide wonderful health benefits, such as helping prevent certain cancers and decreasing inflammation . A 2011 study in the Journal of Agricultural and Food Chemistry found that those key components were poorly absorbed and lacked value in pill form.
Careful with calcium pills. One study found that calcium supplements can increase the risk of a heart attack . Many doctors recommend that people with a high risk of heart disease get their calcium through diet rather than supplements.
Beware of the multivitamin danger. Another study in the Archives of Internal Medicine found that certain dietary supplements, including multivitamins, folic acid, iron and copper, appeared to be associated with an increased risk of death in older women.
But not all vitamins come with health risks — especially if you use them after consulting your doctor first. Some essential vitamins and nutrients are best absorbed in pill form. These include:
Folic acid. For pregnant women and women of childbearing years, this synthetic version of folate, which helps prevent birth defects, is best absorbed in a supplement .
Vitamin D. Taylor says that vitamin D may be most beneficial in pill form because it contains the type of vitamin D that we absorb best — the kind we get through the sun, not food .
Who should take multivitamins?
Anyone who is malnourished or has a nutritional deficiency should talk to their doctor about taking a multivitamin, says Dr. Seballos.
For everyone else, “Ask yourself, ‘Am I doing everything possible to optimize my overall health before taking a multivitamin and/or supplement?’” he says. “Smart lifestyle choices are your best guarantee of future health.”
How to get the most from your food
To get the nutrients you need from food, Taylor recommends:
Don’t overcook your greens. Lightly steaming your broccoli and spinach is the best way to draw nutrients out of the plant cell while not eliminating them (which may occur when boiling).
Consider food combinations to enhance nutrient absorption. Iron, for example, is best absorbed along with vitamin C. So eat C-rich fruits or veggies, such as mandarin oranges, strawberries or red pepper sticks, when eating iron-rich food, such as beef.
Keep fruits and vegetables in sight. A study in the Environment and Behavior journal found that college students ate more fruits and vegetables from clear glass bowls than opaque bowls. Bottom line: If you can see it on your counter, you’re more likely to eat it.
Make meal prep a habit. Spend some weekend time cutting your favorite vegetables (think red pepper sticks or carrots) and putting them in individual sandwich bags. They make an easy snack to grab during the week on your way to work or school.
Focus on whole foods. Processed foods causes nutrients to break down, so choose plenty of whole foods like fresh and frozen vegetables, whole grains, beans and nuts. Limit boxed mixes, canned products, frozen entrees and other convenience foods, which are more processed and typically contain fewer vitamins, minerals and phytochemicals.
5 things you can do to prevent illness (no multivitamin needed)
Research shows that these five steps can reduce your risk of illness — especially cardiovascular disease and cancer:
Eat a diet low in added sugars, processed foods and saturated and trans fats.
Eat lots of fruits, vegetables, whole grains, lean protein and low-fat dairy.
Maintain a body mass index (BMI) between 18.5 to 24.9.
Remain tobacco-free.
Exercise most days of the week.
Dr. Seballos also recommends telling your doctor about all the vitamins and supplements you take. And ask about important screenings you may need based on your age, sex and family history.
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