Lenore Greenstein: It's best to get the nutrients you need from food

In light of the U.S. Dietary Guidelines Committee's recent report on multivitamins, people frequently ask me whether I personally take a multivitamin and if I follow a healthy diet.

The answer to both queries is yes. I start each day with a broad-spectrum multi (one that contains a variety of vitamins and minerals), and I do concentrate on a well-balanced eating plan.

On any given day I may have most of my nutritional needs provided by food alone. But sometimes it is not possible to get in all the nutrients I need from food, even though I try to get in lots of fruits and vegetables, whole grains and some good fats every day. Depending upon the circumstances (such as eating out or traveling), I am not always successful.

I am not alone. The 2005 Dietary Guidelines Advisory Committee found that adults and children typically fall short on vitamin E and the minerals calcium, magnesium and potassium. Adults also often don't get enough of vitamins A and C. The conclusion of some scientists is that many people find it difficult to get all the needed nutrients from food alone.

In addition, absorption becomes an issue for people at age 50, when the stomach produces less acid, reducing absorption of vitamin B-12 found naturally in food. But the crystalline form found in fortified food and in dietary supplements can be absorbed well at all ages. This is why the National Academy of Sciences recommends that people over 50 either eat fortified food or take supplements, since many multivitamins contain 100 percent of the recommended daily intake of B-12.

For a healthy adult to get most of the recommended vitamins and minerals, he or she needs to eat about four servings of fruit per day (or two cups a day of mixed fruit), and approximately 2½ cups of vegetables. This translates into at least one serving of fruits and veggies at every meal, plus extra for snacks. Variety and color are essential, including dark leafy vegetables (spinach, kale, romaine, etc.), as well as orange vegetables and fruit such as sweet potatoes and cantaloupe. These are powerhouses of naturally occurring beta carotene, folic acid and other important nutrients.

Getting in three needed servings of whole grains each day can be problematic for those who are mistakenly cutting out the good carbs. The solution is as simple as eating a cup of high fiber whole grain cereal or a cup of oatmeal for breakfast in the morning and a sandwich on whole wheat at lunch. Three glasses of nonfat milk (or another calcium- and vitamin-D-fortified substitute, such as orange juice, soy milk, cheese or yogurt) will meet 90 percent of the daily calcium for adults 50 and younger. Nuts and healthy oil, such as olive or canola oil, can help provide the recommended daily amount of vitamin E.

Is this ideal diet attainable without going overboard on the calories?

The Dietary Advisory Guidelines Committee found that it is possible to meet all the recommended intakes and still not overeat, but there are few calories left for splurges on sweets, drinks or even some added fat. Just about 10 percent of extra calories remained, or about 200 discretionary calories on a 2,000-calorie daily intake.

Can people taking a multivitamin get too many nutrients?

"We're concerned that some people may be getting too much of certain nutrients," the panel's chair, J. Michael McGinnis, said.

That's because a growing number of foods and drinks are fortified with vitamins and minerals. In 2005, the majority of Americans consumed fortified foods or beverages, which include bread, crackers, cereals, milk, eggs, juices and even water. Vitamin A was among the nutrients whose consumption could easily exceed upper limits, which has been linked to an increased risk of osteoporosis.

Bottom Line: A healthy diet is the best way to get the nutrients you need, and a multivitamin and mineral can help fill in the gaps. Think of it as dietary insurance.

Lenore S. Greenstein is a registered dietitian in private practice in the Naples area.