Vitamins and nutritional supplements
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Vitamins and nutritional supplements are intended to provide essential nutrients, such as vitamins, minerals, fatty acids or amino acids, which are missing or not consumed in sufficient quantities in a person’s diet.
Dietary intake of these nutrients may be reduced due to poor food intake, sickness, diets which exclude some foods, pregnancy or breastfeeding, or chronic (ongoing) medical, psychological or physical reasons.
Being aware of the recommended dietary intakes (RDIs) or upper intake limits of different types of nutrients, according to your age and how active you are, helps determine what (if any) supplement you may need to take.
Many people take vitamins they do not actually need, usually through lack of knowledge, and for this reason it is advisable to seek dietary counselling from a dietitian. This is especially true for people who are intolerant of certain food groups (e.g. lactose or gluten).
Recommended nutrient intakes
Australia and New Zealand publish joint recommendations for nutrient intakes necessary to keep people healthy and to reduce their risk of chronic disease. These recommendations are also used by the Food Standards Australia New Zealand (FSANZ) for guidance on food labelling requirements, including for food imported into and prepared and sold in both countries.
For each nutrient, the level of intake has been calculated (based on available scientific knowledge) according to what is considered adequate to meet the known nutritional needs of almost all healthy people to prevent deficiencies. These are called Nutrient Reference Values, and may differ according to age and gender, as well as for pregnancy and breastfeeding.
People with chronic diseases or premature infants may require further specialist advice. In Australia and New Zealand, the intake of folate (folic acid), calcium and iron for women, as well as iodine and selenium in all people, are thought to be bordering on too low.
The Nutrient Reference Values also give guidance for some nutrients in relation to improving fetal development during pregnancy, and reducing the risk of chronic disease (e.g. heart disease and diabetes), for example:
- folic acid supplementation to prevent deficiency and reduce the risk of neural tube defects in babies: 400 microgram daily before conception and for the first 12 weeks of pregnancy. Women with certain other medical conditions or a family history of neural tube defects will need to consume 5 mg daily (seek medical advice)
- reducing sodium intake to 1600 mg per day (70 mmol/day)
- dietary fibre intake of 38 g per day (men) and 28 g per day (women) to reduce cardiovascular disease risk
- dietary intake for omega-3 fatty acids of 610 mg per day (men) and 430 mg per day (women)
Research has shown it is possible to achieve the RDIs of all nutrients by consuming commonly eaten foods. Diets should be varied and rich in plenty of vegetables and fruits (including some nuts and seeds), wholegrain cereals, reduced-fat dairy foods and lean meats, fish (particularly those rich in omega-3 fats) and poultry, as well as small amounts of polyunsaturated or monounsaturated fats and oils.
Who needs supplements?
Being physically active allows more flexibility of food choice and this is a key component in maintaining a healthy lifestyle. Although vitamin and mineral supplements are not considered necessary in healthy people who are eating a well balanced, varied diet, they may help some people.
People who may benefit from supplements include:
- strict vegetarians who consume no animal foods (may need supplements of vitamin B12, omega-3 fatty acids, iron and zinc)
- elderly people or veiled women with reduced sunlight exposure (may require vitamin D)
- pregnant and breastfeeding women (folic acid required during early pregnancy, iron and calcium supplementation may also be needed)
- older adults with poor nutritional intake, such as people with dementia or living alone, may benefit from protein-rich supplement drinks or meal replacement powders
- women undergoing menopause, for symptom relief
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- if you are pregnant or breastfeeding
- if you are elderly
- if you are taking other medications or have a chronic (ongoing) illness
- to ask for advice on interactions, which can occur with other nutrients, supplements or medicines; in some cases these may be helpful interactions (e.g. vitamin C helps with iron absorption) but in other cases they may stop medicines working properly or cause side effects
- Get the best nutrition from your food by eating a variety of food from each of the following four major food groups every day:
- vegetables and fruits: at least 2 servings of fruit and 5 servings of vegetables (one serving is half a cup of cooked vegetables or one medium apple)
- breads and cereal foods (including rice, oats, corn and barley): at least 6 servings (one serving is one roll or one slice of bread or one cup of cooked rice)
- milk and dairy products: at least 2 servings (one serving is 1 cup of milk or 40 g cheese), especially low-fat varieties (avoid low-fat options for young children)
- lean meats, poultry, fish, eggs, nuts or pulses: 1 serving (e.g. 2 slices of cooked meat or 1 fillet of fish (100 g)
- prepare meals with a minimum of added fat (especially saturated fat) and salt
- choose pre-prepared foods, drinks and snacks that are low in fat (especially saturated fat), salt and sugar
- help to maintain a healthy bodyweight by regular physical activity and eating sensibly
- drink plenty of liquids each day
- if drinking alcohol, do so in moderation
e.g. CAL-600 Tablets, Calci-Tab 600, Cal-Sup, Caltrate range, Citracal
follow recommended guidelines for calcium intake according to age, gender, or if pregnant or breastfeeding
too much calcium may cause kidney stones or affect the heart
Omega-3 and omega-6 fatty acid supplements
e.g. Eye Q range, Blackmores Omega range, Nature’s Own Fish Oil range
omega-3 and omega-6 fatty acids are essential for optimum growth and development, including brain development
Folic acid supplements
e.g. folic acid (Blackmores Folate)
e.g. folic acid with iron (FGF, Fefol, Ferro-F-tab)
taking higher doses of folic acid than recommended are not known to have any adverse effects on healthy individuals
e.g. ferrous sulfate (Ferro-Gradumet, Ferro-Liquid)
e.g. ferrous sulfate with vitamin C (Ferrograd C )
iron is dangerous in overdose and tablets must be taken as directed for the recommended course, as advised by a doctor
keep all iron products out of reach of children
e.g. gluten-free wheat dextrin (Benefiber), inulin fiber (Metamucil range)
- these products provide a source of dietary fibre
- they dissolve completely in liquids and soft foods, and can be used in baking
e.g. supplemental feeds (Sustagen range)
- nutritionally complete and balanced, containing all the essential vitamins and minerals needed for good health
- different types of products are available, e.g. for when dietary intake is inadequate, and sports drinks
- some are available as powders which can be added to milk or water for a hot or cold drink, while others are ready to drink
e.g. natural isoflavones (Promensil range)
- may help with menopausal symptoms such as hot flushes and night sweats
See www.nrv.gov.au for Nutrient Reference Values for Australia and New Zealand. This site lists recommended intakes of essential nutrients, such as vitamins and minerals.
Availablity of medicines
- GENERAL SALE available through pharmacies and possibly other retail outlets.
- PHARMACY ONLY available for sale through pharmacies only.
- PHARMACIST ONLY may only be sold by a pharmacist.
Last Reviewed: 02/06/2016
Your Doctor. Dr Michael Jones, Medical Editor.