Brandon Barrett's List: Manufacturing practices

• Healthy foods, such as whole grains, fruits and vegetables, are the best sources  of vitamins and minerals. But because it is sometimes hard to get all the  nutrients we need from foods, all adults should take one multivitamin per day.  
  

  • Purpose/ view
• It is especially important for women who can become pregnant to get enough folic acid. Folic acid, a B vitamin, helps prevent  birth defects of the brain and spinal cord when taken before and very early in  pregnancy.

  • Effects
• During pregnancy, a woman needs more of some nutrients, such as iron, calcium  and folic acid. For this reason, it is wise to start taking a multivitamin  before pregnancy.
  
• Read the label. The label tells you which vitamins and minerals  the multivitamin contains. It also tells you how to take the multivitamin safely  and how to store it.
  

• Avoid high doses. Some vitamins and minerals are toxic in  high doses for women and their developing babies. Examples are iron, chromium,  selenium and vitamin A. To avoid high doses, choose a multivitamin that contains  no more than 100 percent of the DV for each vitamin and mineral. Before taking  anything other than 100% of the DV, check with your health care provider.

  • Effects

• Look for USP on the label. This means that the multivitamin  meets the standards of U.S. Pharmacopeia (USP). USP is an organization that sets  standards for content, quality, purity and safety. 

   

  Know about name brands and store brands. As you shop,  remember that name brands may be no better than store brands. In fact, the same  manufacturer may make both of them. Store brands often cost less than name  brands. The most important thing is to check the label to be sure you are  getting the vitamins and minerals you need. Although health care providers often  write prescriptions for prenatal vitamins, you can get some brands of these  vitamins at the drugstore without a prescription.

   

  Know about natural and synthetic vitamins. In multivitamins,  natural and synthetic vitamins have the same health benefit. Natural vitamins  cost more than synthetic vitamins.

   

  Avoid extras. Avoid multivitamins that contain herbs,  enzymes or amino acids. You don't need them and they add cost. Herbal remedies  can be toxic. Never take them if you are trying to get pregnant, are pregnant or  are breastfeeding. Many vitamin products contain extra ingredients such as herbs  that are not considered essential under federal guidelines. Medical scientists  do not know if these extra ingredients are safe and effective, especially during  pregnancy.

  • sales/advertising

4 more annotations...

• Consumer Reports warns about buying ultra-cheap vitamins from closeout and  dollar stores. In testing, half the tested vitamins did not contain the claimed  amount of at least one nutrient, and several didn't dissolve enough for the  nutrients to even be absorbed by the body. However, store brands from well-known  retailers like Wal-Mart, Walgreens, Kroger and Eckerd aren't included in this  group. In fact, many generic and store-brand vitamins from major retailers  perform just as well as well-known brands like Centrum and One-A-Day in analysis  by Nutrition Action Healthletter.
• In January 2007, ConsumerLab.com reported lead contamination in The Vitamin  Shoppe's Multivitamins Especially for Women. The Vitamin Shoppe quickly stopped  selling the product and has agreed to settle a class-action suit.
• In another case, ConsumerLab.com found a children's vitamin, Hero Nutritionals  Yummi Bears, contained 5400 IU of vitamin A in the form of retinol per daily  dose. According to the Institute of Medicine, the safe upper limit is just 3000  IU for four-to-eight-year-olds and 2000 IU for kids between one and three (they  only need around 1000 IU a day).
• Several multivitamins have been recalled because they did not have  child-resistant packaging despite containing iron, which can cause serious  injury or death if ingested by children

• Experts warn that liquid and chewable vitamins are often lacking compared to  their pill-form counterparts, so don't assume that different forms of the same  multivitamin are equal without comparing the labels. It's also best to avoid  vitamins that contain herbs or that make extra claims on the label for weight  loss, energy, stress or "maximum" benefit. Such claims haven't been proven in  testing.

• Consumers are lambasted by advertising for vitamins that help you lose  weight, vitamins that lower cholesterol and vitamins that give you energy.  However, none of that advertising answers the essential question: Do you really  need a multivitamin? Health experts agree that certain groups of people can  clearly benefit from a multivitamin. These include pregnant or breastfeeding  women, or women who are trying to conceive. Multivitamins are also recommended  for people with nutrient-depleting diseases of the gastrointestinal system,  diabetes or cancer. Those who are strict vegetarians and people on restricted  diets should also consider a multivitamin to replace nutrients they may not be  receiving through diet alone.
• However, for most other people, getting vitamins and minerals from food is best  because interactions between foods may offer benefits that can't be matched by  supplements. The reality, however, is that many of us don't eat healthy enough  diets to get all of our DV of vitamins and minerals. In 2002, the Journal of the  American Medical Association recommended that all adults supplement their diets  with a multivitamin, but a review by a federal panel in May 2006 concluded that  there's no evidence to recommend for or against multivitamins for people who  don't fall into one of the risk groups mentioned above.

5 more annotations...

• First, ConsumerLab.com, a watchdog of the supplement industry, found that  more than half of the 21 multis it tested had too much (or too little) of  certain vitamins -- or had been contaminated with dangerous substances such as  lead. Then a controversial paper from researchers in Denmark and other European  countries, published in the Journal of the American Medical Association, made  the claim that taking vitamins may actually shorten your life.
• mins have been recommended for years because they help you get key nutrients if  your diet's low on fruits and veggies -- and may even help prevent cancer and  heart disease. And it's unlikely that one critical paper (speculating that  vitamin supplements might upset your body's natural healing process and boost  your risk of death) will change that.

• Longtime vitamin experts at Tufts University and the Linus Pauling Institute  at Oregon State University continue to say multis aren't dangerous and the  paper's findings are wrong. The paper analyzed previous studies, including many  with people who were sick before taking vitamins, so there's a good chance  vitamins weren't responsible for shortening their lives. Experts say the paper  also ignored two major studies that found vitamins reduced the risk of  death.
• At the same time, the study from ConsumerLab.com shows that you can't assume  just any vitamin is safe. Because there are no uniform manufacturing rules for  supplements, a multi may not contain what the bottle claims, could be  contaminated with something from the manufacturing plant, or might have tainted  ingredients.
• Avoid the vitamins singled out by ConsumerLab.com, and stick with mainstream  names such as Centrum Silver and One-A-Day Women's, which were found to be free  of impurities and accurately labeled. Also, check vitamin bottles for the United  States Pharmacopoeia (USP), NSF International (NSF), or ConsumerLab.com (CL)  seals. The USP and NSF are nonprofit groups that verify whether companies offer  contamination-free products and use good manufacturing practices. Not every  brand has the seals -- some don't want to submit to testing--but those that do  (Kirkland and Nature Made carry the USP seal, for instance) are reliable.
• Price isn't a sign of quality.

• In your childbearing years, make sure your multi has 400 micrograms (mcg) of  folic acid, which helps make and maintain new cells. And pregnant women should  take a vitamin with 600 mcg of folic acid daily; this nutrient also reduces the  incidence of neural tube birth defects such as spina bifida.
• A premenopausal woman should look for a multivitamin with iron to replace the  iron lost during menstruation. Menopausal women should go without the iron. "Too  much iron may raise the risk of heart disease," says Meir Stampfer, Ph.D.,  professor of nutrition and epidemiology at Harvard School of Public Health.
• If you're taking a prescription, check with your doctor about risky  interactions. (Vitamin E, for instance, may be a problem if you're taking a  blood thinner.) If you're a cancer patient, you should ask your doctor about  risks before taking vitamins. "Cancer cells need vitamins to grow, too,"  Stampfer says. Plus, some vitamins can interfere with chemotherapy.

7 more annotations...