Under what circumstances might vitamin–mineral supplements be appropriate?

Question

What will be an ideal response?

Answer 1

To Correct Overt Deficiencies
In the United States, adults rarely suffer nutrient deficiency diseases such as scurvy, pellagra, and beriberi, but nutrient deficiencies do still occur. To correct an overt deficiency disease, a physician may prescribe therapeutic doses two to ten times the RDA (or AI) of a nutrient. At such high doses, the supplement is having a pharmacological effect and acting as a drug.

To Support Increased Nutrient Needs

Nutrient needs increase during certain stages of life, making it difficult to meet some of those needs without supplementation. For example, women who lose a lot of blood and therefore a lot of iron during menstruation each month may need an iron supplement. Women of childbearing age need folate supplements to reduce the risks of neural tube defects. Similarly, pregnant women and women who are breastfeeding their infants have exceptionally high nutrient needs and so usually need special supplements. Newborns routinely receive a single dose of vitamin K at birth to prevent abnormal bleeding. Infants may need other supplements as well, depending on whether they are breastfed or receiving formula, and on whether the water they drink contains fluoride.

To Improve Nutrition Status

In contrast to the classical deficiencies, which present a multitude of symptoms and are relatively easy to recognize, subclinical deficiencies are subtle and easy to overlook—and they are also more likely to occur. Without fortification or supplementation, many adults in the United States fall short of recommended intakes for several vitamins and minerals. People who do not eat enough food to deliver the needed amounts of nutrients, such as habitual dieters and the elderly, risk developing subclinical deficiencies. Similarly, vegetarians who restrict their use of entire food groups without appropriate substitutions may fail to fully meet their nutrient needs. If there is no way for these people to eat enough nutritious foods to meet their needs, then vitamin–mineral supplements may be appropriate to help prevent nutrient deficiencies.

To Improve the Body’s Defenses

Health-care professionals may provide special supplementation to people being treated for addictions to alcohol or other drugs and to people with prolonged illnesses, extensive injuries, or other severe stresses such as surgery. Illnesses that interfere with appetite, eating, or nutrient absorption impair nutrition status. For example, the stomach condition atrophic gastritis often creates a vitamin B12 deficiency. In addition, nutrient needs are often heightened by diseases or medications. In all these cases, supplements are appropriate.

To Reduce Disease Risks

Few people consume the optimal amounts of all the vitamins and minerals by diet alone. Inadequate intakes have been linked to chronic diseases such as heart disease, some cancers, and osteoporosis. For this reason, some physicians recommend that all adults take vitamin–mineral supplements. Such regular supplementation would provide an optimum intake to enhance metabolic harmony and prevent disease at relatively little cost. Others recognize the lack of conclusive evidence and the potential harm of supplementation and advise against such a recommendation. A statement from the National Institutes of Health acknowledges that evidence is insufficient to recommend either for or against the use of supplements to prevent chronic diseases.