Here’s Dr. McDougall on taking vitamins. He’s not a fan.

I’ve posted a lot about the risks of taking too many vitamins. Even the government warns against this. Here’s what they say about calcium:

Getting too much calcium can cause constipation. It might also interfere with the body’s ability to absorb iron and zinc. … In adults, too much calcium (from dietary supplements but not food) might increase the risk of kidney stones. Some studies show that people who consume high amounts of calcium might have increased risks of prostate cancer and heart disease.

Taking too much is clearly a problem. But what about taking a little bit? The RDA? I have been on the fence for years about vitamins. While I agree with Dr. McDougall here, his advice assumes being able to eat a healthful diet. Some people don’t. The ideal, of course, is to get our vitamins from food, but we do not live in an ideal world. These are some people I think would benefit from taking vitamin supplements:

• • Smokers – Necessitates higher consumption of at least vitamin C
  • Alcoholics – Necessitates higher consumption of at least the B vitamins
  • People who use drugs, either prescription or illicit – e.g. the common diabetes drug Metformin can lead to a vitamin B12 deficiency
  • Older adults – Polypharmacy, forgetfulness, difficulty getting food, cooking food, eating food
  • Mentally ill – Difficulty getting food, cooking food, eating food
  • People who are sick or disabled – Difficulty getting food, cooking food, eating food
  • Dieters – May not eat enough, may cut out nutritious food groups
  • People with eating disorders – May not eat enough, may cut out nutritious food groups
  • Fussy eaters – May not eat enough, may cut out nutritious food groups
  • People who lack transportation – Seniors who no longer drive, college students, difficulty getting food
  • People with low income – Access, in all permutations of the word

This mental exercise has shown me the futility of making a list like this. Just about everyone falls into a category that has them eating less-than-ideal. It’s probably more the rule that people don’t eat well than that they do.

Advocating taking supplements opens a Pandora’s box! What to take, how much. Contamination issues, safety issues. It’s so much easier to say we should get our vitamins from food.