Sometimes we get email from our coaching clients that could help the rest of you out. So, with their permission, they get put on the blog for all to enjoy. This one happens to be about how a multivitamin fits into a paleo-style, SPEED enhanced, fat loss plan.

Chris writes:

On a different note, I wanted to ask you guys if you had read any of the stuff from  ( Very intriguing stuff.  In the series on hunger, satiety, satiation, etc. in particular he mentioned this study he sites…  and also in part IV of his series on Why are we hungry, he talks about this inability of obese and formerly obese to garner nutrition from their energy stores.

All in all it looks like a very well researched set of articles, and it makes me wonder if I should be taking some sort of a multi-vitamin/mineral supplement.  Then if so, how the heck do you know which one?  I do take 2,000iu daily of D3, most days, as I have been tested and show low stores of that, and it was prescribed in 10,000iu a week dosage.  But beyond that I am hesitant to start playing with supplements in general because of the importance of the interplay of nutrients, and the general lack of understanding (mine and the science community’s) about the details of nutrients, and the possibility that if they really do what they say could I make matters worse.  I have IBD, in remission right now, don’t wanna rock the boat!

I write back:

J. Stanton’s series on hunger is something I’ll admit I’ve only skimmed, mostly because its conclusions don’t seem to disagree with our recommendations: Eat a whole food, low carb/medium protein/high fat diet, take a multi-vitamin and all the mental trickery found in our Psych and Environment chapters to help control over-eating.

The multivitamin study referenced in the series is interesting, with supplement users losing an average of about 8 lbs over 26 weeks with no dietary modification. (Li 2010) However, in a study when multivitamin use is paired with dietary restriction, no additional weight loss effect is seen. (Major 2008) This means that the vitamin alone in Li did seem to have some effect on weight loss, but good ol’ dietary restriction unsurprisingly trumps this effect. Why did the vitamin in the Li study show a positive effect? The researchers state “possibly through increased energy expenditure and fat oxidation.” With the astounding dietary control (food frequency questionnaire) – yes, that’s sarcasm – we can’t really say. Maybe the vitamin caused the subjects to eat less. Yes, their RQ dropped significantly (P < .01 – yawn), but that also would happen with calorie restriction. I’m not willing to draw any firm conclusions about why the multivitamin caused a slow decrease in body weight in the Li study.

As to whether or not you should take a multivitamin, that’s entirely your choice, of course.  Many consider a multivitamin like nutritional insurance. The evidence for multivitamin use having a positive effect on our health is slim, which I don’t find surprising. Having more of a good thing you already have enough of might not be beneficial, know what I mean? The evidence for multivitamin use causing adverse effects is equally slim, so no harm no foul there. The fact that supplementation with certain antioxidants (vitamin A, beta carotene, vitamin E) may increase mortality leads me to think supplementing with a variety of vitamins and minerals may be more beneficial than going bananas with just a few. (Bjelakovic 2008)

Of course, there is always the possibility that you are deficient in a certain vitamin, at which point you might garner a benefit from supplementation with that vitamin alone or from a multi which includes that specific vitamin. This might be one reason vitamin trials show no benefit; they give a generic multi to a large population and nothing happens on average. What if you’re the one person who was deficient in something important and the multi was sufficient to bring you up to acceptable levels? You don’t care about the average at that point. Of course, you’d never know anyway because you can’t know that you would have suffered. There is no placebo you.

Two things popped into my head as I was mulling this over: First, I’m not sure what we all expect to find one day while studying large populations with vitamin use. “Hey, we gave these people a vitamin and nobody ever died! We’re all living forever!!!” Second, some of the vitamin trials base their outcomes on how people feel or function. That’s great, but doesn’t point to whether the multi is causing cancer to grow more rapidly at the same time. Heroine makes you feel pretty good, right? Third, because I can’t count, if you spend $20/month on a multivitamin, you’ll spend $7,200 over 20 years. Is that worth it? Does the “nutritional insurance” a multi may provide justify its cost? Since you’re already spending money on food, could you just make your best effort to get a wide array of vitamins and minerals through diet? Will I just keep asking questions? Is this starting to remind of you a commercial lead-in on Batman? BAM! KAPOW! SPLOOSH!



Bjelakovic G, Nikolova D, Gluud LL, Simonetti RG, Gluud C. Antioxidant supplements for prevention of mortality in healthy participants and patients with various diseases (Review). Cochrane Collaboration. 2008; Issue 3

Li Y, Wang C, Zhu K, Feng RN, Sun CH. Effects of multivitamin and mineral supplementation on adiposity, energy expenditure and lipid profiles in obese Chinese women. Int J Obes. 2010;34:1070–1077

Major GC, Doucet E, Jacqmain M, St-Onge M, Bouchard C, Tremblay A. Multivitamin and dietary supplements, body weight and appetite: results from a cross-sectional and a randomized double-blind placebo-controlled study. Br J Nutr 2008; 99: 1157–1167.

Out of My Inbox: Vitamins
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