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For most healthy adults who eat a reasonably balanced and varied Indian diet, a daily multivitamin is not routinely necessary. Vitamins and minerals are essential for several important functions in the body, but they are best obtained through a well-planned diet rather than automatically relying on supplements.
A Balanced Diet Can Provide Most Nutrients
A diverse Indian diet containing vegetables, fruits, pulses, whole grains or millets, nuts and seeds, dairy products, and adequate sources of protein can provide most of the nutrients required by the body.
Importantly, food provides much more than isolated vitamins and minerals. It also provides protein, fibre and several other beneficial compounds that a multivitamin cannot replace. A supplement may fill a specific nutritional gap, but it cannot compensate for an overall poor or unbalanced diet.
Who May Actually Need Supplements?
The need for supplementation depends largely on whether an individual has a nutritional deficiency or an increased nutritional requirement.
Certain groups are more likely to need supplements. These include pregnant women, older adults, people following restrictive diets, individuals with poor dietary intake, those with certain gastrointestinal disorders or malabsorption, and people taking medications that affect nutrient absorption or metabolism.
In the Indian population, nutrients such as vitamin B12, vitamin D, iron, folate and calcium may require particular attention depending on a person's diet and individual circumstances.
However, this does not mean that everyone should take a multivitamin containing all these nutrients. Supplementation should ideally be targeted according to dietary intake, risk factors and, where appropriate, blood tests.
More Vitamins Do Not Always Mean Better Health
It is important to distinguish between treating a deficiency and taking supplements for disease prevention.
Evidence from large clinical trials has generally not demonstrated a major overall benefit of routine multivitamin use in preventing cardiovascular disease or reducing mortality in healthy adults. Therefore, taking a multivitamin simply with the expectation that it will prevent heart disease, cancer or make someone significantly healthier is not supported by strong evidence.
More vitamins are also not necessarily better. Certain vitamins and minerals can cause harm when taken in excessive quantities. High-dose supplementation with some antioxidants has not produced the benefits that were initially expected, and some supplements have even been associated with adverse outcomes in specific groups.
There is also a risk of inadvertently taking excessive amounts when a person combines a multivitamin with several individual supplements.
When Supplementation Can Be Beneficial
That said, multivitamins and other supplements are not inherently bad, and there are situations where supplementation is clearly beneficial.
For example, folic acid during pregnancy is important for reducing the risk of neural tube defects. Similarly, a person with a documented vitamin B12, iron or vitamin D deficiency may require therapeutic doses that are considerably higher than what a standard multivitamin provides.
In such cases, supplementation has a clear purpose. The type, dose and duration should depend on the individual's nutritional status and medical needs rather than being decided simply by what is available over the counter.
Think of Supplements as Support, Not a Substitute
The message should not be that multivitamins are bad or that nobody needs them. Rather, they should have a purpose.
If someone has a specific deficiency, increased requirement or dietary limitation, supplementation can be extremely useful. But for a healthy person eating a varied diet, routinely taking a multivitamin is unlikely to provide substantial additional health benefits.
Ultimately, a multivitamin should be viewed as a supplement, not a substitute for a healthy diet. Improving dietary diversity, maintaining an appropriate body weight, exercising regularly, getting adequate sleep and managing existing medical conditions have a much greater impact on long-term health than simply adding a vitamin tablet to the daily routine.
For most healthy adults, the better approach is to focus on food first and supplements when there is a clear reason for them.
Eat a varied diet, identify nutritional gaps and supplement when necessary. A daily multivitamin may be useful for some people, but it should not automatically become part of everyone's routine simply because it is easily available.
In short: eat well first, identify nutritional gaps, and supplement when there is a reason, not simply because a multivitamin is available.
(By Dr. Aditya Phadte, Consultant Endocrinologist, Manipal Hospital, Goa)