Types of multivitamins

Manufacturers are becoming increasingly creative when it comes to multivitamins, and consumers are no longer confined to the traditional pill or chewable tablet. Companies are producing multivitamin drink mixes, juices and chews to attract new customers, but do these alternative multivitamins really work?

The advocacy group Center for Science in the Public Interest (CSPI) is skeptical, especially when it comes to multivitamin-fortified waters; it says vitamin-enhanced waters are "essentially worthless" and a poor replacement for a regular multivitamin. One Vitamin Water flavor, Multi-V Lemonade A-Zinc, fails ConsumerLab.com's latest test because it contains 1,500 percent of the folic acid claimed on the label. In February 2011, the National Consumer League filed a complaint with the Federal Trade Commission alleging that Coca-Cola, the manufacturer of Vitamin Water, is engaging in deceptive advertising. In particular, the group points to an ad that shows a picture of Vitamin Water with the text "flu shots are so last year," implying that the vitamin-enhanced drink can help prevent the flu. "These advertising claims are not only untrue; they constitute a public health menace," says Sally Greenberg, the group's executive director.

Just as with regular multivitamin tablets, experts say that getting your vitamins and minerals from whole foods is a better idea than relying on multivitamin-fortified juices or waters. That's because researchers are still not entirely sure how synthetic supplements interact in the body. For example, large doses of folic acid (the synthetic form of folate) have been linked to an increased risk of prostate and colon cancer. However, those who get a lot of folate from food sources don't have the same risk. As a result, some manufacturers are focusing on food-based ingredients rather than their synthetic counterparts. New Chapter Organics, Garden of Life and Nature's Way are just a few companies that have multivitamin lines with food-based ingredients.

Liquid and gummy multivitamins for adults generally get good reviews from users who have trouble swallowing pills, but we don't see many of these vitamins included in the latest round of testing. We found no evidence to suggest that liquid multivitamins are more effective than pill-based supplements, and ConsumerReports.org states that studies have shown no difference in absorption rates of liquid and pill multivitamins.

Reviewers say the following about shopping for multivitamins:

  • Multivitamins can interfere with prescription medications. Consult your physician before starting a new multivitamin.
  • Formulas for heart health, energy, weight loss or maximum benefit aren't tested for those claims. The extra ingredients included to support these claims are usually in such small amounts that they don't have much of an effect. This includes claims for lutein and lycopene.
  • Store-brand vitamins work just as well as the pricier name brands. In testing, store brands perform on par with their pricier counterparts. Multivitamins from brands like Wal-Mart's Equate, Costco's Kirkland Signature and Target's Up&Up contain the nutrients listed on the label and dissolve properly.
  • Choose a multivitamin that contains 100 percent of the daily value of most of the essential vitamins and minerals. Don't take a multivitamin with excessively high levels of essential vitamins and minerals; at best, you'll just expel the excess through urine, and at worst, you could have health complications.
  • Look for a maximum of 5,000 international units (IU) of vitamin A. Vitamin A comes in two forms: retinol (palmitate or acetate) from animal and dairy sources, and beta-carotene from fruits and vegetables (like carrots). Beta-carotene is converted to usable vitamin A in the body and is considered the safest form of this vitamin. High levels of retinol are linked to liver damage, birth defects and bone fractures. Some experts recommend that at least half of the vitamin A in your multivitamin be in the safer form of beta-carotene.
  • New guidelines have been released for vitamin D and calcium. The updated DRIs were released in late 2010, so the multivitamins currently on store shelves may not reflect the new guidelines. See the Useful Links section for more information.
  • All women of childbearing age should take 400 micrograms (mcg) of folic acid (folate) to prevent neural tube birth defects. The neural tube develops before most women know they're pregnant, and experts advise all women of childbearing age to take folic acid. Once pregnant, women should bump up their intake to 600 mcg per day.
  • Don't assume that all forms of a multivitamin have the same ingredients. Chewable, gummy and liquid multivitamins may not contain the same amount of nutrients that their pill-form counterparts do. Compare labels before you buy. 
  • Always buy a children's formula for children. Children have different nutritional needs than adults. Never give a child a multivitamin designed for adults.
  • Look for an expiration date. Expiration dates are voluntary, but nearly all supplement manufacturers list them on the packaging. In recent months, the Council for Responsible Nutrition released new guidelines for determining expiration dates for multivitamins and supplements. The FDA has said it will be looking for stability test data to back up expiration date claims, which should give these dates a little more credibility.
  • Some companies tout pharmaceutical-grade supplements. These supplements are made in strictly controlled facilities that follow Good Manufacturing Practices (GMP) and claim to have ultra-purified ingredients that are of a higher quality. However, we saw no evidence that pharmaceutical-grade supplements work any better than regular multivitamins.
  • Shop carefully if you are a vegetarian/vegan. Many store-brand and mainstream brands include fish oils or gelatin that's derived from pork or beef. Look specifically for brands labeled as suitable for vegans or vegetarians; if a brand isn't clearly marked, it's safe to assume that it's not suitable for strict vegetarian or vegan diets.

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