Vitamin and Supplement Recommendations Based on Lifestyle
For most healthy adults without specific medical conditions, a balanced diet should be the primary source of nutrients rather than routine supplementation with vitamins or minerals. 1
General Recommendations for Healthy Adults
- The U.S. Preventive Services Task Force (USPSTF) does not recommend routine supplementation for prevention of cardiovascular disease or cancer in healthy adults 2
- Avoid beta-carotene supplements, particularly if you smoke, as they may increase lung cancer risk 1, 2
- Avoid vitamin E supplements for disease prevention as they show no clear benefit 2
When Supplements May Be Beneficial
Certain populations may benefit from specific supplements:
Women of Reproductive Age
- Folic acid: 400-800 μg daily if planning pregnancy or capable of becoming pregnant to prevent neural tube defects 1
Older Adults
- Vitamin D: Recommended for older persons at risk of falling 1
- Calcium: 1,000-1,500 mg daily, especially for older adults, to reduce osteoporosis risk 1
- Take in divided doses (no more than 600 mg at once)
- Calcium citrate may be preferred for those at risk of kidney stones 1
People with Specific Nutritional Gaps
- A multivitamin may help fill small but critical nutritional gaps when dietary intake is inadequate 3
- However, supplements should not replace healthy dietary habits 4
Approach to Determining Need for Supplementation
Assess your diet first:
- Evaluate if you consume adequate fruits, vegetables, whole grains, lean proteins, and dairy/alternatives
- The 2010 Dietary Guidelines for Americans suggest nutrients should come primarily from foods 1
Consider your specific risk factors:
- Age (older adults may need vitamin D and calcium)
- Gender (menstruating women may need iron)
- Dietary restrictions (vegetarians/vegans may need B12, iron, zinc)
- Medical conditions that affect nutrient absorption
Consult with healthcare provider before taking:
- High-dose single nutrient supplements
- Multiple supplements that may interact
- Supplements if you have chronic medical conditions
Cautions and Considerations
- Potential for harm: Fat-soluble vitamins (A, D, E, K) can accumulate to toxic levels 1
- Quality concerns: Supplement content and concentration vary considerably between products 1
- Cost impact: While individual supplements aren't expensive, cumulative spending on supplements in the US was $28.1 billion in 2010 1
- Medication interactions: Some supplements interact with medications (e.g., vitamin K with blood thinners)
Special Circumstances
Post-Bariatric Surgery
If you've had bariatric surgery, specific supplementation is required 1:
- Multivitamin-mineral (two daily for most procedures)
- Calcium citrate (600-1500 mg daily)
- Vitamin D (3000 IU daily)
- Vitamin B12 (250-350 μg daily or 1000 μg weekly sublingual)
- Additional nutrients based on the specific procedure
Diabetes Management
For people with diabetes, evidence doesn't support routine supplementation with minerals like chromium, though addressing deficiencies when present is appropriate 1.
Bottom Line
Focus on obtaining nutrients through a balanced diet rich in fruits, vegetables, whole grains, and lean proteins. Consider targeted supplementation only when specific needs exist due to age, gender, health conditions, or documented deficiencies. Always discuss supplement use with your healthcare provider, especially when taking medications or managing chronic conditions.