No need to independently look for regimens: a biologist - about the right approach to taking vitamins and trace elements

- Vitamin deficiency can affect the development of diabetes, but uncontrolled intake of dietary supplements by patients can harm the body. Before taking vitamins in tablets, it is important to analyze the diet. Scientists from India came to such conclusions, their review article on the relationship between vitamins and diabetes is published in the scientific journal Cureus. How often does taking vitamins lead to their overdose?

Much depends on the composition of dietary supplements to food, as well as on the initial nutritional status of a person: if he initially had a deficiency of certain nutrients, then increased dosages of vitamins and minerals may indeed be required. And if a person already has a fairly balanced diet, and he also takes uncontrollably shocking amounts of vitamins, then there is a risk of overdose.

I note that there are dietary supplements that contain not very high, prophylactic dosages of vitamins, and there are drugs where the dosages can be ten times higher than the daily needs of a person - these are already therapeutic doses.

- Is a similar effect possible due to distortions in the diet?

- In the conditions of everyday life, this is unlikely. This sometimes happened only with polar explorers, when they ate the liver of polar bears or seals, because these products contain a high concentration of vitamin A. As for dietary supplements (BAA), an overdose is also unlikely if you adhere to the dosage regimens specified by the manufacturer.

In terms of overdose, the threat mainly comes from fat-soluble vitamins, which can accumulate in the body, unlike water-soluble ones. Fat-soluble vitamins include vitamins A, D, E and K.

Unfortunately, recently there has been a growing number of cases when doctors, not fully understanding the issue, prescribe to patients, for example, taking increased dosages of vitamin D to treat its deficiency. The patient drinks the vitamin for several months, but a laboratory study shows that the body's vitamin supply is below normal. Then the doctor simply prolongs or even increases the dosage of the vitamin instead of prescribing additional tests and finding out why the vitamin is not absorbed by the patient's body.

• Gettyimages.ru
• © Thomas Barwick

But the deficiency can be caused by a lack of some concomitant vitamins, minerals. For example, you can take vitamin D, but this will not help if you have a concomitant deficiency of vitamins of group B. As studies show, about a quarter of Russians have a polyhypovitaminous state (deficiency of several vitamins at once) against the background of a deficiency of mineral substances. Therefore, the treatment of deficiency should be approached systematically.

- There are two points of view on synthetic vitamins. The first is that they are not digestible and are generally useless. The second is that vitamin complexes should complement even a balanced diet. Which one is correct?

- Vitamins both in food and in supplements have the same chemical formula, they are identical. However, in food, vitamins are often in a bound state – for example, vitamins can be in conjunction with proteins, etc. In order for vitamins to be released from food and absorbed, it must undergo a number of biochemical transformations. In addition, the products may contain compounds that interfere with the absorption of vitamins. Thus, phytates complicate the absorption of divalent metals, in particular calcium. This means that if there are foods containing phytates (legumes, etc.) in the diet, you need to increase the consumption of foods containing calcium.

The problem is that basically the level of physical activity of a modern person is low. And if we make a diet taking into account all the needs of the body in trace elements and vitamins, it is possible that this amount of food will exceed our energy needs, which will lead to obesity. Therefore, you should not neglect supplements, especially since in Russia, and in a number of other countries, the deficiency of vitamins and trace elements is year-round. For example, about 70% of our population suffers from a lack of vitamin D. And this is due not only to the climate, because a deficiency of this vitamin is common even in southern countries. The fact is that the production of vitamin in the sun is limited when the skin is covered with tanning. Plus, obesity contributes to the deficiency, since with an excess of adipose tissue, fat-soluble vitamin D in the body is distributed unevenly.

Not to mention the fact that now in most countries people spend most of the day indoors – at work or at school. So to make up for the deficiency of vitamin D due to sunbathing is very difficult. It is necessary either to introduce more foods rich in them into the diet, or to take synthetic forms.

- Now the so-called vitamin droppers are gaining popularity. With intravenous administration, vitamins immediately enter the bloodstream. What can you say about this practice?

- Yes, now such droppers are really popular. But while there is no reliable scientific evidence that they are more effective than the usual, oral intake of vitamins. In addition, such droppers are sometimes offered to do not only in private clinics, but even in beauty salons. It is good if such a dropper is at least preceded by a consultation with a doctor, but this is not always the case. The composition of such droppers is usually universal, while each person may have his own characteristics (deficiency of certain vitamins, the presence of chronic diseases) - while a standard dropper may not help him, but even harm. Therefore, it is unsafe to independently prescribe such droppers to yourself, mandatory consultation of a specialist is required.

• Gettyimages.ru
• © Xavier Bonghi

— You told you that vitamin deficiencies in Russia do not have a pronounced seasonality. And is there a regional specificity – for example, what nutrients are most often lacking for residents of the Russian middle belt?

- Usually, Russians have a deficiency of three or more vitamins, they can vary depending on individual eating habits. It is clear that vitamin D is in the lead, but also very often there is a deficiency of trace elements: calcium, magnesium, iodine. Iodine deficiency is common in almost all Russian regions, including coastal areas. And the prevention of iodine deficiency should be given special attention. Fortunately, it is enough to use iodized salt for this. It strictly regulates the iodine content in accordance with the legislation - this is what distinguishes iodized salt from sea salt.

- There is an opinion that industrially grown vegetables and fruits have fewer nutrients than organic ones. Is this true? And how does heat treatment affect - are all vitamins stored after it in food?

As studies show, the nutrient content may differ even in apples grown on the north and south sides of the same apple tree. Yes, vegetables and fruits that are grown industrially usually have fewer vitamins and minerals than products grown on their own household plots. The difference is about 10-15% and is due to the fact that the industrial cultivation of vegetables and fruits usually involves the collection of unripened fruits so that they do not spoil during transportation to the supermarket shelf.

As for heat treatment, it must be remembered that vitamins are divided into thermostable and those that are destroyed under the influence of temperature. However, vitamins can be affected not only by heat treatment, but also by light, exposure to oxygen... Therefore, vegetables and fruits should be stored in a dark, cool place, then they will retain more vitamins. And vegetable and fruit salads are better to eat immediately after cutting - then oxidative processes will not have time to occur, which also destroy vitamins. As for heat treatment, it is better if it is short-lived. In addition, vegetable broth should also be eaten, since minerals are washed out of it during the cooking process.

- Does such a thing as "superfood" have the right to exist? Are there foods, especially nutrient-rich foods?

- The term "superfood" was coined by marketers, not nutritionists. Consumers want to believe that there is a magic product that will solve all health problems. But in fact, the so-called superfoods are ordinary products. Yes, they often have a high content of some nutrient, but a similar thing is found in ordinary, unpromised products. In our traditional diet, there are such products that can easily replace "superfoods". For example, avocado contains useful unsaturated fatty acids, but they are also found in nuts, fish, vegetable oils.

- Now more and more actively private laboratories and clinics offer customers to take tests for the level of vitamins. Does it make sense to check the level of nutrients in the blood without symptoms?

- Now people in general have a growing interest in a healthy lifestyle, many have become more thoughtful about their nutrition and well-being. Since the CHI, as a rule, does not cover tests for deficiency of all vitamins, people take them themselves. But, of course, it is better to do this not on your own, but by consulting a doctor who will first collect an anamnesis, and then prescribe tests for vitamins, the risk of deficiency of which is in a particular patient. But even if a person decides to take such tests himself, it is better to show the results to a doctor who can correctly interpret them. You do not need to independently look for regimens for taking a particular vitamin on the Internet, especially if we are talking about increased dosages - only a doctor can prescribe them.

• Gettyimages.ru
• © Thomas Barwick

- Another popular topic is the bioavailability of synthetic vitamins and trace elements. Manufacturers of many dietary supplements declare the increased bioavailability of their products. Is there really a noticeable difference in this parameter between different supplements? Or is it a marketing ploy?

- There are separate studies that show, for example, that the amino acid (chelated) form of minerals is better absorbed than the inorganic. However, it is too early to draw definitive conclusions. And most manufacturers of dietary supplements try to interpret such single studies in their favor, promise consumers that their product is better absorbed.

But in many cases, these claims have no clinical support. Therefore, you can simply buy vitamins in ordinary pharmacies or specialized departments of stores that check the supporting documentation for medicines and dietary supplements.

- The fashion for mono-diets has already gone, but the popularity of other eating patterns is growing - vegetarianism, veganism, intermittent fasting, keto diets, raw food diets. Can such diets cause an imbalance of vitamins and minerals?

Any diet, if it is not selected by a specialist, can disrupt the body's supply of vitamins and minerals. For example, if a person adheres to veganism, but does not take special supplements, then he will have a risk of serious deficiency of vitamin B12, vitamin D, calcium. This was shown by numerous studies that were conducted both in Russia and in other countries, including, for example, India.

The same goes for other diets or non-standard approaches to nutrition. If you exclude from the diet some categories of products, you need to think about how to compensate for the deficiency of nutrients that they contain. Or find a replacement in the form of other products, or take supplements. But even if you do not adhere to any diet, you still need to responsibly approach the formation of your diet. And if there are gaps in it, then restore them due to the additional intake of vitamins and trace elements.