Dear Food Speak: Is there a best time to take a multivitamin?

Pat

Fairfield

You should care more about why, not when, you're taking a multivitamin.

Multivitamins, the most commonly used dietary supplement, are part of a billion-dollar nutrition supplement industry. I can't help but wonder if that will change now that recent research has many experts questioning the worth -- and even the safety -- of taking a daily multivitamin.

One study a few years ago showed that a daily multivitamin failed to ward off cancer and heart disease. Another study last year showed a slightly higher death risk in postmenopausal women who took dietary supplements, including a daily multivitamin. Other studies have proven the harm of mega-dosing of vitamins and minerals.

Until more research provides definitive answers, talk to your doctor and dietitian about whether your current state of health warrants a multivitamin. Ideally, nutrients should come from food. Food packages nutrients in infinite combinations with unlimited variety. That synergistic balance in whole foods may very well be what prevents disease and promotes good health.

Some nutrient supplements may be helpful for certain individuals who are unlikely to meet their nutrient needs by diet alone. Examples include people on strict diets, vegetarians, pregnant women, people with chronic digestive disorders, and some older adults who don't eat properly.

A multivitamin may also be a good idea for people whose hectic lifestyles consistently prevent them from eating a healthy diet. If this describes you, realize that today's food supply is loaded with foods fortified with vitamins and minerals, meaning you may be ingesting more nutrients than you realize.

For instance, if you're taking a multivitamin with 400 micrograms of folic acid (that's 100 percent of the daily value) on top of eating a number of fortified foods like cereal and meal replacement bars, you could be exceeding the upper limit of what's safe (1000 micrograms daily) and that could cover up a vitamin B12 deficiency. If undetected, a vitamin B12 deficiency can eventually cause nerve damage and even paralysis.

If a multivitamin is right for you, take it with a meal to prevent stomach upset. If your stomach tends to be sensitive in the morning, try it with lunch or dinner. Make sure the meal contains a source of fat, since fat-soluble vitamins (vitamins A, D, E and K) require fat for proper absorption. Avoid excess caffeine and alcohol, both of which can interfere with the absorption of several vitamins and minerals.

If you're like many people who forget to take their multivitamin, take it always at the same meal to instill a true habit. Just remember to never let a multivitamin give you a false sense of security: a multivitamin and foods with added vitamins and minerals can be part of -- but never a substitute for -- a healthy diet.

Courtney Sansonetti is a medical nutrition therapist and certified diabetes educator for Rehabilitation Associates Inc. Her Food Speak column appears monthly. Email your questions to c.sansonetti@rehabassocinc.com.