Health
Cost benefit
In Singapore, one orange can cost around S$1 per fruit. In comparison, one pill of multivitamins cost less than a fruit and the vitamin C provided is in excess of the one in one fruit! For example, Centrum's Silver multivitamins is S$0.56 per pill (see below). In comparison, Walmart's orange is also around US$1 per fruit.
However, I agree that fruits are natural and the best option for healthy diet. That is why, supplements should always be such, i.e., "Supplements". For me, I will take my supplement every 2-3 days, and whenever I think that my meals were not well balanced.
Why health supplement?
Vitamins are vulnerable to food processing and storage conditions
If we eat our food fresh, there is no concern about vitamins' stability (and loss) during its processing or storage.
However, if we cook our food, vitamins such as fat-soluble A, D, and E, and water-soluble C, B1,and B5 are more vulnerable to heat and they are inactivated (or lost) during the processing (ref. 3).
In addition, if we store our food over time, some vitamins are lost due to the enduring physical and chemical conditions, e.g., light, oxidant, reductant, humidity (water), acid and alkali. Example of photo-sensitive vitamins are A, D, E, K, and B2, B6, B12, and B9 (ref. 3).
Unhealthy style of cooking depletes vitamins
For many of us who prefer deep-fried, pan-fried, or broth (i.e., soup), we may deplete some essential vitamins from the cooked food.
If we are picky eater and avoid greens and fruits, we may not be getting enough vitamins to support our optimal health.
Health supplements
- Vitamins
Vitamins are micronutrients that are predominantly acquired through our diet, not synthesized in any amount that is sufficient for us to function properly. We get our daily Recommended Dietary Allowance (RDA) of vitamins from our balanced diet. It is important to have a balanced diet comprising a quarter plate of wholegrain, a quarter plate of protein, and a half plate of fruits and vegetables as recommended by Singapore Health Promotion Board or HPB (ref. 1). Unfortunately, it is challenging to have a balanced diet (and in a healthy variety over time), especially when we eat out more often than having a proper home-cooked meal..
If we know that our diet is less balanced than it can be, we need to supplement our vitamin intake by taking vitamin supplements.
We need to ask ourselves (based on our daily diet), "is there a need for supplement?". If yes, what is the added benefit (or cost of ignoring it)?
- Essential vitamins
There are 5 main groups of essential vitamins
Fat-soluble vitamins A,D,E,K
Water-soluble vitamins B, C
Vitamins B are more diverse, with 8 family members, e.g., thiamin (B1), riboflavin (B2), niacin (B3), pantothenic acid (B5), pyridoxine (B6), biotin (B7), folate (B9), and cyanocobalamin (B12).
Vitamins function as coenzymes, i.e., they help enzymes to increase the rate of chemical reactions that are important for all aspect of our beings, e.g., brain function, digestion, energy, immune system, complexion, body healing, and many more.
- We can target the right vitamins for our health
Immune function
Cognitive function
Body healing
Acne
Fortified processed food
A good example of fortified food would be our milk powder (or powdered milk). Others include drinks, e.g., fruit juice, soy milk (fortified with High Calcium and fatty acids like Omega-3),
Powdered milk
Baby (0-12 months). It is important to give babies mother's milk as recommended by many health professionals and WHO (World Health Organisation). Unfortunately, it may be challenging for some working mothers (especially those who travels often) to express enough milk for their babies. In other cases, such as our experience, we tried to give 100% mother's milk to our two children. Most of the time, we were successful, while other times we needed help in the form of formula milk, especially when mother developed nipple sore (due to inexperience), or when our baby developed high jaundice (caused by increased bilirubin production). The latter can be resolved if babies can excrete more bilirubin in their stool. Unfortunately, babies would need to consume more milk to produce enough stool (and often time mother's milk is 'insufficient' during the early stages). When our babies developed jaundice, we had to bring them to the hospital ward, and the first thing that the nurse would do was to feed our baby with formula milk (in addition to phototherapy). Some babies are more susceptible to jaundice than other, e.g., higher replacement rate of fetal blood cells with mature red blood cells. Others are due to fetal-maternal blood incompatibility that caused more breakdown in blood cells. The excessive breakdown of fetal hemoglobin would produce plenty of bilirubin that can be toxic if left unattended (ref. 8).
There are plenty of good powered milk (aka 'formula' milk), but we chose Enfagrow solely based on our baby's preference. Our firstborn was very picky and she would not take any milk. We had to search high and low until we got Enfagrow original flavour. We learned earlier that she refused Enfagrow that was vanilla flavoured, and we had to give away a tin of the milk to friend. Our second child was less picky and he was receptive of Enfagrow and we kind of stucked with that milk.
Glossary
Daily RDA
The daily RDA for vitamins and minerals are available here.
Health supplement
It describes product that supplement our daily diet to afford benefit beyond daily intake to support healthy function of body (ref. 2). This is assuming that we are take the recommended daily diet comprising healthy balance of carbohydrate, protein, and essential nutrients from vegetables and fruits (ref. 1).
Multivitamins (MVs)
Multivitamins are broad spectrum vitamins (in contrast to high potent or specialized vitamins) that are taken once a day (and contains all or most of the vitamins required daily). It is recommended for normal supplement, unless there is a special need to increase a single vitamin or mineral due to known deficiency issue.
Multivitamins and minerals (MVMs)
Similar to MVs, MVMs contains all the essential minerals required or recommended for daily intake. It is broad spectrum vitamins and minerals for normal supplement (in contrast to high potent and specialized ones).
Omega-3 fatty acids
There are few major ones, i.e., ALA (alpha-linolenic acid) from nuts/seeds, EPA (Eicosapentaenoic acid) and DHA (Docosahexaenoic acid) from certain cold-watered fish like salmon. These play important function in the eye, brain, heart and others (ref. 5). They are precursors for hormone production and other signaling molecules that helps with cellular communications (ref. 6). The fatty acid is essential to us because we can't produce them in our body. We have evolved to procure them through our diet. Good news is that we are exploring ways to mass produce the essential fatty acids via fermentation process using microbes (ref. 7).
Safe maximum levels (SMLs)
The term describes the upper limit of nutrients based on scientific risk assessment and population reference intakes (ref. 4)
Reference
My Healthy Plate (https://www.healthhub.sg/programmes/55/my-healthy-plate), accessed 2 Jan 2022
Regulatory overview of health supplements (https://www.hsa.gov.sg/health-supplements/overview), accessed 2 Jan 2022
Fortified basics (https://www.dsm.com/content/dam/dsm/nip/en_US/documents/stability.pdf), accessed 9 Jan 2022
Estimating safe maximum levels of vitamins and minerals in fortified foods and food supplements, 2017 (https://dx.doi.org/10.1007%2Fs00394-016-1288-8)
The Facts on Omega-3 Fatty Acids, 14 Jun 2021 (https://www.webmd.com/healthy-aging/omega-3-fatty-acids-fact-sheet)
Fatty Acid Molecules: A Role in Cell Signaling, 2010 (https://www.nature.com/scitable/topicpage/fatty-acid-molecules-a-role-in-cell-14231940/)
Production of Omega-3 Fatty Acids from the Microalga Crypthecodinium cohnii by Utilizing Both Pentose and Hexose Sugars from Agricultural Residues, 2021 (https://doi.org/10.3390/fermentation7040219)
Hyperbilirubinemia in the Term Newborn, 2002 (https://www.aafp.org/afp/2002/0215/p599.html)