Everyone should take a multiple vitamin-mineral (MVM) supplement. One double-blind study of healthy volunteers published in Psychopharmacology2000;150;220-5, found that an MVM supplement significantly reduced anxiety and perceived stress levels, and possibly improved energy and the ability to concentrate. 

Preliminary and double-blind trials have shown that women who use an MVM containing folic acid, beginning three months before becoming pregnant and continuing through the first three months of pregnancy, have a significantly lower risk of having babies with neural tube defects (e.g., spina bifida) and other congenital defects. 

In another double-blind trial, schoolchildren received a daily low-potency vitamin-mineral tablet containing only 50% of the USRDA for most essential vitamins and minerals for three months.  Dramatic gains in certain measures of IQ were observed in about 20% of the supplemented children.  These gains may have been due to the correction of specific nutrient deficiencies (for example, iron ) found in these children.

The primary purpose of an MVM supplement is to provide a convenient way to get a good variety of nutrients from a single product.  They are not meant to replace a healthy diet.  They only serve to enhance the nutritional quality of your diet. 

Micronutrients that should be included in a complete MVM are vitamin A (or beta-carotene), vitamin B-complex (thiamine, riboflavin, niacin and/or niacinamide, vitamin B6, folic acid (folate), vitamin B12, pantothenic acid, and biotoxin), vitamin C, vitamin D, and vitamin E (as d-alpha-tocopherol or mixed tocopherols), and the minerals calcium, magnesium, zinc, iodine, selenium, copper, manganese, chromium, and molybdenum.

Phosphorus is another essential dietary mineral but is so abundant in the diet that it does not need to be included in an MVM formula.  The only exception is for elderly people, whose diets tend to be lower in phosphorous or have impaired digestion.  Calcium interferes with phosphorus' absorption, so older people who are taking a calcium supplement might benefit from taking additional phosphorus. 

Both potassium and iron are efficiently recycled by the body.  If potassium is included in an MVM, it usually has only trivial amounts. Most people get enough potassium from their diets if they include at least two servings per day of broccoli, bananas, sweet potatoes or avocados.  MVMs may contain iron, but these should be taken only by people who have been diagnosed as having, or being at high risk of iron deficiency, or who have a history of frequent iron deficiency.

Some nutrients may be beneficial at levels above what is possible to obtain from diet and an MVM alone. Nutrients that may be useful to most people in larger amounts include vitamin C, folic acid, and B-12 (never take folic acid without B-12), magnesium, vitamin D, vitamin E, and calcium.

What about "one-per-day" multiples?

One-per-day MVMs usually do not provide sufficient amounts of many nutrients such as vitamin E, calcium, magnesium, and vitamin C.  One-per-day MVMs should therefore not be viewed as a way to  "cover all bases" in the way that high-potency MVMs, requiring three or more pills per day, are viewed. 

Because one-per-day formulas typically do not contain even the minimum recommended amounts of some of the way the nutrients listed here, multiples requiring several capsules or tablets per day are preferable.  With two- to six-per day multiples, intake should be spread out at two or three meals each day, instead of taking them all at one sitting.  The amount of vitamins and minerals can be easily increased or decreased by taking more or fewer of the multiple. 

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