00:10
Hey everyone, it's Mikki here. You're listening to Mini Mikkipedia on a Monday and this one will probably be brief. Well, I say that, but I could waffle on about it, but I'll try not to. There seems to be a whole lot of scaremongering in the social media, digital media, and print media space for taking nutrients, which is befuddling to me. And I don't know what is driving this campaign against supplements actually.

00:40
You know, there are different, I guess, schools of thought, and I would absolutely be guilty of thinking this as well early in my career as a nutritionist, after I had spent time studying my postgraduate work, et cetera, saying to people that you didn't need a supplement because you can get everything you need from food. Quite frankly, that is not correct. However, you still see people saying this out in the space, and these are people who are voices of authority, who...

01:08
quite frankly I think should know better. Having said that though, if they are research nutritionists who don't actually work with people and see what people eat outside of the scope of, for example, a population-based study where you get a food frequency questionnaire, then maybe they literally do not know what the real people actually eat. And

01:32
You know, this was a couple of years ago, but I recall that on the news when we used to watch Free to Air TV, there was a research nutritionist who was on the news saying that people didn't need to worry about supplements because they can get everything they need from a healthy diet. Look, I've written a few blogs about this actually, and I will put links in the show notes if you're interested in some sort of detail about why that's incorrect.

02:00
But it really did blow my mind at the time. And from that perspective, the research nutritionist perspective, I do wonder whether there's some sort of, I don't know, like agenda behind it or not agenda, that sounds a little bit too conspiracy theorist. But in order to admit that the food supply doesn't provide all of the nutrients we need, you then also have to suggest that

02:27
almost everyone needs to now spend money on a supplement. And I understand why that's not palatable at the population health level. So people can't even afford good food, as if they're gonna go out and buy some sort of broad-spectrum malby vitamin, which might actually be ideal for them. So it's almost like they live in this fairy tale of not really understanding what the food supply is like at that ground level, where...

02:53
People like myself and other nutritionists are working with people and seeing what people actually do eat. And the other thing that comes up when we think about multivitamins is you often hear that the people that take them are the worried well, quote unquote, the worried well. I just don't know how well these people are. Quite frankly, the people that I work with would absolutely fall under the category of worried well.

03:22
have to eat food which would fill the spectrum of nutrients, yet they still take supplements, which is typically the population they're talking about with the worried well. These people are worried, yes, but quite frankly, they're not well. There are so many reasons why people need to take supplements over and above what you would expect that I think it's just ignorance when you hear that we can get everything we need from food.

03:51
you do not need a supplement. I think at the political level, it's very well recognized that there is a large section of the population that live in poverty and cannot afford good food choices. And I mean, if they were to do anything, they could potentially subsidize a multivitamin for these people to help ensure that they meet some sort of nutrient recommendations.

04:17
But I mean, that brings with it probably a raft of issues as well for sure. But I mean, nothing that they're doing at that sort of policy level is changing the food supply in New Zealand anytime soon. And it isn't just those that are on the poverty line that require additional nutrient support. It is people across the spectrum of the socio-demographic sort of status. And there was a sent an article from a friend of mine actually about

04:46
multivitamins being overused during pregnancy, leading to potential harm. So this was the title. And then it was revealed in the actual study that they linked to in the article, and again I can pop this in the show notes, that showed indeed you had many women who were taking like supplements, which appeared to be taken over above the estimated average requirement and I'll come back to that in a minute. But they also had blood levels.

05:15
available for these nutrients so they could actually see to what extent taking supplements affected their nutrient status. And across the board, bar one marker, no one had levels that were even outside of normal range. So whilst you had many people that appeared to be taking vast quantities over and above some estimated average requirement, the nutrient status was by no means at toxic levels and in fact just came within the normal range.

05:46
And I found it interesting in the study actually that they used estimated average requirement as a cutoff where most of the nutrients they were looking at actually has a recommended dietary intake. And the difference here is really just a numerical one whereby an estimated average requirement is assessed and established, except it is deemed to meet the needs of 50% of the population. And so from there,

06:12
They in fact instead they set a recommended dietary intake that is two standard deviations above. So they give a big buffer. So I'm not sure one, why they didn't use the RDIs in the study, but two, why there was such an inflammatory headline and newspaper article written when the thing that mattered most, which was their nutrient status, was absolutely fine, which just again points to some propaganda behind.

06:42
sort of inflaming the dangers of taking nutrients. Now, I am not suggesting that excessive nutrient intake of anything in this realm isn't harmful. Water will kill you, given half the chance. We know that. But it's these inflammatory headlines, which really, not only are they unnecessary, but they cause potential anxiety amongst a population, who certainly, in my clinical experience,

07:10
need to think about supplementing. What I will add actually is that the most popular pregnancy multivitamin is alevit, which was used, which was reported to be the case in the study as well. It's not actually that great. I will say that the forms of the nutrients in alevit are not the forms that we can readily absorb in our bioavailable. Just because you take something doesn't mean you're actually able to use it. So slight tangent, but

07:38
thorn multivitamin, prenatal, that would be one that I would actually recommend someone take. I mean, for me as a nutritionist, I think that's worrying. And this rant, I suppose, about multivitamins does also come on the back of being sent this article several times this week from the Business Insider, and I believe it was on Science Insider as well, of an 89-year-old man who reportedly

08:06
His cause of death was excessive vitamin D intake from supplements. That was the coroner's finding. Now interestingly, first of all, it was revealed that he died from excessive vitamin D intake, but nothing was revealed at all in the article. Didn't reveal the dose that he was taking or the level of vitamin D in his blood. It didn't even reveal the form that it was taken in and whether or not cofactors were also.

08:33
part of that vitamin D supplement, which is super important when you're taking a vitamin D supplement. So there was a lot of hype without a lot of detail. And I guess that's just a diddle media for you, right? Now I am a fan of vitamin D, as you know, I've done a couple of mini micropedia episodes on it. I have written several blogs. The most recent one was about how important vitamin D is for your immunity. So absolutely, you know, you could

09:01
bunch of things including on my Instagram feed that point to the fact that vitamin D acts like a hormone in the body and not really even a nutrient. It's important for our brain, our hormones, our immune system, obviously good for our bones, our gut, etc. And in New Zealand, most people do not get enough in winter to support their vitamin D status because something to do with the UVB rays not being strong enough across New Zealand.

09:30
in the winter months. So you have to be outside for 60 or 90 minutes a day to have sufficient exposure to the UVB rays for our bodies to synthesize vitamin D. Who does that in normal life unless you are lucky enough to have a job that permits that being outside for that long? In addition, if you have a darker skin tone, you are unable to synthesize vitamin D to the same extent because of the melanin in your skin.

09:59
Also, if you have an autoimmune condition, your vitamin D status is likely higher, or requirements are likely higher than someone who doesn't. So just a couple of other things. The reference range that is provided at the laboratory is between 50 to 150 nanomoles. Experts believe that 100 to 120 is optimal. And ideally, you would test your vitamin D twice a year. It does cost $65. You can get it done despite

10:28
Maybe your GP is saying it's not possible, it is possible, you just have to pay for it yourself. Get it done at the end of summer to know how to supplement effectively for winter, and then coming out of winter in order to assess whether you still need supplemental support in summer. These are just very briefly the recommendations around that I would give for vitamin D based on my understanding of the research and the information I get from legitimate experts.

10:56
Of course, as I said, anything excessive is a problem, and excessive vitamin D can lead to kidney stones, for example. Maybe it can actually lead to death, but we don't know anything about this man's case. All we have is a headline, and we have hype, and we have alarm bells ringing. Someone else also sent me yet another article, which I didn't even read quite frankly, because I could see immediately from the headline.

11:24
that it was a propaganda against nutrient intake. There have been recent changes in the Therapeutic Goods Act that restrict our ability to prescribe and use multivitamins in New Zealand. And it's to the detriment of a lot of things, including mental health, which is a huge one. Professor Julia Rutledge, who I've interviewed on this podcast, who has done most excellent research in this field.

11:53
including the importance of multivitamin supplementation throughout pregnancy in a study that she cannot get published. She has really rallied against the changes in the laws or regulations around vitamins because now you cannot buy, for example, B12 supplement over and above 50 micrograms without a practitioner sort of supplementation. It just limits access across the board.

12:23
So when you get the access being limited from one side of things, you also then get in the public sphere, these alarmist articles that suggest multivitamins are dangerous. And then you get voices in the nutrition space telling us that we can get everything we need from food. It just creates this perfect storm, if you like, of people thinking that they need to do away with their multivitamins to the detriment of their health, in my opinion.

12:53
And then, you know, who benefits from us when we don't take vitamins? Maybe Big Pharma does. Who knows? You know, like that's where my conspiracy head would go if I was thinking about this. I also think it's unpopular in the public health space to suggest that we need vitamins and minerals because it then suggests that government isn't doing enough to protect us with the shitty food supply that we've got in place.

13:21
And so I don't think those messages are welcomed. And I wonder how much of that research sort of space, I wonder how much of that goes on is a factor because they get funding from certain streams. So we don't know that as well. For what it's worth, they do research at University of Otago to quote unquote show that you can get nutrients from food and they fill a grocery.

13:49
basket and they do it at the basic budget level and the indulgent level, essentially assessing the cost of food and what it would take to meet the recommended dietary intake. The foods that they include in that is horrendous to my mind. They limit the red meat because they have to, because they have to come within a budget. They include Milo and biscuits because one, well, Milo is fortified with iron, so that's how you get iron and zinc. And biscuits because they've got to have some treats, right?

14:19
And I just, it blows my mind that this is the type of, you know, these are the re this is the research that is being done, rather than why not do a national nutrition survey? Again, let's actually see the state of what's going on in this country with regards to nutrition. Let's start actually making inroads into improving people's health. Maybe it is some sort of subsidized multivitamin. Maybe it is, in fact, better. Maybe we do give like food vouchers to everyone. Maybe we subsidize meat. I don't know.

14:49
We've got to do something, but alarmist articles and regulation that is limiting access to people who need it, to my mind is not the answer. Anyway, so that's some thoughts. I'll include those links as I talked about, and I'll likely talk more about this. Do check out Professor Julia Rutledge's work. It is awesome. And I hope that she continues to.

15:19
work published in areas which are super important and improve our understanding of nutrients. You can catch me over on threads, Instagram and Twitter @mikkiwilliden, Facebook @mikkiwillidenNutrition, head to my website mikkiwilliden.com, book a call and we can talk about your requirement for multivitamins or anything that you want. All right team, see you later.