One type comes from animal sources of food. It helps you see at night, make red blood cells, and fight off infections. The other type is in plant foods. It helps prevent damage to cells and an eye problem called age-related macular degeneration. (But too much vitamin A can hurt your liver.) Eat orange veggies and fruits like sweet potato and cantaloupe, spinach and other greens, dairy foods, and seafood such as shrimp and salmon.
Like calcium, it keeps your bones strong and helps your nerves carry messages. It also plays a role in fighting germs. Careful time in the sun -- 10 to 15 minutes on a clear day, without sunscreen -- is the best source. Or you could eat fish such as salmon, tuna, and mackerel. There's a little in egg yolks, too. You can also get milk and sometimes orange juice with added vitamin D.
vitamin chart in tamil pdf 15
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You need it for blood clotting and healthy bones. People who take warfarin, a blood-thinner, have to be careful about what they eat, because vitamin K stops the drug from working. A serving of leafy greens -- like spinach, kale, or broccoli -- will give you more than enough K for the day. A Japanese dish called natto, made from fermented soybeans, has even more.
If a person is taking blood thinners, such as warfarin (Coumadin), they should use caution when increasing their intake of dark leafy greens. Doctors recommend maintaining a consistent vitamin K intake over time for people taking these medications.
If a person is taking blood thinners, such as Coumadin, they should use caution when increasing their intake of dark leafy greens. It is best to maintain a consistent vitamin K intake while taking these medications.
People in the United States have taken multi-vitamin/mineral (MVM) and multivitamin (MV) dietary supplements since the early 1940s, when the first such products became available [1]. MVMs, in particular, are popular supplements, currently taken by an estimated one-third of all adults in the United States, and one-quarter of children and adolescents take an MVM or MV [2,3]. MVMs and MVs accounted for 14% of all purchases of supplements and 38% of all sales of vitamin and mineral supplements in the United States in 2019 [4]. U.S. sales of all dietary supplements totaled an estimated $55.7 billion in 2020, including $21.2 billion for all supplements containing vitamins, minerals, or both, of which $8.0 billion was for MVMs and MVs [4].
MVM and MV supplements have no standard or regulatory definition, such as what nutrients they must contain or in what amounts. Therefore, these terms refer to products that have widely varying compositions [5]. These products go by various names, including "multis" and "multiples," and manufacturers determine the combinations and levels of vitamins, minerals, and other ingredients in them.
An additional complication for this product category is that many dietary supplements are not labeled as MVMs even though they contain a variety of vitamins and minerals [1]. For example, a manufacturer might label a product containing vitamins C and E, selenium, zinc, and beta-carotene as an antioxidant formula rather than an MVM.
Furthermore, investigators define MVMs differently (or sometimes not at all) in their studies to evaluate the potential health effects of these products. For example, the Agency for Healthcare Research and Quality, in an evidence-based review of the role of MVMs in chronic disease prevention, defined MVMs as products containing at least three vitamins and minerals in amounts below the UL but no herbs, hormones, or drugs [7]. One team of researchers categorized MVMs more ambiguously as "stress-tab-type," "therapeutic type," and "one-a-day type," so these products probably included MVs as well [8]. Another team defined MVMs as "full-spectrum" products providing all 12 vitamins plus 10 minerals [9]. Some published reports of studies of dietary supplements use the generic term "multivitamins" to include products with and without minerals. Various government surveys of dietary supplements and popular food-frequency questionnaires also define MVs and MVMs differently, include different examples, or ask about different products.
MVMs can also increase the likelihood that users will have intakes of some nutrients that are higher than the ULs [14]. Excess nutrient intakes are even more likely among MVM users who also take single vitamin and mineral supplements [15].
Studies of the association between MVM use and CVD outcomes have focused on several outcomes, including cardiovascular events and mortality. For example, a 2018 meta-analysis of 16 prospective cohort studies (including the study described above and the 2 below) and 2 RCTs evaluated the association between use of MVMs (defined as containing more than three vitamins and minerals) and risk of various CVD outcomes, including coronary heart disease and stroke [25]. The studies included a total of 2,019,862 participants with a mean age of 57.8 years and had a mean duration of 11.6 years. Overall, MVM supplementation was not associated with better cardiovascular outcomes, including lower risk of mortality from CVD and coronary heart disease, or of stroke incidence and mortality.
A third CVD outcomes study prospectively followed a cohort of 37,193 women ages 45 and older (mean age 54 years) participating in the Women's Health Study who were users (38%) or nonusers (62%) of MVMs (including "a wide range of lower-dose vitamins and minerals") for an average of 16.2 years. The study measured rates of major CVD events, including MI, stroke, and CVD death [27]. Neither baseline use nor changes in use of MVMs over time were associated with changes in the long-term risk of major CVD events, MI, stroke, cardiac revascularizations, or death from CVD.
RCTsSome evidence from RCTs has focused on the use of MVMs to reduce the risk of various chronic diseases. In 2006, researchers reviewed 63 published RCTs between 1966 and early 2006 that evaluated the potential impacts of MVs and MVMs and individual nutrient supplements on health and on the risk of certain medical conditions (cancer; age-related sensory loss; and cardiovascular, endocrine, neurologic, musculoskeletal, gastroenterologic, renal, and pulmonary diseases) [7]. Use of MVs and MVMs (products containing three or more vitamins and/or minerals in amounts below the ULs and no herbs) did not reduce the risk of any chronic disease. An expert panel that reviewed this report and participated in a state-of-the-science conference on the use of MVs and MVMs for chronic disease prevention at the National Institutes of Health in 2006 concluded that the evidence was insufficient for them to recommend for or against the use of MVs or MVMs to prevent chronic disease [1].
The COcoa Supplement and Multivitamin Outcomes Study (COSMOS) was a subsequent clinical trial to investigate whether MVMs might help prevent cancer and CVD in both men and women [42]. This study randomly assigned 8,776 men aged 60 years and older and 12,666 women aged 65 years and older to take a daily MVM (Centrum Silver, with small differences in ingredients and amounts than the supplement used in the Physicians Health Study II), a cocoa extract containing 500 mg of cocoa flavanols, both Centrum Silver and the cocoa extract, or both placebos for a median of 3.6 years. MVM supplementation did not reduce total invasive cancers, although it lowered the incidence of lung cancer by 38%, and it did not reduce any cardiovascular events (such as heart attacks or strokes), death from CVD, or all-cause mortality.
MVMs and Use of Supplements Containing Individual Nutrients Found in MVMsOverall, MVMs do not appear to reliably reduce the risk of chronic diseases when people choose to take these products for up to a decade (or more) or when studies randomize people to take them as part of a clinical trial. An evidence review commissioned by the U.S. Preventive Services Task Force (USPSTF) included 78 RCTs with 324,837 participants and 6 cohort studies with 390,689 participants [49]. It concluded that vitamin and mineral supplements had "little or no benefit" in preventing cancer, CVD, and death, except that MVMs may provide a "small benefit" against cancer. Based on this review, the USPSTF concluded there was insufficient evidence to determine "the balance of benefits and harms" in taking MVMs to prevent CVD or cancer [50]. The American Institute for Cancer Research recommends against taking dietary supplements for cancer prevention because supplements do not provide the same benefits as eating whole foods [51]. Similarly, the American Heart Association advises against the use of MVMs to prevent CVD because scientific studies have found them to be of no value for this purpose [52].
Pregnant peopleThe American College of Obstetricians and Gynecologists recommends that pregnant people take a daily "prenatal vitamin" [56]. Acknowledging that most health care providers recommend that pregnant people take a daily prenatal MVM, the DGA states that this practice may be necessary to meet the needs for folate or folic acid, iron, iodine, and vitamin D during pregnancy [54]. The DGA also states that pregnant people might need to take separate supplements of iodine and choline when their health care provider recommends that they do so because many prenatal MVMs do not contain these nutrients or contain only small amounts of them. The report recommends that people following a vegetarian or vegan diet consult their health care provider about whether they need supplementation with iron, vitamin B12, and other nutrients (e.g., choline, iodine, EPA, and DHA). The World Health Organization recommends iron and folic acid supplementation throughout pregnancy [57].
Adults in their 50s and olderThe FNB advises people older than 50 years to obtain recommended amounts of vitamin B12, mainly from fortified foods or dietary supplements. Adults in this age group might not be able to absorb enough of the protein-bound, naturally occurring vitamin B12 in food because gastric acidity tends to decline and atrophic gastritis tends to become more common with age [6]. The DGA also recommends obtaining recommended amounts of vitamin B12 primarily from fortified foods or dietary supplements, but only for people ages 60 and older. The DGA adds that the use of some medications (such as proton pump inhibitors) can decrease absorption of vitamin B12 in foods [54]. 2ff7e9595c
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