India is a paradox when it comes to the intake of vitamins and health supplements. We have seemingly healthy people walking around with vitamin deficiencies and then we have a few who are consuming way too many supplements than they require, causing more harm than good," says Shashank Joshi, consultant endocrinologist, Lilavati Hospital and Research Centre, Mumbai.

He says people should stay away from multi-vitamin pills and only take the supplement for which they have a deficiency. Gayathri Karthik, consultant obstetrician-gynaecologist, Mother and Child Clinic, Bengaluru, agrees. It is better to “eat a well balanced diet", she adds.

According to an article published in the journal Nutrients in February last year, 70% of the Indian adult population is deficient in vitamin D.

Apart from vitamin D deficiency, studies show that a big percentage of Indian women have iron deficiency, leading to anaemia—and this holds true across social classes.  

Similarly, studies find that adult Indian men and women are increasingly deficient in vitamin B12. Micronutrients like iron, zinc and B12 are available in limited quantities in plant-based foods, so vegetarians tend to suffer from deficiencies of these.

Some people may need to take vitamin supplements, but it is best to do so under medical supervision.

The big issue with taking vitamin and health supplements unsupervised is that since the industry isn’t regulated, the consumer doesn’t actually know what is inside the pill or powder.

New Delhi-based psychiatrist Sanjay Chugh says there was a time when he would see about “10 patients every couple of months with symptoms of delusions and paranoia, because they were taking supplements their trainers had recommended in various gyms. Some of these contain amphetamines, a potent nervous system stimulant used to treat attention deficit disorder." He too suggests taking vitamins and minerals only on a doctor’s advice.

Vitamin supplements, when taken in high doses, can have side effects. Pettarusp Wadia, consultant neurologist, Jaslok Hospital, Mumbai, says: “I have seen at least two cases—one patient was a general physician himself—where both patients were rendered unconscious because they were taking mega doses of vitamin D."

An article published in March in the journal Critical Reviews In Food Science And Nutrition, by researchers from the Council of Scientific and Industrial Research’s Central Food Technological Research Institute, Mysuru, said that while micronutrients are indeed found in limited quantities in vegetarian food, age-old cooking practices and certain food combinations together improve the bioavailability of micronutrients. Household processing like sprouting and fermentation increases the bioavailability of iron and carotene from plant foods. Amchur (dry mango powder) and lime enhance the bioavailability of iron, zinc and beta-carotene (a carotenoid vital for vision, immunity), as do onion, garlic, red and black pepper, as well as ginger. Fruits such as mango, when consumed with milk, provide significantly higher amounts of bioavailable beta-carotene than when consumed alone.

If your aim is to get the most vitamins and minerals from food, then perhaps it’s time to go back to our age-old Indian practices of cooking and eating foods in specific combinations.

Sujata Kelkar Shetty, PhD, is a wellness consultant and a clinical scientist trained at the National Institutes of Health in Bethesda, US.

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