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The Harvard researchers found that the elderly, vegans, alcohol-dependent individuals and those suffering from vitamin malabsorption were at high risk for inadequate vitamin intake. While the study looked only at vitamins, suboptimal mineral intake has its risks as well. The Harvard study also pointed out that the excessive intake of fat-soluble vitamins, such as vitamin A, may lead to more problems than it solves.

Confirming that, a study reported in the January 23, 2003 issue of The New England Journal of Medicine found that men with the highest serum retinol levels--meaning those with the most vitamin A in their blood--are at the greatest risk of hip fracture. So, too much of a good thing can be as risky as too little.

get the right stuff

That's why a low-fat diet rich in fruits and vegetables should be your first defense. After that, look to supplements to compensate for nutrients that may be lacking in your diet. But how do you do that?

The one supplement you should take, even if you have an excellent diet, is a quality multivitamin/ multimineral tablet (see "Buy the Best," p. 22). These pills include a variety of nutrients in proper amounts to ensure you're getting an adequate daily intake without the risk of overdoing it.

Beyond that, you need to adjust your supplement regimen according to your specific risk factors.

Are you a strict vegetarian? Consider vitamin [.12] pills to make up for your lack of animal and dairy foods. If you're a postmenopausal woman, take calcium supplements to make up for any deficiencies in your diet that could lead to osteoporosis. If you regularly consume a large amount of alcohol, you may have a deficiency of vitamin C and the B vitamins; check with your health care practitioner. If you're overweight or diabetic--or for any other reason at an increased risk for heart disease--add a daily vitamin E capsule. And the Harvard study showed that the elderly might not adequately absorb vitamins from food, so it may be best to supplement with a multivitamin, calcium and vitamin E.

Regardless of your particular concerns, it's a good idea to consult a health care practitioner who understands nutrition before you begin any supplement regimen. He or she will be your best resource for developing a sound diet and a safe supplement program.

But once you've decided which supplements to take, should you opt for natural or synthetic vitamins?

going natural

Regardless of the ads, all vitamins--even those labeled "natural"--are synthetic to one degree or another. They undergo substantial chemical processing and contain a host of added chemicals.

The real difference between synthetic and natural vitamins is a muddy area. Vitamin C, for example, is often synthesized from corn sugar--but the synthesis requires a virtual army of industrial chemists.

Most B vitamins are actually produced by bacteria. Soybeans go through a high-tech process to make "natural" vitamin E. And whole-food vitamins are often dehydrated foods with vitamins added.

Generally, you can forget about the natural-versus-synthetic question. Vitamins are vitamins no matter how much processing it takes to produce the tablet. And minerals come from a variety of sources. For example, calcium can come from oyster shells or coral. But if you're sold on natural, there are only two nutrients to consider: vitamin E and beta-carotene. Some claim that the body retains natural vitamin E longer and that natural beta-carotene is more potent than synthetic.

special effects

If your diet is varied; is filled with a wide variety of plant-based foods; includes fish, beans, whole grains and low-fat dairy; and limits fatty meats, pastries, fried foods, sweets and calories--and who can say that?--then supplements may be doing nothing for you.

But more likely, your supplements protect you from lapses in your diet. Preventive effects may be subtle and take years to manifest. Taking vitamins is like maintaining a car--start now before something breaks down.

If you take calcium to prevent osteoporosis, or vitamin E to prevent a weakened heart, you may not be sure it's working right now. But as you age and your tests continue to indicate solid bones and a healthy heart, you'll know your entire regimen of diet, exercise and supplements has really worked.

Popping supplements without regard for your diet, your particular risk factors or the proper dosages may be costly in terms of dollars-and your health. But a program tailored to supplement a balanced diet may bring you something absolutely priceless: disease and disability prevention.

RELATED ARTICLE: Now's the time.

It's best to take your supplements at mealtime. For one thing, vitamins and minerals are food components that help the body metabolize other food components. Also, fat-soluble nutrients--vitamins A, D, E and K, and beta-carotene--need a little oil or fat to enhance absorption. On the other hand, calcium can block the absorption of vitamins, so it's best to take calcium at another time of day--preferably evening because calcium offers a calming effect, which is helpful at bedtime.

RELATED ARTICLE: Caps, tabs, liquids or sprays?

Once you have decided on a healthy supplement regimen, you still have to look at the delivery system of the nutrients you need. Supplements come in a variety of forms.

Here's a quick guide to determining which form might be right for you.

* If you find large tablets difficult to swallow, you could pay a little extra for capsules. And whether you down capsules, tablets or gel caps, you'll still be absorbing the same nutrients.

* Some vitamins and minerals are sold in spray form for the mouth or nose. While some say that such sprays are absorbed more efficiently by the body, there's really no proof to back up that claim.

* Liquid vitamins are another option, and liquid multivitamins contain the same nutrients as tablets and capsules. Their drawback, however, is that their main ingredient is often sugar to mask the bitter taste.

* If you're a strict vegetarian or vegan, you'll want to shop around for animal-free, non-gelatin capsules. The gelatin used in most vitamin capsules is an animal product.