Institute of Nutritional Science, Justus Liebig University Giessen
Department of Obstetrics, University Hospital Zurich
Dtsch Arztebl Int. 2020 Jan 6;117(1-2):14-22. doi: 10.3238/arztebl.2020.0014.
Vitamins are vitally important, but they are not always adequately supplied with the diet. In this review, we present the advantages and disadvantages of vitamin supplementation and the indications for it in various life situations.
This review is based on pertinent publications retrieved by a selective search of the literature.
The German National Nutrition Survey II (Nationale Verzehrsstudie II) showed that most people in Germany consume adequate amounts of vitamins in their diet, with the exception of vitamin D and folate. Supplements are often taken by adults who already consume a balanced diet. Depending on the vitamin, 3-13% of survey respondents took vitamin supplements; the ones most often taken were vitamins C and E. No convincing evidence has yet demonstrated a health benefit from vitamin supplementation in addition to a balanced diet for the primary prevention of nutrition-associated diseases. Vitamin supplementation is indicated in certain specific life situations, e.g., pregnancy, but otherwise unnecessary, unless a deficiency has been diagnosed or the individual is at elevated risk.
Vitamin supplementation is recommended for certain population groups: folic acid for pregnant women, vitamin B12 for vegans and persons with resorption disorders, vitamin D for persons with insufficient endogenous synthesis. In all other cases, it should first be tested whether the individual might be substantially helped by dietary changes alone. In general, the potential adverse effects of vitamin supplementation need to be considered, and its benefits weighed against its risks.
维生素至关重要,但它们并不总是能通过饮食得到充分供应。在本次综述中,我们介绍了维生素补充的优缺点,以及在各种生活情况下补充维生素的适应证。
本综述基于通过文献选择性搜索获得的相关出版物。
德国国家营养调查 II 期(Nationale Verzehrsstudie II)显示,除维生素 D 和叶酸外,大多数德国人在饮食中摄入了足够的维生素。均衡饮食者通常会补充维生素。根据维生素的不同,3-13%的调查对象会服用维生素补充剂;最常服用的是维生素 C 和维生素 E。除了均衡饮食之外,维生素补充对于营养相关疾病的一级预防没有明显的健康益处,这方面还没有令人信服的证据。维生素补充仅在某些特定的生活情况下适用,例如妊娠,但除此之外没有必要,除非已确诊缺乏维生素,或者个体处于较高风险中。
对于某些人群,建议补充维生素:孕妇补充叶酸,纯素食者和吸收障碍者补充维生素 B12,维生素 D 缺乏者补充维生素 D。在所有其他情况下,应首先测试个体是否可以通过单纯的饮食改变获得实质性帮助。一般来说,需要考虑维生素补充的潜在不良反应,并权衡其益处与风险。