For Caleb (not his real name), the stress of the lockdowns over the past couple of years made it hard for him to get quality sleep, which often left him feeling groggy and slow to start the day. His usual daily routines were thrown out the window, which meant more than a few skipped meals and the occasional stress eating.

So, when he was offered a trial subscription for vitamin supplements customised to his needs, he was keen to see if they would help.

Caleb found out that nearly half of adults in Malaysia and 70% of older adults above age 60 are on nutrient supplements. About one-third of this total take a daily a multivitamin pill.

Supplements may be essential in cases of deficiency caused by long-term poor nutrition or malabsorption owing to the body’s digestive system not functioning properly. But, for those who follow a healthy diet that includes plenty of fruits, vegetables, whole grains, good protein sources and healthy fats, a multivitamin may have little or no benefit.

Still, the reality is that not everyone eats a healthy diet. Indeed, when it comes to specific vitamins and minerals, some people get less-than-optimal amounts based on criteria by the Malaysian Dietitians Association (MDA).

Certain groups are at a higher risk of nutrient deficiency. The elderly are particularly vulnerable owing to poor food intake caused by difficulty chewing and swallowing, unpleasant changes in taste, or isolation and loneliness that can suppress appetite. They also have trouble absorbing vitamin B12 from food, which is why the MDA recommends that over-50s take vitamin B12 supplements.

It is especially important for pregnant women to get enough folate and vitamin B, since it helps lower the risk of having a baby with spina bifida. To be more effective, the supplements must be taken during the first few weeks of conception.

All women of childbearing age (20 to 45) should consume 600mg of folic acid a day. This and other essential nutrients for pregnancy such as iron, calcium, vitamin D, and DHA are available in a prenatal multivitamin.

Others at risk include those with malabsorption conditions or diseases like celiac, ulcerative colitis, or cystic fibrosis, as well as those who have undergone surgery that removes part of digestive organs, such as a gastric bypass for weight loss.

Further deficiency can stem from the following conditions:

• illnesses that cause excess vomiting or diarrhoea, which prevent nutrients from being absorbed;
• alcoholism, which can prevent nutrients including B vitamins and vitamin C from being absorbed; and
• certain medications and diuretics commonly prescribed to lower blood pressure, which can deplete the body’s stores of magnesium, potassium and calcium.

Here are some scenarios where taking a multivitamin supplement is encouraged:

• when one is eating a limited diet or has poor appetite;
• when a person has dietary restrictions for over one week, such as a liquid diet after a surgical procedure or for weight loss;
• when one has a condition that reduces the body’s ability to absorb nutrients or has undergone surgery that interferes with the normal absorption of nutrients;
• when one is undergoing treatment for cancer and has difficulty eating;
• when there is a temporary increase of nutrient needs, such as during pregnancy; and
• when one who is too busy to eat a balanced diet every day.

Caleb wishes to remind everyone that multivitamin supplements should not replace a healthy, well-balanced diet – its main purpose is to fill in nutritional gaps and provide some of the essentials that are found naturally in food.

TELEME Healing Life Stories is a collection of inspirational stories of how ordinary people triumph over their health conditions and recover to lead a healthier life. Email [email protected] to share your story.

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