As of today, I’ve been approached by two crew members about whether or not to take vitamins while on our mission. Here are my thoughts, first on vitamins in general, and then on vitamins during the mission specifically.
On Vitamins In General
Americans have the most expensive pee in the world. At the same time, they have the worst health outcomes per dollar spent on health of any developed nation (including the $3 billion/year Americans pay out-of-pocket for CAM, Complementary and Alternative Medicine). The US is the purest proof that vitamins taken in as supplements to a poor diet and poor exercise regime cannot take the place of either. So…
…Most people do not need vitamins.
Most NORMAL, HEALTH people with REGULAR diets should not take vitamins. They can actually gum up the works: increase incidence of renal stones, mess with uptake and digestion of other things, and generally wreak expensive and nonsensical havoc.
Most people should eat well IF THEY CAN and leave it at that.
There are exceptions to this. They are:
1) People who can’t eat well, aka poor people. This is too often overlooked. Impoverished children in the US suffer from rampant malnutrition. People who aren’t necessarily in poverty but who live in food deserts will also have poor nutrition, and can therefore benefit from supplementation.
2) Women of childbearing age. That supplement is daily folate.
3) Vegetarians. That supplement is B vitamin complex (or just B12, but most take the complex) that need not be taken daily, necessarily, but often is.
4) All young women (< 25) on hormonal birth control should be taking in lots of calcium orally, or could some consider supplementation.
5) Women with heavy cycles who become anemic secondary to menstrual blood loss. That supplement is iron (diet can sometimes be used to compensate alone).
And that’s about it.
Again, this is healthy people with normal diets and functioning digestive tracts living in the developed world. People with chronic infections, physical disabilities, and GI issues who are routinely exposed to the elements have different needs.
A great example is vitamin C. The only populations who consistently benefit from vitamin C supplementation in recovering from the common cold are young children and military personal conducting maneuvers in extreme environments.
Extraordinary environmental pressures and physical weakness can make vitamins critical where they would not otherwise be. Which leads us to the question…
…Is our trip to simulated Mars an extraordinary physical environment?
On Vitamins on sMars
sMars is going to be different from our regular, daily lives in some ways. The question is: are those ways…UNNATURAL enough…to merit vitamin supplementation?
That is a very good and shockingly complicated question. It will vary a lot by the crew member and the vitamin. The short answer, though, is no. I don’t think so.
Commander Carmel basically lives on a mountain top. Habitat Architect Tristan lives in a skyscraper in Singapore. Their lives are very different. Both probably have more than enough vitamin D. Why? Because it’s in our food AND we make it by stepping into the sunlight now and again.
In terms of stepping out, EVA will be a regular event for us on sMars. Hours of it per week, even through the visor, and we should be good to go. Dietary sources of vitamin D to which we will have access include beans, nuts and tuna. So will we need to take extra vitamin D? Only if our diets don’t include much of these foods and we NEVER get outside in our suits (not even a few minutes a week).
Of course, the key to vitamin D is only 50% consumption. The other 50% is activation. Turning the passive vitamin D that we consume or make into the active vit. D that we need for bone health requires our livers and kidneys to work. BONUS! We’re all healthy! So no worries there.
It’s important for all of us on the mission, especially the younger women in the crew if they take exogenous hormones, to get enough calcium. We will not have fresh milk or fresh juices. Everything will be powdered. So, are we going to get enough, or do we need to supplement?
Since we will still have access to some of the best sources of calcium on the planet – tofu, oatmeal, cereal (which is often fortified), baked beans and yogurt, which Carmel and I are going to make from whole powdered milk – I do not think that we will need calcium supplementation. I know how one of our crew members feels about oatmeal, <grin>so I’ll also throw out there that we can get a lot of calcium from almonds, canned salmon and sardines. YUM!
Want more info on calcium? I use the guide from the National Osteoporosis Foundation.
Iron, Folate and B12
The men of HI-SEAS IV are going to need 8 mg/day of iron. The women will need 18 mg. We won’t have fresh meat or green leafy veggies, at least not at first. Are we going to get enough iron, folate and B12 not to run into trouble with anemia on the mission?
I believe that the answer here is yes. Nuts, beans and veggies have plenty of iron for us all. The grains we will use in our bread will have plenty of iron as well. I believe that we can skip iron supplementation. The women on the crew may supplement their folate as per usual.
Rickets sucks hard. I won’t anyone on this crew to go soft in the bones, stop making tooth enamel or start healing poorly. Fortunately, it won’t happen. Here’s why:
There is a lot of vitamin C in pretty much every kind of fresh, frozen, freeze-dried, pulverized and powdered fruit and vegetable. And we will be getting a LOT of these dehydrated veggies and fruits. A shake a day will not keep the doctor away – I’m in there with you, bwahahaha – but I will MAKE you a SHAKE every day if that’s what it takes to keep your vit C on target. Also, the shake will have tofu. Just sayin’.
Omega Fatty Acids
Honestly, these are the ones that I worry about the most. They are absolutely required to make and maintain healthy neurons, to clot blood properly, and for our arteries to relax. And relaxed arteries are GOOD, yo.
We cannot make these ourselves. We MUST eat them, and, in the normal world, people don’t ingest enough of these. So, there you have it: on sMars we’re cooling with vegetable oil.
That’s right! It’s pretty much that simple. If we want to double down, we can ask for walnuts. We can ask for a small bottle of flaxseed oil if we’re not getting enough salmon or walnuts.
Personally, I would skip the middle man, ask for a bag of flax seeds and walnuts, make bread with iron fortified flour, put a bunch of our homemade yogurt on it and cover that in dried cherries. It’s going to be SO good, and it’s going to keep us all health, but try not to cry. There’s no crying in s-space. Not as long as we have our nuts to keep us going.
I think we’re covered.
I’m ccing Sue Jewell at Med control in case I missed anything. Goodnight all! Dream of milkshakes on Mars.