Multivitamin supplements -
Participants receiving the supplement did not have significantly fewer cardiovascular events, but this finding should be interpreted with caution because many participants did not take the supplement or placebo as directed, and others withdrew from the study early.
A meta-analysis of nine RCTs not including the study described above evaluated the use of MVMs defined as products that included most vitamins and minerals by 22, individuals and a variety of CVD outcomes—including total CVD incidence and mortality, MI incidence and mortality, and stroke incidence and mortality—and all-cause mortality [ 29 ].
MVM use did not alter the risk of any of these outcomes. Several epidemiological studies and small RCTs have suggested associations between higher intakes of antioxidants or zinc and reduced risk of age-related macular degneration AMD , although not consistently [ 30 ].
In the Age-Related Eye Disease Study AREDS , investigators randomized 4, individuals age 55—80 years who had varying degrees of AMD, cataract, or both conditions to receive a placebo or a daily supplement containing high doses of vitamin C mg , vitamin E International Units [IU] , beta-carotene 15 mg , zinc 80 mg , and copper 2 mg [ 30 , 31 ].
Over an average follow-up period of 6. The supplements did not prevent AMD onset or affect cataract risk. A subsequent study, AREDS2, tested whether adding omega-3 fatty acids containing mg eicosapentaenoic acid [EPA] and mg docosahexaenoic acid [DHA] or lutein 10 mg and zeaxanthin 2 mg to the AREDS formula would make it more effective [ 32 ].
This study included 4, participants age 50—85 years who had intermediate AMD in both eyes or intermediate AMD in one eye and advanced AMD in the other eye. Adding omega-3 fatty acids, lutein and zeaxanthin, or both to the AREDS formulation did not further reduce the risk of progression to advanced AMD.
However, the study showed that beta-carotene was not a required ingredient; the original AREDS formulation without beta-carotene provided the same protective effect on reducing the risk of advanced AMD as the AREDS2 formulation. Dietary supplements are commonly taken during pregnancy to increase nutrient intakes, especially of key nutrients such as iron and folic acid.
Some experts have hypothesized that MVM use might increase the chance of a healthy birth outcome. A meta-analysis of 20 RCTs investigated whether supplementation with MVMs whose composition varied by study but that contained multiple nutrients including iron and folic acid by pregnant people led to better birth outcomes than use of supplements containing only iron with or without folic acid or, in one study, a placebo [ 33 ].
The trials included , pregnant people from low- or middle-income countries in Africa and Asia as well as in Mexico where malnutrition and micronutrient deficiencies are not uncommon ; only one of the studies was conducted in a high-income country, the United Kingdom.
MVM supplementation did not have a beneficial or harmful effect on risk of stillbirths or of perinatal and neonatal mortality in comparison with iron and folic acid supplementation.
The trial in the United Kingdom that compared an MVM to a placebo found no beneficial or harmful effect of the MVM on preterm births, birth at a smaller size than normal gestational age, or low birth weight. A similar meta-analysis of 13 RCTs investigated whether use by pregnant adolescents and young adults age 10—19 years of an MVM containing multiple nutrients led to better birth outcomes than supplementation with only iron and folic acid [ 34 ].
The trials included a total of 15, pregnant adolescents and young adults from low- or middle-income countries in Africa and Asia. Several studies have evaluated the link between MVM use and many different health outcomes, including cancer, heart disease, osteoporosis, pulmonary diseases, psychiatric disorders, and mortality.
Most have not found an effect of MVM use on any of the health outcomes measured. One of the largest prospective studies of MVM use was the Women's Health Initiative, which evaluated the health of , postmenopausal women age 50—79 years and their risk factors for cancer, heart disease, and osteoporosis.
A total of When the investigators compared the outcomes of supplement users and nonusers, they found no association between use of these products for a median of 8 years and an increased risk of any common cancer or total cancers, CVD, or total mortality [ 35 ].
Investigators who followed a multiethnic cohort of , men and women age 45—75 years living in Hawaii and California for an average 11 years found similar results [ 36 ]. Other observational data on multiple outcomes come from a cross-sectional analysis of data from participants in the National Health Interview Survey.
This analysis included 4, adults who reported taking an MV or MVM during the previous 12 months and 16, nonusers [ 37 ]. The supplement users reported better overall health than the nonusers, but the results showed no differences in various psychological, physical, or functional health outcomes [ 37 ].
Some evidence from RCTs has focused on the use of MVMs to reduce the risk of various chronic diseases. In , researchers reviewed 63 published RCTs between and early that evaluated the potential impacts of MVs and MVMs and individual nutrient supplements on health and on the risk of certain medical conditions cancer; age-related sensory loss; and cardiovascular, endocrine, neurologic, musculoskeletal, gastroenterologic, renal, and pulmonary diseases [ 7 ].
An expert panel that reviewed this report and participated in a state-of-the-science conference on the use of MVs and MVMs for chronic disease prevention at the National Institutes of Health in concluded that the evidence was insufficient for them to recommend for or against the use of MVs or MVMs to prevent chronic disease [ 1 ].
The Physicians Health Study II was the longest clinical trial to investigate whether MVMs might help prevent chronic disease. The study randomly assigned 14, male physicians in the United States age 50 and older to take a daily MVM Centrum Silver or placebo for a median of Participants who took the MVM did not have fewer major cardiovascular events, myocardial infarctions, strokes, or cardiovascular-related deaths than nonusers [ 38 ].
The supplement also had no effect on cognitive decline with age [ 40 ]. The COcoa Supplement and Multivitamin Outcomes Study COSMOS was a subsequent clinical trial to investigate whether MVMs might help prevent cancer and CVD in both men and women [ 42 ]. This study randomly assigned 8, men age 60 years and older and 12, women age 65 years and older to take a daily MVM Centrum Silver, with small differences in ingredients and amounts than the supplement used in the Physicians Health Study II , a cocoa extract containing mg of cocoa flavanols, both Centrum Silver and the cocoa extract, or both placebos for a median of 3.
An ancillary study to COSMOS, known as COSMOS-Mind, enrolled 2, of the older COSMOS participants mean age 73 years to investigate whether the cocoa extract, MVM, or both supplements might improve cognition compared with placebo over 3 years of daily use [ 43 ]. Participants completed standardized cognitive tests administered over the telephone at baseline and annually for 3 years.
MVM supplementation, with or without the cocoa extract, improved global cognition, a benefit most pronounced in participants with a history of CVD. The MVM also improved memory and executive function. Similar findings were reported from COSMOS-Web, another ancillary study to COSMOS that included 3, participants mean age 71 years [ 44 ].
In this study, participants who took the MVM had significantly better memory at both 1 year and across 3 years of follow-up, on average, compared with those who took placebo.
These findings suggest that MVM supplementation can help maintain or enhance cognitive function in older adults. Other RCTs have evaluated the effects of MVMs on outcomes in individuals with a range of chronic diseases. One RCT conducted in Linxian, China, randomized 3, persons age 40—69 years who had precancerous lesions in the esophagus a relatively common condition in this population, which had a low dietary intake of several nutrients to receive a daily MVM containing 14 vitamins and 12 minerals in doses two to three times recommended amounts or a placebo for 6 years [ 45 ].
The supplement did not reduce incidence or mortality rates for esophageal cancer or the rate of mortality from any cause. After the investigators followed participants for up to 20 additional years, when participants were no longer taking the study supplement, the use of the MVMs during the RCT did not result in lower rates of total mortality or mortality from any cause of death examined, including cancer, heart disease, and stroke [ 46 ].
One meta-analysis of 21 RCTs investigated whether daily use of MVs and MVMs products containing three or more nutrients for at least 1 year affected mortality risk [ 47 ]. The studies included a total of 91, healthy adults average age 62 years taking the MVs or MVMs for an average of 43 months, and the investigators reported 8, deaths.
The products provided an average of 14 nutrients, although the products with three nutrients in five trials did not contain a mineral. The use of MVs or MVMs had no effect on all-cause mortality or on mortality due to CVD or cancer. However, the quality of the studies was generally poor, most had small samples as few as 20 participants , and they used different MVs and MVMs and outcome measures.
One well-known trial of the impact of MVMs on both chronic disease risk and mortality used combinations of antioxidant nutrients. In the French Supplémentation en Vitamines et Minéraux Antioxydants SU. MAX study, investigators randomly assigned 13, adults age 35—60 years to receive a placebo or a daily supplement containing moderate amounts of vitamin C mg , vitamin E 30 mg , beta-carotene 6 mg , selenium mcg , and zinc 20 mg [ 49 ].
After 7. The supplements provided no protection from CVD. Overall, MVMs do not appear to reliably reduce the risk of chronic diseases when people choose to take these products for up to a decade or more or when studies randomize people to take them as part of a clinical trial.
An evidence review commissioned by the U. Preventive Services Task Force USPSTF included 78 RCTs with , participants and six cohort studies with , participants [ 50 ]. It concluded that vitamin and mineral supplements had little or no benefit in preventing cancer, CVD, and death, except that MVMs may provide a small benefit against cancer.
Based on this review, the USPSTF concluded there was insufficient evidence to determine the balance of benefits and harms in taking MVMs to prevent CVD or cancer [ 51 ]. The American Institute for Cancer Research recommends against taking dietary supplements for cancer prevention because supplements do not provide the same benefits as eating whole foods [ 52 ].
Similarly, the American Heart Association advises against the use of MVMs to prevent CVD because scientific studies have found them to be of no value for this purpose [ 53 ]. Although MVM use might not reduce overall chronic disease risk, several nutrients in MVMs might benefit certain groups of people.
Examples of these populations are described below. Obtaining sufficient amounts of folic acid in the periconceptual period reduces the risk of neural tube defects in newborns. The Usage Calculator helps you determine how much of a product your household will consume over time so you can order what you need, when you need it.
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Made for your life today and how you really live it. Ingredients picked and traced from nature to you. Purple Carrot. A true superfruit that is a rich source of dark-red color with antioxidants.
Another red superfruit, it provides antioxidants in a rich color and it is known as a rich source of phytonutrients. Acerola Cherry. This superfruit is the highest vitamin C source in nature, equivalent to the vitamin C in 50 oranges! Vitamin C is an essential vitamin to help support immune health functions.
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Satiety and nutrient absorption research shows Dental plaque risk Nutrition myths unmasked infection from Multivitxmin biopsies. Discrimination at work is linked to high supplemejts pressure. Icy fingers Multifitamin toes: Poor circulation or Raynaud's Multivitamij If you take a multivitamin, it's probably because you want to do everything you can to protect your health. But there is still limited evidence that a daily cocktail of essential vitamins and minerals actually delivers what you expect. Most studies find no benefit from multivitamins in protecting the brain or heart. But There are potential benefits and no risks from a one daily standard multivitamin. Nearly Nutrition myths unmasked of xupplements in the U. There supplementts certainly diseases caused by a lack of specific nutrients Multivitamin supplements the Multivitamn. Classic examples include scurvy Cognitive function improvement exercises a lack of vitamin Cberi-beri vitamin B1pellagra vitamin B3and rickets vitamin D. But these conditions are rare in the U. and other developed countries where there is generally more access to a wide range of foods, some of which are fortified with vitamins.
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