I wish it were that easy. Although there is some encouraging data regarding the benefits of multivitamins for healthy adults, this supplement is not a panacea.
There were three major studies investigating whether multivitamins affect important health outcomes, all of which received private and public support, including from supplement companies.
- A French study of nearly 13,000 adults between the ages of 35 and 60 found that after taking the supplement daily for seven and a half years, there was an improvement in cancer risk and mortality in men, but not in women. No improvement.
- Another study surveyed more than 14,000 male physicians in the United States over the age of 50 and found that multivitamin use for a median of about 11 years was associated with an 8% increase in cancer risk, although there was no difference in mortality rates. showed that it was associated with a decrease in
- A study called COSMOS, which looked at more than 21,000 older adults using multivitamins over a median period of about 3.5 years, found no improvements in cancer risk, mortality, or cardiovascular disease in both men and women. There wasn't. Ancillary studies found that certain aspects of cognition improved significantly in men and women over the age of 60.
Taking a daily multivitamin is generally considered safe. However, the U.S. Preventive Services Task Force does not recommend it because there is insufficient evidence of its effectiveness in healthy adults.
My takeaway? Eating a healthy diet is well-established in multiple large-scale studies to improve many health outcomes, from improving coronary heart disease to reducing cancer risk.
Taking pills to compensate for nutritional deficiencies will not restore a poor, unbalanced diet.
Is it better to eat healthy or take vitamins?
Many people have researched the health benefits of supplementing certain nutrient deficiencies with pills. For example, magnesium is a popular supplement and a common feature in many multivitamins.
Research consistently shows that magnesium supplementation alone is not sufficient to reap the benefits of a magnesium-rich diet. This is probably because many of the other health benefits that come with a balanced diet cannot be easily distilled into one or even just a handful of nutrients removed from their original form. It's possible.
Do multivitamins help cognitive function?
A large study published in 2023 based on the COSMOS database found that people who took multivitamins for a year performed better on instant word recall tests. In this test, participants are asked to read 20 unrelated words several times in a row, then read a new list of 20 words to distract them, and then read the first list of 20 words. asked to recall as many words as possible from The study authors concluded that multivitamin supplementation was effective in improving age-related memory changes on this test by approximately 3.1 years.
This data is encouraging. Additional studies are likely needed to further understand the extent of this effect and target appropriate populations. For example, people who appear to benefit the most are people with baseline cardiovascular disease. Although the reason is not clear, these patients may have had micronutrient deficiencies, possibly related to certain heart medications.
Still, studies using more extreme endpoints, such as the development of dementia, have not shown any benefit from over-the-counter supplements. teeth Leads to healthy eating. And in a 2023 study, multivitamins had no significant effect on executive function or other cognitive tests that assess recognition of novel objects.
Who should take multivitamins?
There are several scenarios where multivitamins are known to be important.
- People who are malnourished: This may include people with alcohol use disorders and older adults living in long-term care facilities who may have low fruit and vegetable intake. Other people with specific nutritional deficiencies, such as vitamin B12 deficiency in vegans, can also reasonably take a daily multivitamin to compensate for their deficiencies, provided the multivitamin contains the appropriate daily proportion of vitamin B12. can.
- People who have had bariatric surgery. Many multivitamins may not contain a complete daily supply of minerals, so these patients should ensure that their supplements also meet their calcium, iron, copper, and zinc goals. You need to be careful.
- People who are pregnant or breastfeeding. In this case, you should take a multivitamin containing 400-800 mg of folic acid as directed by your doctor.
How do I choose the best multivitamin for me?
Multivitamins are not regulated as medicines by the Food and Drug Administration, so there can be significant differences in what is included in each brand's formula.
They typically contain a few percent of your daily intake of important vitamins and minerals. Some brands contain 70 percent of your daily value for nutrients like vitamin C, while others contain 200 percent.
If you're healthy, do you need to supplement with 200% of your daily intake of vitamin C? Few clinical trials provide such a specific answer.
But in general, it makes the most sense to choose vitamins that are targeted to your gender and age group. Multivitamins aimed at young women tend to be high in folic acid (for pregnancy) and iron, which is often deficient due to menstrual losses.
Participants in the COSMOS trial took Centrum Silver multivitamin daily, which contains high concentrations of vitamin D and vitamin B12, which are commonly found in multivitamins intended for older adults.
If you are taking multiple supplements, read the labels carefully. Do not consume too much of any nutrient.
Smokers should avoid taking multivitamins containing more than 20 mg of beta-carotene per day. This is because several studies have pointed to an increased risk of lung cancer in smokers.
What we want patients to know
When we put something into our bodies, we have to calculate the risks and benefits. Many people feel that taking a multivitamin is better than not taking it at all, and the risks are very low. I agree with at least the second half of that reasoning, but from a larger perspective, the harm comes not from multivitamins themselves, but from a more fundamental failure on the part of health care providers and society to address them. Maybe I will. When healthy patients talk to me about multivitamins, I use that as a starting point to understand what nutrients they're worried about that they're not getting from their diet, and how they can help them eat a more balanced diet. We will explore ways to support you so that you can take in the following.
