The Benefits of MultiVitamins Re Explored
Most experts advocate for obtaining essential nutrients primarily through food consumption, emphasizing the significance of the synergistic interactions among these nutrients. This synergy likely contributes to their effectiveness, possibly explaining why trials focusing on single nutrients often yield inconclusive results.
However, certain exceptions warrant supplementation. For instance, inadequate sunlight exposure for vitamin D synthesis and limited dietary sources necessitate a daily vitamin D supplement. Individuals adhering to strict vegetarian diets or those using daily acid blockers for gastrointestinal issues should consider vitamin B12 supplementation.
Regarding multivitamin (MVM) usage, prior to recent times, its recommendation was discouraged due to inconsistent findings across multiple studies. Observational studies comparing individuals who opted for multivitamin supplements with non-users often encountered challenges in attributing health benefits solely to supplementation, given the influence of other healthy behaviors [1]. While some experts theorized potential benefits in reducing cancer risk or cardiovascular disease (CVD) incidence, large prospective studies have not consistently supported these hypotheses [2]. The Women’s Health Initiative Study did show that the rate of death from breast cancer was 30% lower among the MVM users when compared to nonusers [3]. In the randomized controlled COSMOS Trial, participants who took a MVM supplement did not show a reduction in total invasive cancers but did have a 38% lower incidence of lung cancer, when compared to those who did not [4]. One large observational study reported that the use of MVMs for more than 3 years was associated with a substantial 44% reduction in CVD mortality rates among women but not men [5]. This has not however been reported in additional observational studies or randomized trials
Based on brain health benefits, the lack of benefit of a daily multivitamin is being challenged. A supplementary investigation to the large COSMOS Trial, known as COSMOS-Mind, enrolled 2,262 older participants with an average age of 73 years [6]. This study aimed to assess the potential cognitive benefits of cocoa extract, MVM (Centrum Silver), or a combination of both supplements compared to a placebo over a 3-year daily intake period. Those who received the MVM supplement, with or without cocoa extract, exhibited enhanced global cognition, reflecting overall cognitive abilities encompassing various domains such as recall, recognition, and learning. Particularly noteworthy was the pronounced improvement observed in participants with a history of cardiovascular disease (CVD). Additionally, individuals taking the MVM also demonstrated enhancements in memory and executive function.
Similar positive outcomes were observed in the COSMOS-Web, which involved 3,562 participants with an average age of 71 years [7]. Participants who received the MVM showed significantly better memory performance both at the 1-year mark and throughout the 3-year follow-up period compared to those who received a placebo. A third ancillary study, COSMOS-Clinic, consisting of 573 participants with an average age of 69 years, reported improvements in episodic memory among individuals taking the MVM over a 2-year period compared to those taking a placebo [8].
Furthermore, a meta-analysis incorporating data from all three ancillary studies, involving over 5,000 participants, indicated that MVM supplementation contributed to the enhancement of both global cognition and episodic memory over time. These findings collectively suggest that MVM supplementation may play a role in maintaining or even enhancing cognitive function.
Safety concerns, including interactions with medications like blood thinners, should be considered when taking multivitamins. Additionally, selecting appropriate multivitamin formulations tailored to age, sex, and life stage is advisable, ensuring optimal nutrient intake without exceeding recommended levels.
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