[, Park S-Y, Murphy SP, Wilkens LR, Henderson BE, Kolonel LN. The greatest improvements in intake were for vitamins A and E and zinc. Know the Science: 9 Questions To Help You Make Sense of Health Research. The USPSTF advises people who are planning to become or capable of becoming pregnant to take a dietary supplement providing 400 to 800 mcg/day of folic acid daily [55]. This study prospectively followed 18,530 male physicians aged 40 years and older, of whom 20% reported taking an MV or MVM for an average of 12.2 years [24]. [, Bailey RL, Fakhouri TH, Park Y, Dwyer JT, Thomas PR, Gahche JJ, et al. Over an average follow-up period of 6.3 years, the supplements significantly reduced the risk of progression from intermediate to advanced AMD by 28% and reduced rates of loss of visual acuity by 27%. The products provided an average of 14 nutrients, although the products with 3 nutrients in 5 trials did not contain a mineral. Nausea. Results from several studies demonstrate both the use of MVMs for nutritional insurance by some individuals and the potential of MVMs to lead to excessive intakes for others. [, Rock CL. Taking a daily dose of a basic MVM is unlikely to pose a health risk for most people. Updated evidence report and systematic review for the US Preventive Services Task Force. The DGA also states that pregnant people might need to take separate supplements of iodine and choline when their health care provider recommends that they do so because many prenatal MVMs do not contain these nutrients or contain only small amounts of them. MVM supplementation did not reduce total invasive cancers, although it lowered the incidence of lung cancer by 38%, and it did not reduce any cardiovascular events (such as heart attacks or strokes), death from CVD, or all-cause mortality. Nutrition Business Journal. Join the ODS Email List. A review of 16 RCTs of MVs and MVMs (containing more than four nutrients including, in most cases, at least one mineral) in 1,719 participants who had at least one of six types of psychiatric symptoms (depression, post-disaster stress, antisocial behavior, behavioral deficits in dementia, attention-deficit/hyperactivity disorder, or autism) found that the supplements provided no clear reduction in symptoms [47]. According to the federal governments 2020-2025 Dietary Guidelines for Americans, "Because foods provide an array of nutrients and other components that have benefits for health, nutritional needs should be met primarily through foods. [. [, Jenkins DJA, Spence JD, Giovannucci EL, Kim Y-I, Josse RG, Vieth R, et al. Iron-deficiency can lead to decreased production of hemoglobin and a microcytic, hypochromic anemia. MVMs and MVs accounted for 14% of all purchases of supplements and 38% of all sales of vitamin and mineral supplements in the United States in 2019 [4]. Any mention in this publication of a specific product or service, or recommendation from an organization or professional society, does not represent an endorsement by ODS of that product, service, or expert advice. Deficiency Signs and Symptoms. Association of multivitamin and mineral supplementation and risk of cardiovascular disease. Homeostatic regulation of Blood Pressure by a negative feedback system Positive Feedback Mechanisms In positive feedback mechanisms, the result or . Pregnant people Overall, women are more likely (34.0%) to take an MVM than men (28.3%) [2]. Composition of Product: Lycopene + Multivitamins+ Multi minerals. Iron supplements may be recommended for women of childbearing age, pregnant women, preterm infants, older infants, and teenage girls because they are at greater risk of developing deficiency. When taken as directed, multivitamins and minerals are not expected to cause serious side effects. An analysis by the National Health and Nutrition Examination Survey (NHANES) of data collected from 2003 to 2006 found 33% of the U.S. population ages 1 year and older took an MVM supplement in a given month. In addition, the supplement reduced the risk of cataracts by 9% but did not help prevent AMD [41]. However, if you take a blood thinner, such as warfarin (Coumadinand other brand names), talk to your health care provider before taking any MVM or dietary supplement that contains vitamin K (this vitamin lowers themedicines effectiveness, and doctors base the medicines dose partly on the overall amount of vitamin K a person usually consumes in foods. Theres no standard or regulatory definition for MVMs, or any dietary supplement, as to what nutrients they must contain or at what levels. JAMA Intern Med 2013;173:1259-61. Explore the pages linked above to learn about: What vitamin D, iron, and zinc do. B12 6mcg, biotin 30mcg, folic . Mechanism of Action. Theoretical basis for harm. [, Sesso HD, Rist PM, Aragaki AK, Rautiainen S, Johnson LG, Friedenberg G, et al. Increase nutrient intakes Nutrients 2018, 10, 248. Furthermore, men who reported using MVs or MVMs for 20 years or more had a lower risk of major CVD events, stroke, ischemic heart disease, and cardiac revascularization than men who did not take MVs or MVMs. Women. J Nutr 2016;146:1235-40. [, Rautiainen S, Rist PM, Glynn RJ, Buring JE, Gaziano JM,Sesso HD. The mechanisms of action of bitter melon in the reduction of blood glucose in relation to T2DM and AD. However, no two RCTs have used MVMs with the same combinations and amounts of nutrients. JAMA 2017;317:183-9. The DGA also recommends obtaining recommended amounts of vitamin B12 primarily from fortified foods or dietary supplements, but only for people ages 60 and older. 2002; Huang, 2003; Wu, 2005). Obtaining sufficient amounts of folic acid in the periconceptual period reduces the risk of neural tube defects in newborns. When choosing an MVM product, consumers should consider taking a product designed for people of their age, sex, and life stage (e.g., pregnancy). Macrocytic Megaloblastic Anemia. Obimin Plus is a pre- and postnatal supplement to help provide adequate supply of vitamins, minerals and DHA and EPA, during pregnancy and lactation. Pregnancy and birth outcomes However, few randomized clinical trials (RCTs) have been conducted because these studies need to be long enough to show effects on disease risk that go beyond simply identifying intermediate biomarkers that might suggest such risk. 2013;309:2005-15. Espaol (Spanish) | Print. An ancillary study to COSMOS, known as COSMOS-Mind, enrolled 2,262 of the older COSMOS participants (mean age 73 years) to investigate whether the cocoa extract, MVM, or both supplements might improve cognition as compared to placebo over 3 years of daily use [43]. Use rates by sex and age are 19.5% for men and 26.1% for women ages 1930 years, 25.1% for men and 33.0% for women ages 3150 years, 34.5% for men and 36.2% for women ages 5170 years, and 40.9% for men and 44.0% for women ages 71 years and older. A cross-sectional analysis of a nationally representative sample of 1,003 pregnant U.S. people aged 20 to 40 years from the 20012014 NHANES found that many consumed less than recommended amounts of many nutrients from diet alone [17]. 8. Basic MVMs contain both vitamins and minerals, most in amounts that do not exceed the DVs. Supplemental vitamins and minerals for cardiovascular disease prevention and treatment. Am J Clin Nutr 2013;97:437-44. Inflammation comes from the Latin word inflammare, which means "to set on fire.". Effects of cocoa extract and a multivitamin on cognitive function: A randomized clinical trial. The randomized Linxian dysplasia nutrition intervention trial after 26 years of follow-up: No effect of multivitamin supplementation on mortality. At baseline, 37.8% reported taking an MVM (typically containing 2030 vitamins and minerals). J Nutr, 2021. Pregnancy vitamin with Omega-3 for baby's brain development. Vitamins are not sources of energy as are carbohydrates, fats, and proteins. Recommended Daily Intake of Vitamins and Minerals for Adults. Am J Clin Nutr 2010;91:1268-1272. [, Neuhouser ML, Wassertheil-Smoller S, Thomson C, Aragaki A, Anderson GL, Manson JE, et al. Pediatrics 2008;122:1142-52. Multivitamins and minerals are also used to treat vitamin or mineral deficiencies caused by illness, pregnancy, poor nutrition, digestive disorders, certain medications, and many other conditions. Check Price on Chewy. 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. * This fact sheet focuses primarily on these basic, broad-spectrum MVMs. Among the 69.8% who took a dietary supplement (most likely a prenatal MVM supplement), the risk of inadequate intakes of many nutrients was lower. After 7.5 years of use, the supplements lowered total cancer incidence by 31% and all-cause mortality rates by 37% in men but not women. Common side effects may include: upset stomach; Multiple-micronutrient supplement for women during pregnancy (review). We will explore situations that a multivitamin may be health-promoting, as well as if there is a benefit or harm in taking extra nutrients . Blumberg JB, Bailey RL, Sesso HD, Ulrich CM. These beneficial effects include a significant increase of glucose uptake by skeletal muscle cells of up to 450%. Self-reported health without clinically measurable benefits among adult users of multivitamin and multimineral supplements: A cross-sectional study. Vitamin, mineral, and multivitamin supplementation to prevent cardiovascular disease and cancer. Here are some of the key benefits of consuming red cabbage: Rich in nutrients: Red cabbage is a good source of vitamins and minerals, including vitamin C, vitamin K, vitamin A, potassium, calcium, and iron. JAMA Network open 2019;2(6):e195967. Ironically, the populations at highest risk of nutritional inadequacy who might benefit the most from MVMs are the least likely to take them [1]. Taking excess vitamin A (as retinol or other preformed forms of vitamin A but not beta-carotene) during pregnancy can increase the risk of birth defects in infants. Several studies have found that MVM users tend to have higher micronutrient intakes from their diet alone than nonusers [15]. 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 [45]. Circ Cardiovasc Qual Outcomes 2018; 11(7):e004224. 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. However, they are required to bear a Supplement Facts label and ingredient list describing whats in theproduct. Participants completed standardized cognitive tests administered over the telephone at baseline and annually for 3 years. This is a fact sheet intended for health professionals. Otten JJ, Hellwig JP, Meyers LD (editors). Long-term multivitamin supplementation and cognitive function in men: A randomized trial. For example, several B vitamins are necessary for basic survival function, such as converting glucose from food into cellular energy (adenosine triphosphate . A number of minerals are essential for health: calcium, phosphorus, potassium, sodium, chloride, magnesium, iron, zinc, iodine, sulfur, cobalt, copper, fluoride, manganese, and selenium. This analysis included 4,933 adults who reported taking an MV or MVM during the previous 12 months and 16,670 nonusers [37]. MVMs providing nutrients at or up to 100% DV do not typically interact with medications. Another team defined MVMs as "full-spectrum" products providing all 12 vitamins plus 10 minerals [9]. Men. There are also reports of . Ophthalmology 2014;121:525-34. The Physicians Health Study II was the longest clinical trial to investigate whether MVMs might help prevent chronic disease. Brand Name: Generic Name: 32 Multivitamins & Multiminerals Dosage form: Tablet Indications: For the prevention and treatment of vitamins & mineral deficiencies as a complete daily nutritional supplement. Published online ahead of print. Upper Limit. 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 2006 concluded that the evidence was insufficient for them to recommend for or against the use of MVs or MVMs to prevent chronic disease [1]. A lack of these vitamins and minerals typically impairs blood health and the conversion of macronutrients into usable energy (i.e., ATP). The DGA, noting the difficulty of obtaining sufficient vitamin D from foods, advises that young children might need to continue taking a vitamin D supplement after age 12 months [54]. Minerals (especially taken in large doses) can cause side effects such as tooth staining, increased urination, stomach bleeding, uneven heart rate, confusion, and muscle weakness or limp feeling. Studies of the association between MVM use and CVD outcomes have focused on several outcomes, including cardiovascular events and mortality. Most studies of the potential value of MVMs to enhance health and prevent disease have been observational and compared individuals who chose to take MVM supplements with others who did not take supplements. Nutrition Reviews 2021; published online ahead of print. Breast Cancer Res Treat 2013;141:495-505. [, Saldanha LG, Dwyer JT, Haggans CJ, Mills JL, Potischman N. Perspective: Time to resolve confusion on folate amounts, units, and forms in prenatal supplements. It is reasonably priced, and there's enough product to last a single cat about a month. ** These MVMs might also include other nutrients and botanical ingredients. Essentially all vitamin absorption occurs in the small intestine. Many foods also have fiber and other substances that can provide health benefits. People who take certain blood thinners, such as warfarin (Coumadin, Jantoven), should talk with their health care providers before taking any MVM or dietary supplement containing vitamin K [67,68]. Vitamin D, iron, and zinc are three important ones. How to use Theragran-M oral. Clinical trials, where individuals are randomly assigned to take the dietary supplement or a placebo, are better than observational studies for determining whether MVMs might affect disease risk. Among children and adolescents, MVM use rates were 11.0% for up to 2 years of age, 34.6% for ages 25 years, 29.5% for ages 611 years, and 17.3% for ages 1219 years [11]. Ann Pharmacother 2011;45:476-84. Approximately 7476% of the men and 7275% of the women had adequate intakes on average from food alone of the 17 nutrients examined, but use of MVMs increased the prevalence of adequacy to 84% for the men and 83% for the women. Absorption of vitamins in the intestine is critical in avoiding deficiency states, and impairment of . Follow all directions on the product package, or take as directed by your doctor. Examples of these populations are described below: People who could become pregnant Blood levels of oxygen, carbon dioxide, and minerals. The known vitamins include A, C, D, E, and K, and the B vitamins: thiamin (B1), riboflavin (B2), niacin (B3), pantothenic acid (B5), pyridoxal (B6), cobalamin (B12), biotin, and folate/folic acid. MVMs, in particular, are popular supplements, currently taken by an estimated one-third of all adults in the United States, and one-quarter of children and adolescents take an MVM or MV [2,3]. US Preventive Services Task Force recommendation statement. Some experts have hypothesized that MVM use might reduce the incidence of CVD or rates of deaths from this disease, possibly because certain nutrients in these products might reduce blood pressure or affect vascular function. Clinical trials and observational studies to assess the chronic disease benefits and risks of multivitamin-multimineral supplements. "Vitamin D and . [, Omenn GS, Goodman GE, Thornquist MD, Balmes J, Cullen MR, Glass A, et al. . 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 [51]. Although MVM use might not reduce overall chronic disease risk, several nutrients in MVMs might benefit certain groups of people. The vitamin A UL during pregnancy is 2,800 mcg/day for adolescents and 3,000 mcg/day for women [66]. The studies (which were of low quality overall) included a total of 355,034 women ages 2079; those taking MVs and MVMs took them for at least 3 years. However, MVMs often have small amounts of certain nutrients, such as calcium, magnesium, and potassium, so supplement users should check product labels. J Natl Cancer Inst 1993;85:1492-8. View in Scopus Google . . Iron is also a nutrient of public health concern for infants ages 611 months who are fed primarily human milk and do not consume enough iron from complementary foods, adolescent females, and people who are pregnant. Inflammation is a biological response of the immune system that can be triggered by many factors, like microbes, infections, and damaged cells. They belong to the micro nutrients and are required for normal metabolism in layer poultry. Vitamin (Common Names) Recommended Dietary Allowance (RDA) or Daily Adequate Intake (AI)*. Pregnant and breastfeeding people, adult women, non-Hispanic Blacks, people of low socioeconomic status, and individuals who are underweight or overweight are among the groups with the greatest risk of deficient intakes of one or more nutrients [9]. The NCCIH Clearinghouse provides information onNCCIHand complementary and integrative health approaches, including publications and searches of Federal databases of scientific and medical literature. 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]. N Engl J Med 1994;330:1029-35. Participants who took the MVM did not have fewer major cardiovascular events, myocardial infarctions, strokes, or cardiovascular-related deaths than nonusers [38]. One team of researchers categorized MVMs more ambiguously as "stress-tab-type," "therapeutic type," and "one-a-day type," so these products probably included MVs as well [8]. Theres no convincing evidence that MVMs help prevent chronicdisease. Am J Clin Nutr 2007;85:325S-7S. For guidance from NCCIH on using PubMed, see How To Find Information About Complementary Health Approaches on PubMed. For more information about building a healthy dietary pattern refer to the Dietary Guidelines for Americans and the U.S. Department of Agriculture's MyPlate. An analysis of dietary supplement use in the United States from the 20172018 National Health and Nutrition Examination Survey (NHANES) found that MVMs (defined as products containing three or more vitamins and at least one mineral) were the most commonly consumed supplement. Cochrane Database of Systematic Reviews 2019, Issue 3. Vitamin and mineral supplements for the primary prevention of cardiovascular disease and cancer. All results were adjusted to exclude potential confounders, such as the use of single vitamin or mineral supplements. Some evidence from RCTs has focused on the use of MVMs to reduce the risk of various chronic diseases. Choosing whole grain side dishes, cereals, breads and more may lower the risk for heart disease, type 2 diabetes and cancer and improve digestion, too. In the Age-Related Eye Disease Study (AREDS), investigators randomized 4,757 individuals aged 5580 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 (500 mg), vitamin E (400 IU), beta-carotene (15 mg), zinc (80 mg), and copper (2 mg) [30,31]. Rosenberg IH. Furthermore, investigators define MVMs differently (or sometimes not at all) in their studies to evaluate the potential health effects of these products. MVM supplementation, with or without the cocoa extract, improved global cognition, a benefit most pronounced in participants with a history of CVD. Multivitamins, vision are an over-the-counter (OTC) product used to reduce the risk of vision loss among moderate to advanced age-related macular degeneration (AMD) patients and as an ocular (eye) vitamin supplement. Lim J, Weinstein SJ, Liao LM, Sinha R, Huang J, Albanes D. Multivitamin use and overall and site-specific cancer risks in the National Institutes of Health-AARP Diet and Health Study. NCCIH and the National Institutes of Health (NIH) provide tools to help you understand the basics and terminology of scientific research so you can make well-informed decisions about your health. Normally provided in combination with dietary minerals. Other observational data on multiple outcomes come from a cross-sectional analysis of data from participants in the 2012 National Health Interview Survey. Multivitamin use and the risk of cardiovascular disease in men. Minerals (especially taken in large doses) can cause side effects such as tooth staining . Minerals, vitamins, and an immunity booster derived from various plant extracts are included. J Acad Nutr Diet 2018;118:2162-73. History of changes to this fact sheet, U.S. Department of Health & Human Services, Division of Program Coordination, Planning, and Strategic Initiatives, Strengthening Knowledge and Understanding of Dietary Supplements, Multivitamin/mineral Supplements - Health Professional, My Dietary Supplement and Medicine Record, Analytical Methods and Reference Materials (AMRM), NIH Consortium for Advancing Research on Botanical and Other Natural Products (CARBON) Program, Computer Access to Research on Dietary Supplements (CARDS) Database, Dietary Supplement Ingredient Database (DSID), ODS Funding of Grants & Administrative Supplements: FAQ, Administrative Supplements for Validation Studies of Analytical Methods, Staff Bios, Publications, and Presentations, Federal Working Group on Dietary Supplements, NIH Dietary Supplement Research Coordinating Committee, consumer fact sheet on Multivitamin/mineral Supplements, Dietary Reference Intakes: The Essential Guide to Nutrient Requirements, Multivitamin/Mineral Supplements and Prevention of Chronic Disease, Dietary supplement use among adults: United States, 2017-2018, How to prevent cancer: 10 recommendations, Multivitamins do not promote cardiovascular health, Dietary Guidelines for Americans, 2020-2025, WHO recommendations on antenatal care for a positive pregnancy experience, Dietary Reference Intakes for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc. NCCIH has provided this material for your information. : CD004905. Am J Clin Nutr 2007;85:257S-264S. Both the men's and women's One a Day 50+ multivitamins, which Miller and Sonpal recommend, contain calcium and vitamin D, a powerful combo for keeping aging bones strong. As with some observational studies, some RCTs have suggested that MVM use has potential health benefits, but others have found no such benefits. Use of MVs and MVMs (products containing three or more vitamins and/or minerals in amounts below the ULs and no herbs) did not reduce the risk of any chronic disease. MVMs were taken in the past 30 days by 24.0% of men and women aged 2039 years, 29.8% of those aged 4059 years, and 39.4% of those aged 60 and over [10]. 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 [52].