Disclaimer: This content has been produced purely for informational and educational purposes only and is never intended to be used as a substitute for professional medical guidelines including diagnosis, advice, and treatment. 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. MVMs cannot take the place of eating a variety of foods that are important to a healthy diet. Function: It is necessary for producing energy and hormones. One RCT conducted in Linxian, China, randomized 3,318 persons ages 4069 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 2 to 3 times recommended amounts or a placebo for 6 years [44]. Multivitamin/mineral supplements (MVM) are widely used in many populations. Secondary metabolites. There is no one single thing that makes it work. A multivitamin is a preparation intended to serve as a dietary supplement with vitamins, dietary minerals, and other nutritional elements.Such preparations are available in the form of tablets, capsules, pastilles, powders, liquids, or injectable formulations.Other than injectable formulations, which are only available and administered under medical supervision, multivitamins are recognized by . Your child needs a variety of vitamins and minerals to grow healthy and strong. Take this medication by mouth, usually once daily or as directed. 8. When you combine at least two or more of these brain-enhancing formulas, what you get is called a stack. Rosenberg IH. For example, 27.7% had inadequate intakes of vitamin A from foods alone, but this rate dropped to 15.5% when supplements were included. However, one study in this meta-analysis found a 19% higher risk of breast cancer in 25.5% of 35,329 Swedish women who reported taking an MV or MVM (in most cases nutrients in amounts close to RDA levels) than in women who did not take these supplements over an average of 9.5 years [21]. The supplements provided no protection from CVD. Next: . Iron is necessary for the production of hemoglobin. Overall, MVM supplementation was not associated with better cardiovascular outcomes, including lower risk of mortality from CVD and coronary heart disease, or of stroke incidence and mortality. Am J Clin Nutr 2022;115:1501-10. Many multivitamin products also contain minerals such as calcium, iron, magnesium, potassium, and zinc. Even in the United States, the amount of folic acid in prenatal MVM supplements is typically 800 or 1,000 mcg, which is much higher than the recommended amount (400 mcg) to reduce the risk of neural tube defects in babies [19]. In Canada, almost all prenatal MVM supplements provide 1,000 mcg/day of folic acid. 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. Cancer Causes and Control 2001;12:927-34. Nutrients 2017, 9, 849. For example, the Agency for Healthcare Research and Quality, in an evidence-based review of the role of MVMs in chronic disease prevention, defined MVMs as products containing at least three vitamins and minerals in amounts below the UL but no herbs, hormones, or drugs [7]. Data from the later AREDS2 study showed that a supplement formulation containing the carotenoids lutein and zeaxanthin instead of beta-carotene was safer and more effective in slowing the progression of AMD. When taken as directed, multivitamins and minerals are not expected to cause serious side effects. Multivitamins in the prevention of cancer in men: the Physicians' Health Study II randomized controlled trial. [. which is why it's a critical component in prenatal vitamins mechanism of action. Vitamins A, C, D and E were used alone, in combination or with other nutritional and non . However, use of MVs or MVMs conferred no protection among participants consuming less than two alcoholic beverages per day, whereas use among those consuming more was associated with a 29% lower risk of colon cancer mortality. 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. Other observational data on multiple outcomes come from a cross-sectional analysis of data from participants in the 2012 National Health Interview Survey. Telecommunications relay service (TRS): 7-1-1, Email: info@nccih.nih.gov (link sends email). Blood levels of oxygen, carbon dioxide, and minerals. 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]. The effect of vitamin E and beta carotene on the incidence of lung cancer and other cancers among male smokers. After adjustment for potentially confounding variables (e.g., age, race, BMI, serum lipids, and blood pressure), 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. Mechanism of Action. . [, Rautiainen S, Rist PM, Glynn RJ, Buring JE, Gaziano JM,Sesso HD. 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. Abdominal pain. Absorption of Vitamins. 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]. 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]. 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. 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. Association of multivitamin and mineral supplementation and risk of cardiovascular disease. [, Bailey RL, Pac SG, Fulgoni III VL, Reidy KC, Catalano PM. [, Rose EG, Murphy MSQ, Erwin E, Muldoon KA, Harvey ALJ, White RR, et al. Prevalence of dietary supplement use in US children and adolescents, 2003-2014. The use of MVMs resulted in lower odds of low birth weight (less than 2,500 g) by 12%, birth at a smaller size than normal for gestational age by 8%, and premature births (before week 37 of pregnancy) by 10% than use of supplements containing iron with or without folic acid alone or placebo. ET, or . This document does not contain all possible side effects and others may occur. BMJ Open 2020;10:e039119. View in Scopus Google . The compound is produced by plants as a defense mechanism against stress, injury, and infection. American College of Obstetrics and Gynecologists. Another team defined MVMs as "full-spectrum" products providing all 12 vitamins plus 10 minerals [9]. Enzymes for detoxification of various mycotoxins: origins and mechanisms of catalytic action. Nutrients 2020;12, 3394. [, Murphy SP, White KK, Park S-Y, Sharma S. Multivitamin-multimineral supplements' effect on total nutrient intake. US Pharm. Therefore, these terms refer to products that have widely varying compositions [5]. Mishra S, Stierman B, Gahche JJ, Potischman N. Stierman B, Mishra S, Gahche JJ, Potischman N, Hales CM. Another large prospective study investigated the association between use of MVs and MVMs (mostly MVMs described as "therapeutic or theragran," "one-a-day," or "stress-tab") and risk of cancer by following 489,640 men and women aged 5071 years for 16 years [8]. 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. 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]. 2007;1:42-55. The MVM also improved memory and executive function. Another type of neural control mechanism is the withdrawal reflex, in which the hand is jerked away from a painful stimulus such as broken glass. Water and some water-soluble vitamins are absorbed by diffusion. Although they are all considered micronutrients, vitamins and minerals differ in basic ways. Taking excess amounts of vitamin A (preformed retinol form, not as beta-carotene) during pregnancy has been shown to increase the risk of birth defects. 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]. Prevention of rickets and vitamin D deficiency in infants, children, and adolescents. Theoretical basis for harm. The DGA adds that the use of some medications (such as proton pump inhibitors) can decrease absorption of vitamin B12 in foods [54]. Vitamins and minerals serve crucial functions in almost all bodily processes and must be obtained from foods or supplements, as our bodies are unable to make them. Multivitamin use and the risk of cardiovascular disease in men. One RCT randomized 1,708 participants aged 50 years and older who had had an MI at least 6 weeks earlier to take a daily MVM containing 27 nutrients (many in doses higher than recommended amounts) for a median of 31 months (range 13 to 60 months) or a placebo as well as their standard medications. [, Qato DM, Alexander GC, Guadamuz JS, Lindau ST. The model comprises an oxygenation that is coupled to carbon-carbon bond . Any vitamins, minerals, or other types of dietary supplements? Systematic information on the bioavailability and bioequivalence of vitamins and minerals in marketed products and on potential drug interactions is scarce. [, Bird JK, Murphy RA, Ciappio ED, McBurney MI. In some cases, fortified foods and dietary supplements are useful when it is not possible otherwise to meet needs for one or more nutrients (e.g., during specific life stages such as pregnancy" [54]. However, if you consume fortified foods and beverages (such as cereals or drinks with added vitamins and minerals) along with dietary supplements, you should make sure that your total intake of vitamins and minerals is not more than the safe upper limits for any nutrients. Both observational studies and clinical trials have examined this possibility. In another RCT of 18,314, smokers, former smokers, and asbestos-exposed persons, participants who took a combination of 30 mg/day of beta-carotene plus 25,000 IU/day of vitamin A (as retinol) had a 28% higher lung cancer risk than those taking a placebo after an average 4-year follow-up period [65]. Women. Cardiovascular disease (CVD)
Various government surveys of dietary supplements and popular food-frequency questionnaires also define MVs and MVMs differently, include different examples, or ask about different products.