Q: What are the benefits of taking a multivitamin? Should I take one even if I’m healthy?

A: In Care Of One third of Americans Taking a lot of vitamins regularly. Many buy the supplement because they think it can have a wide range of health effects—helping them live longer, reducing the risk of cancer and reducing cardiovascular disease. Otherwise, healthy people take it to fill gaps in their diet.

I wish it was that straightforward. Although there is some encouraging evidence regarding the benefits of multivitamins for healthy adults, the supplement is not just medicine.

There have been three major studies investigating whether multivitamins have beneficial health effects, all with private and public funding, including from supplement companies:

  • French Research 13,000 adults ages 35 to 60 found an improvement in cancer risk and death in men, but not women, after 7½ years of daily intake.
  • other Research A study of more than 14,000 American men age 50 and older found that taking a multivitamin for 11 years was associated with an 8 percent reduction in cancer, although there was no difference in death.
  • A study called Cosmos A study of over 3½ years of multivitamin use in more than 21,000 older adults found no improvement in cancer risk, death, or cardiovascular disease for men and women. Another study found that some aspects of cognition improved significantly in men and women over the age of 60.

Taking a multivitamin every day is generally safe. But because there is insufficient evidence for benefits in healthy adults, the US Preventive Services Task Force does not Recommend it.

My take? A healthy diet has been well established in several large studies to improve many health outcomes Reversal of cardiovascular disease to the Reducing the risk of cancer.

You can’t make up for a poor or unbalanced diet by popping a pill to fill nutrient gaps.

Is it better to eat healthy or take vitamins?

Many people have studied the health benefits of supplementing specific nutrient gaps with pills—for example, magnesium is a supplement and a common feature of many multivitamins.

Research shows that magnesium supplementation is not enough to achieve the benefits that come with a magnesium-rich diet. This is possible because of the many other health benefits that go along with a balanced diet that simply boils down to one – or a few – of the ingredients taken from their original forms.

Do multivitamins help cognition?

Big Research In the year Data from the COSMOS database, published in 2023, showed that people who took a multivitamin for a year immediately showed better results in verbal memory. In this test, participants read 20 unique unrelated words several times in a row and then were asked to read a new list of 20 words as a distractor, before being asked to recall as many words as possible from the original list. The study authors concluded that multivitamin supplementation had the effect of improving age-related memory changes in this trial by 3.1 years.

This information is encouraging. We may need more research to better understand the magnitude of this effect and target the right population. For example, people with cardiovascular disease seem to have the most benefit. It is not clear why, but these patients may have a micronutrient deficiency, possibly related Some heart medications.

still, Studies Those who used a more extreme endpoint, such as dementia development, did not show benefit from over-the-counter supplements — something is it. From A Healthy diet. And in the 2023 study, multivitamins did not significantly affect executive functions or other cognitive tests that evaluate the recognition of new objects.

Who should take a multivitamin?

There are a few conditions where we know multivitamins are important:

  • People with food shortages; This may include older adults who have alcohol use disorders or who live in long-term care facilities and lack fruit and vegetable intake. Other people with vitamin B12 deficiency, such as vegans, can take a daily multivitamin to target their deficiency if a multivitamin contains the Daily Value.
  • People who have had bariatric surgery. These patients should be careful to make sure they are meeting their calcium and iron, copper, and zinc goals in their supplements because many multivitamins may not contain the complete daily value of minerals.
  • People who are pregnant or breastfeeding. In this case, a multivitamin with 400 to 800 mg of folic acid should be taken as prescribed by their doctor.

How do I choose the best multivitamin for me?

Multivitamins are not regulated as drugs by the Food and Drug Administration, so there can be wide variations in each brand’s formula.

Typically, they contain a certain percentage of your daily intake of key vitamins and minerals. Some brands contain 70 percent of the daily value of a nutrient—say, vitamin C—while others contain 200 percent.

If you’re healthy, do you need a 200 percent daily vitamin C supplement? Few clinical trials exist to provide specific answers to these questions.

But in general, it makes more sense to choose a vitamin that targets your gender and age group. Multivitamins aimed at young women contain high levels of folic acid (during pregnancy) and iron, which are often low due to losses due to menstruation.

Participants in the COSMOS trial took a Centrum Silver daily multivitamin containing high levels of vitamin D and vitamin B12, which are often found in multivitamins targeted at older individuals.

If you are someone who takes a lot of supplements, read the labels carefully. You don’t want to overdo it on any ingredient.

Smokers should avoid multivitamins containing more than 20 mg of beta-carotene per day. Increase risk Lung cancer in this group.

What I want my patients to know

Putting anything into our bodies involves a risk-benefit calculation. Many people feel that taking a multivitamin is better than nothing and that the risk is very low. While I agree with at least the second part for this reason, in the bigger picture, the harm may come more from the multivitamin itself than from what we as health care providers and society have fundamentally failed to address. When an otherwise healthy patient tells me about a multivitamin, I use that as a starting point to think about what nutrients they’re worried about not getting through their diet and ways we can help them eat more nutritiously.