Take supplements? Study of 400,000 people delivers an unbiased verdict on multivitamins...and it's not good

Consumers agree: the supplements industry generated a revenue of £610 million this year alone.

Business may be booming but it doesn't necessarily follow that the money is being well spent. Studies consistently suggest that multivitamins fail to live up to their promise.

Now, researchers have subjected the biggest claims to even greater scientific scrutiny - and the results are in.

Previous studies of multivitamin use and mortality have yielded mixed results and been limited by short follow-up times.

To more deeply explore the relationship between long-term regular multivitamin use and overall mortality and death from cardiovascular disease and cancer, the researchers analysed data from three large, geographically diverse prospective studies involving a total of 390,124 US adults who were followed for more than 20 years. The full results are published in JAMA Network.

The participants included in this analysis were generally healthy, with no history of cancer or other chronic diseases.

Because the study population was so large and included lengthy follow-up and extensive information on demographics and lifestyle factors, the researchers were able to mitigate the effects of possible biases that may have influenced the findings of other studies. For example, people who use multivitamins may have healthier lifestyles in general, and sicker patients may be more likely to increase their use of multivitamins.

The analysis showed that people who took daily multivitamins did not have a lower risk of death from any cause than people who took no multivitamins.

There were also no differences in mortality from cancer, heart disease, or cerebrovascular diseases. The results were adjusted for factors such as race and ethnicity, education, and diet quality.

The researchers noted that it is important to evaluate multivitamin use and risk of death among different kinds of populations, such as those with documented nutritional deficiencies, as well as the potential impact of regular multivitamin use on other health conditions associated with ageing.

The new study builds on previous evidence suggesting that multivitamins are a lame duck.

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In an editorial in the journal Annals of Internal Medicine titled “Enough Is Enough: Stop Wasting Money on Vitamin and Mineral Supplements”, Johns Hopkins researchers reviewed evidence about supplements, including three very recent studies:

• An analysis of research involving 450,000 people, which found that multivitamins did not reduce risk for heart disease or cancer.
• A study that tracked the mental functioning and multivitamin use of 5,947 men for 12 years found that multivitamins did not reduce risk for mental declines such as memory loss or slowed-down thinking.
• A study of 1,708 heart attack survivors who took a high-dose multivitamin or placebo for up to 55 months. Rates of later heart attacks, heart surgeries and deaths were similar in the two groups.

It would be foolish to dismiss the weight of evidence stacking up against multivitamin use.

However, popping one a day will not do you any harm. And it may offer some cognitive benefit, although the effects are likely to be small.

I would defer to the NHS advice on this one: "Most people should get all the nutrients they need by having a varied and balanced diet, although some people may need to take extra supplements."