Multivitamin-Mineral Use Is Associated with Reduced Risk of Cardiovascular Disease Mortality among Women in the United States

Bailey, Regan L; Fakhouri, Tala H.I.; Park, Yikyung; Dwyer, Johanna T.; Thomas, Paul R.; Gahche, Jaime J; Miller, Paige E.; Sempos, Christopher T.; Murray, David M.

doi:10.3945/jn.114.204743

Cited by 28 publications

(20 citation statements)

References 23 publications

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“…Despite the popularity of MVMs, observational studies and randomized controlled trials with the use of MVMs in populations that are mostly nutrient replete provide mixed results on the efficacy of MVMs for health maintenance and for disease prevention and management (6)(7)(8)(9)(10). Studies of MVM safety and effectiveness conducted to date have relied on nutrient content that is based exclusively on the label claims.…”

Section: Introductionmentioning

confidence: 99%

Analytical ingredient content and variability of adult multivitamin/mineral products: national estimates for the Dietary Supplement Ingredient Database ,

Andrews

Roseland

Gusev

et al. 2017

The American Journal of Clinical Nutrition

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Background: Multivitamin/mineral products (MVMs) are the dietary supplements most commonly used by US adults. During manufacturing, some ingredients are added in amounts exceeding the label claims to compensate for expected losses during the shelf life. Establishing the health benefits and harms of MVMs requires accurate estimates of nutrient intake from MVMs based on measures of actual rather than labeled ingredient amounts. Objectives: Our goals were to determine relations between analytically measured and labeled ingredient content and to compare adult MVM composition with Recommended Dietary Allowances (RDAs) and Tolerable Upper Intake Levels. Design: Adult MVMs were purchased while following a national sampling plan and chemically analyzed for vitamin and mineral content with certified reference materials in qualified laboratories. For each ingredient, predicted mean percentage differences between analytically obtained and labeled amounts were calculated with the use of regression equations. Results: For 12 of 18 nutrients, most products had labeled amounts at or above RDAs. The mean measured content of all ingredients (except thiamin) exceeded labeled amounts (overages). Predicted mean percentage differences exceeded labeled amounts by 1.5-13% for copper, manganese, magnesium, niacin, phosphorus, potassium, folic acid, riboflavin, and vitamins B-12, C, and E, and by w25% for selenium and iodine, regardless of labeled amount. In contrast, thiamin, vitamin B-6, calcium, iron, and zinc had linear or quadratic relations between the labeled and percentage differences, with ranges from 26.5% to 8.6%, 23.5% to 21%, 7.1% to 29.3%, 20.5% to 16.4%, and 21.9% to 8.1%, respectively. Analytically adjusted ingredient amounts are linked to adult MVMs reported in the NHANES 2003-2008 via the Dietary Supplement Ingredient Database (http://dsid.usda.nih.gov) to facilitate more accurate intake quantification. Conclusions: Vitamin and mineral overages were measured in adult MVMs, most of which already meet RDAs. Therefore, nutrient overexposures from supplements combined with typical food intake may have unintended health consequences, although this would require further examination.Am J Clin Nutr 2017;105:526-39.

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Section: Introductionmentioning

confidence: 99%

Analytical ingredient content and variability of adult multivitamin/mineral products: national estimates for the Dietary Supplement Ingredient Database ,

Andrews

Roseland

Gusev

et al. 2017

The American Journal of Clinical Nutrition

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“…Moreover, in one of the studies, only men were enrolled; therefore, gender analysis of the results was not possible. On the contrary, a retrospective epidemiological study showed that use of multivitamin-mineral supplements for ≥3 years was associated with reduced risk of CVD mortality among women when models controlled for age, race, education, body mass index, alcohol, aspirin use, serum lipids, blood pressure and blood glucose/glycated hemoglobin [ 56 ]. These findings were confirmed by the results of a Swedish study in which the use of multivitamins was associated with reduced risk of myocardial infarction, and this reduction was even greater if women used supplements for ≥5 years [ 57 ].…”

Section: Discussionmentioning

confidence: 99%

Effects of Multivitamin, Multimineral and Phytonutrient Supplementation on Nutrient Status and Biomarkers of Heart Health Risk in a Russian Population: A Randomized, Double Blind, Placebo Controlled Study

et al. 2018

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The primary objective of this clinical study was to evaluate the effect of a dietary multivitamin, multimineral and phytonutrient (VMP) supplement on blood nutrient status and biomarkers of heart health risk in a Russian population. One hundred twenty healthy adults (40–70 years) were recruited for a 56-day (eight-week) randomized, double blind, placebo controlled study with parallel design. Subjects were divided into two groups and received either a VMP or a placebo (PLA) supplement. Blood nutrient levels of β-carotene, α-tocopherol, vitamin C, B6, B12, red blood cell (RBC) folate, Zinc and Selenium were measured at baseline and on Days 28 and 56, and quercetin was measured at baseline and on Day 56. Blood biomarkers of heart health, i.e. homocysteine (Hcy), high-sensitivity C-reactive protein (hs-CRP), oxidized LDL (ox-LDL), gamma-glutamyl transferase (GGT), uric acid and blood lipid profile, were measured at baseline and Day 56. Dietary VMP supplementation for 56 days significantly increased circulating levels of quercetin, vitamin C, RBC folate and partially prevented the decline in vitamin B6 and B12 status. Both serum Hcy and GGT were significantly reduced (−3.97 ± 10.09 µmol/L; −1.68 ± 14.53 U/L, respectively) after VMP supplementation compared to baseline. Dietary VMP supplementation improved the nutrient status and reduced biomarkers of heart health risk in a Russian population.

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“…We however had information on various health factors for the participants during midlife, which were consistent with the information available for later in life and confirmed that users had, in some ways, a healthier lifestyle than non-users. Many others have reported supplement users to be healthier than non-users, which make it difficult to separate the impact of supplements from other health-related factors on chronic disease outcomes (20,(30)(31)(32)(33)(34) .…”

Section: Discussionmentioning

confidence: 99%

“…Other cohort studies have come to the same conclusion on no association of multivitamin use and total mortality (14)(15)(16)(17)(18)(19) or CVD-related mortality (9,14,17,18,20,35) . The observational studies that have reported an association between multivitamin use and statistically significant lower risks for CVD-related mortality tend to include specialised groups with inadequate diets (14,36) or long duration of use (15,30,37) .…”

Section: Discussionmentioning

confidence: 99%

Dietary supplement use in the older population of Iceland and association with mortality

et al. 2017

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Dietary supplements are often used by the elderly to improve their nutritional status. However, intake above the recommended dietary levels may be detrimental, and uncertainty exists on the potential health benefits of supplementation in this population. The aim of this study was to describe supplement use among Icelandic older adults and to assess its association with total mortality and CVD-related mortality. This study used data from the Age Gene/Environment Susceptibility-Reykjavik study, which recruited 5764 participants aged 66–98 years in 2002–2006. Intake of vitamins and minerals from dietary supplements was estimated from interviews. Hazard ratios (HR) for mortality were estimated in multivariate analyses with follow-up ending in 2009. The results showed that most (77 %) of the participants used supplements. Overall, the consumption of vitamins and minerals from supplements was moderate although 22 and 14% of users exceeded the upper recommended intake levels for vitamin B6 and Zn, respectively. Supplement users followed in general a healthier lifestyle than non-users. There were 1221 deaths including 525 CVD-related deaths during the follow-up period. When comparing multivitamin users with non-users in multivariable models, no associations with total mortality (HR 0·91; 95% CI: 0·77, 1·08) or CVD-related mortality (HR 0·91; 95% CI 0·70, 1·18) were observed. In conclusion, users of supplements generally lead healthier lifestyles than non-users and supplements did not confer any added advantage or harm relative to mortality risk. However, the intake of vitamin B6 and Zn from dietary supplements exceeded the recommended daily intake for almost a quarter of the supplement users.

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Multivitamin-Mineral Use Is Associated with Reduced Risk of Cardiovascular Disease Mortality among Women in the United States

Cited by 28 publications

References 23 publications

Analytical ingredient content and variability of adult multivitamin/mineral products: national estimates for the Dietary Supplement Ingredient Database ,

Analytical ingredient content and variability of adult multivitamin/mineral products: national estimates for the Dietary Supplement Ingredient Database ,

Effects of Multivitamin, Multimineral and Phytonutrient Supplementation on Nutrient Status and Biomarkers of Heart Health Risk in a Russian Population: A Randomized, Double Blind, Placebo Controlled Study

Dietary supplement use in the older population of Iceland and association with mortality

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