Multivitamin-multimineral supplementation and mortality: a meta-analysis of randomized controlled trials

Macpherson, Helen; Pipingas, Andrew; Pase, Matthew P.

doi:10.3945/ajcn.112.049304

Cited by 93 publications

(67 citation statements)

References 52 publications

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“…These results are consistent with other rodent studies indicating that nutraceutical supplements have no effect on lifespan, or shorten it (Ristow and Schmeisser 2011;Selman et al 2013;Spindler et al 2013b). Our results also are consistent with studies of initially healthy humans indicating that the use of dietary supplements is associated with either no effect or a negative effect on survival (e.g., Bjelakovic et al 2004; Chowdhury et al Macpherson et al 2013;Miller et al 2005;Myung et al 2013;Rizos et al 2012). While some supplements may be effective in treating specific disease states, most data suggest that either simple or complex combinations of supplements are not effective in delaying the onset or progress of the major causes of death in mice or humans.…”

Section: Discussionsupporting

confidence: 90%

“…Meta-analysis of randomized controlled human trials, and studies performed with rodents generally do not support the idea that the consumption of dietary supplements can increase the lifespan of initially healthy individuals (e.g., Macpherson et al 2013;Spindler 2012;Spindler and Mote 2007;Spindler et al 2013b). Rather, some nutraceutical supplements appear to decrease the longevity of some individuals (e.g., Heinonen and Albanes 1994;Hemila and Kaprio 2011).…”

Section: Introductionmentioning

confidence: 99%

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Lifespan effects of simple and complex nutraceutical combinations fed isocalorically to mice

Spindler

Mote

Flegal

2013

AGE

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Present data suggest that the consumption of individual dietary supplements does not enhance the health or longevity of healthy rodents or humans. It might be argued that more complex combinations of such agents might extend lifespan or health-span by more closely mimicking the complexity of micronutrients in fruits and vegetables, which appear to extend health-span and longevity. To test this hypothesis we treated long-lived, male, F1 mice with published and commercial combinations of dietary supplements and natural product extracts, and determined their effects on lifespan and health-span. Nutraceutical, vitamin or mineral combinations reported to extend the lifespan or health-span of healthy or enfeebled rodents were tested, as were combinations of botanicals and nutraceuticals implicated in enhanced longevity by a longitudinal study of human aging. A cross-section of commercial nutraceutical combinations sold as potential health enhancers also were tested, including Bone Restore®, Juvenon®, Life Extension Mix®, Ortho Core®, Ortho Mind®, Super K w k2®, and Ultra K2®. A more complex mixture of vitamins, minerals, botanical extracts and other nutraceuticals was compounded and tested. No significant increase in murine lifespan was found for any supplement mixture. Our diverse supplement mixture significantly decreased lifespan. Thus, our results do not support the hypothesis that simple or complex combinations of nutraceuticals, including antioxidants, are effective in delaying the onset or progress of the major causes of death in mice. The results are consistent with epidemiological studies suggesting that dietary supplements are not beneficial and even may be harmful for otherwise healthy individuals.

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Section: Discussionsupporting

confidence: 90%

Section: Introductionmentioning

confidence: 99%

Lifespan effects of simple and complex nutraceutical combinations fed isocalorically to mice

Spindler

Mote

Flegal

2013

AGE

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“…115 Low-fat dairy products may benefit neurocognitive health, 127 while protein and energy supplementation in malnourished people recovering from illness appears to reduce complications and hospital readmissions and increase grip strength. 128 Supplements not supported by the literature included multivitamins, 129,130 B vitamins, [131][132][133] omega-3 fatty acids [134][135][136][137] or supplementing older people without malnutrition with amino acids or protein. 138 High doses of betacarotene, vitamin E and vitamin A are likely to be harmful and should be avoided in older adults.…”

Section: Nutritionmentioning

confidence: 99%

Home-based health promotion for older people with mild frailty: the HomeHealth intervention development and feasibility RCT

Walters

Frost

Kharicha

et al. 2017

Health Technol Assess

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Background Mild frailty or pre-frailty is common and yet is potentially reversible. Preventing progression to worsening frailty may benefit individuals and lower health/social care costs. However, we know little about effective approaches to preventing frailty progression. Objectives (1) To develop an evidence- and theory-based home-based health promotion intervention for older people with mild frailty. (2) To assess feasibility, costs and acceptability of (i) the intervention and (ii) a full-scale clinical effectiveness and cost-effectiveness randomised controlled trial (RCT). Design Evidence reviews, qualitative studies, intervention development and a feasibility RCT with process evaluation. Intervention development Two systematic reviews (including systematic searches of 14 databases and registries, 1990–2016 and 1980–2014), a state-of-the-art review (from inception to 2015) and policy review identified effective components for our intervention. We collected data on health priorities and potential intervention components from semistructured interviews and focus groups with older people (aged 65–94 years) (n = 44), carers (n = 12) and health/social care professionals (n = 27). These data, and our evidence reviews, fed into development of the ‘HomeHealth’ intervention in collaboration with older people and multidisciplinary stakeholders. ‘HomeHealth’ comprised 3–6 sessions with a support worker trained in behaviour change techniques, communication skills, exercise, nutrition and mood. Participants addressed self-directed independence and well-being goals, supported through education, skills training, enabling individuals to overcome barriers, providing feedback, maximising motivation and promoting habit formation. Feasibility RCT Single-blind RCT, individually randomised to ‘HomeHealth’ or treatment as usual (TAU). Setting Community settings in London and Hertfordshire, UK. Participants A total of 51 community-dwelling adults aged ≥ 65 years with mild frailty. Main outcome measures Feasibility – recruitment, retention, acceptability and intervention costs. Clinical and health economic outcome data at 6 months included functioning, frailty status, well-being, psychological distress, quality of life, capability and NHS and societal service utilisation/costs. Results We successfully recruited to target, with good 6-month retention (94%). Trial procedures were acceptable with minimal missing data. Individual randomisation was feasible. The intervention was acceptable, with good fidelity and modest delivery costs (£307 per patient). A total of 96% of participants identified at least one goal, which were mostly exercise related (73%). We found significantly better functioning (Barthel Index +1.68; p = 0.004), better grip strength (+6.48 kg; p = 0.02), reduced psychological distress (12-item General Health Questionnaire –3.92; p = 0.01) and increased capability-adjusted life-years [+0.017; 95% confidence interval (CI) 0.001 to 0.031] at 6 months in the intervention arm than the TAU arm, with no differences in other outcomes. NHS and carer support costs were variable but, overall, were lower in the intervention arm than the TAU arm. The main limitation was difficulty maintaining outcome assessor blinding. Conclusions Evidence is lacking to inform frailty prevention service design, with no large-scale trials of multidomain interventions. From stakeholder/public perspectives, new frailty prevention services should be personalised and encompass multiple domains, particularly socialising and mobility, and can be delivered by trained non-specialists. Our multicomponent health promotion intervention was acceptable and delivered at modest cost. Our small study shows promise for improving clinical outcomes, including functioning and independence. A full-scale individually RCT is feasible. Future work A large, definitive RCT of the HomeHealth service is warranted. Study registration This study is registered as PROSPERO CRD42014010370 and Current Controlled Trials ISRCTN11986672. Funding This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 21, No. 73. See the NIHR Journals Library website for further project information.

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“…There is epidemiologic and clinical trial data supporting an increased risk of cardiovascular events in men taking supplemental calcium 13 , of advanced and fatal prostate cancers in healthy men 14 and transaminitis in HIV patients 16 with multivitamin use, and of mortality in lung cancer patients taking beta carotene and vitamin A 15 . Apart from the risks, the literature is littered with negative clinical trials studying multivitamins [71][72][73][74][75][76] . Thus, we should not automatically assume that multivitamin therapy is not without risks.…”

Section: Assessment Of the Literature And Recommendationsmentioning

confidence: 99%

Is Routine Multivitamin Supplementation Necessary in US Chronic Adult Hemodialysis Patients? A Systematic Review

Tucker

Safadi

Friedman

2015

Journal of Renal Nutrition

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Multivitamin-multimineral supplementation and mortality: a meta-analysis of randomized controlled trials

Abstract: Multivitamin-multimineral treatment has no effect on mortality risk.

Cited by 93 publications

References 52 publications

Lifespan effects of simple and complex nutraceutical combinations fed isocalorically to mice

Lifespan effects of simple and complex nutraceutical combinations fed isocalorically to mice

Home-based health promotion for older people with mild frailty: the HomeHealth intervention development and feasibility RCT

Is Routine Multivitamin Supplementation Necessary in US Chronic Adult Hemodialysis Patients? A Systematic Review

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