Please read periodic updates at this link - the debate continues!

Below is information found to date by Nutrition Investigator. The National Institutes of Health sponsored a symposium in May, 2006 on Multivitamin/Mineral Supplements and Chronic Disease Prevention.

Multivitamins are currently taken by between 30 to 85% of adults depending on the source you rely on, but it is unclear whether they are useless and potentially harmful unless taken under a doctor's supervision, or whether they are good for you. Multivitamins do not include enough vitamin C, E, and calcium to meet the requirements for high levels, but do add significantly to the intake of potentially harmful substances like beta-carotene and selenium. Those who take multivitamins in the U.S. are generally those who eat the best diets. As they get nearly 100% of their RDAs from the diet, it is questionable whether the supplements is helpful or harmful, and the studies below indicate varied results. Many distinguished experts say taking a multivitamin is a bad idea, others believe that everyone should do it [Walter Willett, Bruce Ames]. Certainly many among the elderly and poor populations in our country have low intakes of a certain nutrients. Unfortunately, these are the people least likely to be taking a multivitamin.

Dosage: It is unclear whether to take one or not. If you eat a good diet with fruits and vegetables, it is probably unnecessary, and may be harmful. If you do take one, be especially cautious about high doses of fat-soluble vitamins and minerals. They can be hazardous, especially if you eat a good diet.Unfortunately, good studies are lacking. When I was taken to dinner by the industry leaders of probably the leading brand of vitamin, they only knew of studies on starving people in China who showed benefit from a multivitamin.

See also C-reactive protein

Losonczy, K. G., Harris, T.B., and Havlik, R. J. "Vitamin E and vitamin C supplement use and risk of all-cause and coronary heart disease mortality in older persons: the Established Populations for Epidemiologic Studies of the Elderly", Am. J. Clin. Nutr. 64:190-6 (1996)

Study of 11,000 people over 66 for 3 years. See table 2:
Relative risk
supplement use	mortality	heart disease	cancer
none	1	1	1
multivitamin	1.04	1.14	1.08
both C and E	0.58	0.47	0.78

Frishman, R. "Aging Alters Mineral Needs", Harvard Health Letter 22: 6-7 (Apr, 1996 )

"There is no evidence that older Americans are short on [magnesium], and there is scant reason for any healthy adult to take magnesium supplements" "Tufts researchers believe that even the lower limit of this range [of chromium set by the Food and Nutrition Board] is higher than necessary...This is another nutrient supplement that need not be purchased." "Not only can [single nutrient supplements] be toxic, but they can interact with other minerals and disrupt the body's nutrient balance"

Stampfer, M. J. and Rimm, E. B. , "Epidemiologic Evidence For Vitamin E In Prevention Of Cardiovascular Disease", Am. J. Clin. Nutr. 62(suppl): 1365S-9S (1995)

Figure 1: Risk of coronary heart disease in Nurses' Health Study according to use of multivitamins and vitamin E supplements.

Vitamin Use Relative Risk

No supplement 1.0

Multivitamin only 0.85

Vitamin E alone 0.40

Vitamin E + multivitamin 0.50

[Personal Health Corporation Conclusion: Multivitamins provide no protection from coronary heart disease and may actually elevate risk. Vitamin E (even in multivitamin) reduces risk. THEREFORE, ONE SHOULD TAKE VITAMIN E. ONE SHOULD NOT TAKE MULTIVITAMINS.]

Blot, W. J., Li, J., Taylor, P.R., Guo, W., Dawsey, S.M., and Li, B., "The Linxian Trials: Mortality Rates By Vitamin-Mineral Intervention Group", Am J Clin Nutr 62(suppl): 1424S-6S (1995)

"After multiple vitamin and mineral supplements were given for 6 y [in a clinical trial of 3318 people], reductions in total and cancer mortality ...were not significant."

Hankinson, S. E., Stampfer, M.J., Seddon, J.M., Colditz, G.A., Rosner, B., Speizer, F.E., and Willett, W.C., "Nutrient Intake and Cataract Extraction in Women: A Prospective Study", British Medical Journal 305: 335-39 (1992)

Trial of 51,000 female nurses in the US, "The risk of cataract was 45% lower among women who used vitamin C supplements for 10 or more years, but no association was noted for multivitamin intake."

Herbert, V. and The Mt. Sinai School of Medicine faculty, Total Nutrition: The Only Guide You Will Ever Need, St, Martin's Press, 1995

"[supplements] are as likely to be harmful as to be helpful."

"One third of Americans regularly consume supplements of ascorbate"

The April, 1993 issue of the American Journal of Public Health points out that "Since supplements help some, harm others, and have no effect on most, one would expect no effect on overall mortality of Americans. ...when they compared the longevity of American non-users (of supplements) versus users, the overall value of supplements to Americans was zero".

"The nutrition quack uses anecdotes and testimonials to support claims. Separating cause and effect can be difficult, especially for the layperson."

"The quack promises quick, dramatic, or miraculous cures."

"Claims are couched in pseudomedical terms or jargon"

Buchman, A.L. ",Vitamin supplementation in the elderly: a critical evaluation", Gastroenterologist 4: 262-75 (1996)

"Routine vitamin supplementation for the elderly has been advocated by many. Specific vitamin deficiencies are rare in free-living elderly"

Hankinson, S. E., et al, "Nutrient intake and cataract extraction in women: a prospective study", BMJ 305:335-39 (1992)

Study of cataracts and supplement use among 50,828 women. Note highest risk is among women taking multivitamins.

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