Vitamin and mineral supplements
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The Role of Vitamin and Mineral Supplements in Health
Introduction to Vitamin and Mineral Supplements
Vitamin and mineral supplements are widely used with the intention of preventing chronic diseases, enhancing cognitive function, and improving overall health. Despite their popularity, the efficacy and safety of these supplements remain subjects of extensive research and debate.
Prevention of Cardiovascular Disease and Cancer
Multivitamins and Cancer Prevention
Research indicates that multivitamin use may have a modest effect on reducing cancer incidence in men. Two large trials involving 27,658 participants reported a lower cancer incidence in men who took multivitamins for over ten years, with a relative risk of 0.93 1. However, this effect was not observed in women 1. Another systematic review found that multivitamin use was associated with a lower incidence of any cancer and lung cancer, although the evidence had significant limitations 6.
Single Nutrients and Chronic Disease
Studies on single and paired nutrients such as vitamins A, C, D, folic acid, selenium, and calcium have shown no clear evidence of benefit or harm in preventing cardiovascular disease (CVD) or cancer 16. Notably, beta-carotene was associated with an increased risk of lung cancer in smokers and did not prevent CVD or cancer 16.
Cognitive Function and Dementia
B Vitamins and Antioxidants
Research on the effects of B vitamins (folic acid, vitamin B12, and vitamin B6) on cognitive function in healthy adults over 40 years old suggests that these supplements likely have little to no effect on global cognitive function up to ten years 2. Similarly, studies on antioxidant vitamins (beta-carotene, vitamin C, and vitamin E) provided mixed results, with some evidence of benefit for beta-carotene and vitamin C after long-term use, but no significant effect on dementia incidence 2.
Vitamin D and Minerals
Vitamin D3 and calcium supplements showed no significant effect on overall cognitive function or the incidence of dementia over a period of up to ten years 2. Zinc and copper supplementation also demonstrated little to no effect on cognitive outcomes 2.
Specific Populations and Conditions
Inflammatory Bowel Disease (IBD)
A study on patients with IBD in remission found that multivitamin and mineral supplements did not reduce the risk of infections compared to a placebo 5. This suggests that supplementation may not provide additional benefits in preventing infections for this specific group.
High-Risk Populations
In Linxian, China, a population with high rates of esophageal and stomach cancer, supplementation with beta-carotene, vitamin E, and selenium was associated with a significant reduction in total mortality and cancer rates, particularly stomach cancer 3. This indicates that in populations with specific nutritional deficiencies, targeted supplementation can have beneficial effects.
Safety and Risks
Adverse Effects
While most studies report that vitamin and mineral supplements are generally safe, some supplements have been associated with adverse effects. For instance, beta-carotene increased lung cancer risk in smokers, and vitamin E was linked to a higher risk of hemorrhagic stroke 16. Additionally, high doses of vitamin A were associated with an increased risk of hip fractures, and vitamin C and calcium were linked to kidney stones 6.
Conclusion
The evidence on the benefits of vitamin and mineral supplements for preventing chronic diseases, enhancing cognitive function, and improving overall health is mixed. While multivitamins may offer a small benefit in reducing cancer incidence in men, single nutrients generally show no clear benefit for preventing CVD or cancer. Cognitive benefits from supplementation are also limited, with some potential for long-term antioxidant use. Safety concerns exist for certain supplements, particularly in high-risk populations. Therefore, the use of vitamin and mineral supplements should be considered carefully, with attention to individual health needs and potential risks.
Sources and full results
Most relevant research papers on this topic
Vitamin and Mineral Supplements in the Primary Prevention of Cardiovascular Disease and Cancer: An Updated Systematic Evidence Review for the U.S. Preventive Services Task Force
Vitamin and mineral supplements show limited evidence for preventing cancer or cardiovascular disease, with two trials showing a small, borderline-significant benefit for men only and no effect on CVD.
Systematic Review
Highly CitedVitamin and mineral supplementation for maintaining cognitive function in cognitively healthy people in mid and late life.
Vitamin and mineral supplementation may not significantly improve cognitive function in cognitively healthy adults aged 40 years or older.
Meta-Analysis
Very Rigorous JournalHighly CitedNutrition intervention trials in Linxian, China: supplementation with specific vitamin/mineral combinations, cancer incidence, and disease-specific mortality in the general population.
Dietary supplementation with beta carotene, vitamin E, and selenium may reduce cancer risk and mortality rates in Linxian adults.
RCTHighly CitedThe Efficacy and Safety of Multivitamin and Mineral Supplement Use To Prevent Cancer and Chronic Disease in Adults: A Systematic Review for a National Institutes of Health State-of-the-Science Conference
Multivitamin and mineral supplements are effective in primary prevention of cancer and chronic diseases in adults, with no known adverse effects.
Systematic ReviewHighly CitedThe Efficacy of an Over-the-Counter Multivitamin and Mineral Supplement to Prevent Infections in Patients With Inflammatory Bowel Disease in Remission With Immunomodulators and/or Biological Agents: A Randomized, Double-Blind, Placebo-Controlled Clinical Trial.
An over-the-counter multivitamin and mineral supplement did not reduce the risk of infection for patients with inflammatory bowel disease in remission treated with immunomodulators, biologic therapy, or combination therapy.
RCT
Large Human TrialVitamin and Mineral Supplements for the Primary Prevention of Cardiovascular Disease and Cancer: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force.
Multivitamin use may lower cancer incidence, but the evidence for this benefit is limited, and vitamin D and vitamin E supplementation may not significantly impact cardiovascular disease or cancer outcomes.
Systematic ReviewHighly CitedThe Effects of Vitamin-Mineral Supplements on Serious Rule Violations in Correctional Facilities for Young Adult Male Inmates: A Randomized Controlled Trial
A daily dose of 100% RDA vitamin-mineral supplements, but not higher doses, resulted in 39% fewer serious rule violations than placebo in young adult male inmates.
RCTLarge Human TrialVitamins and minerals
This chapter explains the properties, biological importance, and loss of vitamins, as well as the benefits and concerns of vitamin supplementation, and provides recommendations for daily intake of 14 essential minerals.
Highly CitedThe Role of Vitamins and Minerals in Hair Loss: A Review
Micronutrients play a crucial role in normal hair follicle development and immune cell function, and deficiency may be a modifiable risk factor for alopecia.
Systematic ReviewHighly CitedUse of vitamin and mineral supplements: demographics and amounts of nutrients consumed. The 1987 Health Interview Survey.
Vitamin and mineral supplementation is a common health habit for most Americans, but does not pose a significant health risk for most individuals.
Observational StudyHighly Cited