Absorption of vitamins in the intestine is critical in avoiding deficiency states, and impairment of . The trials included 141,849 pregnant people from low- or middle-income countries in Africa and Asia as well as in Mexico (where malnutrition and micronutrient deficiencies are not uncommon); only one of the studies was conducted in a high-income country, the United Kingdom. Multivitamins/multiminerals (MVMs) are the most frequently used dietary supplements, with close to half of American adults taking them. No. Systematic information on the bioavailability and bioequivalence of vitamins and minerals in marketed products and on potential drug interactions is scarce. Mutlvitamin-multimineral supplementation and mortality: A meta-analysis of randomized controlled trials. As with some observational studies, some RCTs have suggested that MVM use has potential health benefits, but others have found no such benefits. Dietary supplement use differs by socioeconomic and health-related characteristics among U.S. adults, NHANES 2011-2014. When the investigators compared the outcomes of supplement users and nonusers, they found no association between use of these products for a median of 8 years and an increased risk of any common cancer or total cancers, CVD, or total mortality [35]. [, Park S-Y, Murphy SP, Wilkens LR, Henderson BE, Kolonel LN. ** These MVMs might also include other nutrients and botanical ingredients. Because people with healthier diets and lifestyles are more likely to use dietary supplements, attributing health benefits that are distinct from the benefits of healthy behaviors to the use of supplements is difficult [13]. Vitamin B12 (Cobalamin) Mechanism and Deficiency. 1. Vitamin (Common Names) Recommended Dietary Allowance (RDA) or Daily Adequate Intake (AI)*. Carbohydrates, such as cellulose, pass through the human intestinal tract undigested. It is reasonably priced, and there's enough product to last a single cat about a month. Multivitamins in the prevention of cardiovascular disease in men: the Physicians' Health Study II randomized controlled trial. Pediatrics 2008;122:1142-52. [, Grodstein F, O'Brien J, Kang JH, Dushkes R, Cook NR, Okereke O, et al. The model comprises an oxygenation that is coupled to carbon-carbon bond . Secondary metabolites. Challenges and opportunities in the translation of the science of vitamins. Am J Clin Nutr 2007;85:325S-7S. Nevertheless, some users consider use of an MVM as a form of dietary or nutritional insurance, a concept first introduced by Miles Laboratories to market its One-A-Day line of nutrient supplements in the 1940s [13]. Cancer [. It is also indicated to meet the increased demands for vitamins & minerals. We encourage you to discuss any decisions about treatment or care with your health care provider. B12 6mcg, biotin 30mcg, folic . Read the label of any multivitamin product you take to make sure you are aware of what it contains. Huang H-Y, Caballero B, Chang S, Alberg AJ, Semba RD, Schneyer C, et al. What Is Complementary, Alternative, or Integrative Health? NCCIH has provided this material for your information. MVM use did not alter the risk of any of these outcomes. This study included 4,203 participants aged 5085 years who had intermediate AMD in both eyes or intermediate AMD in one eye and advanced AMD in the other eye. Yetley, EA. Revitalize Multi-vitamin and Mineral Complex: Iron (1.5 mg / cap) + Ascorbic acid . Read the Nutrition Facts label on packaged foods or the Supplement Facts label of MVMs to see if the level far exceeds 100% DV. J Am Coll Cardiol 2021;77:423-36. US Preventive Services Task Force recommendation statement. Men and women who reported taking more than one MV or MVM daily at the beginning of the study had an 18% lower risk of developing colon cancer than nonusers. RCTs The effect of vitamin E and beta carotene on the incidence of lung cancer and other cancers among male smokers. A total of 41.5% of the women took an MVM (containing 2030 vitamins and minerals in amounts not exceeding the RDAs), an MV (10 or more vitamins in amounts of 100% or more of the RDA), or a "stress multisupplement" (containing at least 10 nutrients, some in amounts more than twice the RDA) at least once a week. The fat-soluble group includes the Vitamins A, D, E and K, while vitamins of the B complex (B1, B2, B6, B12, niacin, pantothenic . Neither baseline use nor changes in use of MVMs over time were associated with changes in the long-term risk of major CVD events, MI, stroke, cardiac revascularizations, or death from CVD. This document does not contain all possible side effects and others may occur. The products provided an average of 14 nutrients, although the products with 3 nutrients in 5 trials did not contain a mineral. MVM use is less common among smokers and members of certain ethnic and racial groups, such as African Americans, Hispanics, and Native Americans, than among Whites. Vitamins serve crucial functions in almost all bodily processes example immune, hormonal and nervous systems. [, Chan ALF, Leung HWC, Wang S-F. Multivitamin supplement use and risk of breast cancer: A meta-analysis. This is the essential step leading to carboxylation and activation of the blood-clotting proteins. An earlier analysis of 20112014 NHANES data found that 31.2% of the U.S. adult population aged 19 years and older reported taking an MVM in the past 30 days [2]. For example, several B vitamins are necessary for basic survival function, such as converting glucose from food into cellular energy (adenosine triphosphate . Marra MV, Bailey RL. MVM supplementation did not reduce total invasive cancers, although it lowered the incidence of lung cancer by 38%, and it did not reduce any cardiovascular events (such as heart attacks or strokes), death from CVD, or all-cause mortality. [, Gaziano JM, Sesso HD, Christen WG, Bubes V, Smith JP, MacFadyen J, et al. J Nutr 2015;572-8. Because breastmilk provides little vitamin D, the American Academy of Pediatrics recommends that exclusively and partially breastfed infants receive supplements of 400 IU (10 mcg)/day of vitamin D beginning in the first few days after birth and continued until the infant is weaned and drinks at least 1 liter or 1 quart of vitamin D-fortified formula or whole milk daily [58]. Iron is also a nutrient of public health concern for infants ages 611 months who are fed primarily human milk and do not consume enough iron from complementary foods, adolescent females, and people who are pregnant. Vitamin D, iron, and zinc are three important ones. Multivitamins and minerals are also used to treat vitamin or mineral deficiencies caused by illness, pregnancy, poor nutrition, digestive disorders, certain medications, and many other conditions. Cancer Causes and Control 2001;12:927-34. Some electrolytes and water non-soluble vitamins require an active uptake mechanism. One RCT randomized 1,708 participants aged 50 years and older who had had an MI at least 6 weeks earlier to take a daily MVM containing 27 nutrients (many in doses higher than recommended amounts) for a median of 31 months (range 13 to 60 months) or a placebo as well as their standard medications. Observational studies In some cases, fortified foods and dietary supplements are useful when it is not possible otherwise to meet needs for one or more nutrients (e.g., during specific life stages such as pregnancy" [54]. Abdominal pain. It is not intended to substitute for the medical expertise and advice of your health care provider(s). The supplements did not prevent AMD onset or affect cataract risk. People in the United States have taken multi-vitamin/mineral (MVM) and multivitamin (MV) dietary supplements since the early 1940s, when the first such products became available [1]. One team of researchers categorized MVMs more ambiguously as "stress-tab-type," "therapeutic type," and "one-a-day type," so these products probably included MVs as well [8]. A similar meta-analysis of 13 RCTs investigated whether use by pregnant adolescents and young adults aged 10-19 years of an MVM (containing multiple nutrients) led to better birth outcomes than supplementation with only iron and folic acid [34]. The evolving role of multivitamin/multimineral supplement use among adults in the age of personalized nutrition. Multivitamin-mineral use is associated with reduced risk of cardiovascular disease mortality among women in the United States. Therefore, the folic acid intakes of pregnant people who take these supplements and consume any foods fortified with this nutrient exceed the UL for this nutrient (1,000 mcg), even though many do not consume recommended amounts of folate from dietary sources alone [18]. Nausea. However, individuals who take MVMs and other supplements and who consume fortified foods and beverages might obtain some nutrients in amounts exceeding the UL, increasing the possibility of adverse effects [62]. Based on these two trials, the USPSTF warned that beta-carotene supplementation may increase the risk of lung cancer in people who smoke, have smoked, or have occupational exposure to asbestos [50]. Check with your physician for additional information about side effects. Nutrients 2017, 9, 849. The randomized Linxian dysplasia nutrition intervention trial after 26 years of follow-up: No effect of multivitamin supplementation on mortality. Pregnancy vitamin with Omega-3 for baby's brain development. Am J Clin Nutr 2022;115:1501-10. After 7.5 years of use, the supplements lowered total cancer incidence by 31% and all-cause mortality rates by 37% in men but not women. Minerals (especially taken in large doses) can cause side effects such as tooth staining, increased urination, stomach bleeding, uneven heart rate, confusion, and muscle weakness or limp feeling. Some experts have hypothesized that MVM use might reduce the incidence of CVD or rates of deaths from this disease, possibly because certain nutrients in these products might reduce blood pressure or affect vascular function. National Institutes of Health. Helps strengthen bones and make joints flexible. Nutrients 2018;10(8). The radioprotective effect ex vivo, in vitro and in vivo of vitamins was reviewed using PubMed and Embase and conducted according to the PRISMA statement. Recommended Daily Intake of Vitamins and Minerals for Adults. Some published reports of studies of dietary supplements use the generic term "multivitamins" to include products with and without minerals. This page specifically discusses the use of multivitamins, which typically contain about 26 different vitamins and minerals, and often provide 100% of the Recommended Daily Allowance of these micronutrients. [. Iron supplements may be recommended for women of childbearing age, pregnant women, preterm infants, older infants, and teenage girls because they are at greater risk of developing deficiency. US Pharm. Follow all directions on the product package, or take as directed by your doctor. Participants receiving the supplement did not have significantly fewer cardiovascular events, but this finding should be interpreted with caution because many participants did not take the supplement or placebo as directed, and others withdrew from the study early. The. [. Studies of MVMs that have focused on cancer have been observational. The prenatal supplement with BOTH DHA & EPA to help in baby's brain development. Choosing whole grain side dishes, cereals, breads and more may lower the risk for heart disease, type 2 diabetes and cancer and improve digestion, too. Vitamin A (preformed = retinol; beta-carotene can be converted to Vitamin A) 700 micrograms (2,333 IU) 900 micrograms (3,000 IU) [, Mulholland CA, Benford DJ. Excess intakes can also be a concern for people taking MVMs that contain some vitamins or minerals in amounts approaching or exceeding the UL. The USPSTF advises people who are planning to become or capable of becoming pregnant to take a dietary supplement providing 400 to 800 mcg/day of folic acid daily [55]. Updated: Macrocytic Megaloblastic Anemia. The mechanism of action of vitamin K is discussed in terms of a new carbanion model that mimics the proton abstraction from the gamma position of protein-bound glutamate. The SU.VI.MAX study: a randomized, placebo-controlled trial of the health effects of antioxidant vitamins and minerals. Women who took more than one MV or MVM daily had a 53% higher risk of oropharyngeal cancer but a 35% lower risk of leukemia. Ironically, the populations at highest risk of nutritional inadequacy who might benefit the most from MVMs are the least likely to take them [1]. Examples of these populations are described below: People who could become pregnant [, Rock CL. What is a multivitamin? Am J Clin Nutr 2007;85:269S-276S. Another large prospective study investigated the association between use of MVs and MVMs (mostly MVMs described as "therapeutic or theragran," "one-a-day," or "stress-tab") and risk of cancer by following 489,640 men and women aged 5071 years for 16 years [8]. Iron-deficiency can lead to decreased production of hemoglobin and a microcytic, hypochromic anemia. Art. Website: https://pubmed.ncbi.nlm.nih.gov/. A subsequent study, AREDS2, tested whether adding omega-3 fatty acids (containing 650 mg eicosapentaenoic acid [EPA] and 350 mg docosahexaenoic acid [DHA]) or lutein (10 mg) and zeaxanthin (2 mg) to the AREDS formula would make it more effective [32]. Overall, MVM supplementation was not associated with better cardiovascular outcomes, including lower risk of mortality from CVD and coronary heart disease, or of stroke incidence and mortality.

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