Taking multivitamins actually increases mortality? We should stop taking them? This is a misunderstanding →

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“Does taking multivitamins increase mortality?”

Studies have shown that taking multivitamins increases the risk of death by 4%, so don't take them anymore.

Rumor Analysis

This statement is a misreading of the research.

Although the study mentioned that multivitamins are associated with an increased risk of death, current research shows that the two are only correlated, not causal. For people who are deficient in vitamins, proper multivitamin supplementation has more benefits than disadvantages, so there is no need to worry about it.

In recent years, people have paid more and more attention to their health, and various multivitamin supplements have gradually become indispensable health products in people's lives.

But recently there have been claims online that the latest research found that taking multivitamins every day actually increases the risk of death by 4%, and can lead to premature death, so people should stop taking them blindly, and that multivitamins are a waste of money, etc.

Do multivitamins really increase mortality and lead to premature death? Should we still take multivitamins?

Is it true that you take multivitamins?

Will it increase the mortality rate?

This statement cannot be said to be "fabricated out of thin air". It comes from a recent study by the National Cancer Institute of the National Institutes of Health.

This study screened more than 390,000 people from three large population cohort studies in the United States, including the National Institutes of Health-AARP Diet and Health Study (NIH-AARP) cohort, the Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Trial Cohort, and the U.S. Agricultural Health Study (AHS) cohort. Ultimately, during the more than 20 years of follow-up, a total of 164,762 deaths of participants were recorded. Among them, 49,836 died of cancer, 35,060 died of heart disease, and another 9,275 died of cerebrovascular disease.

An analysis of the use of multivitamins in these people found that compared with non-users, daily multivitamin use was associated with a 4% increased risk of all-cause mortality, a 4% increased risk of cardiovascular mortality, a 2% reduced risk of cancer mortality, and a 6% increased risk of cerebrovascular mortality.

This is also the reason why the Internet says that multivitamins increase the risk of death by 4% and lead to early death. Many reports on the Internet therefore say that "taking multivitamins can actually increase mortality" and "lead to early death."

So, is this true? Actually, this is a wrong interpretation of the research results.

First of all, this is an observational study. It only found that there is a correlation between "taking multivitamins every day and a 4% increased risk of all-cause mortality", but correlation does not ≠ causality, and it cannot be concluded that "taking multivitamins will increase the risk of death by 4%".

When we discuss a study, we need to consider the number of samples and the characteristics of the sample. The sample of this study is mainly elderly people in the United States, whose diet and lifestyle habits may be different from ours.

Secondly, this study itself was not intended to prove that taking multivitamins would increase mortality. Through further comprehensive analysis, the final conclusion of the study was that multivitamins (MV) use was not associated with lower all-cause mortality risk in the first.

In other words, taking multivitamin supplements does not reduce mortality. Why do we need to emphasize this point? Because many people in the United States take multivitamins, believing that they are healthy and can prolong life (they may even "not eat well" or "not see a doctor well"), and one of the purposes of this study is probably to dissuade such people from taking them.

In fact, you don’t need to be too surprised by this research! Because there has been constant controversy about multivitamins abroad, there are many studies, and the conclusions are both good and bad, and there are some restrictions.

For example, a report in 2022 pointed out that vitamin and mineral supplements have little benefit in preventing cancer, cardiovascular disease and death, and even excessive supplementation of some vitamins may increase the risk of cancer! In 2013, scientists published an article titled "Enough, Stop Wasting Money on Vitamin and Mineral Supplements", which argued that there is no benefit for healthy people to take vitamin supplements.

So the question is, what is considered "oversupplementation"? Who is considered a "healthy person"? Let's talk about it briefly according to the situation.

What do you think of multivitamins?

I believe everyone is most concerned about: Am I lacking vitamins? Can I take multivitamins?

First of all, if you are really deficient or even have a deficiency syndrome, it is beneficial to take dietary supplements appropriately.

Judging from the dietary nutrition data of the Chinese population in recent years, the number of people lacking certain nutrients is not small . For example, data from 2015 showed that the proportion of adults whose intake of retinol (VA), thiamine (VB1) and vitamin C was less than the average requirement was more than 50%, and the proportion of the population with insufficient intake of riboflavin (VB2) and calcium exceeded 85% and 95% respectively.

From this perspective, taking multivitamin supplements appropriately has more benefits than disadvantages for most people.

However, it must be emphasized here that the more dietary supplements you take, the better. In fact, any nutrient has two sides. Lack of it is not good for your health, but taking too much can also cause problems for your health.

The supplemental dosage of nutrients should be based on the Chinese Residents' Dietary Reference Intake of Nutrients. Excessive supplementation may not necessarily increase health benefits, but may bring negative effects and even increase the risk of disease. For example, if you supplement too high a dose of vitamin C every day (adults should not exceed 2,000 mg per day), it may cause adverse reactions such as kidney stones, as well as nausea, diarrhea and other discomfort symptoms; if pregnant women take large doses of vitamin A every day in the early stages, the risk of giving birth to a deformed baby increases. Many studies have found that vitamins and minerals may be detrimental to health, and a big reason for this is that they take too large a dose.

In addition, dietary supplements are not medicines and cannot treat or prevent diseases. Do not give up necessary medications or medical treatments because of superstition about them.

Many people expect to take dietary supplements to treat diseases, but this is not scientifically based. Dietary supplements should be used to supplement dietary deficiencies and should not be a substitute for a balanced diet. Normal consumption of dietary supplements such as multivitamins and minerals is safe and can improve the nutritional level of people with micronutrient deficiencies, but there is currently no evidence to support that taking dietary supplements can prevent chronic diseases or treat diseases.

One point that needs to be emphasized here is that you should not take many supplements at the same time on your own (especially those that can supplement multiple nutrients at the same time). Otherwise, the total intake of certain nutrients may exceed the standard, which may be detrimental to your health.

These people are recommended to take supplements

Some special groups, such as women preparing for pregnancy/pregnant women, the elderly, people with osteoporosis, people with vitamin B12 deficiency, patients with gastrointestinal diseases or obesity surgery (weight loss surgery), etc., are more likely to lack micronutrients or have relatively high requirements for micronutrients, and they can also take multivitamin dietary supplements . If you belong to the following groups, you can take multivitamin dietary supplements appropriately:

1. Women who are preparing to become pregnant need to supplement 400 micrograms of folic acid every day to reduce the risk of certain serious congenital defects in the fetus.

2. Pregnant or lactating women need to increase certain nutrients, especially DHA, folic acid, iron, iodine, etc.; if calcium-containing foods are not consumed abundantly, calcium supplements are also required.

3. Menopausal women. In order to reduce the loss of calcium in bones, in addition to eating calcium-rich foods, you can also take calcium supplements in moderation.

4. Dieters. Since excessive dietary control (such as dieting to lose weight) will lead to insufficient nutrient content in food, it is recommended to take multivitamin and mineral supplements, of course, it is best to be under the guidance of a doctor and nutritionist.

5. Vegetarians. If you rarely consume dairy products and animal products in your daily diet, you need additional calcium, iron, vitamin B12 and vitamin D.

6. Newborns. During the rapid growth and development stage, vitamin D is often insufficient. Vitamin D supplementation may play a positive role in preventing premature birth and low birth weight in newborns.

7. Elderly people and adults who have little exposure to sunlight may need vitamin D supplements. In addition, it is recommended that adults over 50 years old take vitamin B12 from rich sources of food or supplements.

8. Special patients. People or patients with certain special conditions, such as gastrointestinal diseases or patients undergoing obesity surgery (weight loss surgery), have low nutrient absorption, excessive nutrient consumption or loss, and it is difficult for ordinary diets to meet their needs. They should focus on using nutritional supplements. However, it is best to choose under the guidance of doctors and nutritionists.

9. For people in special environments or special occupations, such as those working in high altitudes, high temperatures, low temperatures, low sunlight, high-intensity exercise and physical activity, it is necessary to use nutrient supplements according to the nature of their work. They can take supplements under the guidance of nutrition professionals (nutritionists, nutrition experts or doctors).

Looking in the mirror of rumors

In the field of nutrition, seemingly "contradictory" conclusions often appear. If you are confused about this, you can read credible popular science content. On the one hand, you should pay attention to whether the conclusion is "correlation" or "causality". On the other hand, we should also consider how similar the situation of the research sample is to our own. Of course, if you think this is a bit troublesome, you can just keep in mind the principle of "balanced nutrition" and refer to the current version of the "Dietary Guidelines for Chinese Residents" to plan your diet reasonably.

References

[1]Loftfield E, O'Connell CP, Abnet CC, Graubard BI, Liao LM, Beane Freeman LE, Hofmann JN, Freedman ND, Sinha R. Multivitamin Use and Mortality Risk in 3 Prospective US Cohorts. JAMA Netw Open. 2024 Jun 3;7(6):e2418729. doi: 10.1001/jamanetworkopen.2024.18729. PMID: 38922615; PMCID: PMC11208972.↑

[2]US Preventive Services Task Force. Vitamin, Mineral, and Multivitamin Supplementation to Prevent Cardiovascular Disease and Cancer: US Preventive Services Task Force Recommendation Statement. JAMA. 2022;327(23):2326–2333. doi:10.1001/jama.2022.8970↑

[3]Guallar E, Stranges S, Mulrow C, Appel LJ, Miller ER 3rd. Enough is enough: Stop wasting money on vitamin and mineral supplements. Ann Intern Med. 2013 Dec 17;159(12):850-1. doi: 10.7326/0003-4819-159-12-201312170-00011. Erratum in: Ann Intern Med. 2014 Jan 21;160(2):143. PMID: 24490268.↑

[4] Huang Qiumin, Wang Liusen, Zhang Bing, et al. Trends and demographic characteristics of dietary micronutrient intake among adults in nine provinces (autonomous regions) in my country from 1991 to 2015[J]. Environmental and Occupational Medicine, 2019, 36(5): 410-417. DOI: 10.13213/j.cnki.jeom.2019.19089.↑

[5] Scientific consensus on the use of nutrient supplements by Chinese residents (Popular Science Edition)[J]. Chinese Health Education, 2018, 34(08):767. DOI:10.16168/j.cnki.issn.1002-9982.2018.08.023.↑

[6]Blumberg JB, Cena H, Barr SI, Biesalski HK, Dagach RU, Delaney B, Frei B, Moreno González MI, Hwalla N, Lategan-Potgieter R, McNulty H, van der Pols JC, Winichagoon P, Li D. The Use of Multivitamin/Multimineral Supplements: A Modified Delphi Consensus Panel Report. Clin Ther. 2018 Apr;40(4):640-657. doi: 10.1016/j.clinthera.2018.02.014. Epub 2018 Mar 21. PMID: 29573851.↑

[7]Incze M. Vitamins and Nutritional Supplements: What Do I Need to Know? JAMA Intern Med. 2019;179(3):460. doi:10.1001/jamainternmed.2018.5880↑

Planning and production

Author: Ruan Guangfeng, Director of the Science and Technology Department of the Kexin Food and Nutrition Information Exchange Center

Reviewer: Song Shuang, Associate Researcher, Institute of Nutrition and Health, Chinese Center for Disease Control and Prevention