Cardiovascular disease is the leading cause of death in individuals with diabetes mellitus. The role of increased oxidative stress in the occurrence of vascular complications in subjects with diabetes has led to hypothesis that higher intakes of antioxidant nutrients could help lower the risk of CVD in diabetic subjects . Another meta-analysis of trials found no effect of vitamins E and C, alone or in combination, on measures of β-cell function and insulin resistance. Yet, most studies were small and of short duration and thus did not assess the consequence of long-term use of antioxidant vitamins on the risk of vascular complications in diabetic patients.
Both vitamin C and aspirin reduced fasting blood glucose and HbA1c concentrations and improved blood lipid profile in metformin-treated patients. Compared to placebo, both treatments were found to be more likely to limit risk factors contributing to diabetes-related complications, as well as to lower the risk of future cardiovascular events over a 10-year period . Overall, MVMs do not appear to reliably reduce the risk of chronic diseases when people choose to take these products for up to a decade or when studies randomize people to take them as part of a clinical trial. In 2021, after another review of studies published since 2013, the USPSTF concluded that the evidence is still insufficient to weigh the benefits and harms of MVM use to prevent CVD or cancer .
The American Institute for Cancer Research recommends against taking dietary supplements for cancer prevention because supplements do not provide the same benefits as eating whole foods . Similarly, the American Heart Association advises against the use of MVMs to prevent CVD because scientific studies have found them to be of no value for this purpose . Furthermore, investigators define MVMs differently in their studies to evaluate the potential health effects of these products. 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 . Another team defined MVMs as "full-spectrum" products providing all 12 vitamins plus 10 minerals . Some published reports of studies of dietary supplements use the generic term "multivitamins" to include products with and without minerals.
Various government surveys of dietary supplements and popular food-frequency questionnaires also define MVs and MVMs differently, include different examples, or ask about different products. According to MedlinePlus, the life-expectancy gap between men and women has decreased, but men need to pay more attention to their bodies. If you do not eat a healthy diet, it recommends that you add a daily multivitamin to your diet to ensure that you get the proper vitamins that you need everyday. A cross-sectional analysis of a nationally representative sample of 1,003 pregnant U.S. people aged 20 to 40 years from the 2001–2014 NHANES found that many consumed less than recommended amounts of many nutrients from diet alone . Among the 69.8% who took a dietary supplement , the risk of inadequate intakes of many nutrients was lower.
Should A 20 Year Old Take Vitamins For example, 27.7% had inadequate intakes of vitamin A from foods alone, but this rate dropped to 15.5% when supplements were included. However, supplement use increased the proportion of pregnant people with some intakes of iron (27.9%) and folic acid (33.4%) above the UL. During 2017–2018, 57.6% of U.S. adults used any dietary supplement in the past 30 days. The percentage of adults using dietary supplements increased with increasing age. Dietary supplement use was higher among women than men in all age groups. The use of multiple dietary supplements increased with increasing age; nearly one-quarter of adults aged 60 and over (24.9%) reported taking four or more dietary supplements.
Multivitamin-mineral supplements were the most common dietary supplements used by adults in all age groups, followed by vitamin D and omega-3 fatty acid products. From 2007–2008 through 2017–2018, the percentage of adults reporting dietary supplement use increased in all age groups. Nonetheless, vitamin C supplementation led to a 36% lower risk of placental abruption and to a significant increase in gestational age at birth . The amount of vitamin C required to help prevent chronic disease is higher than the amount required for prevention of scurvy. Information regarding vitamin C and the prevention of chronic disease is based on both observational prospective cohort studies and randomized controlled trials. Prospective cohort studies can examine the incidence of a specific disease in relation to vitamin C intake or body status in a cohort of participants who are followed over time.
"Vitamins and minerals are vital for maintaining good general health and wellbeing, and our 20s are the building blocks to achieve this. One of the largest prospective studies of MVM use was the Women's Health Initiative, which evaluated the health of 161,808 postmenopausal women aged 50–79 years and their risk factors for cancer, heart disease, and osteoporosis. A total of 41.5% of the women took an MVM (containing 20–30 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" at least once a week.
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 . Investigators who followed a multiethnic cohort of 182,099 men and women aged 45–75 years living in Hawaii and California for an average 11 years found similar results . Approximately 48% of the men and 52% of the women in this study reported taking an MV or MVM. Combined evidence from metabolic, pharmacokinetic, and observational studies, and from randomized controlled trials supports consuming sufficient vitamin C to achieve plasma concentrations of at least 60 μmol/L. While most generally healthy young adults can achieve these plasma concentrations with daily vitamin C intake of at least 200 mg/day, some individuals may have a lower vitamin C absorptive capacity than what is currently documented.
Thus, the Linus Pauling Institute recommends a vitamin C intake of 400 mg daily for adults to ensure replete tissue concentrations — an amount substantially higher than the RDA yet with minimal risk of side effects. Taking a basic MVM that provides nutrients in amounts that are approximately the same as recommended intakes should be safe for healthy people. Studies of MVM users reveal no adverse effects, except that both treatment and placebo groups in some studies experienced some minor gastrointestinal issues . 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 .
Excess intakes can also be a concern for people taking MVMs that contain some vitamins or minerals in amounts approaching or exceeding the UL. Surprisingly, when an antioxidant combination (1,000 mg vitamin C, 800 IU vitamin E, 100 µg selenium, and 25 mg β-carotene daily) was taken with the simvastatin-niacin combination, the protective effects were diminished. Since the antioxidants were taken together in this trial, the individual contribution of vitamin C cannot be determined. These contradictory findings indicate that further research is needed on potential interactions between antioxidant supplements and cholesterol-lowering drugs, such as HMG-CoA reductase inhibitors .
Basic MVMs contain both vitamins and minerals, most in amounts that do not exceed the DVs. However, MVMs often have small amounts of certain nutrients, such as calcium, magnesium, and potassium, so supplement users should check product labels. When choosing an MVM product, consumers should consider taking a product designed for people of their age, sex, and life stage (e.g., pregnancy). MVMs for "senior" men and women, for example, often contain little or no iron and more calcium, vitamin D, and vitamin B12 than MVMs for younger adults .
Prenatal supplements generally provide no vitamin A in the form of retinol, and most children's MVMs provide age-appropriate amounts of nutrients. One well-known trial of the impact of MVMs on both chronic disease risk and mortality used combinations of antioxidant nutrients. 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. Other RCTs have evaluated the effects of MVMs on outcomes in individuals with a range of chronic diseases.
The supplement did not reduce incidence or mortality rates for esophageal cancer or the rate of mortality from any cause. Some evidence from RCTs has focused on the use of MVMs to reduce the risk of various chronic diseases. Use of MVs and MVMs (products containing three or more vitamins and/or minerals in amounts below the ULs and no herbs) did not reduce the risk of any chronic disease. For those who eat a healthful diet, a multivitamin may have little or no benefit.
A diet that includes plenty of fruits, vegetables, whole grains, good protein sources, and healthful fats should provide most of the nutrients needed for good health. When it comes to specific vitamins and minerals, some Americans get less than adequate amounts, according to criteria set by the National Academy of Medicine. For example, more than 90% of Americans get less than the Estimated Average Requirement for vitamin D and vitamin E from food sources alone.
Only one large trial in more than 14,000 older men participating in the Physicians' Health Study II reported on cardiovascular outcomes. PHS II found that vitamin C supplementation (500 mg/day) for an average of eight years had no significant effect on major cardiovascular events, total myocardial infarction, or cardiovascular mortality . Notably, this study had several limitations , including no measurement of vitamin C status and the recruitment of a well-nourished study population. Smokers and, possibly, former smokers should avoid MVM products providing large amounts of beta-carotene or vitamin A because two studies have linked these nutrients to an increased risk of lung cancer in smokers .
The human body requires 13 vitamins and at least 16 minerals essential to your health.However, while all adults need a variety of key vitamins and minerals every day, men and women have different requirements. For instance, women of reproductive age require more iron than men of the same age, so women's supplements typically include iron and men's supplements don't. If you're asking yourself, "What vitamins should I take daily for a man? " keep in mind that it varies depending on your age and lifestyle. Good quality long-term trials are needed to examine whether the anti-hypertensive effect of vitamin C is sustained over time and eventually results in a reduced risk of cardiovascular events.
Vitamins in small quantities are essential for normal metabolism. Our bodies don't make them, so we must get them from a well-balanced diet. The American Academy of Pediatrics advises that children who receive a well-balanced diet do not need extra vitamin intake over and above the recommended dietary allowances . More than one-third of children in the U.S. take dietary supplements routinely. Health expert, Marina Wegorek, says that the reason may lie in women not consuming the exact combination of vitamins that will make a real difference in our health.
The founder of ProYouth Nutrition, specializing in wholefoods-based and high performance protein, says that women aged over 25 have specific vitamins and minerals needs in order to support a balanced, urban lifestyle. "Our vitamin needs vary from each woman, and largely depends on her diet, lifestyle, genetics, and even environmental factors," she points out. One meta-analysis of 21 RCTs investigated whether daily use of MVs and MVMs for at least 1 year affected mortality risk . The studies included a total of 91,074 healthy adults taking the MVs or MVMs for an average of 43 months, and the investigators reported 8,794 deaths. The products provided an average of 14 nutrients, although the products with 3 nutrients in 5 trials did not contain a mineral.
The use of MVs or MVMs had no effect on all-cause mortality or on mortality due to CVD or cancer. Most studies of the potential value of MVMs to enhance health and prevent disease have been observational and compared individuals who chose to take MVM supplements with others who did not take supplements. 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 . Some studies have suggested potential health benefits or harms from the use of MVMs, but others have found none. Participants in these studies used a wide variety of MVMs containing different combinations and amounts of nutrients. In Canada, almost all prenatal MVM supplements provide 1,000 mcg/day of folic acid.
Even in the United States, the amount of folic acid in prenatal MVM supplements is typically 800 or 1,000 mcg, which is much higher than the recommended amount to reduce the risk of neural tube defects in babies . There's little, if any, proof that multivitamins benefit seniors who are otherwise healthy. The U.S. Preventive Services Task Force recommends against daily multivitamins to ward off cancer or heart disease.
Multivitamins marketed at seniors may be tailored with higher doses of vitamins D or B12 or less iron. But unless you have a poor appetite or have conditions that keep you from eating a healthy diet, you probably don't need them. If you're a healthy adult, taking a multivitamin won't lower your risk of heart attack, stroke or death from cardiovascular disease. Preventive Services Task Force concluded that there is insufficient evidence to support any benefit from vitamin and mineral supplementation for the prevention of cancer or cardiovascular disease.
I'm not saying guys shouldn't also pay attention to their diet (I advocate a plant-heavy Mediterranean approach), but it's not likely that you're eating all the nutrients you need all the time. Data suggests that 90 percent of men fall short in one or more of the 16 essential vitamins and minerals. "One popular men's vitamin contains a little more of certain nutrients to help the prostate, heart, and blood pressure," he said. "However, although there may be some mild evidence associating those nutrients with these conditions, there are no randomized controlled trials showing better health outcomes in subjects who took those nutrients."
Whether older adults have higher requirements for vitamin C is not yet known with certainty, yet some older populations have been found to have vitamin C intakes considerably below the RDA of 75 and 90 mg/day for women and men, respectively . A vitamin C intake of at least 400 mg daily may be particularly important for older adults who are at higher risk for age-related chronic diseases. Pharmacokinetic studies in older adults have not yet been conducted, but there is some evidence suggesting that the efficiency of one of the molecular mechanisms for the cellular uptake of vitamin C declines with age . Anyone who struggles to eat a healthy, varied, and balanced diet may benefit from taking supplements. For teenagers, it may be helpful to take iron, calcium, and vitamin D if you feel you are lacking these essential vitamins and minerals.
Before you or your teenager start taking any new supplements it's a good idea to check with your GP or a pharmacist. While many young children are picky eaters, that doesn't necessarily mean that they have nutritional deficiencies. Many common foods — including breakfast cereal, milk and orange juice — are fortified with important nutrients, such as B vitamins, vitamin D, calcium and iron. So your child may be getting more vitamins and minerals than you think.
The DGA does not mention MVMs, but it does recommend that Americans choose healthy, nutrient-dense food and beverages. The DGA lists nutrients of special public health concern in American diets, such as calcium, potassium, dietary fiber, and vitamin D in both adults and children. Iron is also a nutrient of public health concern for infants ages 6–11 months who are fed primarily human milk and do not consume enough iron from complementary foods, adolescent females, and people who are pregnant.
Depending on their formulations, MVMs can help individuals obtain adequate amounts of these nutrients, except for potassium and dietary fiber. Clinical trials, where individuals are randomly assigned to take the dietary supplement or a placebo, are better than observational studies for determining whether MVMs might affect disease risk. However, few randomized clinical trials have been conducted because these studies need to be long enough to show effects on disease risk that go beyond simply identifying intermediate biomarkers that might suggest such risk. As with some observational studies, some RCTs have suggested that MVM use has potential health benefits, but others have found no such benefits. However, no two RCTs have used MVMs with the same combinations and amounts of nutrients. In one study, for example, investigators assessed the diets and use of MVMs in a large multiethnic cohort of 90,771 men and women ages 45 and older from Los Angeles and Hawaii .
The investigators calculated nutrient intakes from participants' diets using a food frequency questionnaire and from MVMs (taken by 23%) using the nutrient composition of two commonly used MVMs. Approximately 74–76% of the men and 72–75% of the women had adequate intakes on average from food alone of the 17 nutrients examined, but use of MVMs increased the prevalence of adequacy to 84% for the men and 83% for the women. The greatest improvements in intake were for vitamins A and E and zinc.
However, MVM users had excessive intakes of several nutrients; 10–15% had excessive intakes of vitamin A, iron, and zinc, and 48–61% had excessive intakes of niacin. Emerging science and technologies are making customized and individualized healthcare more readily available and affordable for most. Blind supplementation will become a thing of the past with companies like Rootine and Sun Genomics. Rootine optimizes your daily performance with precision nutrition.
More than a standard multivitamin, it's a comprehensive system designed to help you achieve your best health, featuring the first precision-crafted micronutrient formula informed by your individual lifestyle and health data . The company provides a unique formulation that's specific to you and your needs. This allows you to nourish your cells to build a more efficient, focused, and higher-performing version of yourself. Your microbiome is also unique and has a huge impact on your overall health.
Sun Genomics uses DNA sequencing within your gut microbiome to customize a unique probiotic based on your goals and symptoms. Its custom formulation can help with digestion, increase energy, and reduce bloating while ultimately helping you perform at your best. There are certainly diseases caused by a lack of specific nutrients in the diet. Classic examples include scurvy , beri-beri , pellagra , and rickets . But these conditions are rare in the U.S. and other developed countries where there is generally more access to a wide range of foods, some of which are fortified with vitamins. Individual vitamin supplementation may also be essential in certain cases, such as a deficiency caused by long-term poor nutrition or malabsorption caused by the body's digestive system not functioning properly.
