mechanism of action of multivitamins and minerals

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 (400 mcg) to reduce the risk of neural tube defects in babies [19]. [, Biesalski HK, Tinz J. Multivitamin/mineral supplements: Rationale and safety. Be sure to check the percent daily value (% DV) to see what proportion of your daily allotment youregetting. Folic acid supplementation for the prevention of neural tube defects. Most have not found an effect of MVM use on any of the health outcomes measured. The Age-Related Eye Disease Study (AREDS), which was led by NIHs National Eye Institute and concluded in 2001, showed that daily high doses of vitamins C and E, beta-carotene, and the minerals zinc and coppercalled the AREDS formulationcan help slow the progression to advanced age-related macular degeneration (AMD), a blinding eye disease. U.S. Department of Agriculture and U.S. Department of Health and Human Services. Vitamins & Minerals. A multivitamin is a preparation intended to serve as a dietary supplement with vitamins, dietary minerals, and other nutritional elements.Such preparations are available in the form of tablets, capsules, pastilles, powders, liquids, or injectable formulations.Other than injectable formulations, which are only available and administered under medical supervision, multivitamins are recognized by . Vitamin C is responsible for synthesizing collagen and is necessary for proper wound healing.6 Vitamin C is also secreted in breast milk thus, a higher dietary intake is recommended for lactating women to make up for this loss. 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 [63]. US Preventive Services Task Force recommendation statement. 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. However, use of MVs or MVMs conferred no protection among participants consuming less than two alcoholic beverages per day, whereas use among those consuming more was associated with a 29% lower risk of colon cancer mortality. Approximately 7476% of the men and 7275% 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. Mechanism of Action Exerts oncotic pressure, which expands volume of circulating blood and maintains cardiac output. The report recommends that people following a vegetarian or vegan diet consult their health care provider about whether they need supplementation with iron, vitamin B12, and other nutrients (e.g., choline, iodine, EPA, and DHA). Use of MVs or MVMs (not further defined) was associated with an 11% lower risk of colon cancer mortality than among nonusers. An evidence review commissioned by the U.S. Preventive Services Task Force (USPSTF) included 78 RCTs with 324,837 participants and 6 cohort studies with 390,689 participants [49]. Position of the Academy of Nutrition and Dietetics: Micronutrient supplementation. Some studies have suggested potential health benefits or harms from the use of MVMs, but others have found none. During the study, 4,517 died of colon cancer. [, Qato DM, Alexander GC, Guadamuz JS, Lindau ST. Effects of cocoa extract and a multivitamin on cognitive function: A randomized clinical trial. Vitamin K. Accessed January 12, 2011. A 2021 meta-analysis of 9 RCTs (not including the study described above) evaluated the use of MVMs (defined as products that included most vitamins and minerals) by 22,773 individuals and a variety of CVD outcomesincluding total CVD incidence and mortality, MI incidence and mortality, and stroke incidence and mortalityand all-cause mortality [29]. Among the more common ingredients are amino acids, protein, creatine, and caffeine. However, the supplement users had a 14% lower risk of undergoing cardiac revascularization (coronary angioplasty or coronary artery bypass grafting). 2007;1:42-55. On the whole, the . Theres no standard or regulatory definition for MVMs, or any dietary supplement, as to what nutrients they must contain or at what levels. Formulations for children, adult men and women, pregnant people, and seniors typically provide different amounts of the same vitamins and minerals to meet the needs of these populations. Obtaining sufficient amounts of folic acid in the periconceptual period reduces the risk of neural tube defects in newborns. American College of Obstetrics and Gynecologists. Am J Clin Nutr 2013;97:437-44. Product Presentation. Oral high-dose multivitamins and minerals after myocardial infarction. N Engl J Med 1996;334:1150-5. Individuals who have poor nutrient intakes from diet alone, consume low-calorie diets, or avoid certain foods (such as strict vegetarians and vegans) might benefit from taking an MVM [60]. Ask ODS Multivitamins in the prevention of cardiovascular disease in men: the Physicians' Health Study II randomized controlled trial. Water and some water-soluble vitamins are absorbed by diffusion. Among the 69.8% who took a dietary supplement (most likely a prenatal MVM supplement), the risk of inadequate intakes of many nutrients was lower. Studies of the association between MVM use and CVD outcomes have focused on several outcomes, including cardiovascular events and mortality. 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. 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. 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 more) or when studies randomize people to take them as part of a clinical trial. 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. Overall, women are more likely (34.0%) to take an MVM than men (28.3%) [2]. Arch Intern Med 2004;164:2335-42. [, Bailey RL, Fakhouri TH, Park Y, Dwyer JT, Thomas PR, Gahche JJ, et al. This study prospectively followed 18,530 male physicians aged 40 years and older, of whom 20% reported taking an MV or MVM for an average of 12.2 years [24]. The DGA also states that pregnant people might need to take separate supplements of iodine and choline when their health care provider recommends that they do so because many prenatal MVMs do not contain these nutrients or contain only small amounts of them. NCCIH has provided this material for your information. Below mentioned are some of the details about this product. It is water-soluble. Abstract Replacement of natural protein intake, low total antioxidant status (TAS) and DNA oxidation and high phenylalanine (Phe) blood levels are . Absorption of Vitamins. We encourage you to discuss any decisions about treatment or care with your health care provider. Investigators who followed a multiethnic cohort of 182,099 men and women aged 4575 years living in Hawaii and California for an average 11 years found similar results [36]. Vitamins are not sources of energy as are carbohydrates, fats, and proteins. Disclaimer: This content has been produced purely for informational and educational purposes only and is never intended to be used as a substitute for professional medical guidelines including diagnosis, advice, and treatment. 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. What Is Complementary, Alternative, or Integrative Health? National Institutes of Health. They are also used to treat iron or vitamin deficiencies caused by illness, pregnancy, poor nutrition, digestive disorders, and many other conditions. From Sources and Bioavailability to Cardiovascular-Health Benefits and Molecular Mechanisms of Action - NCBI. Mechanism of Action. Wagner CL, Greer FR, and the Section on Breastfeeding and Committee on Nutrition. Adv Nutr 2020;11:753-9. Any vitamins, minerals, or other types of dietary supplements? An expert panel that reviewed this report and participated in a state-of-the-science conference on the use of MVs and MVMs for chronic disease prevention at the National Institutes of Health in 2006 concluded that the evidence was insufficient for them to recommend for or against the use of MVs or MVMs to prevent chronic disease [1]. Ann Pharmacother 2011;45:476-84. However, no two RCTs have used MVMs with the same combinations and amounts of nutrients. Common side effects may include: upset stomach . Vitamins and Minerals for Layer Poultry have been divided into two groups based on their solubility in lipids or in water. Multiple-micronutrient supplement for women during pregnancy (review). Acknowledging that most health care providers recommend that pregnant people take a daily prenatal MVM, the DGA states that this practice may be necessary to meet the needs for folate or folic acid, iron, iodine, and vitamin D during pregnancy [54]. However, few randomized clinical trials (RCTs) 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. The micronutrient combination tested had a comparable efficacy to insulin in facilitating glucose uptake by . It concluded that vitamin and mineral supplements had "little or no benefit" in preventing cancer, CVD, and death, except that MVMs may provide a "small benefit" against cancer. 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. Target Actions . 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 [16]. According to the federal governments 2020-2025 Dietary Guidelines for Americans, "Because foods provide an array of nutrients and other components that have benefits for health, nutritional needs should be met primarily through foods. The trials included a total of 15,283 pregnant adolescents and young adults from low- or middle-income countries in Africa and Asia. The mineral fluoride not only helps bone formation but also keeps dental cavities from starting or worsening. [, Keats EC, Akseer N, Thurairajah P, Cousens S, Bhutta ZA, the Global Young Women's Nutrition Investigators' Group. People who take certain blood thinners, such as warfarin (Coumadin, Jantoven), should talk with their health care providers before taking any MVM or dietary supplement containing vitamin K [67,68]. Observational studies The products provided an average of 14 nutrients, although the products with 3 nutrients in 5 trials did not contain a mineral. 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]. In the French Supplmentation en Vitamines et Minraux Antioxydants (SU.VI.MAX) study, investigators randomly assigned 13,017 adults aged 3560 years to receive a placebo or a daily supplement containing moderate amounts of vitamin C (120 mg), vitamin E (30 mg), beta-carotene (6 mg), selenium (100 mcg), and zinc (20 mg) [48]. This publication is not copyrighted and is in the public domain. However, evidence to support their use for overall health or disease prevention in the general population remains limited. 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]. Manufacturers choose which vitamins, minerals, and other ingredients, as well as their amounts, to include in their products. One well-known trial of the impact of MVMs on both chronic disease risk and mortality used combinations of antioxidant nutrients. Helps strengthen bones and make joints flexible. [, Neuhouser ML, Wassertheil-Smoller S, Thomson C, Aragaki A, Anderson GL, Manson JE, et al. Do not take more . An analysis of dietary supplement use in the United States from the 20172018 National Health and Nutrition Examination Survey (NHANES) found that MVMs (defined as products containing three or more vitamins and at least one mineral) were the most commonly consumed supplement. Vitamins and minerals are essential substances that our bodies need to develop and function normally. U.S. sales of all dietary supplements totaled an estimated $55.7 billion in 2020, including $21.2 billion for all supplements containing vitamins, minerals, or both, of which $8.0 billion was for MVMs and MVs [4]. Nutrition Business Journal. These beneficial effects include a significant increase of glucose uptake by skeletal muscle cells of up to 450%. Risk of deficiency in multiple concurrent micronutrients in children and adults in the United States. 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. J Natl Cancer Inst 1993;85:1492-8. If you have questions about affording vitamin supplements, contact CF Foundation Compass by calling 844-COMPASS, Monday through Friday, 9 a.m. until 7 p.m. Blood levels of oxygen, carbon dioxide, and minerals. [, Mulholland CA, Benford DJ. The SU.VI.MAX study: a randomized, placebo-controlled trial of the health effects of antioxidant vitamins and minerals. The compound is produced by plants as a defense mechanism against stress, injury, and infection. A third CVD outcomes study prospectively followed a cohort of 37,193 women ages 45 and older (mean age 54 years) participating in the Women's Health Study who were users (38%) or nonusers (62%) of MVMs (including "a wide range of lower-dose vitamins and minerals") for an average of 16.2 years. We will explore situations that a multivitamin may be health-promoting, as well as if there is a benefit or harm in taking extra nutrients . The studies included a total of 91,074 healthy adults (average age 62 years) taking the MVs or MVMs for an average of 43 months, and the investigators reported 8,794 deaths. When your child needs vitamin D, iron, and zinc. [, Bailey RL, Pac SG, Fulgoni III VL, Reidy KC, Catalano PM. 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. 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. Multivitamin use and risk of cancer and cardiovascular disease in the Women's Health Initiative cohorts. 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. Vitamin, mineral, and multivitamin supplementation to prevent cardiovascular disease and cancer. [. The American Academy of Pediatrics adds that all non-breastfed infants ingesting less than 1,000 mL/day of vitamin Dfortified formula or milk should receive a supplement containing 400 IU (10 mcg)/day vitamin D [58]. Inflammation comes from the Latin word inflammare, which means "to set on fire.". Vitamin D, iron, and zinc are three important ones. A randomized, placebo-controlled, clinical trial of high-dose supplementation with vitamins C and E, beta carotene, and zinc for age-related macular degeneration and vision loss: AREDS report no. Essentially all vitamin absorption occurs in the small intestine. The known vitamins include A, C, D, E, and K, and the B vitamins: thiamin (B1), riboflavin (B2), niacin (B3), pantothenic acid (B5), pyridoxal (B6), cobalamin (B12), biotin, and folate/folic acid. Among children and adolescents, MVM use rates were 11.0% for up to 2 years of age, 34.6% for ages 25 years, 29.5% for ages 611 years, and 17.3% for ages 1219 years [11]. Impact of frequency of multi-vitamin/multi-mineral supplement intake on nutritional adequacy and nutrient deficiencies in U.S. adults. Multivitamins are supplements that contain many different vitamins and minerals, sometimes alongside other ingredients ().Given that there's no standard for what constitutes a multivitamin . MVM supplementation resulted in 13% lower odds of low birth weight, 12% lower odds of preterm birth, and 14% lower odds of small size for gestational age than iron and folic acid supplementation alone. [, Kim J, Choi J, Kwon SY, McEvoy JW, Blaha MJ, Blumenthal RS, et al. For more information about building a healthy dietary pattern refer to the Dietary Guidelines for Americans and the U.S. Department of Agriculture's MyPlate. However, the study showed that beta-carotene was not a required ingredient; the original AREDS formulation without beta-carotene provided the same protective effect on reducing the risk of advanced AMD as the AREDS2 formulation. A cross-sectional analysis of a nationally representative sample of 1,003 pregnant U.S. people aged 20 to 40 years from the 20012014 NHANES found that many consumed less than recommended amounts of many nutrients from diet alone [17]. Eye floaters are small, semi-transparent specks or cobweb-like substances that appear to float in the eye's vitreous humor, which is the clear, gel-like fluid that fills . about your interest in, questions about, or use of dietary supplements and what may be best for your overall health. According to results of the National Health and Nutrition Examination Survey, 52% of adults take dietary supplements.