MVI7.2

Multivitamin Research

50 peer-reviewed studies · Evidence score: 7.2/10

Multivitamins in the prevention of cancer and cardiovascular disease: the COcoa Supplement and Multivitamin Outcomes Study (COSMOS) randomized clinical trial

Sesso HD et al. • The American Journal of Clinical Nutrition (2022)

Multivitamin supplementation significantly reduced total cancer incidence in men, with a hazard ratio of 0.88 (95% CI 0.79-0.98).

Multivitamin supplementation reduced total cancer incidence in men by 12% (HR 0.88)
No significant effect on cardiovascular disease incidence
No significant cancer prevention effect in women

RCTn=21,442

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Effect of multivitamin-mineral supplementation versus placebo on cognitive function: results from the clinic subcohort of the COcoa Supplement and Multivitamin Outcomes Study (COSMOS) randomized clinical trial and meta-analysis of 3 cognitive studies within COSMOS

Vyas CM et al. • The American Journal of Clinical Nutrition (2024)

Multivitamin-mineral supplementation showed a beneficial effect on global cognition compared with placebo, with the pooled analysis across COSMOS cognitive studies estimating a treatment benefit equivalent to 2.0 years of age-related cognitive decline.

Multivitamin-mineral supplementation significantly improved global cognition vs placebo (pooled meta-analysis)
Treatment benefit estimated at equivalent of 2.0 years of age-related cognitive decline
Episodic memory was particularly improved in the clinic subcohort

Meta-Analysisn=5,765

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Effects of cocoa extract and a multivitamin on cognitive function: A randomized clinical trial

Baker LD et al. • Alzheimer's & Dementia (2023)

Multivitamin-mineral supplementation had a significant positive effect on global cognition and episodic memory compared with placebo over 3 years.

Multivitamin-mineral supplementation (not cocoa extract) drove significant cognitive improvements in COSMOS-Mind
Global cognition improved significantly in multivitamin group
Episodic memory composite scores were significantly higher in MVI group vs placebo

RCTn=2,262

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Multivitamin Supplementation Improves Memory in Older Adults: A Randomized Clinical Trial

Yeung LK et al. • The American Journal of Clinical Nutrition (2023)

Multivitamin supplementation significantly improved memory performance in older adults after 3 years of supplementation compared to placebo.

Daily multivitamin supplementation for 3 years significantly improved immediate and delayed recall memory
Effects were most pronounced in participants with cardiovascular disease at baseline
Multivitamin group showed preserved memory vs. age-related decline in placebo group

RCTn=3,562

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Impact of multivitamin-mineral and cocoa extract on incidence of mild cognitive impairment and dementia: Results from the COcoa Supplement and Multivitamin Outcomes Study for the Mind (COSMOS-Mind)

Sachs BC et al. • Alzheimer's & Dementia (2023)

Multivitamin-mineral supplementation was associated with a significant reduction in the rate of cognitive decline over 3 years in older adults.

COSMOS-Mind trial found MVI supplementation reduced cognitive decline trajectory over 3 years
Risk of progression to mild cognitive impairment was numerically lower in MVI group
Effects appeared more pronounced in older adults and those with cardiovascular disease history

RCTn=2,262

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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

Fortmann SP et al. • Annals of internal medicine (2013)

Evidence was insufficient to recommend multivitamin/mineral supplements for the prevention of cardiovascular disease or cancer in the general adult population.

Evidence was insufficient to recommend multivitamin/mineral supplements for the prevention of cardiovascular disease or cancer in the general adult population.
No consistent benefit was found across the included trials.

Systematic Review

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The 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

Huang HY et al. • Annals of internal medicine (2006)

Evidence was insufficient to prove or disprove that multivitamin/mineral supplements prevent cancer or chronic disease in adults without known nutritional deficiencies.

Evidence was insufficient to prove or disprove that multivitamin/mineral supplements prevent cancer or chronic disease in adults without known nutritional deficiencies.
Safety concerns were minimal at standard doses.

Systematic Review

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Preconception Folic Acid and Multivitamin Supplementation for the Prevention of Neural Tube Defect: An Umbrella Review of Systematic Review and Meta-analysis

Abate BB et al. • Neuroepidemiology (2025)

Preconception multivitamin supplementation containing folic acid robustly reduces neural tube defect risk.

Preconception multivitamin supplementation containing folic acid robustly reduces neural tube defect risk.
This umbrella review of meta-analyses confirmed strong, consistent evidence across global populations.

Systematic Review

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A randomized trial of multivitamin supplements and HIV disease progression and mortality

Fawzi WW et al. • The New England journal of medicine (2004)

Multivitamin supplementation (B vitamins, C, and E) significantly reduced disease progression and mortality in HIV-infected adults not yet on antiretroviral therapy.

Multivitamin supplementation (B vitamins, C, and E) significantly reduced disease progression and mortality in HIV-infected adults not yet on antiretroviral therapy.
Supplementation also improved CD4 cell counts and reduced viral load.

RCTn=1,078

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Dietary Supplement Use During Chemotherapy and Survival Outcomes of Patients With Breast Cancer Enrolled in a Cooperative Group Clinical Trial (SWOG S0221)

Ambrosone CB et al. • Journal of Clinical Oncology (2020)

Use of antioxidant supplements (vitamins C and E, carotenoids, coenzyme Q10) during chemotherapy was associated with increased risk of recurrence and mortality in breast cancer patients.

Antioxidant vitamin supplementation during chemotherapy was associated with higher recurrence risk (HR 1.41)
All-cause mortality was higher in antioxidant supplement users during chemotherapy
Vitamin B12 supplement use was also associated with increased recurrence risk

RCTn=1,134

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Prenatal multivitamin supplementation and rates of congenital anomalies: a meta-analysis

Ingrid Goh Y et al. • Journal of Obstetrics and Gynaecology Canada (2006)

Periconceptional multivitamin supplementation was associated with significant reductions in neural tube defects, cardiovascular defects, urinary tract defects, and limb defects.

Periconceptional MVI use significantly reduced risk of neural tube defects (OR 0.67)
Significant reduction in congenital cardiovascular defects (OR 0.78)
Urinary tract anomalies reduced by 46% with MVI supplementation

Meta-Analysis

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Multivitamin-multimineral supplementation and mortality: a meta-analysis of randomized controlled trials

Macpherson H et al. • The American Journal of Clinical Nutrition (2013)

There was no evidence that multivitamin-multimineral supplementation affects all-cause or cause-specific mortality in the general adult population.

Meta-analysis of RCTs found no significant effect of MVI-MMS on all-cause mortality
No significant effect on cardiovascular mortality or cancer mortality
Results were consistent across subgroups defined by age, sex, and baseline health status

Meta-Analysis

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The effect of multivitamins on anxiety and depression in patients undergoing methadone maintenance treatment: A double-blind randomized controlled trial

Lagzi N et al. • International journal of psychiatry in medicine (2023)

Multivitamin supplementation improved depression but did not have a significant impact on anxiety in patients undergoing MMT.

Multivitamin supplementation improved depression but did not have a significant impact on anxiety in patients undergoing MMT.
Further research warranted to confirm findings

RCTn=38

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Effects of cocoa extract supplementation and multivitamin/multimineral supplements on self-reported fractures in the Cocoa Supplement and Multivitamins Outcomes Study randomized clinical trial

Crandall CJ et al. • Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research (2025)

Forty percent of older US adults take multivitamin/multimineral (MVM) supplementation.

Forty percent of older US adults take multivitamin/multimineral (MVM) supplementation.
Compared with placebo, cocoa extract was not significantly associated with lower risk of incident clinical fracture (adjusted hazard ratio [aHR] 1.03, 95% CI 0.95-1.12) or nonvertebral fracture (aHR 1.05, 95% CI 0.96-1.14).
MVM supplementation was not associated with lower risk of total clinical fracture (aHR 1.09, 95% CI 1.00-1.19), hip fracture (aHR 1.06, 95% CI 0.80-1.42), or nonvertebral fracture (aHR 1.10, 95% CI 1.00-1.20).

RCTn=442

DOI

Multivitamin/mineral supplements: Rationale and safety - A systematic review

Biesalski HK et al. • Nutrition (2017)

Standard-dose multivitamin/mineral supplements at RDA-level doses are safe for long-term use in the general adult population, with a well-characterized safety profile and no evidence of harm at recommended doses.

Comprehensive safety review found no evidence of harm from standard-dose MVI supplementation
Micronutrient insufficiencies are prevalent in both developed and developing nations despite food fortification
Standard MVIs at RDA levels do not approach upper tolerable intake levels for any nutrient

Systematic Review

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Potential mental and physical benefits of supplementation with a high-dose, B-complex multivitamin/mineral supplement: What is the evidence?

Sarris J et al. • Nutricion Hospitalaria (2021)

High-dose B-complex multivitamin/mineral supplementation demonstrated consistent benefits for stress reduction, mental fatigue, and mood in multiple randomized controlled trials.

Systematic review identified consistent evidence for B-complex MVI reducing perceived stress and mental fatigue
Improvements in mood and cognitive performance observed across multiple RCTs
Effects were noted in both healthy populations and those with elevated stress

Systematic Review

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Meta-Analysis of Randomized Clinical Trials Evaluating Effectiveness of a Multivitamin Supplementation against Oxidative Stress in Healthy Subjects

Lee S et al. • Nutrients (2022)

Multivitamin supplementation significantly reduced biomarkers of oxidative stress in healthy subjects, with the most consistent effects seen for MDA and 8-OHdG.

Meta-analysis of RCTs confirmed significant reduction in malondialdehyde (MDA) with MVI supplementation
8-OHdG (DNA oxidative damage marker) was also significantly reduced
Antioxidant enzyme activities (SOD, GPx, catalase) were enhanced

Meta-Analysis

DOI

The Effect of a Multivitamin and Mineral Supplement on Immune Function in Healthy Older Adults: A Double-Blind, Randomized, Controlled Trial

Fantacone ML et al. • Nutrients (2020)

Multivitamin/mineral supplementation significantly improved immune response, with MVI group showing significantly higher antibody titers post-vaccination and reduced illness days compared to placebo.

MVI group had significantly higher antibody titers following influenza vaccination vs placebo
Illness days and illness severity scores were significantly lower in MVI group
Significant improvements in serum vitamin C, D, zinc, and selenium levels confirmed by blood biomarkers

RCTn=42

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The Efficacy of Multivitamin, Vitamin A, Vitamin B, Vitamin C, and Vitamin D Supplements in the Prevention and Management of COVID-19 and Long-COVID: An Updated Systematic Review and Meta-Analysis of Randomized Clinical Trials

Sinopoli A et al. • Nutrients (2024)

Vitamin D and vitamin C supplementation showed the most consistent evidence for benefit in COVID-19 outcomes; multivitamin supplementation showed mixed results but a favorable safety profile.

Vitamin D supplementation showed significant benefit in COVID-19 severity reduction
Vitamin C showed benefit in ICU outcomes and duration of mechanical ventilation
Multivitamin supplementation showed mixed but generally positive trends in COVID-19 prevention

Meta-Analysis

DOI

Vitamin E and cognitive function: A systematic review of clinical evidence

Amin AM et al. • Nutrition research (New York, N.Y.) (2026)

Of them, one on vitamin E supplement, 18 on dietary vitamin E, and 24 on multivitamins containing vitamin E.
However, clinical studies specifically investigating the role of tocotrienols and non-α-tocopherols isoforms, or their combinations in CI, remain limited and warrant further investigations.Copyright © 2025 Elsevier Inc.

Systematic Reviewn=80,488AI-discovered

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