MD, PhD, FMedSci, FSB, FRCP, FRCPEd

Multivitamins are widely used, mainly for disease prevention, and particularly cardiovascular disease (CVD). But there are only few prospective studies investigating their association with both long- and short-term risk. In view of these facts, new evidence is more than welcome.

The objective of this study was to investigate how multivitamin use is associated with the long- and short-term risk of CVD. A prospective cohort study was conducted of 37,193 women from the Women’s Health Study aged ≥45 y and free of CVD and cancer at baseline who were followed for an average of 16.2 y. At baseline, women self-reported a wide range of lifestyle, clinical, and dietary factors. Women were categorized into 1) no current use and 2) current use of multivitamins. Duration and updated measures over the course of the follow-up to address short-term effects were also considered. Women were followed for major CVD events, including myocardial infarction (MI), stroke, and CVD death.

During the follow-up, 1493 incident cases of CVD [defined as myocardial infarction (MI), stroke, and CVD death] occurred. In multivariable analyses, multivitamin use compared with no use was not associated with major CVD event, stroke, or CVD death. A non-significant inverse association was observed between baseline multivitamin use and major CVD events among women aged ≥70 y (P-interaction = 0.04) and those consuming <3 servings/d of fruit and vegetables (P-interaction = 0.01). When updating information on multivitamin use during the course of follow-up, no associations were observed for major CVD events, MI, stroke, and CVD death.

The authors concluded that, in this study of middle-aged and elderly women, neither baseline nor time-varying multivitamin use was associated with the long-term risk of major CVD events, MI, stroke, cardiac revascularizations, or CVD death. Additional studies are needed to clarify the role of multivitamins on CVD.

Even the most enthusiastic vitamin fan will find it hard to argue with these findings; they seem rock solid. Vitamins have their name from the fact that they are vital for our survival – we all need them. But, in developed countries, we all get them through our daily food. Any excess of water-soluble vitamins is swiftly excreted via the urine. Any excess of fat-soluble vitamins is stored in the body and may, in some cases, even represent a health risk.

Exceptions are vulnerable groups such as children, the elderly, pregnant women and patients with certain diseases. These individuals can suffer from hypovitaminoses, the only reason for regularly using vitamin supplements. But for the vast majority of the population, the only effects of regular vitamin supplementation are that we enrich the manufacturers and render our urine expensive.

5 Responses to What do multivitamins do? They render your urine more expensive!

  • I’m curious how you came to the conclusion that: “Multivitamins are widely used, mainly for disease prevention, and particularly cardiovascular disease (CVD).”
    Is this based on consumer survey or something? I don’t doubt the study findings you quote, I just find it a stretch to imagine people take them thinking they are meant to prevent “heart attack, stroke, and death from CVD”. I’d imagine filling in dietary gaps and nutritional deficiencies would be the main reason. Yes, if you eat a healthy diet, you should cover all your bases, but we know people don’t always do that and that certain sub-populations are deficient or sub-optimal in certain nutrients: vitamin B12, magnesium, iron, and vitamin D being the main ones. I would agree that if you are in one of the sub-populations deficient in one or more of these nutrients, it would be better to supplement just with those specific ones, rather than the catch-all multivitamin, but people like convenience too much…no doubt there are many people consuming multi-vitamins daily that do not need to still though.

    • I wondered about the CVD risk reduction issue as well. The people I know (doesn’t mean much, I know) take them, as you say, for “insurance” in case they don’t eat the right things all the time. This is likely not necessary as people probably get adequate vitamin intake unless they eat REALLY crappy. I don’t really have any issue with people popping a daily multi vitamin–it’s the mega users and the wild claim bunch that bother me. They will not likely be deterred by this or any study, unfortunately. At least I’ll have a good link when I make comments elsewhere 🙂

    • “Multivitamins are widely used, mainly for disease prevention…”

      That doesn’t seem like much of a leap. It would make sense that anyone taking multivitamins are doing so for ‘general health’…which I guess would be disease prevention.

      “…and particularly cardiovascular disease (CVD).”

      Well, that’s what the cited study was about, so why not speculate that people are using multivitamins for prevention of CVD? That technically WOULD fall under the category of disease prevention. It’s technically true…sort of…ish…

      On the other hand, maybe there’s data to back up what seems to be speculative?

      • Thank you jm–I need to reread the entry obviously. I guess it just amazes me that anyone would think they can prevent heart disease by taking vitamins. In fact, some (Vit E) have been shown to cause harm. I think fish oil is the fad of the season, although it’s not a vitamin. I have CVD, sort of. Since losing and maintaing a healthy weight, I don’t seem to have it anymore–other than I know it lurks in my genes, particularly the early-onset type that plagues my family.

  • I suspect most people who take multi vitamins don’t take them for a specific reason; they take them because they’re “good for you”. If pushed, they’d probably suggest cancer and cvd but only because thoso are common concerns and they’d suggest those for any health promotion intervention. Our at least they would when the study began, type 2 diabetes might get more of s mention today.

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