Abstract
Micronutrient deficiencies occur in segments of the adult population in the United States. Multivitamin/multimineral supplements (MVMS) are widely used by this population, which reduces inadequacies in micronutrient intake, but the potential for exceeding tolerable upper intake levels in others should be considered. There are concerns associated with the excessive intake of certain nutrients, particularly folic acid, and potential untoward consequences. The advent of nutrigenomics and the enhanced ability to directly study the interactions between nutrition and genetic variants and expression will allow for the conduct of more targeted studies with specific endpoints and may ultimately lead to progress in the field of personalized nutrition. The role of MVMS in health maintenance and chronic disease prevention remains controversial. Conducting studies in this area has been hampered by, among other factors, inconsistent definitions of MVMS, ranging from as few as three vitamins to broad-spectrum products containing more than two dozen vitamins and minerals. Results from some observational studies and large-scale, randomized, controlled trials suggest that MVMS may reduce the risk of some forms of cancer and, potentially, cardiovascular disease. The ongoing COcoa Supplement and Multivitamin Outcomes Study (COSMOS) is expected to build on this research and provide additional insights into these areas.
Highlights
The World Health Organization has estimated that more than 2 billion people worldwide experience deficiencies in the intake of essential vitamins and minerals [1]
In the Women’s Health Initiative (WHI) study, women with high folate status during the period prior to routine folic acid fortification had lower levels of DNA methylation than in the postfortification period. These results suggest that the relationship between folate status and DNA methylation is not linear and that fortification in otherwise well-nourished individuals may attenuate the positive effects of folate and cause adverse health outcomes [58]
The use of dietary Multivitamin/multimineral supplements (MVMS) is common among adults in the United States (US), and using an MVMS has been shown to reduce the prevalence of inadequate micronutrient intake and status
Summary
The World Health Organization has estimated that more than 2 billion people worldwide experience deficiencies in the intake of essential vitamins and minerals [1]. In the United States (US), a number of shortfall nutrients have been identified in the general population as described by the Dietary Guidelines Advisory Committee to the US Departments of Health and Human Services and Agriculture, which include vitamins A, C, D, and E and choline, calcium, magnesium, iron, and potassium [2]. Nutrients 2018, 10, 248 the Estimated Average Requirement (EAR) [3,4,5]. These dietary shortfalls occur despite the wide use of dietary supplements [6,7,8]. In particular among older women, multiple supplements can be used, which can increase the potential for oversupplementation and excessive nutrient intake [7,9]
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