Multivitamin-mineral Supplement Research Articles

Effects of Multivitamin-Mineral Supplementation on Chronic Stress-Induced Oxidative Damage in Swiss Albino Mice.

Stress is a hazardous occurrence that causes a variety of physiological and behavioral responses in a person. It increases energy metabolism and enhances oxidative stress, both of which are implicated in the pathophysiology of several diseases. Numerous vitamins and minerals have the ability to modulate oxidative stress. The present investigation aimed to evaluate the effectiveness of a multivitamin-mineral (MM) supplement in addressing oxidative imbalances caused by chronic stress in the plasma, hepatic, and renal tissues of Swiss albino mice. Thirty healthy male Swiss albino mice were randomly assigned to one of the three groups, with 10 animals each: control, unpredictable chronic stress (UCS), and MM + UCS. The experiment lasted for four weeks, after which all the animals underwent cervical decapitation, and samples of their blood, liver, and kidney were taken for biochemical studies. DNA damage analysis was performed on lymphocytes. Exposure to UCS negatively affected all biochemical markers, as indicated by reduced levels of antioxidants (superoxide dismutase, catalase, glutathione S-transferase, glutathione reductase, and reduced glutathione) in the plasma, liver, and kidney tissues, along with enhanced levels of lipid peroxidation and marker enzymes. MM supplementation normalized the deranged biochemical markers in stress-exposed mice. The results of DNA damage supported the biochemical findings mentioned above. The findings suggest that MM supplementation could help reduce oxidative disturbances caused by stress in both healthy and diseased conditions.

The Effect of Micronutrients on Obese Phenotype of Adult Mice Is Dependent on the Experimental Environment.

The environment of the test laboratory affects the reproducibility of treatment effects on physiological phenotypes of rodents and may be attributed to the plasticity of the epigenome due to nutrient-gene-environment interactions. Here, we explored the reproducibility of adding a multi-vitamin-mineral (MVM) mix to a nutrient-balanced high-fat (HF) diet on obesity, insulin resistance (IR), and gene expression in the tissues of adult male mice. Experiments of the same design were conducted in three independent animal facilities. Adult C57BL/6J male mice were fed an HF diet for 6 weeks (diet induced-obesity model) and then continued for 9-12 weeks on the HF diet with or without 5-fold additions of vitamins A, B1, B6, B12, Zn, and 2-fold Se. The addition of the MVM affected body weight, fat mass, gene expression, and markers of IR in all three locations (p < 0.05). However, the direction of the main effects was influenced by the interaction with the experimental location and its associated environmental conditions known to affect the epigenome. In conclusion, MVM supplementation influenced phenotypes and expression of genes related to adipose function in obese adult male mice, but the experimental location and its associated conditions were significant interacting factors. Preclinical studies investigating the relationship between diet and metabolic outcomes should acknowledge the plasticity of the epigenome and implement measures to reproduce studies in different locations.

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

BackgroundLonger effects of multivitamin-mineral (MVM) supplementation on late-life cognitive function remain untested using in-person, detailed neuropsychological assessments. Furthermore, insufficient evidence exists for healthcare providers to recommend daily MVM supplements to prevent cognitive decline. ObjectivesThis study aimed to test MVM effects on cognitive change using in-person, detailed neuropsychological assessments and conduct a meta-analysis within COSMOS (COcoa Supplement and Multivitamin Outcomes Study) cognitive substudies for a robust evaluation of MVM effects on cognition. MethodsCOSMOS is a 2 × 2 factorial trial of cocoa extract (500 mg flavanols/d) and/or a daily MVM supplement for cardiovascular disease and cancer prevention among 21,442 United States adults aged ≥60 y. There were 573 participants in the clinic subcohort of COSMOS (that is, COSMOS-Clinic) who completed all cognitive tests administered at baseline. For the meta-analysis, we included nonoverlapping participants across 3 COSMOS cognitive substudies: COSMOS-Clinic (n = 573); COSMOS-Mind (n = 2158); COSMOS-Web (n = 2472). ResultsIn COSMOS-Clinic, we observed a modest benefit of MVM compared with placebo on global cognition over 2 y {mean difference [95% confidence interval (CI)] = 0.06 SD units (SU) (−0.003, 0.13)}, with a significantly more favorable change in episodic memory [mean difference (95% CI) = 0.12 SU (0.002, 0.23)] but not in executive function or attention [mean difference (95% CI) = 0.04 SU (−0.04, 0.11)]. The meta-analysis of COSMOS substudies showed clear evidence of MVM benefits on global cognition [mean difference (95% CI) = 0.07 SU (0.03, 0.11); P = 0.0009] and episodic memory [mean difference (95% CI) = 0.06 SU (0.03, 0.10); P = 0.0007]; the magnitude of effect on global cognition was equivalent to reducing cognitive aging by 2 y. ConclusionsIn COSMOS-Clinic, daily MVM supplementation leads to a significantly more favorable 2-y change in episodic memory. The meta-analysis within COSMOS cognitive substudies indicates that daily MVM significantly benefits both global cognition and episodic memory. These findings within the COSMOS trial support the benefits of a daily MVM in preventing cognitive decline among older adults.This trial was registered at COSMOS—clinicaltrials.gov as NCT02422745, at COSMOS-Mind—clinicaltrials.gov as NCT03035201, and at COSMOS-Web—clinicaltrials.gov as NCT04582617.

Effect of cocoa extract supplementation on cognitive function: results from the clinic subcohort of the COSMOS trial

BackgroundSome prior randomized clinical trials (RCTs) that tested the effects of cocoa extract (CE), a source of flavanols, on late-life cognition have yielded promising findings. A long-term RCT using in-person neuropsychological tests covering multiple cognitive domains may clarify the cognitive effects of CE. ObjectivesTo test whether daily supplementation with CE, compared with placebo, produces better cognitive change over 2 y. MethodsThe COcoa Supplement and Multivitamin Outcomes Study (COSMOS) is a 2 × 2 factorial RCT of CE [500 mg flavanols/d, including 80 mg (–)-epicatechin] and/or a daily multivitamin-mineral supplement for cardiovascular disease and cancer prevention among 21,442 United States adults aged ≥60 y. There were 573 participants in the clinic subcohort of COSMOS (that is, COSMOS-Clinic) who completed all cognitive tests at baseline; of these, 492 completed 2-y follow-up assessments. The primary outcome was global cognition (averaging z-scores across 11 tests). Secondary outcomes were episodic memory and executive function/attention. Repeated measures models were used to compare randomized groups. ResultsParticipants' mean age (standard deviation) was 69.6 (5.3); 49.2% were females. Daily supplementation with CE, compared with placebo, had no significant effect on 2-y change in global cognition {mean difference [95% confidence interval (CI)]: −0.01 (−0.08, 0.05) standard deviation units (SU)}. CE, compared with placebo, had no significant effects on 2-y change in episodic memory [mean difference (95% CI): −0.01 (−0.13, 0.10) SU] or executive function/attention [mean difference (95% CI): 0.003 (−0.07, 0.08) SU]. Subgroup analyses uncorrected for multiple-testing suggested cognitive benefits of CE supplementation, compared with placebo among those with poorer baseline diet quality. ConclusionsAmong 573 older adults who underwent repeat in-person, detailed neuropsychological assessments over 2 y, daily CE supplementation, compared with placebo, showed no overall benefits for global or domain-specific cognitive function. Possible cognitive benefits of CE among those with poorer diet quality warrant further study. Trial registrationThis trial was registered at clinicaltrials.gov with identifier – NCT02422745.

Effect of multivitamin‐mineral supplementation on change in cognitive function in the COSMOS Clinical subcohort and meta‐analysis of COSMOS cognition studies

AbstractBackgroundFew randomized clinical trials (RCTs) have investigated the effect of multivitamin‐mineral supplementation (MVM) on cognitive change among community‐dwelling older adults and effects remain untested using detailed in‐person, gold‐standard neuropsychological assessments; thus, we tested the effect of daily MVM vs. placebo on cognitive function among older adults enrolled in the in‐clinic component of COSMOS (COcoa Supplement and Multivitamin Outcomes Study). Furthermore, we conducted a meta‐analysis of the findings from the three COSMOS cognition studies: COSMOS‐Clinic (n = 603 for the detailed in‐person cognitive assessments), COSMOS‐Mind (n = 2262 for telephonic‐based cognitive assessments); and COSMOS‐Web (n = 3562 for computer‐based cognitive assessments) to provide a robust evaluation of the effects of MVM on cognition.MethodsCOSMOS is a 2×2 factorial RCT of cocoa extract supplements (Mars Edge; containing 500 mg/day flavanols) and/or MVM (Haleon, as Centrum Silver) for cardiovascular and cancer prevention. In COSMOS‐Clinic, n = 573 of n = 603 COSMOS‐Clinic participants completed all cognitive tests at baseline; n = 492 completed all cognitive tests at both baseline and 2‐year follow‐up. The primary outcome was global cognitive score [averaging z‐scores of 11 tests: general cognition (the Modified Mini‐Mental State), episodic memory (Consortium to Establish a Registry for Alzheimer’s Disease [CERAD] word list learning and delayed recall tests; East Boston Memory Test immediate and delayed recall trials), CERAD word list recognition, and executive function/attention (two fluency tests; Trail Making Tests A and B; digit span backwards)]. Episodic memory and executive function/attention were examined separately. Finally, we used random‐effects models to meta‐analyze the findings of three COSMOS cognition studies.ResultsIn COSMOS‐Clinic, we observed a signal for effect of MVM vs. placebo on improvement in global cognition over two years (mean difference = 0.06, 95% confidence interval [CI]: ‐0.003, 0.12). MVM vs. placebo led to significant improvement in episodic memory (mean difference = 0.11, 95% CI: 0.001, 0.23) but not in executive function/attention (mean difference = 0.04, 95% CI: ‐0.04, 0.11). The meta‐analysis of three COSMOS studies showed significant benefits of MVM on global cognition and episodic memory (will be presented in detail).ConclusionDaily MVM compared to placebo showed improvement in global cognition and episodic memory over 2 years among community‐dwelling older adults.

Vitamin and Mineral Deficiency 12 Years After Roux-en-Y Gastric Bypass a Cross-Sectional Multicenter Study

PurposeMicronutrient deficiencies are common after Roux-en-Y gastric bypass (RYGB). This study explores whether vitamin and mineral deficiency was associated with adherence to recommended supplementation 12 years after RYGB.Materials and MethodsThe cross-sectional Bariatric Surgery Observation Study (BAROBS) was conducted in 2018–2020 at three hospitals in Central Norway. We report data on 490 patients’ self-reported adherence to recommended supplements and vitamin and mineral levels in the blood. The patients, who had RYGB between 2003 and 2009, were recommended an over-the-counter multivitamin-mineral supplement, calcium/vitamin D (1000 mg/20 µg) and vitamin B12 injections (reimbursed), since bariatric supplements were not available then.ResultsMean (SD) age was 40.1 ± 9 years at RYGB, and time to follow-up 11.7 ± 1.6 years. Of 490 patients, 393 (80%) were women. Among 361 (74%) patients’ adherent to multivitamin-mineral supplements; folate, vitamin B2, and vitamin B6 deficiency were present in 39 (11%), 103 (29%), and 63 (17%) patients, respectively. The same deficiencies occurred in 44 (34%), 67 (52%), and 67 (52%) patients’ non-adherent to recommendations. Although 466 (95%) patients reported adherence to vitamin B12 supplements, sub-optimal levels were found in 73 (16%) patients.Though 336 (69%) patients adhered to calcium/vitamin D supplements (1000 mg/20 µg), sub-optimal vitamin D levels (< 75 nmol/l) were found in 174/336 (52%) adherent patients and 120/154 (78%) non-adherent patients.ConclusionTwelve years after RYGB, adherence to supplements, though in sub-optimal doses of new recommendations, decreases the probability of vitamin and mineral deficiency, especially for thiamine, vitamin B2, vitamin B6, folate, vitamin B12, and vitamin D, but does not eliminate it.Graphical

Dietary supplements increase the risk of excessive micronutrient intakes in Danish children

PurposeDietary supplement use is common in Northern Europe. Many dietary supplements contain 100% of nutrient reference values (NRV) of micronutrients. This study investigates the contribution of dietary supplements to micronutrient intake, the prevalence of excess intake of micronutrients, and parental characteristics of dietary supplement use in Danish children.MethodsData on 499 4–10-year-old children from the Danish National Survey of Diet and Physical Activity 2011–2013 were analysed using non-parametric statistics to compare micronutrient intake from the diet and dietary supplements to the reference intake (RI), and to the tolerable Upper Intake Level (UL) for users and non-users of dietary supplements. Furthermore, characteristics of the parents of users and non-users of dietary supplements were examined by logistic regression analysis.ResultsSixty-four percent of the children were dietary supplement users. Multivitamin-mineral supplements were the most frequently used type of supplement (60%). Children of never-smokers were more likely to use supplements than children of smokers. Users had significantly higher total intakes of 15 micronutrients compared to non-users. Intakes of vitamin A, zinc, and iodine from the diet alone exceeded ULs in 12–30% of the children. Use of dietary supplements gave rise to 21–73% of children in exceedance of the aforementioned three ULs as well as the UL for iron (6–45%).ConclusionDietary supplement use was common among 4–10-year-old Danish children and resulted in a considerable proportion of users exceeding the ULs for vitamin A, zinc, iodine, and iron. The long-term health consequences of exceeding these ULs for children are unknown.

Iodine Status of Mother-Infant Dyads from Montréal, Canada: Secondary Analyses of a Vitamin D Supplementation Trial in Breastfed Infants

BackgroundMost pregnant or lactating women in Canada will not meet iodine requirements without iodine supplementation. ObjectivesTo assess the iodine status of 132 mother-infant pairs based on secondary analyses of a vitamin D supplementation trial in breastfed infants from Montréal, Canada. MethodsMaternal iodine status was assessed using the breastmilk iodine concentration (BMIC). Singleton, term-born infants were studied from 1–36 months of age. Usual (adjusted for within-person variation) iodine intakes were estimated from urinary iodine and creatinine concentrations. Iodine status was assessed using median urinary iodine concentrations (UICs) and by estimating inadequate intakes by the cut-point method using a proposed Estimated Average Requirement for infants 0–6 months of age (72 μg/d). ResultsAt 1, 3, and 6 months of age, 70%, 63%, and 3% of infants, respectively, were exclusively breastfed. From 1–36 months of age (n = 82–129), the median UICs were ≥100 μg/L (range, 246–403 μg/L), which is the cutoff for adequate intakes set by the WHO for children <2 years. Almost all (98%–99%) infants at 1 and 2 months, 2 and 3 months, and 3 and 6 months of age had usual creatinine-adjusted iodine intakes ≥ 72 μg/d. The median BMIC was higher (P < 0.001) at 1 month compared to 6 months of lactation [1 month, 198 μg/kg (IQR, 124–274; n = 105) and 6 months, 109 μg/kg (IQR, 67–168; n = 78)]. At 1 and 6 months, 96% and 79% of mothers, respectively, had a BMIC ≥ 60 μg/kg, the lower limit of a normal reference range. The percentages of mothers that used a multivitamin-mineral (MVM) supplement containing iodine were 90% in pregnancy and 79% and 59% at 1 and 6 months of lactation, respectively. ConclusionsThe iodine status of infants was adequate throughout infancy. These results support a recommendation that all women who could become pregnant, who are pregnant, or who are breastfeeding take a daily MVM supplement containing iodine.

Evaluation effects of essential amino acids and zinc and iron supplementation on the prevention of early hair loss after sleeve gastrectomy

Background: Due to the reduction in micronutrients and proteins available to the body after LSG, we evaluated effects of various supplements and rate of hair loss in the postoperative period. Material and Methods: In this interventional study, we examined female candidates of LSG. individuals randomly divided into three groups. Group 1 received routine multivitamin mineral supplements, group 2 took received zinc + iron + B vitamins supplements plus routine multivitamin mineral until the end of the third month after surgery, and group 3 took supplements containing wheat and sesame proteins and methionine and cysteine in addition to Zinc + Iron + B vitamins supplements and routine multivitamin mineral supplements. number of hairs in the frontal area were counted using trichoscope before surgery and after 3 month follow up. Results: the mean number of hairs in the frontal area in group 1 before and after surgery was about143 and 100 hairs per cm² respectively, in group 2 was 142 and 116 and In group 3, 137 and 177 hairs per cm². the mean number of trichoscopic hairs in the frontal area, was significantly higher in group 3 than other groups. (p &lt; 0.001) Conclusion: The present study clearly showed that the use of protein supplements, in addition to the use of micronutrients in individuals, more and better reduces the rate of hair loss after LSG. This can be considered and evaluated for future surgeries

The impact of micronutrient supplementation in alcohol-exposed pregnancies on reaction time responses of preschoolers in Ukraine.

The potential of micronutrients to ameliorate the impact of prenatal alcohol exposure (PAE) on attentional regulation skills was explored in a randomized clinical trial conducted in Ukraine. Women who differed in prenatal alcohol use were recruited during pregnancy and assigned to one of three groups [No study-provided supplements, Multivitamin/Mineral Supplement (MVM), or MVM plus Choline]. Their offspring were seen in the preschool period and a reaction time task was administered. Participants were asked to press a response button as quickly as possible as 30 stimuli from the same category (animals) were presented consecutively and then followed by six stimuli from a novel category (vehicles). Number correct, mean latency of the response over trials, and variability in the latency were analyzed separately by sex. During the initial animal trials, boys whose mothers received MVM during pregnancy had more correct responses and reduced response latency compared to boys whose mothers had no MVM treatment. During vehicle trials, maternal choline supplementation was associated with increased response speed in males without a PAE history. Females receiving supplements did not show the same benefits from micronutrient supplementation and were more adversely impacted by prenatal alcohol exposure. Relationships between maternal levels of choline, betaine, and dimethylglycine (DMG) and task performance were also assessed. Although no effects were found for choline after adjusting for multiple comparisons, lower baseline DMG level was associated with greater accuracy and shorter latency of responses in the initial animal trials and shorter latency in the vehicle trials in female preschoolers. Level of betaine in Trimester 3 was associated with reduced variability in the latency of male responses during the animal trials. Maternal micronutrient supplementation in pregnancy appears to improve preschool reaction time performance, but the effects varied as a function of sex and PAE exposure status.

Iodine Status of Canadian Children, Adolescents, and Women of Childbearing Age

BackgroundAdequate iodine intake is important for children and women of childbearing age because iodine is vital for fetal brain development and early life. ObjectiveIodine status of children (n = 1875), adolescents (n = 557), and women of childbearing age (n = 567) was assessed using urinary iodine concentrations (UIC) from duplicate spot samples collected in the Canadian Health Measures Survey, cycle 5 (2016–2017). MethodsDaily iodine intakes were estimated from urinary iodine and creatinine concentrations using a formula based on iodine absorption and predicted 24-h creatinine excretion. Usual UIC and iodine intakes, adjusted for within-person variation, were estimated using the National Cancer Institute method. Iodine status was assessed by 1) comparing median UIC with WHO/UNICEF/ICCIDD reference ranges and 2) estimating the prevalence of inadequate and excessive intakes using the estimated average requirement (EAR) and tolerable upper intake level (UL) cut-point method, respectively. ResultsMedian UIC for males and females 6–11 or 12–19 y old were ≥100 μg/L, the lower cutoff for adequate intakes. For women 20–39 y old, the median UIC of an unadjusted sample was 81 μg/L (95% CI: 67, 95) and for the usual UIC was 108 μg/L (95% CI: 84, 131). The percentage of children 3 y old with iodine intake ≥EAR was 82% (95% CI: 75, 89). The corresponding estimates for males 4–8, 9–13, and 14–18 y old were 93% (95% CI: 88, 97), 91% (95% CI: 87, 96), and 84% (95% CI: 76, 91), respectively. Estimates for females 4–8, 9–13, 14–18, and 19–39 y old were 86% (95% CI: 83, 89), 87% (95% CI: 80, 95), 68% (95% CI: 55, 80), and 68% (95% CI: 59, 76), respectively. For all sex–age groups, 91–100% had iodine intakes ≤UL. ConclusionsIodine intakes may be insufficient for some women of childbearing age. Public health policies and programs should continue to recommend that all women who could become pregnant, or women who are pregnant or breastfeeding, take a daily multivitamin–mineral supplement containing iodine.

Mineral Supplements, Multivitamins, and Energy Drinks are Commonly Consumed

In India, there has been an increase in the use of energy drinks and dietary supplements. However, the benefit of taking multivitamins and nutritional mineral supplements on a regular basis is still debatable. The purpose of this study was to collect information on the types of nutritional mineral supplements and energy drinks consumed by school adolescents, with a focus on the impact of consumption on BMI (BMI). The study involved 120 high school adolescent students between the ages of 14 and 19. A semi-structured questionnaire was used to collect data. Diet-related questions were asked using a 24-hour dietary recall method, and the questionnaire also determined their physical activity. The subjects' height and weight were measured, and their BMI was calculated. In this study, 55 percent of respondents said they had consumed energy and sports drinks in the previous two weeks, and 43 percent said they had consumed one or more types of multivitamin and nutritional mineral supplements without analysing their need or visiting a physician. Vitamin C (5%) and D (5%) were the most commonly consumed vitamins without a prescription, while iron (6%) and calcium (5%) were the most commonly consumed minerals without a prescription among the study participants. Curiosity was cited as a reason for using energy and sports drinks, followed by peer pressure, while students who consumed them cited perceived short-term health benefits and parental supply as common causes. The consumption of energy and sports drinks was also found to be statistically significant when measured by the body mass index (BMI). Thus, in order to be most relevant and effective, health education programmes should incorporate young people's perceptions, aspirations, and motivations into the planning of interventions and activities.

Self-Reported Dietary Supplement Use Is Reproducible and Relatively Valid in the Cancer Prevention Study-3 Diet Assessment Substudy

BackgroundDietary supplement use is common, particularly among cancer survivors and those at increased risk for cancer. ObjectiveThe objectives of this study were to assess 1-year test–retest reproducibility of dietary supplement use reported via food frequency questionnaire (FFQ-1 vs FFQ-2) and relative validity in comparison to repeated 24-hour dietary recalls (FFQ-2 vs DRs). DesignThis ancillary study was conducted within a large prospective cohort, the American Cancer Society’s Cancer Prevention Study-3. Participants/settingBetween 2015 and 2016, 684 participants in the United States (64% women; 62% non-Hispanic White, 23% non-Hispanic Black, and 15% Hispanic) completed two FFQs and up to six unannounced telephone interviewer-administered DRs over 1 year as part of the Cancer Prevention Study-3 Diet Assessment Substudy. Primary outcome measuresFFQs queried current multivitamin-mineral supplement (≥10 components) use, frequency and dose (range) for seven supplements taken individually or as part of a complex (individual/complex) including calcium, vitamins D, C, and E, folic acid, fish oil, and glucosamine. DRs allowed exact reporting of supplement frequency and dose. Statistical analysesWeighted κ statistics were used to evaluate reproducibility between FFQ-1 and FFQ-2 and Spearman correlation coefficients assessed agreement between supplemental nutrient amounts assessed by FFQ-2 and the average of DRs. ResultsJust more than half of the participants reported taking multivitamin-mineral supplements on the baseline FFQ. Kappa statistics for the comparison of categorical responses between FFQ-1 and FFQ-2 were 0.67 for multivitamin-mineral supplements. Kappas for individual/complex supplements ranged from 0.47 for folic acid to 0.74 for vitamin D, with a mean of 0.64. Results were similar between men and women. Spearman correlation coefficients comparing FFQ-2 with the average of DRs (validity) for nutrient intakes from all sources ranged from 0.65 (fish oil for women) to 0.77 (vitamin D for men and calcium for women); results were similar among men and women. ConclusionsThese findings suggest the FFQ used in Cancer Prevention Study-3 has good reproducibility over 1 year and yields estimates comparable to a more detailed assessment for commonly consumed dietary supplements.

A beneficial cardiometabolic health profile associated with dietary supplement use: A cross-sectional study.

As a follow-up to an earlier study demonstrating healthier cardiometabolic profiles among long-term multiple dietary supplement (LTMDS) users, we examined if cardiometabolic health benefits associated with LTMDS use persisted with aging. The study is based on LTMDS users from North America and 2007-2010 NHANES participants who were used for comparison to the LTMDS users. NHANES subjects were classified as non-dietary supplement (NS) users, single supplement/single purpose supplement (SS) users, multivitamin/mineral supplement (MVMS) users, and multiple dietary supplement (MDS) users. Supplement groups were compared for total, HDL and LDL cholesterol; triglycerides; glucose; insulin; CRP and HbA1c≥6.5%, adjusting for age, sex, income, education, BMI, history of CVD, and medications for hypercholesterolemia and diabetes. Geometric mean (95% confidence interval) LDL cholesterol was significantly lower (P<0.05) for all supplement groups (SS: 110 (104-117) mg/dL; MVMS: 113 (107-119) mg/dL; MDS: 115 (111-118) mg/dL; LTMDS: 112 (105, 119) mg/dL) compared with the NS users (122 (118-126) mg/dL). Compared with the NS group, MDS users had significantly (P<0.05) lower mean total cholesterol (198 (194-201) vs 201 (197, 206) mg/dL), MDS and LTMDS users higher mean HDL cholesterol (54.2 (53.3-55.1) and 60.0 (57.4, 62.7) mg/dL vs 52.0 (50.8-53.3) mg/dL), LTMDS users lower fasting glucose (100 (98-103) vs 105 (103-106) mg/dL), SS and MDS users lower insulin (8.4 (7.4-9.6) and 9.1 (8.3-9.9) vs 10.2 (9.4-11.1) μIU/mL), and MDS users lower CRP (%≥1.5mg/L, 50.8 (47.9-53.6) vs 57.0 (52.4-61.6) %). These findings add to the evidence that use of dietary supplements may provide cardiometabolic health benefits.

The effect of consuming multivitamin/mineral supplements on elderly quality of life: Based on randomized control trial

BACKGROUND:Clinical trials concerning the effect of supplements or multivitamin on improving the quality of life have proven different results. The present study was conducted to examine the effect of multivitamin supplement on quality of life of the elderly.MATERIALS AND METHODS:Sixty-four old people over 65 years of age in Kermanshah Elderly Care Center participated in this randomized trial. The samples were first selected using the convenience sampling and then were randomly assigned into intervention and control groups. The intervention group received one multivitamin mineral (MVM) supplement capsule every day for 3 months with no intervention for the control group. Standard quality of life questionnaire was used to collect the data. Data were analyzed using the SPSS software version 22.RESULTS:The mean age of the participants was 70.77 ± 8.29 years. The results of intra-group evaluation of the aspects of quality of life of the elderly show the lack of significant changes in the mean scores of physical health and environmental health of the elderly in the intervention group (P > 0.05) and the significant reduction of these aspects in the control group (P < 0.05) after intervention. The mean score of mental health scores in the intervention group significantly increased (P = 0.01), but there are no significant changes in the control group (P = 0.273). The mean scores of social relationships as well as the overall score of quality of life in the intervention and control groups showed no significant changes (P > 0.05).CONCLUSION:The present study showed that the consumption of MVM supplements can have a positive effect on increasing the quality of life of the elderly, but it is recommended to be done in the long term along diet. Moreover, considering the fact that no change was observed in the other aspects of the quality of life, attentions should be paid to the environmental and social factors such as social supports and empowerment of the old people in the future studies.

The Effect of Multi-Vitamin/Multi-Mineral Supplementation on Nutritional Status in Older Adults Receiving Drug Therapies: A Double-Blind, Placebo-Controlled Trial

Polypharmacy regimens may increase the susceptibility of older adults to micronutrient inadequacy and deficiency via impairment of nutritional status. We hypothesized that a multi-vitamin-mineral supplement (MVMS) could improve nutritional status in older adults prescribed diuretics, metformin, and/or proton pump inhibitors (PPIs). We conducted a randomized, double-blind, placebo controlled, parallel clinical trial in which eligible subjects were instructed to consume either a MVMS or placebo for 16 wk. Fasting blood was collected at baseline, 8, and 16 wk and the status of selected vitamins and minerals determined. Thirty-five and 19 men and women aged 45–75 yrs in the in MVMS and placebo arms, respectively, completed the trial. The mean total number of medications among the three drug classes taken by participants did not differ between two groups. The status of vitamins B1, B12, C and folate and calcium, copper, magnesium and zinc at baseline were within normal ranges. The MVMS group had a greater change in nutrient status after 16 wk compared to the placebo group for serum folate (7.5 vs. –1.6 ng/mL, p < 0.0001), vitamin B12 (159.2 vs. –33.9 pg/mL, p = 0.007), and plasma vitamin C (0.2 vs. 0.0 mg/dL, p = 0.004). Other measured vitamins and minerals were not significantly changed during the intervention. In conclusion, the status of vitamins B12, C and folate improved with MVMS but remained within normal ranges in older adults taking diuretics, metformin, and/or PPIs.

Differences in Dietary Intake and Vitamin and Mineral Status of Infants and Children on Dialysis Receiving Feeds or Eating Normal Food

Knowledge of the vitamin and mineral intake and status of children on dialysis is scarce. Guidelines suggest supplementation of water-soluble vitamins, but the need for supplementation of minerals is less clear. We evaluated vitamin and mineral intake and status of children on chronic dialysis in our center. We reviewed patient records of all 33 children aged 0-16years who were treated with chronic dialysis at a University Hospital between December 2014 and August 2019. Dietary intake was estimated from feed prescriptions and 3-day food records. Vitamin and mineral determinations were performed as part of routine care. Food records or adherence to dietary prescription of feeds were available for 29 children. Dietary intake of most nutrients was sufficient in children on feeds, but children not on feeds had low intakes of vitamins D, B1, B2, and B6 as well as zinc, iron, and calcium from their diet. Insufficient intake was corrected with supplementation. We discovered some children with blood concentrations below the reference range for vitamins D (3.1%) and C (15.4%) and copper (16.7%) and selenium (3.1%). In contrast, various proportions of children with blood concentrations above the reference range were detected for all nutrients apart from vitamin D. In our study, children receiving sufficient amounts of renal-specific feeds to meet at least 100% of age-specific requirements do not appear to need multivitamin-mineral supplementation, apart from vitamin D and calcium; in addition, children on PD usually need a sodium supplement and, on rare occasions with low intake from feeds, a phosphate supplement is needed. This study further revealed that other children at our center are more prone to deficient intakes of several vitamins and minerals, requiring supplementation based on dietetic review and, in some instances, laboratory measurements.

Children’s Multivitamin/Mineral Supplements: Label Claims and Measured Content Compared to Recommended Dietary Allowances and Tolerable Upper Intake Levels

Abstract Objectives US children ages 4 and older use multivitamin/mineral supplements (MVMs) formulated to meet the Daily Values for adults. To better evaluate the potential for nutrient adequacy and excess, it is helpful to determine actual ingredient content instead of amounts declared on labels. We tested children's MVMs and compared the products’ labeled and measured contents with Recommended Dietary Allowances (RDA) and Upper Tolerable Intake Levels (UL) established for children ages 4 to 8 years. Methods Children's MVMs were defined as dietary supplements (DSs) containing three or more vitamins with or without minerals and other bioactive components labeled for individuals ages 4 and older. Nationally representative children's MVMs were identified based on relative market share estimates (RMSE) derived from frequency of use and respondents’ weights in infant/pediatric MVM subsets of 2003–2006 National Health and Nutrition Examination Surveys, and store surveys. The 21 top and 43 lower market share DSs selected for this study represented ∼72% of the total RMSE. The DSs were purchased in 2008 from multiple market channels in regions of AL, CA, MI, MO, NY, and OK identified using a multistage probability-proportional-to-size approach. Vitamin and mineral content was measured by commercial labs in 3 to 6 lots of 47 chewable tablets, 11 gummies, 4 liquids, 1 gumball, and 1 powder DS. Results For 13 of 16 nutrients (copper, iodine, iron, zinc, folic acid, niacin, riboflavin, thiamin, vitamins A, B-12, B-6, D and E), most MVMs were labeled at or above the RDA but below UL levels. For calcium, magnesium and phosphorus, all the studied DSs were labeled below the RDAs. The DSs that contained zinc, niacin and retinol labeled above their ULs had overall mean RMSEs comparable to the DSs labeled within the RDA-UL ranges. Overages resulted in levels exceeding the UL for folic acid in 24 out of 29 DSs labeled at the UL and for retinol in 10 out 40 DSs labeled below the UL, including one of the three most highly consumed MVMs. Conclusions The prevalence of children's MVMs on the US market with labeled levels at or above the RDA, or at UL, combined with analytically verified overages, suggests risks of excess in intakes for zinc, niacin, retinol and folic acid, especially when MVM use is combined with diets containing many highly fortified foods. Funding Sources NIH ODS and USDA ARS.

Acute and chronic effects of multivitamin/mineral supplementation on objective and subjective energy measures

BackgroundVitamins and minerals play an essential role within many cellular processes including energy production and metabolism. Previously, supplementation with a multivitamin/mineral (MVM) for ≥28 days resulted in improvements to cognition and subjective state. We have also demonstrated shifts in metabolism during cognitively demanding tasks following MVM in females, both acutely and following 8-week supplementation. The current study aimed to assess these effects further in males and females using metabolically challenging exercise and cognitive tasks.MethodsThe current randomised, placebo-controlled, parallel groups study investigated the effects of a MVM complex in 82 healthy young (18-35y) exercisers. Subjective ratings and substrate metabolism were assessed during 30 min each of increasingly effortful incremental exercise and demanding cognitive tasks. Assessments took place on acute study days following a single dose (Day 1) of MVM, containing 3 times recommended daily allowance of water-soluble vitamins plus CoQ10, and following 4-week supplementation (Day 28).ResultsEnergy expenditure (EE) was increased during cognitive tasks following MVM across Day 1 and Day 28, with greater effects in males. In males, MVM also increased carbohydrate oxidation and energy expenditure during exercise across Day 1 and Day 28. In females, mental tiredness was lower during exercise; increases in physical tiredness following 30 min of exercise were attenuated; and stress ratings following cognitive tasks were reduced following MVM. In males, MVM only lowered mental tiredness following 10 min of exercise. These effects were apparent irrespective of day, but effects on mental tiredness were greater on Day 28. Ferritin levels were also higher on Day 28 in those receiving MVM.ConclusionThese findings extend on existing knowledge, demonstrating increased carbohydrate oxidation and increased energy expenditure in males following MVM supplementation for the first time. Importantly, they show modulation of energy expenditure and subjective tiredness following a single dose, providing further evidence for acute effects of MVM. Differential effects in men and women suggest that sex may play an important role in the effects of MVM on energy metabolism and should be considered in future research.Trial registrationClinicalTrials.gov, NCT03003442. Registered 22nd November 2016 – retrospectively registered

Relationship Between Modified Body Adiposity Index and A Body Shape Index with Biochemical Parameters in Bariatric Surgery Candidates.

Body mass index, an estimate of body fat percentage, has been previously shown to be associated with metabolic disorders. However, there is little data on the associations between a body shape index (ABSI) or modified body adiposity index (MBAI), which provide valuable definitions of body fat, with serum biochemical parameter levels. Therefore, this study was conducted to find either ABSI or MBAI associations with serum biochemical parameter levels in bariatric surgery candidates. This cross-sectional study was conducted on 776 bariatric surgery candidates (age range 18-69 years) between November 2010 and September 2017. Demographic data, anthropometric indices, biochemical parameters, and body composition analysis data were drawn from the National Obesity Surgery Database, Iran. ABSI and MBAI were calculated using related equations. A stepwise multivariate linear regression was used to evaluate whether ABSI or MBAI was associated with each serum biochemical parameter. ABSI, age, and multivitamin/mineral supplementation (MVMS) were independently associated with serum vitamin D (β = 24.374, SE 10.756, P value 0.026; β = 0.022, SE 0.007, P value 0.002; β = 0.639, SE 0.235, P value 0.008). However, a negative association was observed between MBAI and vitamin D (β = - 0.037, SE 0.016, P value 0.025) in a model adjusted for age and MVMS. Additionally, MBAI and age showed a significant positive association with serum HDL-c (β = 0.185, SE 0.085, P value 0.028; β = 0.171, SE 0.033, P value < 0.001), although there was a negative association between male sex and HDL-c (β = - 4.004, SE 0.891, P value < 0.001). ABSI and MBAI may be appropriate indices in predicting serum vitamin D and HDL-c levels.