Multimineral Supplements Research Articles

Examining nutrition strategies to influence DNA methylation and epigenetic clocks: a systematic review of clinical trials.

Nutrition has powerful impacts on our health and longevity. One of the mechanisms by which nutrition might influence our health is by inducing epigenetic modifications, modulating the molecular mechanisms that regulate aging. Observational studies have provided evidence of a relationship between nutrition and differences in DNA methylation. However, these studies are limited in that they might not provide an accurate control of the interactions between different nutrients, or between nutrition and other lifestyle behaviors. Here we systematically reviewed clinical studies examining the impact of nutrition strategies on DNA methylation. We examined clinical studies in community-dwelling adults testing the effects of nutrition interventions on i) global DNA methylation and its proxies, and ii) epigenetic clocks. We included 21 intervention studies that focused on the effects of healthy nutrition patterns, specific foods or nutrients, as well as the effect of multivitamin or multimineral supplements. In four studies on the methylation effects of healthy dietary patterns, as defined by being rich in vegetables, fruits, whole-grains, and nuts and reduced in the intake of added sugars, saturated fat, and alcohol, two of them suggested that a healthy diet, is associated with lower epigenetic age acceleration, one of them reported increases in global DNA methylation, while another one found no diet effects. Studies examining epigenetic effects of specific foods, nutrients, or mixtures of nutrients were scarce. For both folic acid and polyunsaturated fatty acids, the available independent studies produced conflicting findings. Although more evidence is still needed to draw firm conclusions, results begin to suggest that healthy dietary patterns have positive effects on DNA methylation. Additional evidence from large randomized-controlled clinical trials is needed to support the effects of healthy nutrition on the DNA methylome.

Healthy longevity: a systematic review of nutrological and lifestyle aspects

Introduction: In the context of healthy longevity, quality of life, genetic, environmental, and lifestyle factors can determine the life expectancy of human beings. Nutrition is a key component affecting our health, and several studies show that nutrition also has the potential to increase lifespan. Objective: It was to carry out a systematic review of the impacts of nutrology and lifestyle on the longevity of human beings, as well as to point out the main dietary and lifestyle care based on the results of clinical studies. Methods: The systematic review rules of the PRISMA Platform were followed. The research was carried out from April to July 2023 in Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 311 articles were found, and 147 articles were evaluated and 47 were included in this systematic review. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 29 studies with a high risk of bias and 51 studies that did not meet GRADE. Most studies showed homogeneity in their results, with X2 =87.3%>50%. There is scientific evidence that nutrients and natural substances of human physiology and biochemistry such as melatonin and coenzyme Q10 control the functions of the immune system. Many metabolic or chronic diseases have been implicated with poor diet and lifestyle. Improved diet quality is associated with reduced all-cause mortality, whereas multivitamins and multimineral supplements can improve life expectancy. Overall well-being is improved when sedentary but sufficiently physically active adults reduce sedentary time and increase physical activity levels. The results of the pandemic indicate there have been a variety of lifestyle changes, physical inactivity, and psychological issues. Still, adults over 40 years old, with children, unemployed, and those living in a macroeconomic region were shown to be more exposed to unhealthy behaviors. The maintenance of dietary intervention through telemedicine can reduce the negative impact of eating habits and physical activity patterns.

The Extent of the Use of Multivitamins and Multimineral Supplements Without Clinically Measurable Benefits Among Adults in Ha'il, Saudi Arabia: A Cross-Sectional Study.

Introduction Multivitamins and multiminerals (MVMM) are nutritional supplements that contain a wide range of important nutrients. The use of vitamins and minerals has been showing a tremendous increase over the past few years due to the high demand for supplements to replenish nutritional deficiencies. Purpose This study aimed to assess MVMM usage, the reasons why people chose to use MVMM, and the factors related to this usage. Methodology A cross-sectional study was conducted on adults living in Ha'il, Saudi Arabia. Data were collected between October 31 and December 14, 2022, a self-administered online questionnaire was used, and data were analyzed using SPSS version 25.0 (IBM Corp, Armonk, NY). Results A total of 310 participants enrolled in the study, of which 240 (77.42%) were females and 70 (22.58%) were males. The extent ofthe use of MVMM supplements without clinically measurable benefits was more than half of the present study participants (58.71%). There was a significant difference between MVMM use and gender or employment status. MVMM usage on a regular basis was found to be associated with satisfaction with the outcomes. The majority of participants used MVMM to promote health. Calcium and vitamin D were found to be the most common types of dietary supplements used. Conclusion The use of MVMM supplements without clinically measurable benefits was more prevalent among females. It is important to promote public health awareness programs about the benefits and risks of overdose.

Androgenic steroids in Over-the-Counter dietary Supplements: Analysis for association with adverse health effects.

From 2012 to 2013, approximately 16 New York residents reported vague, nonspecific adverse health effects which included fatigue, loss of scalp hair, and muscle aches. One patient was hospitalized for liver damage. An epidemiological investigation identified a common factor among these patients; the consumption of B-50 vitamin and multimineral supplements from the same supplier. To investigate whether these nutritional supplements might have been responsible for the adverse health effects observed, comprehensive chemical analyses of marketed lots of the supplements were performed. To determine presence of organic components and contaminants, organic extracts of samples were prepared and analyzed using gas chromatography-mass spectrometry (GC-MS), liquid chromatography-tandem mass spectrometry (LC-MS/MS), liquid chromatography high-resolution mass spectrometry (LC-HRMS), and nuclear magnetic resonance (NMR). These analyses revealed the presence of significant levels of methasterone (17β-hydroxy-2α,17α-dimethyl-5α-androstane-3-one), an androgenic steroid and schedule III-controlled substance; dimethazine, an azine-linked dimer of methasterone; and methylstenbolone (2,17α-dimethyl-17β-hydroxy-5α-androst-1-en-3-one), a related androgenic steroid. Methasterone and extracts of certain supplement capsules were identified as highly androgenic in luciferase assays by using an androgen receptor promoter construct. This androgenicity persisted for several days after cell exposure to the compounds. The presence of these components in implicated lots were associated with adverse health effects and the hospitalization of one patient and the presentation of symptoms of severe virilization in a child. These findings underscore the need for more rigorous oversight of the nutritional supplement industry.

Self-reported health without clinically measurable benefits among adult users of multivitamin and multimineral supplements: a cross-sectional study

ObjectiveMultiple clinical trials fail to identify clinically measurable health benefits of daily multivitamin and multimineral (MVM) consumption in the general adult population. Understanding the determinants of widespread use of MVMs...

Co-trimoxazole or multivitamin multimineral supplement for post-discharge outcomes after severe anaemia in African children: a randomised controlled trial

SummaryBackgroundSevere anaemia is a leading cause of paediatric admission to hospital in Africa; post-discharge outcomes remain poor, with high 6-month mortality (8%) and re-admission (17%). We aimed to investigate post-discharge interventions that might improve outcomes.MethodsWithin the two-stratum, open-label, multicentre, factorial randomised TRACT trial, children aged 2 months to 12 years with severe anaemia, defined as haemoglobin of less than 6 g/dL, at admission to hospital (three in Uganda, one in Malawi) were randomly assigned, using sequentially numbered envelopes linked to a second non-sequentially numbered set of allocations stratified by centre and severity, to enhanced nutritional supplementation with iron and folate-containing multivitamin multimineral supplements versus iron and folate alone at treatment doses (usual care), and to co-trimoxazole versus no co-trimoxazole. All interventions were administered orally and were given for 3 months after discharge from hospital. Separately reported randomisations investigated transfusion management. The primary outcome was 180-day mortality. All analyses were done in the intention-to-treat population; follow-up was 180 days. This trial is registered with the International Standard Randomised Controlled Trial registry, ISRCTN84086586, and follow-up is complete.FindingsFrom Sept 17, 2014, to May 15, 2017, 3983 eligible children were randomly assigned to treatment, and followed up for 180 days. 164 (4%) were lost to follow-up. 1901 (95%) of 1997 assigned multivitamin multimineral supplement, 1911 (96%) of 1986 assigned iron and folate, and 1922 (96%) of 1994 assigned co-trimoxazole started treatment. By day 180, 166 (8%) children in the multivitamin multimineral supplement group versus 169 (9%) children in the iron and folate group had died (hazard ratio [HR] 0·97, 95% CI 0·79–1·21; p=0·81) and 172 (9%) who received co-trimoxazole versus 163 (8%) who did not receive co-trimoxazole had died (HR 1·07, 95% CI 0·86–1·32; p=0·56). We found no evidence of interactions between these randomisations or with transfusion randomisations (p>0·2). By day 180, 489 (24%) children in the multivitamin multimineral supplement group versus 509 (26%) children in the iron and folate group (HR 0·95, 95% CI 0·84–1·07; p=0·40), and 500 (25%) children in the co-trimoxazole group versus 498 (25%) children in the no co-trimoxazole group (1·01, 0·89–1·15; p=0·85) had had one or more serious adverse events. Most serious adverse events were re-admissions, occurring in 692 (17%) children (175 [4%] with at least two re-admissions).InterpretationNeither enhanced supplementation with multivitamin multimineral supplement versus iron and folate treatment or co-trimoxazole prophylaxis improved 6-month survival. High rates of hospital re-admission suggest that novel interventions are urgently required for severe anaemia, given the burden it places on overstretched health services in Africa.FundingMedical Research Council and Department for International Development.

Patterns and dietary determinants of essential and toxic elements in blood measured in mid-pregnancy: The Norwegian Environmental Biobank

BackgroundInadequate stores or intakes of essential minerals in pregnancy, or too high exposure to both toxic and essential elements, can have adverse effects on mother and child. The main aims of this study were to 1) describe the concentrations and patterns of essential and toxic elements measured in maternal whole blood during pregnancy; 2) identify dietary, lifestyle and sociodemographic determinants of element status; and 3) explore the impact of iron deficiency on blood element concentrations. MethodsThis study is based on blood samples collected from 2982 women in gestational week 18 in The Norwegian Mother and Child Cohort study (MoBa) which were analyzed as part of the Norwegian Environmental Biobank. We derived blood element patterns by exploratory factor analysis, and associations between blood element patterns and diet were explored using sparse partial least squares (sPLS) regression. ResultsBlood concentrations were determined for the essential elements (in the order of most abundant) Zn > Cu > Se > Mn > Mo > Co, and the toxic metals Pb > As > Hg > Cd > Tl. The concentrations were in ranges that were similar to or sometimes more favorable than in other pregnant and non-pregnant European women. We identified two blood element patterns; one including Zn, Se and Mn and another including Hg and As. For the Zn-Se-Mn pattern, use of multimineral supplements was the most important dietary determinant, while a high score in the Hg-As pattern was mainly determined by seafood consumption. Concentrations of Mn, Cd and Co were significantly higher in women with iron deficiency (plasma ferritin < 12 μg/L) than in women with plasma ferritin ≥ 12 μg/L. ConclusionOur study illustrates complex relationships and coexistence of essential and toxic elements. Their potential interplay adds to the challenges of studies investigating health effects related to either diet or toxicants.

The impact of social determinants and lifestyles on dietary patterns during pregnancy: evidence from the "Mamma & Bambino" study.

During pregnancy, maternal dietary patterns play a critical role in determining maternal and new-born health. Recent evidence highlighted the influence of either social determinants and lifestyles on the adherence to different dietary patterns. In this cross-sectional analysis, we evaluated the association of social determinants and lifestyles with maternal dietary patterns in the "Mother & Child" cohort, a prospective study that enrols mother-child pairs from Catania, Italy. Dietary patterns were derived using Food Frequency Questionnaire and Principal Component Analysis. Logistic regression models were used to evaluate the association between socio-demographic factors (i.e., age, educational level and employment status), lifestyles (i.e., smoking status, body mass index, use of folic acid, multivitamin and multi-mineral supplements) and dietary patterns. Overall, 332 women were enrolled and the following dietary patterns were derived: the "western" dietary pattern, characterized by high intake of red meat, fries, dipping sauces, salty snacks and alcoholic drinks; the second one, named "prudent", characterized by high intake of potatoes, raw and cooked vegetables, legumes, rice and soup. Multivariable analysis showed that young age, low educational level and smoking were positively associated with the adherence to the western dietary pattern. In contrast, pre-gestational body mass index was negatively associated with the adherence to the prudent dietary pattern. Our results raise the need of strategies for promoting healthy dietary habits among women in their reproductive age, which might also help control their body weight before and during pregnancy. These strategies should be prioritized to young women of low educational level, who generally share other unhealthy behaviours.

OSTEO-ARTICULAR DISORDER IN CHILDREN WITH CYSTIC FIBROSIS

Osteo-articular disorder in cystic fibrosis is considered a common complication of this pathology. The most efficient strategies used for bone health maintenance in patients with cystic fibrosis are early recognition, prevention and correct treatment. The purpose of this study was the clinical and paraclinical evaluation of patients hospitalized in the 3rd Clinic of Pediatrics, “Sf. Maria” Children’s Emergency Hospital Iasi, diagnosed with cystic fibrosis that exhibited also symptoms of osteo-articular manifestation. The results from this study support the idea that the association of treatment, calcium, multimineral supplements with appropriate hygienic-dietary regimen and with the background therapy of the disease can contribute significantly to better health and wellbeing. Also, non-compliance to treatment among patients and their families significantly contributes to early installation of the complications, including the osteo-articular ones (even from the age of 6 years).

Micronutrient Intake among Children in Puerto Rico: Dietary and Multivitamin-Multimineral Supplement Sources.

Micronutrients are critical for healthy growth and development of children. Micronutrient intake from dietary sources is inadequate among some children and may be improved by use of multivitamin and multimineral (MVMM) supplements. To assess micronutrient intake from dietary and MVMM supplement sources among 12-year-old children in Puerto Rico. A representative sample of 732 children enrolled in an oral health study in Puerto Rico, who completed dietary and MVMM assessments through one 24-h recall, were included in this analysis. Micronutrient intake sources were described and compared to the Dietary Reference Intakes (DRIs) using the Estimated Average Requirement when available (used Adequate Intake for vitamin K and pantothenic acid). Micronutrient profiles of MVMM users and non-users were compared using t-tests. Mean intakes of vitamins A, D, E, and K, pantothenic acid, calcium, and magnesium from food and beverage sources were below the DRIs. From food and beverage sources, MVMM users had higher intakes of riboflavin and folate compared to non-users (p < 0.05). When MVMM supplements were taken into account, users had higher intakes of all nutrients except vitamin K. With the help of MVMM, users increased intake of vitamins E, A, D, and pantothenic acid to IOM-recommended levels but calcium, magnesium, and vitamin K remained below guidelines. Micronutrient intake from diet was below the IOM-recommended levels in the total sample. MVMM use improved intake of selected micronutrients and facilitated meeting recommendations for some nutrients. Public health measures to improve micronutrient intake among children in Puerto Rico are needed.

A Systematic Review of Multivitamin–Multimineral Use and Cardiovascular Disease and Cancer Incidence and Total Mortality

Multivitamin–multimineral (MVM) supplements are the most frequently used dietary supplements in the United States, with one third or more of the population using at least one daily. However, the health-related implications of MVM use are unclear. Thus, we systematically reviewed and summarized the prospective studies of MVM supplementation and all-cause and cause-specific mortality, as well as cardiovascular disease (CVD) and cancer incidence, to critically evaluate the current evidence on this topic. We included studies of generally healthy adult populations that evaluated multivitamin (the most commonly used dietary supplement) and/or multimineral supplement use or simultaneous use of 3 or more vitamins and minerals. We did not evaluate individual supplements. A total of 12 cohort studies and 3 primary prevention randomized controlled trials met our inclusion criteria. The majority of the studies were conducted in the United States (n = 11), and the remaining were conducted in European countries (n = 3) and Japan (n = 1). Although between-study methodological variation was present, most relative risks hovered closely around or slightly below the null value. No clear patterns of associations by study country, gender, smoking status, or frequency of use were observed. Based upon the available scientific evidence to date, supplementation with MVMs does not appear to increase all-cause mortality, cancer incidence or mortality, or CVD incidence or mortality and may provide a modest protective benefit.

Inductively coupled plasma optical emission spectrometric determination of fifteen elements in dietary supplements: Are the concentrations declared in the labels accurate?

A study was carried out to establish a reliable procedure for determining 15 elements (As, Bi, Cd, Cr, Cu, Fe, Hg, Mn, Mo, Ni, Pb, Sb, Se, V and Zn) in different brands of dietary supplements purchased in Argentina and USA. Supplements were digested with HNO3 and H2O2 using an optimized microwave procedure. Inductively coupled plasma optical emission spectrometry (ICP OES) was selected for total element determination. The overall approach was tested in tablets of: (i) Se supplement, (ii) two multimineral supplements, (iii) cholesterol control tablets, (iv) multivitamins for men, and (v) a multivitamin+multimineral supplement. Arsenic, Cd and Pb concentrations were in all the analyzed samples below the detection limits for these elements (As, 1.2μgg−1; Cd, 0.09μgg−1 and Pb, 1.5μgg−1). Elemental concentrations of the other elements investigated showed a great variability depending on the trade mark analyzed. Measured metal concentration ranged from 0.78±0.19μgg−1 (Ni) to 13.5±0.7% (Ca). Most abundant elements, detected as percentage were Ca, Mg and Fe. In general terms, the study evidenced that metal content reported by the manufacturer in labels of dietary supplements agree with found values. On the other hand, significant differences in metal concentration were found among tablets of the same bottle.

Independent component analysis algorithms for spectral decomposition in UV/VIS analysis of metal-containing mixtures including multimineral food supplements and platinum concentrates

Various independent component analysis (ICA) algorithms (MILCA, JADE, SIMPLISMA, RADICAL) are applied for simultaneous spectroscopic determination of two groups of transition metals: Co(II)–Fe(III)–Cu(II)–Zn(II)–Ni(II) and Pt(IV)–Pd(II)–Ir(IV)–Rh(III)–Ru(III)) in complex mixtures. The analysis is based on the decomposition of spectra of multicomponent mixtures in the UV-VIS region based on the natural absorbance of metal salts, or, when a better sensitivity is desirable, based on the absorbance of their complexes with 4-(2-pyridylazo)resorcinol (PAR) and ethylenediaminetetraacetic acid (EDTA). Good quality spectral resolution of up to seven-component mixtures was achieved (correlation coefficients between resolved and experimental spectra are not less than 0.90). In general, the relative errors in the recovered concentrations are at levels of only several percent. While being superior to other ICA algorithms, MILCA is comparable or even outperforms other classical chemometric methods for quantitative analysis that were used for comparison purposes (Partial Least Squares (PLS), Principal Component Regression (PCR), Alternating Least Squares (ALS)). Simultaneous quantitative analysis is possible for mixtures containing up to five metals in the broad concentration ranges even when individual spectra show 99% overlap. A small excess of derivatization reagent (till threefold excess to the sum of metal concentrations) is optimal to obtain good quantitative results. The proposed method was used for analysis of authentic samples (multimineral supplements and platinum concentrates). The resolved ICA concentrations match well with the labelled amounts and the results of other chemometric methods (ALS, PLS). ICA decomposition considerably improves the application range of spectroscopy for metal quantification in mixtures.

The Adult Vitamin and Mineral Supplement Maze

The content and daily cost of 14 popular multi-vitamin/ multi-mineral (MVMM) supplements promoted for adults 50 years of age or older in the United States were compared in order to provide pharmacists with objective information, enabling them to make more informed recommendations for these products. The labeled ingredients for MVMM products contained on Drug Topic's "Top 200" over-the-counter product list and for several other popular brands were compared with the Institute of Medicine's (IOM) recommendations for the Dietary Reference Intake (DRI) of micronutrients. DRIs for micronutrients are generally the same for adults between ages 31 to 70. However, vitamin B6, vitamin D, and calcium have increased daily DRIs for adults 50 years of age or older, and the DRI for vitamin D for those 70 years of age and older is higher. All products reviewed met IOM's recommendations for vitamin B6 and vitamin D for individuals 70 years of age or older. No product contained the daily DRI for calcium, particularly products designed for men. The cost and number of tablets per daily dose for MVMM varies and may affect product selection. The most significant difference among MVMM products is the calcium content. IOM's recommendations for calcium are the same for both genders 50 years of age or older, but products developed for men contain very low amounts of calcium compared with products for women. Individuals who have a low dietary intake of vitamin D and calcium should take additional supplements with a daily MVMM. Formulations change frequently, and pharmacists should read labeling before making any specific product recommendations.

Selenium and Diabetes: More Bad News for Supplements

In this issue, Stranges and colleagues report an increased risk for diabetes among participants randomly assigned to receive selenium supplements in the Nutritional Prevention of Cancer trial. The ...

Effect of multivitamin and multimineral supplementation on cognitive function in men and women aged 65 years and over: a randomised controlled trial.

BackgroundObservational studies have frequently reported an association between cognitive function and nutrition in later life but randomised trials of B vitamins and antioxidant supplements have mostly found no beneficial effect. We examined the effect of daily supplementation with 11 vitamins and 5 minerals on cognitive function in older adults to assess the possibility that this could help to prevent cognitive decline.MethodsThe study was carried out as part of a randomised double blind placebo controlled trial of micronutrient supplementation based in six primary care health centres in North East Scotland. 910 men and women aged 65 years and over living in the community were recruited and randomised: 456 to active treatment and 454 to placebo. The active treatment consisted of a single tablet containing eleven vitamins and five minerals in amounts ranging from 50–210 % of the UK Reference Nutrient Intake or matching placebo tablet taken daily for 12 months. Digit span forward and verbal fluency tests, which assess immediate memory and executive functioning respectively, were conducted at the start and end of the intervention period. Risk of micronutrient deficiency at baseline was assessed by a simple risk questionnaire.ResultsFor digit span forward there was no evidence of an effect of supplements in all participants or in sub-groups defined by age or risk of deficiency. For verbal fluency there was no evidence of a beneficial effect in the whole study population but there was weak evidence for a beneficial effect of supplementation in the two pre-specified subgroups: in those aged 75 years and over (n 290; mean difference between supplemented and placebo groups 2.8 (95% CI -0.6, 6.2) units) and in those at increased risk of micronutrient deficiency assessed by the risk questionnaire (n 260; mean difference between supplemented and placebo groups 2.5 (95% CI -1.0, 6.1) units).ConclusionThe results provide no evidence for a beneficial effect of daily multivitamin and multimineral supplements on these domains of cognitive function in community-living people over 65 years. However, the possibility of beneficial effects in older people and those at greater risk of nutritional deficiency deserves further attention.

A cost-utility analysis of multivitamin and multimineral supplements in men and women aged 65 years and over

As people age there is a progressive dysregulation of the immune system that may lead to an increased risk of infections, which may precipitate hospital admission in people with chronic heart or respiratory diseases. Mineral and vitamin supplementation in older people could therefore influence infections in older people. However, the evidence from the available randomised controlled trials (RCTs) is mixed. The aim of the study was to assess the relative efficiency of multivitamin and multimineral supplementation compared with no supplementation. Cost-utility analysis alongside an RCT. Participants aged 65 years or over from six general practices in Grampian, Scotland, were studied. They were randomised to one tablet daily of either a multivitamin and multimineral supplement or matching placebo. Exclusion criteria were use of mineral, vitamin or fish oil supplements in the previous 3 months (1 month for water soluble vitamins), vitamin B12 injection in the last 3 months. Nine hundred and ten participants were recruited (454 placebo and 456 supplementation). Use of health service resources and costs were similar between the two groups. The supplementation arm was more costly although this was not statistically significant ( pound15 per person, 95% CI-3.75 to 34.95). After adjusting for minimisation and baseline EQ-5D scores supplementation was associated with fewer QALYs per person (-0.018, 95% CI-0.04 to 0.002). It was highly unlikely that supplementation would be considered cost effective. The evidence from this study suggests that it is highly unlikely that supplementation could be considered cost effective.

Effect of multivitamin and multimineral supplements on morbidity from infections in older people(MAVIS trial)

Effect of multivitamin and multimineral supplements on morbidity from infections in older people(MAVIS trial)

Effect of Multivitamin and Multimineral Supplements on Morbidity From Infections in Older People (MAVIS trial): Pragmatic, Randomised, Double Blind, Placebo Controlled Trial

Effect of Multivitamin and Multimineral Supplements on Morbidity From Infections in Older People (MAVIS trial): Pragmatic, Randomised, Double Blind, Placebo Controlled Trial

Multivitamin and multimineral supplements did not reduce reported infection days or related use of healthcare services in elderly people

Multivitamin and multimineral supplements did not reduce reported infection days or related use of healthcare services in elderly people