Do not take multivitamins to live longer or prevent cardiovascular disease
Around 14,000 male doctors took multivitamins for eleven years. Serious cardiovascular events and deaths were no less common than among those taking a placebo. Combining nine trials involving over 50,000 people also showed no association with mortality. Skipping the supplements saves RMB 200–700 a year. This does not apply to diagnosed deficiencies or folic acid during pregnancy.
What it takes
About RMB 0.5–2 a day, or 200–700 a year. Taking a pill takes almost no time, but the habit can become psychologically reassuring: missing a day starts to feel like neglecting something important.
What you may gain
The Physicians’ Health Study II enrolled 14,641 male physicians and followed them for a median of 11.2 years: half were followed longer and half for less time. Major cardiovascular events were equally common, with a hazard ratio (HR) of 1.01; a value of 1 means no difference. The 95% confidence interval (CI), expressing the uncertainty around that estimate, was 0.91–1.10. All-cause mortality was also similar: HR 0.94 (0.88–1.02). In 2022, the US Preventive Services Task Force (USPSTF) combined nine randomized controlled trials involving 51,550 people and found no association between multivitamins and overall mortality. It issued an I statement, meaning the evidence was insufficient to determine the balance of benefits and harms. The product feels like good value because “all your nutrients in one pill” sounds convincing and the daily price is small.
Context & considerations
A qualification: cancer was also studied in the same group of male physicians. Cancer incidence was about 8% lower among supplement users (CI 0.86–0.998; P=0.04, only just meeting the usual threshold for statistical significance). Cancer mortality was about 12% lower (0.77–1.01), but that interval includes 1, so chance remains a possible explanation. Any benefit was small and observed only in male physicians. People with confirmed nutritional deficiencies, pregnant people taking folic acid, and people with severely restricted diets are exceptions; supplement as advised by a clinician.
Research & references
Sesso HD et al. (2012). Multivitamins in the prevention of cardiovascular disease in men: the Physicians’ Health Study II randomized controlled trial. JAMA. https://doi.org/10.1001/jama.2012.14805; US Preventive Services Task Force (2022). Vitamin, Mineral, and Multivitamin Supplementation to Prevent Cardiovascular Disease and Cancer. JAMA. https://doi.org/10.1001/jama.2022.8970; Gaziano JM et al. (2012). Multivitamins in the Prevention of Cancer in Men. JAMA. https://doi.org/10.1001/jama.2012.14641 (the cancer finding discussed below).