A Hard Pill to Swallow: Daily Multivitamin May Be an Unnecessary Habit

Summary: Researchers say, for the majority of people, taking daily multivitamins does little to prevent diseases or extend lifespan.

Source: Harvard

Are you among the one in three Americans who gulps down a multivitamin every morning, probably with a sip of water? The truth about this popular habit may be hard to swallow.

"Most people would be better off just drinking a full glass of water and skipping the vitamin," says Dr. Pieter Cohen, an associate professor of medicine at Harvard Medical School and an internist at Harvard-affiliated Cambridge Health Alliance. In addition to saving money, you'll have the satisfaction of not succumbing to misleading marketing schemes.

That's because for the average American adult, a daily multivitamin doesn't provide any meaningful health benefit, as noted recently by the US Preventive Services Task Force (USPSTF).

Their review, published in JAMA, which analyzed 84 studies involving nearly 700,000 people, found little or no evidence that taking vitamin and mineral supplements helps prevent cancer and cardiovascular disease that can lead to heart attacks and stroke, nor do they help prevent an early death.

"We have good evidence that for the vast majority of people, taking multivitamins won't help you," says Dr. Cohen, an expert in dietary supplement research and regulation.

Who might need a multivitamin or individual supplements?

There are some exceptions, however. Highly restrictive diets and gastrointestinal conditions, or certain weight-loss surgeries that cause poor nutrient absorption, are examples of reasons why a multivitamin or individual vitamins might be recommended.

A daily vitamin D supplement may be necessary when a person gets insufficient sun exposure. Your doctor may recommend an iron supplement if you have a low red blood cell count (anemia).

Why is it hard to give up the habit of a daily multivitamin?

Surveys suggest people take vitamins to stay healthy, feel more energetic, or gain peace of mind, according to an editorial that accompanied the USPSTF review. These beliefs stem from a powerful narrative about vitamins being healthy and natural that dates back nearly a century.

"This narrative appeals to many groups in our population, including people who are progressive vegetarians and also to conservatives who are suspicious about science and think that doctors are up to no good," says Dr. Cohen.

Unproven marketing claims for dietary supplements

Vitamins are very inexpensive to make, so the companies can sink lots of money into advertising, says Dr. Cohen. But because the FDA regulates dietary supplements as food and not as prescription or over-the-counter drugs, the agency only monitors claims regarding the treatment of disease.

This shows vitamin pills in a daily pill holderA daily vitamin D supplement may be necessary when a person gets insufficient sun exposure. Image is in the public domain

For example, supplement makers cannot say that their product "lowers heart disease risk." But their labels are allowed to include phrases such as "promotes a healthy heart" or "supports immunity," as well as vague promises about improving fatigue and low motivation.

"Supplement manufacturers are allowed to market their products as if they have benefits when no benefit actually exists. It's enshrined into the law," says Dr. Cohen. It's wise to note the legally required disclaimer on each product: "These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease."

But even the strong language in this disclaimer—"not intended to diagnose, treat, cure, or prevent"—doesn't seem to affect how people perceive the marketing claims.

Although multivitamins aren't helpful, at least they're not harmful. But the money people spend on them could be better spent on purchasing healthy foods, Dr. Cohen says.

About this vitamins and health research news

Author: Julie Corliss
Source: Harvard
Contact: Julie Corliss – Harvard
Image: The image is in the public domain

Original Research: Open access.
"Vitamin and Mineral Supplements for the Primary Prevention of Cardiovascular Disease and Cancer: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force" by Elizabeth A. O'Connor et al. JAMA


Vitamin and Mineral Supplements for the Primary Prevention of Cardiovascular Disease and Cancer: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force


Cardiovascular disease and cancer are the 2 leading causes of death in the US, and vitamin and mineral supplementation has been proposed to help prevent these conditions.


To review the benefits and harms of vitamin and mineral supplementation in healthy adults to prevent cardiovascular disease and cancer to inform the US Preventive Services Task Force.

Data Sources  

See also

This shows a brain

MEDLINE, PubMed (publisher-supplied records only), Cochrane Library, and Embase (January 2013 to February 1, 2022); prior reviews.

Study Selection  

English-language randomized clinical trials (RCTs) of vitamin or mineral use among adults without cardiovascular disease or cancer and with no known vitamin or mineral deficiencies; observational cohort studies examining serious harms.

Data Extraction and Synthesis  

Single extraction, verified by a second reviewer. Quantitative pooling methods appropriate for rare events were used for most analyses.

Main Outcomes and Measures  

Mortality, cardiovascular disease events, cancer incidence, serious harms.


Eighty-four studies (N=739 803) were included. In pooled analyses, multivitamin use was significantly associated with a lower incidence of any cancer (odds ratio [OR], 0.93 [95% CI, 0.87-0.99]; 4 RCTs [n=48 859]; absolute risk difference [ARD] range among adequately powered trials, −0.2% to −1.2%) and lung cancer (OR, 0.75 [95% CI, 0.58-0.95]; 2 RCTs [n=36 052]; ARD, 0.2%). However, the evidence for multivitamins had important limitations. Beta carotene (with or without vitamin A) was significantly associated with an increased risk of lung cancer (OR, 1.20 [95% CI, 1.01-1.42]; 4 RCTs [n=94 830]; ARD range, −0.1% to 0.6%) and cardiovascular mortality (OR, 1.10 [95% CI, 1.02-1.19]; 5 RCTs [n=94 506] ARD range, −0.8% to 0.8%).

Vitamin D use was not significantly associated with all-cause mortality (OR, 0.96 [95% CI, 0.91-1.02]; 27 RCTs [n=117 082]), cardiovascular disease (eg, composite cardiovascular disease event outcome: OR, 1.00 [95% CI, 0.95-1.05]; 7 RCTs [n=74 925]), or cancer outcomes (eg, any cancer incidence: OR, 0.98 [95% CI, 0.92-1.03]; 19 RCTs [n=86 899]). Vitamin E was not significantly associated with all-cause mortality (OR, 1.02 [95% CI, 0.97-1.07]; 9 RCTs [n=107 772]), cardiovascular disease events (OR, 0.96 [95% CI, 0.90-1.04]; 4 RCTs [n=62 136]), or cancer incidence (OR, 1.02 [95% CI, 0.98-1.08]; 5 RCTs [n=76 777]).

Evidence for benefit of other supplements was equivocal, minimal, or absent. Limited evidence suggested some supplements may be associated with higher risk of serious harms (hip fracture [vitamin A], hemorrhagic stroke [vitamin E], and kidney stones [vitamin C, calcium]).

Conclusions and Relevance  

Vitamin and mineral supplementation was associated with little or no benefit in preventing cancer, cardiovascular disease, and death, with the exception of a small benefit for cancer incidence with multivitamin use. Beta carotene was associated with an increased risk of lung cancer and other harmful outcomes in persons at high risk of lung cancer.

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