They sit on the “stack” of your biohacking guru who swears they reversed their biological age by a dozen years — and in the drawer of your Average Joe who hopes these pills can cover the blind spots in their lifestyle.
Since hitting the market in the early 1940s [1], multivitamins have been seen as the quintessential supplement.
Technically, they’re multivitamin and multimineral products, often containing magnesium, iron, and zinc. But most people just call them multivitamins, multis, or MVM for short.
Today, more than one-third of U.S. adults take these products [2]. Surveys suggest people use them because they believe MVM help them stay healthy, boost energy, or reduce stress [3].
Despite their widespread use, no standard definition exists for MVM [4]. The US National Institutes of Health (NIH), however, defines vitamins and minerals as “essential substances that our bodies need to function normally” [5]. That makes the idea of bundling several into one daily pill an easy sell. It also certainly helps that, when taken in doses that do not exceed each nutrient’s daily recommended value, MVM are typically safe for most people [6].
Despite their commercial success, MVM have long faced scrutiny in research, with investigations about whether they truly provide the benefits the public expects. Many are looking for answers, especially in this age of longevity, where people look to multivitamins as a preventive measure to extend healthspan and delay chronic diseases.
So today, let’s examine the latest research on MVM and discuss five important considerations if you’re thinking about using them for longevity.
The State of Multivitamin Research
As signatures of the wellness industry for nearly a century, with several global players in the mix, multivitamins have been the subject of an extensive body of research, including numerous randomized controlled trials (RCTs). Considered the gold standard of clinical research, RCTs randomly assign participants to either an intervention or control group in order to determine potential cause-and-effect relationships while minimizing bias. Some of the most well-known RCTs on MVM have focused on disease prevention.
One of these is the Physicians’ Health Study II (PHS II), launched in 1997, which tracked 14,641 US male physicians aged 50 and older to evaluate whether daily multivitamin use could help prevent chronic diseases, including cardiovascular disease and cancer, with an average follow-up period of 11.2 years [7]. Another major study, the Cocoa Supplement and Multivitamin Outcomes Study (COSMOS), began in 2015 and followed 21,442 US men and women aged 60 and older for 3.6 years to assess the effects of daily multivitamin use and cocoa extract on cardiovascular health and cancer risk [8]. Both studies provide important insights into the potential benefits of multivitamins in aging populations.
However, in 2022, the U.S. Preventive Services Task Force published a landmark systematic review combining data from these two RCTs along with 82 other studies, totaling 739,803 participants. The review concluded that multivitamin use was associated with “little or no benefit in preventing cancer, cardiovascular disease, and death” [9].
While the methodology of this review is rigorous, such a broad analysis inevitably comes with nuances. Some researchers have argued that a one-size-fits-all verdict on MVM supplementation may overlook potential benefits that personalized approaches might provide. The diversity in study designs and populations means that determining the value of multivitamins for health outcomes requires thorough, individualized assessment.
And so next, let us examine the considerations you should keep in mind if you choose to include multivitamins in your routine.
1- Multivitamins’ Benefits May Vary Based on Sex
Following the aforementioned systematic review, a meta-analysis focused on sex-specific effects of MVM on cancer prevention was conducted. It included data from PHSII, COSMOS, and another clinical trial, involving a total of 28,558 men and 20,542 women. Despite the purported conclusion of little to no effect on cancer prevention, researchers hypothesized that sex might have influenced the outcomes in all three trials.
Their hypothesis proved correct. After analyzing the results, they found that for men, taking multivitamins was associated with a 9% lower risk of cancer incidence. For women, however, the analysis found no noticeable effect on their health risk from taking multivitamins [10].
One prevailing theory for this difference is that men tend to have less healthy eating habits than women, including consuming fewer fruits, vegetables, and fiber [11]. This supports the broader hypothesis that MVM supplementation may be most effective for individuals with sub-optimal nutritional patterns.
2- Multivitamins Show Promising Results for Cognitive Health
Beyond cancer and heart disease, evidence is continuing to emerge about the role of MVM in cognitive health for older adults.
An ancillary study to COSMOS, known as COSMOS-Mind, enrolled 2,262 participants with an average age of 73. The study examined whether MVM might improve cognitive performance over a three-year period. Participants completed standardized cognitive tests over the telephone at baseline and annually. Those who took the MVM supplement showed improved global cognition, reflecting enhanced recall, recognition, and learning abilities. Interestingly, the benefits were most pronounced in individuals with a history of cardiovascular disease [12].
Another study, COSMOS-Web, included 3,562 participants with a mean age of 71. They completed computer-based cognitive assessments, and results revealed that MVM users enjoyed significantly better memory after one year and over three years compared with those on placebo [13].
A third study, COSMOS-Clinic, involved 573 participants with an average age of 69. Participants underwent in-person neuropsychological assessments at baseline and at year two. Compared with the placebo group, MVM users experienced improved episodic memory over two years [14].
These findings suggest that multivitamins may play a key role in maintaining or enhancing cognitive function in older adults.
3- More Research Is Ongoing on Multivitamins
Speaking of ancillary COSMOS studies, there’s still plenty of additional studies either already running or planned. The advantage of such large-scale, well-funded RCTs is that if samples are collected, they can be stored in biobanks so they remain available when further research is needed and new ideas emerge.
For example, COSMOS investigators are currently researching the effect of MVM supplementation on the gut microbiome, as 300 participants provided stool samples at baseline and at a 2-year follow-up. The gut microbiome influences digestion, immune function, and brain health, making it a key factor in overall well-being. Investigating whether MVM impacts its composition could provide new insights into the relationship between nutrition and microbiome health.
Research on MVM supplementation and hallmarks of aging is also an exciting new frontier. These biological processes contribute to age-related decline and are central to understanding longevity. One study examined MVM use and telomere length. Telomeres, like the plastic tips on shoelaces, protect chromosomes and shorten over time, leading to cellular aging. A cross-sectional study of 586 women aged 35–74 years found that those who took MVM daily had telomeres that were, on average, 5.1% longer than non-users [15].
An ongoing RCT in Singapore is also investigating how daily MVM supplementation affects biological age, primarily by measuring DNA methylation — an epigenetic process that regulates gene activity and influences aging. This trial includes 400 participants aged 40–60 years who are relatively healthy, defined as free of chronic diseases but having a biological age higher than their chronological age [16].
The findings from this trial, along with the many other upcoming studies, will be interesting to follow. As research continues, these results may provide a clearer picture of whether and how MVM supplementation contributes to long-term health.
4- The Multivitamins Market Is Oversaturated
After reading through the research so far, you might feel convinced to try an MVM supplement for the first time — if you haven’t already. For convenience, you might turn to Amazon to source one. But then you’ll find an entire multivitamins category with astonishingly over 4,000 products to choose from.
The differences between them are substantial, not just from one manufacturer to another but also from formula to formula. And according to the NIH, no two RCTs have tested MVM with the same combinations and amounts of nutrients [17]. So if any product garners positive results, it’s hard to extrapolate these to other ones even if they’re from the same manufacturer.
Some formulations are basic or broad-spectrum, containing all or most essential vitamins and minerals in amounts that do not exceed daily values. Others are high-potency, designed for people with specific deficiencies. Also, some products target certain demographics, such as pregnant women or older adults, while others are tailored for particular health goals, like boosting energy or supporting immune function.
Deciding which product best suits you functionally is already challenging. But once you consider quality and safety, it becomes even trickier. That’s why it’s always recommended to choose products that are third-party tested by organizations such as the US Pharmacopeial Convention, an independent nonprofit that sets quality standards.
For further guidance, the NIH Office of Dietary Supplements has launched a helpful resource to help you determine which MVM, if any, is right for you.
5- Multivitamins Are Still Supplements
At the end of the day, remember that you’ll find two disclaimers on any US-based MVM product. The first one is:
“These statements have not been evaluated by the Food and Drug Administration.”
Yes, the Dietary Supplement Health and Education Act restricts the FDA’s ability to regulate products marketed as dietary supplements, including MVM. In contrast, medications undergo strict FDA review. Manufacturers must submit data supporting safety and efficacy before approval.
For supplements, the FDA does not validate claims such as “promoting a healthy heart” or “boosting immunity.” Instead, the agency monitors whether these products claim to treat or affect disease risk. That’s why the second disclaimer on your MVM package reads:
“This product is not intended to diagnose, treat, cure, or prevent any disease.”
This disclaimer is essential, reminding consumers that supplements are just that — they supplement healthy routines. They can provide valuable nutrients but can’t replace balanced diets, regular exercise, or other healthy behaviors.
As Dr. Larry Appel, Director of the Johns Hopkins Welch Center for Prevention, Epidemiology, and Clinical Research, once said:
“Pills are not a shortcut to better health and the prevention of chronic diseases.”
It is important to view multivitamins as one component of an overall wellness strategy rather than a standalone solution.
To conclude, multivitamins have their place, but they’re not magic pills. They should supplement, not replace, a balanced diet and active lifestyle. Use them wisely as one tool among many in your pursuit of lasting health.
References:
[1] NIH State-of-the Science Panel. (2007). National Institutes of Health State-of-the-Science Conference Statement: Multivitamin/Mineral Supplements and Chronic Disease Prevention. The American Journal of Clinical Nutrition, 85(1), 257S264S. https://doi.org/10.1093/ajcn/85.1.257s
[2] Cowan, A. E., Jun, S., Gahche, J. J., Tooze, J. A., Dwyer, J. T., Eicher-Miller, H. A., Bhadra, A., Guenther, P. M., Potischman, N., Dodd, K. W., & Bailey, R. L. (2018). Dietary Supplement Use Differs by Socioeconomic and Health-Related Characteristics among U.S. Adults, NHANES 2011−2014. Nutrients, 10(8). https://doi.org/10.3390/nu10081114
[3] Ubel, P. A. (2022). Why Too Many Vitamins Feels Just About Right. JAMA Internal Medicine. https://doi.org/10.1001/jamainternmed.2022.0119
[4] Yetley, E. A. (2007). Multivitamin and multimineral dietary supplements: definitions, characterization, bioavailability, and drug interactions. The American Journal of Clinical Nutrition, 85(1), 269S276S. https://doi.org/10.1093/ajcn/85.1.269s
[5] National Center for Complementary and Integrative Health. (2018, February). Vitamins and Minerals. NCCIH. https://www.nccih.nih.gov/health/vitamins-and-minerals
[6] Biesalski, H. K., & Tinz, J. (2017). Multivitamin/mineral supplements: Rationale and safety. Nutrition, 36, 60–66. https://doi.org/10.1016/j.nut.2016.06.003
[7] Gaziano, J. M., Sesso, H. D., Christen, W. G., Bubes, V., Smith, J. P., MacFadyen, J., Schvartz, M., Manson, J. E., Glynn, R. J., & Buring, J. E. (2012). Multivitamins in the Prevention of Cancer in Men. JAMA, 308(18), 1871. https://doi.org/10.1001/jama.2012.14641
[8] Sesso, H. D., Manson, J. E., Aragaki, A. K., Rist, P. M., Johnson, L. G., Friedenberg, G., Copeland, T., Clar, A., Mora, S., Moorthy, M. V., Sarkissian, A., Carrick, W. R., & Anderson, G. L. (2022). Effect of cocoa flavanol supplementation for the Prevention of Cardiovascular Disease Events: The Cocoa Supplement and Multivitamin Outcomes Study (Cosmos) randomized clinical trial. The American Journal of Clinical Nutrition, 115(6), 1490–1500. https://doi.org/10.1093/ajcn/nqac055
[9] O’Connor, E. A., Evans, C. V., Ivlev, I., Rushkin, M. C., Thomas, R. G., Martin, A., & Lin, J. S. (2022). Vitamin and Mineral Supplements for the Primary Prevention of Cardiovascular Disease and Cancer. JAMA, 327(23), 2334. https://doi.org/10.1001/jama.2021.15650
[10] J, Š., F, C., L, D., L, B., E, K., & Ab, M. (2023). Personalization matters: the effect of sex in multivitamin-multimineral-based cancer prevention. GeroScience. https://doi.org/10.1007/s11357-023-00882-7
[11] Wardle, J., Haase, A. M., Steptoe, A., Nillapun, M., Jonwutiwes, K., & Bellisie, F. (2004). Gender differences in food choice: The contribution of health beliefs and dieting. Annals of Behavioral Medicine, 27(2), 107–116. https://doi.org/10.1207/s15324796abm2702_5
[12] Baker, L. D., Manson, J. E., Rapp, S. R., Sesso, H. D., Gaussoin, S. A., Shumaker, S. A., & Espeland, M. A. (2022). Effects of cocoa extract and a multivitamin on cognitive function: A randomized clinical trial. Alzheimer’s & Dementia. https://doi.org/10.1002/alz.12767
[13] Yeung, L.-K., Alschuler, D. M., & Wall, M. (2023). Multivitamin supplementation improves memory in older adults: a randomized clinical trial. The American Journal of Clinical Nutrition, 118(1), 273–282. https://doi.org/10.1016/j.ajcnut.2023.05.011
[14] Vyas, C. M., Manson, J. E., Sesso, H. D., Cook, N. R., Rist, P. M., Weinberg, A., Moorthy, M. V., Baker, L. D., Espeland, M. A., Yeung, L.-K., Brickman, A. M., & Okereke, O. I. (2024). 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. The American Journal of Clinical Nutrition. https://doi.org/10.1016/j.ajcnut.2023.12.011
[15] Xu, Q., Parks, C. G., DeRoo, L. A., Cawthon, R. M., Sandler, D. P., & Chen, H. (2009). Multivitamin use and telomere length in women. The American Journal of Clinical Nutrition, 89(6), 1857–1863. https://doi.org/10.3945/ajcn.2008.26986
[16] Daily Intake of Multivitamin & Mineral Supplementation Effects on Biological Age of Relatively Healthy Middle-aged Individuals (CEDIRA). ClinicalTrials.gov identifier: NCT06666660. Updated October 30, 2024. Accessed February 22, 2025. https://clinicaltrials.gov/study/NCT06666660
[17] Office of Dietary Supplements. (2022, November 2). Multivitamin/mineral supplements for health professionals. National Institutes of Health Office of Dietary Supplements. Retrieved February 22, 2025. https://ods.od.nih.gov/factsheets/MVMS-HealthProfessional/