Objective Multiple 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 may guide efforts to better educate the public about effective nutritional practices. The objective of this study was to compare self-reported and clinically measurable health outcomes among MVM users and non-users in a large, nationally representative adult civilian non-institutionalised population in the USA surveyed on the use of complementary health practices.
Design Cross-sectional analysis of the effect of MVM consumption on self-reported overall health and clinically measurable health outcomes.
Participants Adult MVM users and non-users from the 2012 National Health Interview Survey (n=21 603).
Primary and secondary outcome measures Five psychological, physical, and functional health outcomes: (1) self-rated health status, (2) needing help with routine needs, (3) history of 10 chronic diseases, (4) presence of 19 health conditions in the past 12 months, and (5) Kessler 6-Item (K6) Psychological Distress Scale to measure non-specific psychological distress in the past month.
Results Among 4933 adult MVM users and 16 670 adult non-users, MVM users self-reported 30% better overall health than non-users (adjusted OR 1.31; 95% CI 1.17 to 1.46; false discovery rate adjusted p<0.001). There were no differences between MVM users and non-users in history of 10 chronic diseases, number of present health conditions, severity of current psychological distress on the K6 Scale and rates of needing help with daily activities. No effect modification was observed after stratification by sex, education, and race.
Conclusions MVM users self-reported better overall health despite no apparent differences in clinically measurable health outcomes. These results suggest that widespread use of multivitamins in adults may be a result of individuals’ positive expectation that multivitamin use leads to better health outcomes or a self-selection bias in which MVM users intrinsically harbour more positive views regarding their health.
- nutrition & dietetics
- general medicine (see internal medicine)
- complementary medicine
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MDP and ACC contributed equally.
Contributors MDP and ACC conceived and designed the study. MDP extracted data from NHANES. MDP, ACC, IP, PQD, JKW, RO, NJR, AA, AH, CCL, VO, IU, ALN, BSG, KTH, DHM and GNN analysed the data. MDP, ACC, KTH and DHM wrote the manuscript. MDP, ACC, KTH, DHM, GNN and RSC critically revised the manuscript for important intellectual content. All authors commented and approved the manuscript.
Funding ACC and PQD were supported by NIH Medical Scientist Training Program Training Grants T32GM007739 and T32GM007205 respectively.
Competing interests None declared.
Patient consent for publication Not required.
Provenance and peer review Not commissioned; externally peer reviewed.
Data availability statement Data are available in a public, open access repository. All data used in the study are publicly available from the National Health Interview Survey.
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