This is the current release of the guideline.

Note: For the purpose of this statement, the term MVM refers to any supplement containing three or more vitamins and minerals but no herbs, hormones, or drugs, with each component at a dose less than the tolerable upper level determined by the Food and Nutrition Board—the maximum daily intake likely to pose no risk for adverse health effects.

Use of multivitamin/mineral supplements (MVMs) has grown rapidly over the past several decades, and dietary supplements are now used by more than half of the adult population in the United States. In general, MVMs are used by individuals who practice healthier lifestyles, thus making observational studies of the overall relationship between MVM use and general health outcomes difficult to interpret. Despite the widespread use of MVMs, there is still insufficient knowledge about the actual amount of total nutrients that Americans consume from diet and supplements. This is at least in part due to the fortification of foods with these nutrients, which adds to the effects of MVMs or single-vitamin or single-mineral supplements. Historically, fortification of foods has led to the remediation of vitamin and mineral deficits, but the cumulative effects of supplementation and fortification have also raised safety concerns about exceeding upper levels. Thus, there is a national need to improve the methods of obtaining accurate and current data on the public's total intake of these nutrients in foods and dietary supplements.

In systematically evaluating the effectiveness and safety of MVMs in relation to chronic disease prevention, few rigorous studies were found on which to base clear conclusions and recommendations. Most of the studies examined do not provide strong evidence for beneficial health-related effects of supplements taken singly, in pairs, or in combinations of three or more. Within some studies or subgroups of the study populations, there is encouraging evidence of health benefits, such as increased bone mineral density and decreased fractures in postmenopausal women who use calcium and vitamin D supplements. However, several other studies also provide disturbing evidence of risk, such as increased lung cancer risk with beta-carotene use among smokers.

The current level of public assurance of the safety and quality of MVMs is inadequate, given the fact that manufacturers of these products are not required to report adverse events and the United States Food and Drug Administration (FDA) has no regulatory authority to require labeling changes or to help inform the public of these issues and concerns. It is important that the FDA's purview over these products be authorized and implemented.

Finally, the present evidence is insufficient to recommend either for or against the use of MVMs by the American public to prevent chronic disease. The resolution of this important issue will require advances in research and improved communication and collaboration among scientists, health care providers, patients, the pharmaceutical and supplement industries, and the public.

None provided

The type of supporting evidence is not specifically stated for each recommendation.

Not applicable: The guideline was not adapted from another source.

2006 May 15-17

National Institutes of Health (NIH) State-of-the-Science Panel - Independent Expert Panel

United States Government

National Institutes of Health State-of-the-Science Panel

Panel Members: J. Michael McGinnis, M.D., M.P.P., (Panel and Conference, Chairperson), Senior Scholar, Institute of Medicine, The National Academies, Washington, DC; Diane F. Birt, Ph.D., Distinguished Professor, Department of Food Science and Human Nutrition, Director, Center for Research on Botanical, Dietary Supplements, College of Agriculture and College of Human Sciences, Iowa State University, Ames, Iowa; Patsy M. Brannon, Ph.D., R.D., Professor, Division of Nutritional Sciences, Cornell University, Ithaca, New York; Raymond J. Carroll, Ph.D., Distinguished Professor of Statistics, Professor of Nutrition and Toxicology, Department of Statistics, Texas A&M University, College Station, Texas; Robert D. Gibbons, Ph.D., Director, Center for Health Statistics, Professor of Biostatistics and Psychiatry, University of Illinois at Chicago, Chicago, Illinois; William R. Hazzard, M.D., Professor, Department of Medicine, Division of Gerontology and Geriatric Medicine, University of Washington, Chief, Geriatrics and Extended Care, VA Puget Sound Health Care System, Seattle, Washington; Douglas B. Kamerow, M.D., M.P.H., U.S. Editor, BMJ, Professor of Clinical Family Medicine, Georgetown University, Chief Scientist, Health, Social, and Economics Research, RTI International, Washington, DC; Bernard Levin, M.D., Professor of Medicine, Vice President for Cancer Prevention and Population Sciences, University of Texas M.D., Anderson Cancer Center, Houston, Texas; James M. Ntambi, Ph.D., Steenbock Professor, Departments of Biochemistry and Nutritional Sciences, University of Wisconsin–Madison, Madison, Wisconsin; Nigel Paneth, M.D., M.P.H., Professor of Epidemiology, Pediatrics and Human Development, College of Human Medicine, Michigan State University, East Lansing, Michigan; Douglas Rogers, M.D., Head, Section of Pediatric and Adolescent Endocrinology, The Cleveland Clinic Cleveland, Ohio; Audrey F. Saftlas, Ph.D., M.P.H., Professor, Department of Epidemiology, The University of Iowa, College of Public Health, Iowa City, Iowa; William Vaughan, Senior Policy Analyst Consumer's Union, Washington, DC

All of the panelists who participated in this conference and contributed to the writing of this statement were identified as having no financial or scientific conflict of interest, and all signed forms attesting to this fact. Unlike the expert speakers who present scientific data at the conference, the individuals invited to participate on National Institutes of Health (NIH) Consensus and State-of-the-Science panels are reviewed prior to selection to assure that they are not proponents of an advocacy position with regard to the topic and are not identified with research that could be used to answer the conference questions.

This is the current release of the guideline.

None available

This summary was completed by ECRI on December 12, 2008.

No copyright restrictions apply.