In middle–aged and older men, long–term daily multivitamin use does not prevent cardiovascular disease (CVD), regardless of baseline nutritional status, according to a new analysis of the Physicians Health Study II.

Results of the PHS II reported in 2012 showed no effect of long–term multivitamin use on risk of CVD, but whether baseline nutritional status may have modified the lack of effect was not known.

In the new analysis, published online April 5 in JAMA Cardiology, researchers investigated whether baseline intake of key foods, nutrients, dietary patterns, and dietary supplements modified the long–term effect of multivitamin use on CVD.

In this new analysis of over 13,000 physicians who received a daily multivitamin or placebo and were followed for an average of about 11 years, there was “no consistent evidence” of effect modification by various foods, nutrients, dietary patterns, or baseline supplement use on the effect of multivitamin use on CVD endpoints, the authors said.

A multivitamin has no clear effect on CVD risk–regardless of baseline nutritional status. Fortunately we are not all identical. We have different personalities, traits and nutritional needs. Most of our nutritional needs need to come from whole foods. We do not know what part of a blueberry or strawberry to put in a vitamin. We know from prior studies that these whole fruits including strawberries, blueberries, blackberries, and plums can lower our risk of cardiovascular disease. We now know that a multivitamin can not replace these foods. The populations that live the longest rely on a predominately plant based diet, regular exercise, strong family and community ties, etc.

Any individual decision whether to take a multivitamin should be made in consultation with their health care provider. It is important to first identify whether one has an overall balanced and healthy diet, in which case a multivitamin may not provide much additional nutritional benefits. Many feel compelled to take a multivitamin for general health or to prevent specific conditions, but there remains insufficient evidence on the role of multivitamins on such outcomes. Never count on a vitamin to replace a healthy diet or regular exercise.
Should you take a multivitamin? This is one of the most difficult questions to answer in my practice. I take into account a variety of factors including nutritional status, age, sex and any specific nutritional deficiencies. I always emphasize that a multivitamin will not replace a healthy diet with good oils as well as 8 servings of fruits and vegetables per day. I one is B12 or Vitamin D deficient there may not be enough of these compounds in a multivitamin. Because a multivitamin did not work for cardiovascular prevention it does not mean it may not work for other medical conditions. As usual we always need more research. This is a great discussion to have with your family doctor and have it yearly since nutritional science changes rapidly.