Multivitamin and Mineral Supplement Debate: Experts Respond

Author: Linus Pauling Institute
Published: 3 Jun 2014 - Updated: 6 Oct 2026
Publication Type: Reports & Proceedings

Table of Contents:
Synopsis - Definition - Overview - FAQs - Insights, Updates - Related Content

Synopsis

This report covers a correspondence published in the Annals of Internal Medicine in which nutrition researchers from the Linus Pauling Institute at Oregon State University, the Children's Hospital Oakland Research Institute, Tufts University and the Harvard School of Public Health push back against a widely publicized editorial declaring the case closed on multivitamin and mineral supplements. Their main argument is that many Americans eat diets long on calories and short on nutrients, and that a low-cost daily supplement can safely fill those gaps, support normal body function and possibly lower chronic disease risk. The information carries weight because it comes from established nutrition scientists at four research institutions responding in the same journal that ran the original editorial, and it is particularly useful for older adults and people who are ill or injured - groups the authors identify as having greater micronutrient needs - as well as people with disabilities who may face barriers to eating a consistently balanced diet.*

At a Glance

• 1 - A basic daily multivitamin and mineral supplement can cost as little as $1 a month, according to the researchers.
• 2 - The Physicians' Health Study II, one of the largest and longest controlled trials of its kind, found a significant 8 percent reduction in total cancer incidence among male physicians.
• 3 - Reports of increased mortality linked to vitamins A and E involved doses far beyond what a multivitamin contains. In the case of vitamin E, the researchers say comprehensive meta-analyses have largely refuted the concern.
• 4 - More than 93 percent of U.S. adults fall short of the estimated average requirement for vitamins D and E from diet alone. A further 61 percent do not get enough magnesium, and 50 percent lack sufficient vitamin A and calcium.

Topic Definition

Multivitamin and Mineral Supplement

A multivitamin and mineral supplement is a dietary product, usually taken once a day as a tablet, capsule, chewable or liquid, that combines several vitamins and minerals in amounts generally close to recommended daily intakes. It is meant to supplement the diet rather than replace food, helping to cover shortfalls in micronutrients such as vitamin D, vitamin E, magnesium, calcium and vitamin A that the body needs in small quantities for normal cell function, metabolism, growth and development. There is no standard or regulatory definition of what a multivitamin must contain, so formulas vary by manufacturer and are often tailored to age, sex or life stage, such as products for older adults or for pregnancy.

Overview

Researchers from the Linus Pauling Institute at Oregon State University and three other institutions have taken issue with claims made in a December 2013 editorial that "the case is closed" on whether or not a multivitamin/mineral supplement should be taken by most people to help obtain needed micronutrients.

In a correspondence published June 3, 2014 in the Annals of Internal Medicine, the researchers reasoned that this type of dietary supplement helps fill nutritional gaps, improves general health, might help prevent chronic disease, will cause no harm and is easily worth the few cents a day that it costs.

To "call the case closed" is wrong and "misinforms the public and the medical community," the researchers wrote. Their statements were a response to an editorial in the same publication in December 2013 that argued that such supplements are unnecessary and received widespread publicity.

The statement was authored by nutrition experts from OSU, the Children's Hospital Oakland Research Institute, Tufts University and the Harvard School of Public Health.

While most nutrition experts agree that a balanced and nutritious diet is the best way to obtain needed nutrients, the researchers in this commentary point out that many Americans have a less-than-perfect diet - long on calories and short on nutrients - and the vast majority are not getting enough of several important vitamins and minerals.

"It's naive to ignore the fact that most people have micronutrient inadequacies, and wrong to condemn a daily supplement that could cover these nutritional gaps safely and at low cost," said Balz Frei, then professor and director of the Linus Pauling Institute, and a biochemist in the OSU College of Science.

"There's strong evidence that a multivitamin/mineral supplement supports normal functioning of the body and helps improve overall health, and may even help lower chronic disease risk," Frei said. "It's irresponsible to ignore decades of nutrition research and tell the people of the United States they have no need for a supplement that could be so helpful, and costs as little as $1 a month.

"And if they have a poor diet, people should try to improve that as well," he said. "The two are not mutually exclusive."

Among the points the researchers made in their commentary:

• The vast majority of people in the United States do not meet all of the guidelines for dietary intake of vitamins and minerals.
• More than 93 percent of adults in the U.S. do not get the estimated average requirement of vitamins D and E from their diet; 61 percent not enough magnesium; and 50 percent not enough vitamin A and calcium at the time of the 2014 commentary.
• Many subpopulations have even more critical needs for micronutrients, including older adults, African Americans, obese persons and some people who are ill or injured.
• Concerns about "increased mortality" from supplements of vitamins A and E have been based on extremely high use through supplements far beyond the amount available in a multivitamin, and in the case of vitamin E largely refuted by comprehensive meta-analyses.

The value of proper nutrition, on the other hand, is wide-ranging and positive.

Micronutrients maintain normal cell and tissue function, metabolism, growth and development. A supplement that helps a person "cover all the bases" can help protect daily, routine health. Overt deficiency diseases such as scurvy or rickets are increasingly rare in the U.S. due to improved diet and fortified foods. However, certain vitamin and mineral deficiencies are still a major issue in the developing world, especially vitamin A, iron, iodine and zinc. According to the World Health Organization, more than 650,000 children under the age of five die around the world every year from deficiency in vitamin A at the time of the 2014 commentary.

And the potential for vitamins and other micronutrients to help reduce or prevent chronic disease continues to show promise. One of the longest, largest controlled studies ever done, the Physicians' Health Study II, found a significant 8 percent reduction in total cancer incidence in male physicians - people who, through their education, income and lifestyle, probably had diets much closer to optimal than the average American.

"There are many issues that have helped to mislead people when it comes to the study of micronutrients," Frei said. "For instance, most research is done without first checking to see if a person is inadequate in a nutrient, and you won't find much effect from a supplement if it isn't needed."

"In similar fashion, too much research has been done with groups such as doctors and nurses who are probably not representative of the general population," he said. "Whatever has been shown to be useful in such research probably would be even more effective in people who have poor diets or clear nutritional inadequacies."

The researchers wrote in their conclusion that to "label multivitamin and mineral supplements useless, harmful and a waste of money is wrong."

Frequently Asked Questions

NOTE: Researched FAQs by Disabled World (DW)

Who is most likely to benefit from a daily multivitamin and mineral supplement?

People whose diets are limited or whose nutrient needs are higher tend to benefit most. This includes older adults, people who are pregnant or planning pregnancy, those on restricted or low-calorie diets, people who have had bariatric surgery, and anyone with a condition that reduces nutrient absorption.

Can you take too much of a vitamin or mineral?

Yes. Fat-soluble vitamins A, D, E and K are stored in the body and can build up to harmful levels, and minerals such as iron and zinc can also cause problems in excess. Staying below the Tolerable Upper Intake Level for each nutrient, counting both food and supplements, keeps intake in a safe range.

What does the U.S. Preventive Services Task Force say about multivitamins?

In its 2022 recommendation the task force concluded that current evidence is insufficient to assess the balance of benefits and harms of multivitamins for preventing cardiovascular disease or cancer. It recommended against using beta carotene or vitamin E supplements for that purpose.

Are multivitamins approved by the FDA before they are sold?

No. In the United States multivitamins are regulated as dietary supplements under the Dietary Supplement Health and Education Act of 1994, so the FDA does not approve them for safety or effectiveness before they reach the market. Manufacturers are responsible for product safety and accurate labeling.

Can a multivitamin interact with prescription medications?

Yes. Vitamin K can reduce the effect of the blood thinner warfarin, and minerals such as calcium, iron and magnesium can interfere with absorption of thyroid medication and certain antibiotics. Anyone taking prescription drugs should check with a doctor or pharmacist before starting a supplement.

What is the difference between the Estimated Average Requirement and the Recommended Dietary Allowance?

The Estimated Average Requirement is the daily intake that meets the needs of half the healthy people in a given age and sex group, and it is used to assess the adequacy of population intakes. The Recommended Dietary Allowance is set higher, at a level that covers the needs of 97 to 98 percent of healthy people.

Do older adults need a different multivitamin formula?

Often, yes. Products made for adults over 50 usually contain more vitamin D, vitamin B12 and calcium and little or no iron, because absorption of B12 from food tends to decline with age while iron needs fall after menopause.

How can I tell if a multivitamin is a quality product?

Look for a seal from an independent testing organization such as USP, NSF or ConsumerLab, which indicates the product contains the ingredients and amounts listed on the label and is free of specified contaminants. These seals verify manufacturing quality but do not mean the product has been shown to prevent or treat any disease.

Insights, Analysis, and Developments

Editorial Note: What often gets lost in the supplement argument is a point about study design that Balz Frei, then director of the Linus Pauling Institute, raised directly: most trials never check whether participants are short on a nutrient before giving it to them, and many enroll doctors and nurses whose diets are already better than average. A supplement is unlikely to show much effect in people who do not need it, which means null results in well-fed volunteers say little about someone living on a limited or poor-quality diet. The debate has not been settled since - in 2022 the U.S. Preventive Services Task Force concluded there was insufficient evidence to recommend for or against multivitamins for preventing cardiovascular disease or cancer - so the sensible reading remains the one the researchers offered themselves: a multivitamin is not a substitute for eating well, and improving diet and covering nutritional gaps are not mutually exclusive goals.*

Attribution/Source(s): This quality-reviewed publication was selected for publishing by the editors of Disabled World (DW) due to its relevance to the disability community. Originally issued as a press release by Linus Pauling Institute and published on 3 Jun 2014. Last updated on 6 Oct 2026. This content may have been edited for style, clarity, or brevity.

* Editorial additions by Ian C. Langtree.