This is the second such multivitamin clinical study within COcoa Supplementation and Multivitamin Outcomes Study (COSMOS) — a larger research group examining the health effects of certain dietary supplements — to reach the same conclusion.
The most recent study found that those who took multivitamins showed an estimated 3.1 fewer years of memory loss compared to a control group who took a placebo. Put another way, the multivitamin group was estimated to be 3.1 years “younger” in terms of their memory function than the placebo group.
“The elderly are very concerned about preserving cognition and memory, so this is a very important finding,” says Joan Mansonchief of Brigham’s division of preventive medicine and co-leader of the study with Howard Sesso, associate director of the division. “They are looking for safe and effective prevention strategies. The fact that two separate studies came to similar conclusions is remarkable.
Manson, also a professor of medicine at Harvard Medical School, described the effect of the supplements as “significant.”
He stressed, however, that a dietary supplement “will never be a substitute for a healthy diet and a healthy lifestyle.”
The study used a commonly available multivitamin — Centrum Silver — but “we think any high-quality multivitamin is likely to deliver similar results,” Manson said. Contains Centrum Silver vitamins D, A and B12, thiamine, riboflavin and manganese, among other substances.
Manson and Sesso report grants to their institution from Mars Edge, which is a unit of the food company, Mars, and focuses on nutrition research and makes the dietary supplement CocoaVia. Some of the 10 study authors also reported financial support from the National Institutes of Health.
Mars Edge and Pfizer Consumer Healthcare (now Haleon), the maker of Centrum Silver, donated multivitamin and placebo tablets and packaging. COSMOS is also supported by NIH grants.
Sesso also reported grants from the supplements company, Pure Encapsulations, and the biopharmaceuticals company, Pfizer; and honoraria or travel support for lectures from the trade group for the dietary supplement industry, Council for Responsible Nutrition; chemical company, BASF; NIH; and a group focused on nutrition research, the American Society for Nutrition.
Multivitamins are already popular among older Americans; 39 percent of adults age 60 and older take multivitamins, according to the Centers for Disease Control and Prevention. US sales of multivitamins and multivitamins with minerals are approx $8 billion by 2020according to the NIH.
The memory benefit of multivitamins lasted for three years
The most recent trial included more than 3,500 participants age 60 and older who completed web-based assessments of memory and cognition annually for three years. The tasks were word recall and novel object recognition, and a measure of executive control.
Compared to the placebo group, participants randomized to multivitamin supplementation were significantly better at immediate word recall after one year and maintained that benefit for an additional two years of follow-up, according to the study.
Multivitamin use, however, “did not significantly affect memory retention, executive function, or novel object recognition” when compared to placebo use, the study showed.
Findings that multivitamin use can help memory and cognition are especially important because the brain, like all other organs in the body, needs nutrients for optimal function and can suffer cognitively without them. them, brain health experts said.
“This study is groundbreaking,” said Andrew Budson, professor of neurology at Boston University and chief of cognitive behavioral neurology at the VA Boston Healthcare System, who was not involved in the research.
Low levels of vitamins B1 – also known as thiamine – B12 and D are associated with cognitive decline, he said. “That a simple multivitamin can slow cognitive decline as they age normally is pretty exciting, because it’s something that almost everyone can do,” Budson said.
Paul E. Schulz, professor of neurology and director of the Neurocognitive Disorders Center at McGovern Medical School at UTHealth Houston, says the brain needs lots of vitamins and minerals to function properly. “Think of a complex machine that needs a lot of specialized parts and needs all of them,” said Schulz, who was also not part of the study. “We regularly see people who have a deficiency in them come in with a mental disability.”
The slowing of cognitive aging
The past study, conducted by Brigham and Women’s Hospital and scientists at Wake Forest University School of Medicine, appeared this fall in the journal Alzheimer’s & Dementia. It found a 60 percent slowing of cognitive aging in those taking multivitamins compared to the placebo group.
The two studies were independent of each other and had different designs. But, significantly, they are the same randomized placebo-controlled clinical trialsthe “gold standard” of research in determining the effectiveness of a drug or medical treatment — directly linking cause and effect.
“This is probably the best evidence there is for taking a multivitamin,” says Donald Hensrud, a nutrition specialist at the Mayo Clinic, who was not involved in the research. “A randomized, controlled trial – good study.”
Surprisingly, both studies suggest that the participants who got the biggest benefit may be those with a history of cardiovascular disease, the researchers said.
“This is most intriguing because this same finding was replicated in two studies, with different designs, and no overlapping participants,” said Manson, who speculates that those with heart disease may had a lower nutritional status at the beginning of the study. “They may have started from a lower threshold, so improvements may be easier to see,” he said.
In the overall COSMOS trial, which included different studies, there were lower rates of stomach pain, diarrhoea, skin rash and bruising as side effects with multivitamin use compared to placebo, but an increased rate of gastrointestinal bleeding.
Future research on multivitamins
The study population included people of different races, ethnicities, education levels, socioeconomic status and household income. “However, as is the case for volunteers in any randomized clinical trials, participants tend to be slightly more educated, have slightly higher socioeconomic status, and have less variability than a cross- section of US adults in these age groups,” Manson said. .
The researchers said that future studies should explore whether the findings apply to more diverse participants, including those with lower levels of education and socioeconomic status, because “benefits may be greater in populations with lower incomes and poorer quality diets,” Manson said.
Further studies should also try to identify the nutrients that provide the most benefits, as well as the specific mechanisms involved, the researchers said.
