A cross-sectional analysis of a nationally representative sample of 1,003 pregnant U.S. people aged 20 to 40 years from the 20012014 NHANES found that many consumed less than recommended amounts of many nutrients from diet alone [17]. Because breastmilk provides little vitamin D, the American Academy of Pediatrics recommends that exclusively and partially breastfed infants receive supplements of 400 IU (10 mcg)/day of vitamin D beginning in the first few days after birth and continued until the infant is weaned and drinks at least 1 liter or 1 quart of vitamin D-fortified formula or whole milk daily [58]. MVMs cannot take the place of eating a variety of foods that are important to a healthy diet. There are two different types of vitamin D, vitamin D3, which is the form . The studies (which were of low quality overall) included a total of 355,034 women ages 2079; those taking MVs and MVMs took them for at least 3 years. MMWR 2020;69:1557-62. Approximately 48% of the men and 52% of the women in this study reported taking an MV or MVM. Topically applied minoxidil is generally well tolerated, but common side effects include itching of the eye, itching, irritation at the treated area, and unwanted hair growth elsewhere on the body. However, MVMs often have small amounts of certain nutrients, such as calcium, magnesium, and potassium, so supplement users should check product labels. Yet, iron supplements are a leading cause of poisoning in young children, so parents and guardians should keep iron-containing supplements out of the reach ofchildren. [, Keats EC, Akseer N, Thurairajah P, Cousens S, Bhutta ZA, the Global Young Women's Nutrition Investigators' Group. JAMA 2022;327:2334-47. BMJ Open 2020;10:e039119. Multivitamins, vision are an over-the-counter (OTC) product used to reduce the risk of vision loss among moderate to advanced age-related macular degeneration (AMD) patients and as an ocular (eye) vitamin supplement. Adults in their 50s and older Vitamins serve crucial functions in almost all bodily processes example immune, hormonal and nervous systems. What is a multivitamin? By age 71 or older, 48% of women and 43% of men were taking supplements. Pregnancy and birth outcomes Cataracts and age-related macular degeneration (AMD) Take this medication by mouth, usually once daily or as directed. Inflammation is a response of a tissue to some injury that includes . Long-term multivitamin supplementation and cognitive function in men: A randomized trial. Vitamin B12 (Cobalamin) Mechanism and Deficiency. No U.S. government health agency, private health group, or health professional organization promotes regular use of MVMs. New technologies have allowed innovators to discover the mechanisms of action behind the efficacy of specific strains and bacteria-enhancing combinations, through advanced assay analysis, translational models, and even deep dives into public health data. Have a question? A lack of these vitamins and minerals typically impairs blood health and the conversion of macronutrients into usable energy (i.e., ATP). The American College of Obstetricians and Gynecologists recommends that pregnant people take a daily "prenatal vitamin" [56]. The study measured rates of major CVD events, including MI, stroke, and CVD death [27]. Prevalence of dietary supplement use in US children and adolescents, 2003-2014. [. JAMA 2017;317:183-9. Multivitamin and mineral use and breast cancer mortality in older women with invasive breast cancer in the women's health initiative. Chemical name: pantothenic acid. Arch Intern Med 2009;169:294-304. How to use Theragran-M oral. Increase nutrient intakes Foods provide more than vitamins and minerals. [, Li J-Y, Taylor PR, Li B, Dawsey S, Wang G-Q, Ershow AG, et al. Obimin Plus is a pre- and postnatal supplement to help provide adequate supply of vitamins, minerals and DHA and EPA, during pregnancy and lactation. Nutrition Reviews 2021; published online ahead of print. Further metabolism of vitamin D to its major circulating form (25(OH)D) and hormonal form (1,25(OH)2D) takes place in the liver and kidney, respectively, but also in other tissues where the 1,25(OH)2D produced serves a paracrine/autocrine function . Taking excess amounts of vitamin A (preformed retinol form, not as beta-carotene) during pregnancy has been shown to increase the risk of birth defects. Vitamin K is involved in blood clotting and decreases the effectiveness of warfarin and similar drugs. JAMA. Dietary supplements are commonly taken during pregnancy to increase nutrient intakes, especially of key nutrients, such as iron and folic acid. Previous. U.S. Department of Agriculture and U.S. Department of Health and Human Services. During the study, 4,517 died of colon cancer. 2013;309:2005-15. The DGA, noting the difficulty of obtaining sufficient vitamin D from foods, advises that young children might need to continue taking a vitamin D supplement after age 12 months [54]. Because of limited information on product characteristics, our ability to directly compare results across studies, estimate changes in usage patterns or intakes over time, and generalize . For more information on safe upper levels of nutrients, visit the NIH Office of Dietary Supplements at: Smokers, and possibly former smokers, should avoid MVM products that provide more than 100% DV for vitamin A (either as preformed retinol or beta-carotene or some combination of the two) because two studies have linked high supplemental doses of these nutrients with an increased risk of lung cancer insmokers. However, if you take a blood thinner, such as warfarin (Coumadinand other brand names), talk to your health care provider before taking any MVM or dietary supplement that contains vitamin K (this vitamin lowers themedicines effectiveness, and doctors base the medicines dose partly on the overall amount of vitamin K a person usually consumes in foods. Among women, taking a daily MV or MVM did not affect their overall risk of developing cancer except for oropharyngeal cancer, which increased by 46%. Health care providers determine the dose of this medication for a given patient in part by assessing the amount of vitamin K that the patient routinely consumes. [, Rautiainen S, Rist PM, Glynn RJ, Buring JE, Gaziano JM,Sesso HD. Position of the Academy of Nutrition and Dietetics: Micronutrient supplementation. This study included 4,203 participants aged 5085 years who had intermediate AMD in both eyes or intermediate AMD in one eye and advanced AMD in the other eye. Mechanism. Nutrition 2017;36:60-6. Multivitamins are supplements that contain many different vitamins and minerals, sometimes alongside other ingredients ().Given that there's no standard for what constitutes a multivitamin . Multivitamins/multiminerals (MVMs) are the most frequently used dietary supplements, with close to half of American adults taking them. A 5000Units (40% as beta carotene), thiamine 1.5mg, riboflavin 1.7mg, niacinamide 20mg, pantothenic acid 10mg, pyridoxine 2mg, Vit. [, Bailey RL, Pac SG, Fulgoni III VL, Reidy KC, Catalano PM. Am J Clin Nutr 2022;115:1501-10. Therefore, the folic acid intakes of pregnant people who take these supplements and consume any foods fortified with this nutrient exceed the UL for this nutrient (1,000 mcg), even though many do not consume recommended amounts of folate from dietary sources alone [18]. The FNB notes that RDAs and AIs for nutrients are levels of intake to ingest, on average, each day from the diet [6]. This study prospectively followed 18,530 male physicians aged 40 years and older, of whom 20% reported taking an MV or MVM for an average of 12.2 years [24]. Depending on their formulations, MVMs can help individuals obtain adequate amounts of these nutrients, except for potassium (because MVMs contain only very small amounts of this mineral) and dietary fiber. Various government surveys of dietary supplements and popular food-frequency questionnaires also define MVs and MVMs differently, include different examples, or ask about different products. [, Wang J-B, Abnet CC, Fan J-H, Qiao Y-L, Taylor PR. US Preventive Services Task Force recommendation statement. The SU.VI.MAX study: a randomized, placebo-controlled trial of the health effects of antioxidant vitamins and minerals. Depending on ingredients in the formulaiton may support metabolic functions as well as protein and DNA synthesis. JAMA Pediatr 2018;172:780-2. Taking excess vitamin A (as retinol or other preformed forms of vitamin A but not beta-carotene) during pregnancy can increase the risk of birth defects in infants. Revitalize Multi-vitamin and Mineral Complex: Iron (1.5 mg / cap) + Ascorbic acid . 2002; Huang, 2003; Wu, 2005). [, Omenn GS, Goodman GE, Thornquist MD, Balmes J, Cullen MR, Glass A, et al. According to results of the National Health and Nutrition Examination Survey, 52% of adults take dietary supplements. Even after using MVs and MVMs daily for at least 10 years, the women had the same risk of breast cancer as the nonusers. [, Chan ALF, Leung HWC, Wang S-F. Multivitamin supplement use and risk of breast cancer: A meta-analysis. . Some MVMs contain amounts of some vitamins and minerals that are substantially higher than the DV, RDA, AI, or even, in some cases, the established Tolerable Upper Intake Level (UL). This section summarizes the evidence on the use of MVMs to increase nutrient intakes and to improve health or prevent chronic disease. Vitamin K. Accessed January 12, 2011. The DGA also states that pregnant people might need to take separate supplements of iodine and choline when their health care provider recommends that they do so because many prenatal MVMs do not contain these nutrients or contain only small amounts of them. [, Hercberg S, Galan P, Preziosi P, Bertrais S, Mennen L, Malvy D, et al. Ophthalmology 2014;121:525-34. This publication is not copyrighted and is in the public domain. Pregnant and breastfeeding people, adult women, non-Hispanic Blacks, people of low socioeconomic status, and individuals who are underweight or overweight are among the groups with the greatest risk of deficient intakes of one or more nutrients [9]. Mutlvitamin-multimineral supplementation and mortality: A meta-analysis of randomized controlled trials. U.S. sales of all dietary supplements totaled an estimated $55.7 billion in 2020, including $21.2 billion for all supplements containing vitamins, minerals, or both, of which $8.0 billion was for MVMs and MVs [4]. Studies of MVM users reveal no adverse effects, except that both treatment and placebo groups in some studies experienced some minor gastrointestinal issues [61]. This study randomly assigned 8,776 men aged 60 years and older and 12,666 women aged 65 years and older to take a daily MVM (Centrum Silver, with small differences in ingredients and amounts than the supplement used in the Physicians Health Study II), a cocoa extract containing 500 mg of cocoa flavanols, both Centrum Silver and the cocoa extract, or both placebos for a median of 3.6 years. Instead, vitamins serve as chemical partners for the enzymes involved in the body`s metabolism, cell production, tissue repair, and other vital processes. The studies included a total of 91,074 healthy adults (average age 62 years) taking the MVs or MVMs for an average of 43 months, and the investigators reported 8,794 deaths. Participants who took the MVM did not have fewer major cardiovascular events, myocardial infarctions, strokes, or cardiovascular-related deaths than nonusers [38]. Even in the United States, the amount of folic acid in prenatal MVM supplements is typically 800 or 1,000 mcg, which is much higher than the recommended amount (400 mcg) to reduce the risk of neural tube defects in babies [19]. Over an average follow-up period of 6.3 years, the supplements significantly reduced the risk of progression from intermediate to advanced AMD by 28% and reduced rates of loss of visual acuity by 27%. Dietary vitamins and minerals play ubiquitous roles throughout the human body by serving as veritable "helping hands" (e.g. However, evidence to support their use for overall health or disease prevention in the general population remains limited. Pregnant people Effects of cocoa extract and a multivitamin on cognitive function: A randomized clinical trial. Ann Intern Med 2013;159:806-14. Honey possesses antimicrobial, anti . Multinutrients for the treatment of psychiatric symptoms in clinical samples: A systematic review and meta-analysis of randomized controlled trials. The model comprises an oxygenation that is coupled to carbon-carbon bond . Vitamin B5. Among the 69.8% who took a dietary supplement (most likely a prenatal MVM supplement), the risk of inadequate intakes of many nutrients was lower. Minerals, vitamins, and an immunity booster derived from various plant extracts are included. The. However, no two RCTs have used MVMs with the same combinations and amounts of nutrients. People with healthier diets and lifestyles are more likely to take dietary supplements, making it hard to identify any benefits from their use. Another large prospective study investigated the association between use of MVs and MVMs (mostly MVMs described as "therapeutic or theragran," "one-a-day," or "stress-tab") and risk of cancer by following 489,640 men and women aged 5071 years for 16 years [8]. J Nutr 2016;146:1235-40. The products provided an average of 14 nutrients, although the products with 3 nutrients in 5 trials did not contain a mineral. Self-reported health without clinically measurable benefits among adult users of multivitamin and multimineral supplements: A cross-sectional study. [, Gaziano JM, Sesso HD, Christen WG, Bubes V, Smith JP, MacFadyen J, et al. Mechanism of action of Multivitamin Related doctor hospitals Pharmacy health centres, online consultation, second opinion for Multivitamin Mechanism of action of Multivitamin Published at: 14/11/2016 For more information about building a healthy dietary pattern refer to the Dietary Guidelines for Americans and the U.S. Department of Agriculture's MyPlate. The mention of any product, service, or therapy is not an endorsement by NCCIH. Am J Clin Nutr 2010;91:1268-1272. Huang H-Y, Caballero B, Chang S, Alberg AJ, Semba RD, Schneyer C, et al. [, Age-Related Eye Disease Study 2 Research Group. Introduction. JAMA Intern Med 2013;173:1259-61. Multivitamin-multimineral supplements: who uses them? Studies on the association between MVM use and cancer-related deaths include one that followed 7,728 women in the Women's Health Initiative who had invasive breast cancer for an average of 7.1 years after their diagnosis [22]. Multiple-micronutrient supplement for women during pregnancy (review). Varying definitions of MVMs and the ability of manufacturers to change the composition of their products at will further complicate the study of MVMs' potential health impacts because different studies do not use products of similar composition. 1. Infants and children However, use of MVs or MVMs conferred no protection among participants consuming less than two alcoholic beverages per day, whereas use among those consuming more was associated with a 29% lower risk of colon cancer mortality. [, Park S-Y, Murphy SP, Wilkens LR, Henderson BE, Kolonel LN. Vitamins & Minerals; Supplier Directory; . However, they are required to bear a Supplement Facts label and ingredient list describing whats in theproduct. An expert panel that reviewed this report and participated in a state-of-the-science conference on the use of MVs and MVMs for chronic disease prevention at the National Institutes of Health in 2006 concluded that the evidence was insufficient for them to recommend for or against the use of MVs or MVMs to prevent chronic disease [1]. The DGA adds that infants fed human milk might also require a vitamin B12 supplement if the mother's vitamin B12 status is inadequate, which might occur, for example, if she follows a vegan diet [54]. Know the Science: 9 Questions To Help You Make Sense of Health Research. It is found in various plants, including grapes, berries, peanuts, and red wine. There is no one single thing that makes it work. One of the largest prospective studies of MVM use was the Women's Health Initiative, which evaluated the health of 161,808 postmenopausal women aged 5079 years and their risk factors for cancer, heart disease, and osteoporosis. [, Murphy SP, White KK, Park S-Y, Sharma S. Multivitamin-multimineral supplements' effect on total nutrient intake. Individuals who have poor nutrient intakes from diet alone, consume low-calorie diets, or avoid certain foods (such as strict vegetarians and vegans) might benefit from taking an MVM [60]. The study's goal was to determine whether the supplement reduced the risk of additional cardiovascular events or death [28]. . October 11, 2022 [. At baseline, 37.8% reported taking an MVM (typically containing 2030 vitamins and minerals). 1. The products provided an average of 14 nutrients, although the products with 3 nutrients in 5 trials did not contain a mineral. N Engl J Med 1994;330:1029-35. Men. The COcoa Supplement and Multivitamin Outcomes Study (COSMOS) was a subsequent clinical trial to investigate whether MVMs might help prevent cancer and CVD in both men and women [42]. One RCT conducted in Linxian, China, randomized 3,318 persons ages 4069 years who had precancerous lesions in the esophagus (a relatively common condition in this population, which had a low dietary intake of several nutrients) to receive a daily MVM containing 14 vitamins and 12 minerals in doses 2 to 3 times recommended amounts or a placebo for 6 years [44]. [, Sesso HD, Christen WG, Bubes V, Smith JP, MacFadyen J, Schvartz M, et al. Many of these products contain numerous ingredients in varied combinations and amounts. U.S. Preventive Services Task Force. Many foods also have fiber and other substances that can provide health benefits. Essentially all vitamin absorption occurs in the small intestine. Basic MVMs contain both vitamins and minerals, most in amounts that do not exceed the DVs. N Engl J Med 1996;334:1150-5. J Nutr 2021;151:1976-82. The radioprotective effect ex vivo, in vitro and in vivo of vitamins was reviewed using PubMed and Embase and conducted according to the PRISMA statement. When choosing an MVM product, consumers should consider taking a product designed for people of their age, sex, and life stage (e.g., pregnancy). Furthermore, investigators define MVMs differently (or sometimes not at all) in their studies to evaluate the potential health effects of these products. [, Grodstein F, O'Brien J, Kang JH, Dushkes R, Cook NR, Okereke O, et al. When taken as directed, multivitamins and minerals are not expected to cause serious side effects. Supplement Business Report 2021. Resveratrol is a natural compound that belongs to a group of polyphenols called stilbenes. [, Lamas GA, Boineau R, Goertz C, Mark DB, Rosenberg Y, Stylianou M, et al. Minerals (especially taken in large doses) can cause side effects such as tooth staining, increased urination, stomach bleeding, uneven heart rate, confusion, and muscle weakness or limp feeling. RCTs Multivitamins in the prevention of cardiovascular disease in men: the Physicians' Health Study II randomized controlled trial. Carbohydrates, such as cellulose, pass through the human intestinal tract undigested. Multivitamin and multimineral dietary supplements: definitions, characterization, bioavailability, and drug interactions. Based on this review, the USPSTF concluded there was insufficient evidence to determine "the balance of benefits and harms" in taking MVMs to prevent CVD or cancer [50]. MVMs for "senior" men and women, for example, often contain little or no iron and more calcium, vitamin D, and vitamin B12 than MVMs for younger adults [69]. The studies included a total of 2,019,862 participants with a mean age of 57.8 years and had a mean duration of 11.6 years. The mechanism of action of resveratrol is complex and not fully understood. Observational studies Recommended Daily Intake of Vitamins and Minerals for Adults. These interactions can make a drug less effective, increase the action of a drug, or cause unexpected side effects. For example, the Agency for Healthcare Research and Quality, in an evidence-based review of the role of MVMs in chronic disease prevention, defined MVMs as products containing at least three vitamins and minerals in amounts below the UL but no herbs, hormones, or drugs [7]. Multivitamin use and the risk of mortality and cancer incidence: the Multiethnic Cohort Study. [, US Preventive Services Task Force. In addition, a study examined the association between daily MV or MVM use and colon cancer mortality over 16 years in 776,902 men and women, most of whom were White and middle-aged or older [23]. Am J Clin Nutr 2007;85:277S-9S. Updated: Cochrane Database of Systematic Reviews 2019, Issue 3. This analysis included 4,933 adults who reported taking an MV or MVM during the previous 12 months and 16,670 nonusers [37]. Some experts have hypothesized that MVM use might reduce cancer risk or improve cancer outcomes, possibly because certain nutrients in MVMs might inhibit carcinogenesis or tumor progression. However, if you consume fortified foods and beverages (such as cereals or drinks with added vitamins and minerals) along with dietary supplements, you should make sure that your total intake of vitamins and minerals is not more than the safe upper limits for any nutrients. MVMs and Use of Supplements Containing Individual Nutrients Found in MVMs Supplemental vitamins and minerals for cardiovascular disease prevention and treatment. The use of MVMs resulted in lower odds of low birth weight (less than 2,500 g) by 12%, birth at a smaller size than normal for gestational age by 8%, and premature births (before week 37 of pregnancy) by 10% than use of supplements containing iron with or without folic acid alone or placebo. mechanism of action of multivitamins and minerals. MVMs, in particular, are popular supplements, currently taken by an estimated one-third of all adults in the United States, and one-quarter of children and adolescents take an MVM or MV [2,3]. The study randomly assigned 14,641 male physicians in the United States aged 50 and older to take a daily MVM (Centrum Silver) or placebo for a median of 11.2 years. Adults in this age group might not be able to absorb enough of the protein-bound, naturally occurring vitamin B12 in food because gastric acidity tends to decline and atrophic gastritis tends to become more common with age [6]. The immune system is strengthened by a number of active substances found in SP, including vitamins, minerals, carotenoids, polysaccharides, and linolenic acid [73]. Stay Informed, Stay Healthy! Several epidemiological studies and small RCTs have suggested associations between higher intakes of antioxidants or zinc and reduced risk of AMD, although not consistently [30]. Duplication is encouraged. Am J Clin Nutr 2013;97:437-44. The supplement users reported better overall health than the nonusers, but the results showed no differences in various psychological, physical, or functional health outcomes [37]. In another RCT of 18,314, smokers, former smokers, and asbestos-exposed persons, participants who took a combination of 30 mg/day of beta-carotene plus 25,000 IU/day of vitamin A (as retinol) had a 28% higher lung cancer risk than those taking a placebo after an average 4-year follow-up period [65]. However, individuals who take MVMs and other supplements and who consume fortified foods and beverages might obtain some nutrients in amounts exceeding the UL, increasing the possibility of adverse effects [62]. J Natl Cancer Inst 1993;85:1492-8. ** These MVMs might also include other nutrients and botanical ingredients. Telecommunications relay service (TRS): 7-1-1, Email: info@nccih.nih.gov (link sends email). Adv Nutr 2020;11:753-9. Methylmalonyl CoA to succinyl CoA. An analysis by the National Health and Nutrition Examination Survey (NHANES) of data collected from 2003 to 2006 found 33% of the U.S. population ages 1 year and older took an MVM supplement in a given month. Vitamin A is effective for the treatment of Vitamin A deficiency. When your child needs vitamin D, iron, and zinc. Vitamins are organic and can be broken down by heat, air, or acid. Natural Medicines Comprehensive Database. Otten JJ, Hellwig JP, Meyers LD (editors). Dark stools. Studies that have examined associations of MVMs with CVD risk include the Physicians Health Study I. Multivitamins with iron are used to provide vitamins and iron that are not taken in through the diet. Am J Clin Nutr 2007;85:280S-4S. For a reader-friendly overview of Multivitamin/mineral Supplements, see our consumer fact sheet on Multivitamin/mineral Supplements. This raises questions regarding the safety of . Ann Intern Med 2013;159:797-805. Honey has a low glycemic index, loaded with polyphenols, enzymes, minerals, and vitamins. [, Prentice RL. Your child needs a variety of vitamins and minerals to grow healthy and strong. Nutrition Business Journal. Homeostatic regulation of Blood Pressure by a negative feedback system Positive Feedback Mechanisms In positive feedback mechanisms, the result or . Product Presentation. In general, MVMs might help people who do not eat a nutritious variety of foods to obtain adequate amounts of essential nutrients. Ann Pharmacother 2011;45:476-84. Excess nutrient intakes are even more likely among MVM users who also take single vitamin and mineral supplements [15]. [. Smokers and, possibly, former smokers should avoid MVM products providing large amounts of beta-carotene or vitamin A because two studies have linked these nutrients to an increased risk of lung cancer in smokers [63]. "Vitamin D and . Challenges and opportunities in the translation of the science of vitamins. which is why it's a critical component in prenatal vitamins mechanism of action. Am J Clin Nutr 2007:85:318S-22S. : CD004905. Sometimes a member of your CF care team will ask you to take a single nutrient vitamin supplement, such as vitamin D. Most single nutrient vitamin supplements are available over the counter, although some require a prescription.. Am J Clin Nutr 2007;85:325S-7S. Vitamins are organic molecules necessary for normal metabolism in animals, but either are not synthesized in the body or are synthesized in inadequate quantities and must be obtained from the diet. The brand name of Lycopene Multivitamin and Multimineral Capsules presented by Creogenic Pharma is CREPENE. The effect of vitamin E and beta carotene on the incidence of lung cancer and other cancers among male smokers. [. Pediatrics 2008;122:1142-52. Vitamins and minerals serve crucial functions in almost all bodily processes and must be obtained from foods or supplements, as our bodies are unable to make them. However, MVM use is common in the general population. [, Qato DM, Alexander GC, Guadamuz JS, Lindau ST. Women. . Multivitamin and iron may also be used for . Multiple outcomes Impact of frequency of multi-vitamin/multi-mineral supplement intake on nutritional adequacy and nutrient deficiencies in U.S. adults. Small Business Research Grant Program (SBIR), About Research Training and Career Development, Training Grant Application, Review, and Award Process, Integrative Medicine Research Lecture Series, Division of Extramural Research Sponsored by NCCIH, Division of Intramural Research Conducted at NCCIH, Dietary Guidelines for Americans 20152020, How To Find Information About Complementary Health Approaches on PubMed, Most individuals can get all of the necessary vitamins and minerals through a healthy eating pattern of nutrient-dense foods. Abdominal pain. One well-known trial of the impact of MVMs on both chronic disease risk and mortality used combinations of antioxidant nutrients. Wagner CL, Greer FR, and the Section on Breastfeeding and Committee on Nutrition. Deficiency: Symptoms include paresthesia, or "pins and needles . August 25, 2022 . In 2006, researchers reviewed 63 published RCTs between 1966 and early 2006 that evaluated the potential impacts of MVs and MVMs and individual nutrient supplements on health and on the risk of certain medical conditions (cancer; age-related sensory loss; and cardiovascular, endocrine, neurologic, musculoskeletal, gastroenterologic, renal, and pulmonary diseases) [7]. [, Macpherson H, Pipingas A, Pase MP. An earlier analysis of 20112014 NHANES data found that 31.2% of the U.S. adult population aged 19 years and older reported taking an MVM in the past 30 days [2].