Don’t take multivitamins just to live longer or protect your heart and blood vessels

14,400 male doctors took multivitamins for 11 years. The number of serious heart or blood vessel problems and deaths among them was no different from those who didn’t take them. When nine studies involving over 50,000 people were combined, there was still no effect on overall mortality. Skipping multivitamins saves you 200–700 yuan each year. This does not apply to people who truly lack certain nutrients or pregnant women needing folic acid.

Cost

About 0.5–2 yuan per day, or 200–700 yuan per year. Taking them takes almost no time — just one pill each day. Over time, though, people can become dependent, feeling they’ve missed out on something important if they skip a day.

Benefit

The PHS II trial followed 14,641 male doctors for a median of 11.2 years. Both groups — those taking multivitamins and those who didn’t — showed the same rate of major cardiovascular events. The hazard ratio was 1.01 (meaning no real difference), with a 95% confidence interval of 0.91–1.10. Similarly, overall mortality rates were identical, with a hazard ratio of 0.94 (95% CI 0.88–1.02). In 2022, USPSTF evaluated nine randomized controlled trials involving 51,550 participants and concluded there is no link between multivitamin use and reduced mortality; they assigned it a Grade I rating, meaning evidence is insufficient to draw any firm conclusions. The idea that multivitamins are a good deal stems partly from the convenience of “one pill for all nutrients” and their low daily cost.

Notes

A point of debate: among these same male doctors, cancer rates were slightly lower among multivitamin users — about 8% fewer cases (95% CI 0.86–0.998, P=0.04, just barely significant). Deaths from cancer were also reduced by roughly 12% (95% CI 0.77–1.01), though this range includes 1, so it may simply be a coincidence. Any such benefit is very small and has only been observed in male doctors. It does not apply to people with proven nutrient deficiencies, pregnant women needing folic acid, or those with extremely poor diets. 〔14000〕

Sources · 3

1. Sesso HD et al. (2012). Multivitamins in the prevention of cardiovascular disease in men: the Physicians' Health Study II randomized controlled trial. JAMA. doi.org/10.1001/jama.2012.14805
2. US Preventive Services Task Force (2022). Vitamin, Mineral, and Multivitamin Supplementation to Prevent Cardiovascular Disease and Cancer. JAMA. doi.org/10.1001/jama.2022.8970
3. Gaziano JM 等 (2012). Multivitamins in the Prevention of Cancer in Men. JAMA. doi.org/10.1001/jama.2012.14641（备注里那项癌症结果）