TY - JOUR
T1 - Multivitamins in the prevention of cancer and cardiovascular disease
T2 - The COcoa Supplement and Multivitamin Outcomes Study (COSMOS) randomized clinical trial
AU - the COSMOS Research Group
AU - Sesso, Howard D.
AU - Rist, Pamela M.
AU - Aragaki, Aaron K.
AU - Rautiainen, Susanne
AU - Johnson, Lisa G.
AU - Friedenberg, Georgina
AU - Copeland, Trisha
AU - Clar, Allison
AU - Mora, Samia
AU - Moorthy, M. Vinayaga
AU - Sarkissian, Ara
AU - Wactawski-Wende, Jean
AU - Tinker, Lesley F.
AU - Carrick, William R.
AU - Anderson, Garnet L.
AU - Manson, Joann E.
AU - Manson, Joann E.
AU - Sesso, Howard D.
AU - Rist, Pamela M.
AU - Lagerstrom, Susanne Rautiainen
AU - Bassuk, Shari S.
AU - Wang, Lu
AU - Hazra, Aditi
AU - Gibson, Heike
AU - Leboff, Meryl S.
AU - Mora, Samia
AU - Okereke, Olivia I.
AU - Tobias, Deirdre K.
AU - Cook, Nancy R.
AU - Chandler, Paulette D.
AU - Christen, William
AU - Friedenberg, Georgina
AU - Copeland, Trisha
AU - Hanna, Jasmah
AU - Clar, Allison
AU - D'Agostino, Denise
AU - Vinayagamoorthy, Manickavasagar
AU - Gibson, Heike
AU - Kim, Eunjung
AU - Van Denburgh, Martin
AU - Kotler, Gregory
AU - Li, Chunying
AU - Bubes, Vadim
AU - Sarkissian, Ara
AU - Smith, Doug
AU - Pereira, Eduardo C.
AU - Okeke, Melvyn
AU - Roche, Elise
AU - Bates, David
AU - Ridge, Claire
N1 - Publisher Copyright:
© 2022 The Author(s) 2022.
PY - 2022/6/1
Y1 - 2022/6/1
N2 - Background: Although older adults commonly take multivitamin-multimineral (MVM) supplements to promote health, evidence on the use of daily MVMs on invasive cancer is limited. Objectives: The study objective was to determine if a daily MVM decreases total invasive cancer among older adults. Methods: We performed a randomized, double-blind, placebo-controlled, 2-by-2 factorial trial of a daily MVM and cocoa extract for prevention of cancer and cardiovascular disease (CVD) among 21,442 US adults (12,666 women aged ≥65 y and 8776 men aged ≥60 y) free of major CVD and recently diagnosed cancer. The intervention phase was from June 2015 through December 2020. This article reports on the MVM intervention. Participants were randomly assigned to daily MVM or placebo. The primary outcome was total invasive cancer, excluding nonmelanoma skin cancer. Secondary outcomes included major site-specific cancers, total CVD, all-cause mortality, and total cancer risk among those with a baseline history of cancer. Results: During a median follow-up of 3.6 y, invasive cancer occurred in 518 participants in the MVM group and 535 participants in the placebo group (HR: 0.97; 95% CI: 0.86, 1.09; P = 0.57). We observed no significant effect of a daily MVM on breast cancer (HR: 1.06; 95% CI: 0.79, 1.42) or colorectal cancer (HR: 1.30; 95% CI: 0.80, 2.12). We observed a protective effect of a daily MVM on lung cancer (HR: 0.62; 95% CI: 0.42, 0.92). The composite CVD outcome occurred in 429 participants in the MVM group and 437 participants in the placebo group (HR: 0.98; 95% CI: 0.86, 1.12). MVM use did not significantly affect all-cause mortality (HR: 0.93; 95% CI: 0.81, 1.08). There were no safety concerns. Conclusions: A daily MVM supplement, compared with placebo, did not significantly reduce the incidence of total cancer among older men and women. Future studies are needed to determine the effects of MVMs on other aging-related outcomes among older adults.
AB - Background: Although older adults commonly take multivitamin-multimineral (MVM) supplements to promote health, evidence on the use of daily MVMs on invasive cancer is limited. Objectives: The study objective was to determine if a daily MVM decreases total invasive cancer among older adults. Methods: We performed a randomized, double-blind, placebo-controlled, 2-by-2 factorial trial of a daily MVM and cocoa extract for prevention of cancer and cardiovascular disease (CVD) among 21,442 US adults (12,666 women aged ≥65 y and 8776 men aged ≥60 y) free of major CVD and recently diagnosed cancer. The intervention phase was from June 2015 through December 2020. This article reports on the MVM intervention. Participants were randomly assigned to daily MVM or placebo. The primary outcome was total invasive cancer, excluding nonmelanoma skin cancer. Secondary outcomes included major site-specific cancers, total CVD, all-cause mortality, and total cancer risk among those with a baseline history of cancer. Results: During a median follow-up of 3.6 y, invasive cancer occurred in 518 participants in the MVM group and 535 participants in the placebo group (HR: 0.97; 95% CI: 0.86, 1.09; P = 0.57). We observed no significant effect of a daily MVM on breast cancer (HR: 1.06; 95% CI: 0.79, 1.42) or colorectal cancer (HR: 1.30; 95% CI: 0.80, 2.12). We observed a protective effect of a daily MVM on lung cancer (HR: 0.62; 95% CI: 0.42, 0.92). The composite CVD outcome occurred in 429 participants in the MVM group and 437 participants in the placebo group (HR: 0.98; 95% CI: 0.86, 1.12). MVM use did not significantly affect all-cause mortality (HR: 0.93; 95% CI: 0.81, 1.08). There were no safety concerns. Conclusions: A daily MVM supplement, compared with placebo, did not significantly reduce the incidence of total cancer among older men and women. Future studies are needed to determine the effects of MVMs on other aging-related outcomes among older adults.
KW - cancer
KW - cardiovascular disease
KW - cocoa extract
KW - flavanols
KW - multivitamin
KW - randomized clinical trial
UR - https://www.scopus.com/pages/publications/85131702279
U2 - 10.1093/ajcn/nqac056
DO - 10.1093/ajcn/nqac056
M3 - Article
C2 - 35294969
AN - SCOPUS:85131702279
SN - 0002-9165
VL - 115
SP - 1501
EP - 1510
JO - American Journal of Clinical Nutrition
JF - American Journal of Clinical Nutrition
IS - 6
ER -