139 replies to this topic

[Mind]

This is another study that once again refines the nature and dosage of vitamin supplements/usage. Contrary to MSM hype, more anti-oxidants are not a panacea and multiple studies indicate large doses over long time periods increase mortality. (That is why it was brilliant that we went with a less is more approach on Vimmortal - high quality too)

This has been discussed many times in the past and it would be nice if we could aggregate some links in this latest iteration of the topic.

Here are 2 to begin with:

Multi-vitamins undo the positive effects of exercise.

Some vitamins probably increase mortality.

Feel free to link some positive vitamin discussions as well. There are plenty of studies showing benefits from individual supps.

High dose low quality multis - not so great, according to most recent population studies.

[hivemind]

well, it's been "proven" that long-term high doses of follic acid and vitamin E increase all-cause mortality and that beta-caroten increases all-cause mortality (or just lung cancer?) between smokers (and possibly passive smokers?). i don't really like multivitamins, you never know what you get and mostly the forms of nutrients are low quality - which can explain what's OP is talking about: people care less about their health because they think: i'm taking multivitamin anyway so some junk food won't hurt me. but the problem is that multivitamin may not really be working ...

This study has been all around finnish health sites in recent days

But are all the folate supplement -studies using the unnatural folic acid? Many products have natural folate. For example the AOR Multi Basics has 5-methyl tetrahydrofolate.



http://www.ncbi.nlm....?tool=pmcentrez

Folate supplementation in the trial was in the form of folic acid, a fully oxidized, monoglutamyl form of folate that may differ in its effects from the natural reduced and methylated forms (mostly 5-methyl tetrahydrofolate). Folic acid is more bioavailable than natural sources (20); natural folates exist as polyglutamates that are hydrolyzed to monoglutamates in the small intestine and then polyglutamated in peripheral cells (21).

Edited by Trip, 11 October 2011 - 11:33 PM.

[Dorian Grey]

Sorry I don't have the links but I've seen a lot of chatter about a big push going on to regulate supplements recently. I know the second hand smoke regs all started with a lot of well financed studies that were not very truthful to the scientific process so it seems likely big pharma could be working on this model.

What is interesting to me is, this study is of older women and I've noticed a lot of women seem to think they need to take iron. I've read quite a bit on the dangers of iron supplements and I'm even donating blood to reduce my iron levels. There are some who think life long iron buildup in men is the reason they don't live as long as women, who tend to lose some iron during their child bearing years.

Look for more cherry picking of studies in the future, and people starting to worry about the danger of second hand supplements!

Personally, I'd like to see some of the mega-doses reduced so perhaps some good can come of this after all.

[niner]

Here's the abstract take from the Arch Int Med site. It doesn't seem to be in Pubmed yet, which is kind of weird considering that it's being splashed all over the press.

LESS IS MORE
Dietary Supplements and Mortality Rate in Older Women
The Iowa Women's Health Study
Jaakko Mursu, PhD; Kim Robien, PhD; Lisa J. Harnack, DrPH, MPH; Kyong Park, PhD; David R. Jacobs Jr, PhD
Arch Intern Med. 2011;171(18):1625-1633. doi:10.1001/archinternmed.2011.445
Background Although dietary supplements are commonly taken to prevent chronic disease, the long-term health consequences of many compounds are unknown.
Methods We assessed the use of vitamin and mineral supplements in relation to total mortality in 38 772 older women in the Iowa Women's Health Study; mean age was 61.6 years at baseline in 1986. Supplement use was self-reported in 1986, 1997, and 2004. Through December 31, 2008, a total of 15 594 deaths (40.2%) were identified through the State Health Registry of Iowa and the National Death Index.
Results In multivariable adjusted proportional hazards regression models, the use of multivitamins (hazard ratio, 1.06; 95% CI, 1.02-1.10; absolute risk increase, 2.4%), vitamin B₆ (1.10; 1.01-1.21; 4.1%), folic acid (1.15; 1.00-1.32; 5.9%), iron (1.10; 1.03-1.17; 3.9%), magnesium (1.08; 1.01-1.15; 3.6%), zinc (1.08; 1.01-1.15; 3.0%), and copper (1.45; 1.20-1.75; 18.0%) were associated with increased risk of total mortality when compared with corresponding nonuse. Use of calcium was inversely related (hazard ratio, 0.91; 95% confidence interval, 0.88-0.94; absolute risk reduction, 3.8%). Findings for iron and calcium were replicated in separate, shorter-term analyses (10-year, 6-year, and 4-year follow-up), each with approximately 15% of the original participants having died, starting in 1986, 1997, and 2004.
Conclusions In older women, several commonly used dietary vitamin and mineral supplements may be associated with increased total mortality risk; this association is strongest with supplemental iron. In contrast to the findings of many studies, calcium is associated with decreased risk.

Author Affiliations: Department of Health Sciences, Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio Campus, Kuopio, Finland (Dr Mursu); Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis (Drs Mursu, Robien, Harnack, and Jacobs); Department of Food and Nutrition, Yeungnam University, Gyeongbuk, Republic of Korea (Dr Park); and Department of Nutrition, School of Medicine, University of Oslo, Oslo, Norway (Dr Jacobs).

I take it the numbers for all the supplements other than multis were from individual supplemental sources, possibly in addition to a multi? Copper (the worst of all by far) and artificial folate make sense. These were older women, presumably post menopausal, so iron should have been out of their regimen. I guess they didn't get the memo on that one. Although they are the least bad, I was surprised to see B6, Mg, and Zn on the list. What kind of women took individual doses of B6, Mg, or Zn between 1986 and 2004? What else were they doing? What forms and quantities did they take? I don't have access to the full text as of yet, and something tells me these questions won't be answered there anyway. It's a fair guess that individual supplements, while they may or may not be better forms than found in a consumer multi, stand a good chance of being overdosed.

So what does this report tell us? First, it tells us that things that we know are bad for us (Cu, Fe, artificial folate) are bad for us. We are pretty sure that crappy forms are bad, and that overdoses are bad. Some of what we're looking at here is probably representative of either or both of those.

[hivemind]

http://junkscienceco...n-mortality.pdf

Here is the full text.

Attached Files

•  aim-multivitamin-older-women-mortality.pdf   167.1KB   42 downloads

[wolfeye]

What's the deal with calcium benefits? Less bone fractures?

[niner]

What's the deal with calcium benefits? Less bone fractures?

I suspect that's it. The study population was elderly women, so osteoporosis is an occupational hazard. It's not uncommon for an elderly woman to break a hip, never really heal, and be dead in short order. (Within a year.) In younger people, supplemental calcium might be a negative, depending on form and dose. I think maybe the biggest problem with this study is that it used a very non-representative population. Suddenly it's spun as "all supplements are bad" with "for everyone" as the unspoken addition.

[mwestbro]

This one is strange. From the full text, it isn't clear to me if they were asking about individual supplements, or about components of a multi or multimineral. If they were asking only about individual supplements, who the hell takes individual copper pills? If they included multis in their figures for individual nutrients, then in essence they are just repackaging the multi news, which I attribute to the iron in a generic multi. Especially in the eighties--I remember when a standard Centrum had 27 milligrams of iron. Did I miss something in the text that would explain this?

I also note that the relative risk numbers consistently go down with later follow-up. The last RR for multis is .94. Each individual number is not statistically significant, but I wonder what the P for the overall trend would be. This might be part of a pattern which has jumped out at me in other epidemiological studies. Nutrients have their most potent effects at the beginning of a disease process, so you have to wait ten years or more to see benefit for slow developing conditions. If a disease like cancer is already present when you begin supplementation, then the nutrients may have a neutral effect or even accelerate the progress of the tumor. The authors note that many of the women began supplementation during the study itself, which would fit with this pattern. The rule for benefit might be start early and don't stop.

Mike

[hav]

The article seems to indicate that iron is the most problematical. Which seems logical. Younger women often need additional iron during their reproductive years. But things change with menopause. I imagine that women who take a multivitamin rich in iron when they're younger might not realize they should switch to a different formulation in later life as their needs change.

Howard

[Jay]

@Niner, how do we know that copper and iron supplements are bad? Copper containing foods seem to be among the healthiest -- oysters, mussels, crab, lobster, liver, chocolate, coconut, potatoes. If you're going by the epidemiology of serum copper, please note that serum copper is far more closely linked with inflammation than with copper intake. If you're going by test-tube reactivity of copper and iron, I don't think those results a very likely to apply to living humans.

Re calcium and magnesium. I think the story here may have a lot to do with vitamin D and its non-bone, systemic effects. Calcium intake reduces the need for vit D, presumably freeing some of it to do tasks not related to calcium homeostasis (i.e., disease prevention). Magnesium is part of the calcium/vit D story and i would not be surprised if bad things happen to calcium and vit D deficient people that take excessive magnesium. I suspect that magnesium is beneficial in vit D replete people (though would caution against more than occasional dosing).

Re folic acid: The problem could be unmetabolized folic acid or it could simply be that excess folate is bad for people. I suspect that too much folate is a big problem by itself (i.e., it's not all about folic acid).

[Dorian Grey]

Ray Peat (PhD) on iron and copper...

http://raypeat.com/a...n-dangers.shtml

"During aging, our tissues tend to store an excess of iron. There is a remarkably close association between the amount of iron stored in our tissues and the risk of death from cancer, heart disease, or from all causes. This relationship between iron and death rate exists even during childhood, but the curve is downward until the age of 12, and then it rises steadily until death. The shape of this curve, representing the iron burden, is amazingly similar to the curves representing the rate of death in general, and the rate of death from cancer. There is no other relationship in biology that I know of that has this peculiar shape, with its minimum at the age of 12, and its maximum in old age at the time of death.
One of the major lines of aging research, going back to the early part of this century, was based on the accumulation of a brown material in the tissues known as "age-pigment." The technical name for this material, "lipofuscin," means "fatty brown stuff." In the 1960s, the "free radical theory" of aging was introduced by Denham Harman, and this theory has converged with the age-pigment theory, since we now know that the age-pigment is an oxidized mass of unsaturated fat and iron, formed by uncontrolled free radicals. Until a few years ago, these ideas were accepted by only a few researchers, but now practically every doctor in the country accepts that free radicals are important in the aging process. A nutrition researcher in San Diego suspected that the life-extending effects of calorie restriction might be the result of a decreased intake of toxins. He removed the toxic heavy metals from foods, and found that the animals which ate a normal amount of food lived as long as the semi-starved animals. Recently, the iron content of food has been identified as the major life-shortening factor, rather than the calories. [Choi and Yu, Age vol. 17, page 93, 1994.]"

[Alec]

The group said they saw "little justification" for the general use of vitamin supplements.

Yeah sure, I'll just throw away all of my supplements immediately this instant!

Edited by Alec, 14 October 2011 - 01:42 AM.

[longevitynow]

I take a high potency multi-vit, multi-mineral that is iron and copper free. I also take a green drink with a lot of vegetables in it, that makes sure I am getting a lot of unidentified phytonutrients in case I am over-consuming something like beta carotene (actually my multi contains "mixed-carotenoids"). I also do a hair analysis 1x a year to make sure I don't have any minerals too high. Recently it revealed too much Arsenic!!! It isn't from my multi as I have been taking it for years, but I am guessing it might be one of the bulk powdered supplements I have been taking...

[Mind]

Here is decent rebuttal from the Life Extension Foundation, pointing to the many possible flaws associated with this study.

[nowayout]

Quoting the LEF on this is like asking Exxon their opinion on global warming.

[hivemind]

Quoting the LEF on this is like asking Exxon their opinion on global warming.

:D

[Mind]

I understand the attempt at humor, but LEF mentions the same reasons that many sophisticated supplement consumers at Imminst mentioned as to why this study is not a "gold standard". One example, large amounts of iron used to be prevalent in many low grade multivitamins 10 to 20 years ago. Excessive iron intake has been associated with an increased rate of many chronic and age-related illnesses. This alone could account for the tiny increase in mortality found in this study. It is a valid criticism whether or not it came from LEF, XOM, or martians.

The take home for me is that more is not better when it comes to multivitamins. I used to get a gut feeling about this when I looked at ingredients 5 to 10 years ago and saw 5,000, 10,000, etc. percent RDA of vitamins going into some supplements (some energy drinks are probably toxic as well with 8,000% RDA of many B-vitamins). The anti-oxidant theory of aging and age-related damage is not so clear cut as "just soak up all of the ROS with anti-oxidants (ie, vitamins) and everything will be great". The body produces many key ROS for proper growth/maintenance/functioning and getting rid of them all is probably not good.

[Alec]

Here is decent rebuttal from the Life Extension Foundation, pointing to the many possible flaws associated with this study.

A problem with their rebuttal IMO. They say "Life Extension members usually take high-potency antioxidant formulas that provide gamma tocopherol (which is critical to balance the effects of alpha tocopherol in the body)...", yet none of their multivitamin formulas seem to have any gamma tocopherol or any other kind of vitamin E besides the high amount of alpha tocopheryl succinate.

[pamojja]

That's less a problem with the rebuttal, but that they didn't specify the high-potency antioxidant formulas LE members usually take didn't mean their multivitamin formula, but something like their 'Super Booster' softgels instead.

This is the response from OMS:

FOR IMMEDIATE RELEASE
Orthomolecular Medicine News Service, October 12, 2011
What Kind of Medical Study Would Have Grandma Believe that Her Daily Multivitamin is Dangerous?

by Robert G. Smith, PhD

(OMNS, Oct 12, 2011) A newly released study suggests that multivitamin and nutrient supplements can increase the mortality rate in older women [1]. However, there are several concerns about the study's methods and significance.

• The study was observational, in which participants filled out a survey about their eating habits and their use of supplements. It reports only a small increase in overall mortality (1%) from those taking multivitamins. This is a small effect, not much larger than would be expected by chance. Generalizing from such a small effect is not scientific.
• The study actually reported that taking supplements of B-complex, vitamins C, D, E, and calcium and magnesium were associated with a lower risk of mortality. But this was not emphasized in the abstract, leading the non-specialist to think that all supplements were associated with mortality. The report did not determine the amounts of vitamin and nutrient supplements taken, nor whether they were artificial or natural. Further, most of the association with mortality came from the use of iron and copper supplements, which are known to be potentially inflammatory and toxic when taken by older people, because they tend to accumulate in the body [2,3,4]. The risk from taking iron supplements should not be generalized to imply that all vitamin and nutrient supplements are harmful.
• The study lacks scientific plausibility for several reasons. It tabulated results from surveys of 38,000 older women, based on their recall of what they ate over an 18-year period. But they were only surveyed 3 times during that period, relying only on their memory of what foods and supplements they took. This factor alone causes the study to be unreliable.
• Some of these women smoked (~15%) or had previously (~35%), some drank alcohol (~45%), some had high blood pressure (~40%), and many of them developed heart disease and/or cancer. Some preexisting medical conditions were taken into account by adjusting the risk factors, but this caused the study to contradict what we already know about efficacy of supplements. For example, the study reports an increase in mortality from taking vitamin D, when adjusted for several health-relevant factors. However, vitamin D has recently been clearly shown to be helpful in preventing heart disease [5] and many types of cancer [6], which are major causes of death. Furthermore, supplement users were twice as likely to be on hormone replacement therapy, which is a more plausible explanation for increased mortality than taking supplements.
• The effect of doctor recommendations was not taken into account. By their own repeated admissions, medical doctors and hospital nutritionists are more likely to recommend a daily multivitamin, and only a multivitamin, for their sicker patients. The study did not take this into account. All it did was tabulate deaths and attempt to correct the numbers for some prior health conditions. The numbers reported do not reflect other factors such as developing disease, side effects of pharmaceutical prescriptions, or other possible causes for the mortality. The study only reports statistical correlations, and gives no plausible cause for a claimed increase in mortality from multivitamin supplements.
• The effect of education was not taken into account. When a doctor gives advice about illnesses, well-educated people will often respond by trying to be proactive. Some will take drugs prescribed by the doctor, and some will try to eat a better diet, including supplements of vitamins and nutrients. This is suggested by the study itself: the supplement users in the survey had more education than those who did not take supplements. It seems likely, therefore, the participants who got sick were more likely to have taken supplements. Because those who got sick are also more likely to die, it stands to reason that they would also be more likely to have taken supplements. This effect is purely statistical; it does not represent an increase in risk that taking supplements of vitamins and essential nutrients will cause disease or death. This type of statistical correlation is very common in observational health studies and those who are health-conscious should not be confounded by it.
• The known safety of vitamin and nutrient supplements when taken at appropriate doses was not taken into account. The participants most likely took a simple multivitamin tablet, which contains low doses. Much higher doses are also safe [4,7], implying that the low doses in common multivitamin tablets are very safe. Further, because each individual requires different amounts of vitamins and nutrients, some people must take much higher doses for best health [8].

Summary: In an observational study of older women in good health, it was said that those who died were more likely to have taken multivitamin and nutrient supplements than those who did not. The effect was small, and does not indicate any reason for disease or death. Instead, the study's methods suggest that people who have serious health conditions take vitamin and mineral supplements because they know that supplements can help. Indeed, the study showed a benefit from taking B-complex, C, D, and E vitamins, and calcium and magnesium. Therefore, if those wanting better health would take appropriate doses of supplements regularly, they would likely continue to achieve better health and longer life.

(Robert G. Smith is Research Associate Professor, University of Pennsylvania Department of Neuroscience. He is a member of the Institute for Neurological Sciences and the author of several dozen scientific papers and reviews.)

References:

[1] Mursu J, Robien K, Harnack LJ, Park K, Jacobs DR Jr (2011) Dietary supplements and mortality rate in older women. The Iowa Women's Health Study. Arch Intern Med. 171(18):1625-1633.
[2] Emery, T. F. Iron and your Health: Facts and Fallacies. Boca Raton, FL: CRC Press, 1991.
[3] Fairbanks, V. F. "Iron in Medicine and Nutrition." Chapter 10 in Modern Nutrition in Health and Disease, editors M. E. Shils, J. A. Olson, M. Shike, et al., 9th ed. Baltimore, MD: Williams & Wilkins, 1999.
[4] Hoffer, A., A. W. Saul. Orthomolecular Medicine for Everyone: Megavitamin Therapeutics for Families and Physicians. Laguna Beach, CA: Basic Health Publications, 2008.
[5] Parker J, Hashmi O, Dutton D, Mavrodaris A, Stranges S, Kandala NB, Clarke A, Franco OH. Levels of vitamin D and cardiometabolic disorders: systematic review and meta-analysis. Maturitas. 2010 Mar;65(3):225-36.
[6] Lappe JM, Travers-Gustafson D, Davies KM, Recker RR, Heaney RP. Vitamin D and calcium supplementation reduces cancer risk: results of a randomized trial. Am J Clin Nutr. 2007 Jun;85(6):1586-91.
[7] Padayatty SJ, Sun AY, Chen Q, Espey MG, Drisko J, Levine M. Vitamin C: intravenous use by complementary and alternative medicine practitioners and adverse effects. PLoS One. 2010 Jul 7;5(7):e11414.
[8] Williams RJ, Deason G. (1967) Individuality in vitamin C needs. Proc Natl Acad SciUSA.57:16381641.
Also of Interest:

Orthomolecular Medicine News Service, April 29, 2010. Multivitamins Dangerous? Latest News from the World Headquarters Of Pharmaceutical Politicians, Educators and Reporters. http://orthomolecula...s/v06n15.shtml

This article may be reprinted free of charge provided 1) that there is clear attribution to the Orthomolecular Medicine News Service, and 2) that both the OMNS free subscription link http://orthomolecula.../subscribe.html and also the OMNS archive link http://orthomolecula...mns/index.shtml are included.

[nowayout]

Whatever...

I think what it all comes down to is that vitamins may either help or hurt a tiny bit. Maybe you can massage the data until the conclusion becomes that certain vitamins help acertain population a tiny bit. But at the end of the day, this bit is so insignificant that, unless you have a documented deficiency, there are better things to spend our time on in the context of indefinite life extension

[idquest]

Paul Jaminet, Ph.D., made an entry in his blog (scroll down to somewhat to the middle of the page) where he attempted to make his own statistical assessment based on the raw data. Here is his conclusion:

"My take? Judging by the data in Table 2 plus corroborating evidence from clinical trials reviewed in our book, I would say that a well-formulated supplement program, begun at age 62, may increase the odds of survival to age 82 by something on the order of 5% to 10%. Perhaps not a magic pill; but worthwhile."

His point is that the data, even if taken as accurate which is not that obvious, were interpreted/statistically manipulated towards the negative result for multivitamine use.

[Steve_86]

It's not multivitamins per say, it's the mega doses of individual vitamins/minerals that people have been taking for long periods, especially metals like zinc, iron, and copper.

I take 30mg of Zinc daily, could this be a dangerous dose? :O

[niner]

Quoting the LEF on this is like asking Exxon their opinion on global warming.

Normally I'd agree with that, and the LEF response was a bit emotional, but it was pretty accurate and it was referenced well. People can read the references and make their own decisions without having to take LEF's word for it.

I think what it all comes down to is that vitamins may either help or hurt a tiny bit. Maybe you can massage the data until the conclusion becomes that certain vitamins help acertain population a tiny bit. But at the end of the day, this bit is so insignificant that, unless you have a documented deficiency, there are better things to spend our time on in the context of indefinite life extension

I hope that you didn't come to this conclusion on the basis of this bit of junk science and the media parroting that followed it. If overdosed, which is common, some vitamins and minerals hurt more than a tiny bit. Bruce Ames has a pretty strong hypothesis regarding the negative effects of sub-optimal levels of micronutrients; in a nutshell, it isn't good. Frank deficiency is one thing, and that might be rare for some micronutrients, but certainly not others (eg, vitamin D). Our ideas about what constitutes a deficiency have been in flux, and will probably continue to change. Likewise, our notions of optimality are going to continue to evolve, but based on what we know today, I think it would be hard to find a person who had optimal levels of all micronutrients with no supplementation whatsoever.

[against_all_odds]

The problem with a study like this making it to all the major media outlets is that people will look at it as conclusive proof that we don't need any supplement to meet dietary requirements and that's dangerous. Every time there's a new study that's reported in this way, it's nearly always to tell people how useless or dangerous taking supplements are and people buy into it every time.

‎Whenever you try talking about a certain supplement with people, they will always revert to "but i heard on the news.." followed by how useless the certain supplement they claimed was and this somehow gives all supplements a bad name. So to who's benefit are these studies?

[nowayout]

Bruce Ames has a pretty strong hypothesis regarding the negative effects of sub-optimal levels of micronutrients; in a nutshell, it isn't good.

We need more than hypotheses. Hypothesis after hypothesis has failed in study after study. The hypotheses are always based on logical premises and credible physiological mechanisms, yet no supplementation (beyond fixing deficiencies) has ever been shown to make a significant difference to life- or healthspan, including vitamin D by the way.

At some point it just all starts to sound like grasping at straws: "If only they would do just the right study with just the right combination of just the right forms of just the right vitamins in just the right quantities on just the right population while restricting intake of just the right other vitamins and minerals, then they will finally see the real benefits of vitamin X." Pathetic, no?

[niner]

yet no supplementation (beyond fixing deficiencies) has ever been shown to make a significant difference to life- or healthspan, including vitamin D by the way.

How about EPIC-Heidelberg? Or VITAL? These are big studies with significant health improvements. Telomere length is a marker, but clearly an important one. Multivitamin use is associated with longer telomeres in women.

[Logan]

It's not multivitamins per say, it's the mega doses of individual vitamins/minerals that people have been taking for long periods, especially metals like zinc, iron, and copper.

I take 30mg of Zinc daily, could this be a dangerous dose? :O

I wouldn't take a metal like that at that amount everyday for the rest of my life. Why do you take zinc?

[nowayout]

yet no supplementation (beyond fixing deficiencies) has ever been shown to make a significant difference to life- or healthspan, including vitamin D by the way.

How about EPIC-Heidelberg? Or VITAL? These are big studies with significant health improvements. Telomere length is a marker, but clearly an important one. Multivitamin use is associated with longer telomeres in women.

Is that the best we can come up with after more than a century of vitamin studies? EPIC-Heidelberg actually found increased mortality in people who started using vitamins during the study. VITAL wasn't even about vitamins or life span - it showed garlic and grape seed might reduce blood cancers. And as for telomeres, the evidence from the other vitamin studies seems to be that longer telomeres won't protect you from dying earlier.

Edited by viveutvivas, 17 October 2011 - 11:33 AM.

[niner]

yet no supplementation (beyond fixing deficiencies) has ever been shown to make a significant difference to life- or healthspan, including vitamin D by the way.

How about EPIC-Heidelberg? Or VITAL? These are big studies with significant health improvements. Telomere length is a marker, but clearly an important one. Multivitamin use is associated with longer telomeres in women.

Is that the best we can come up with after more than a century of vitamin studies? EPIC-Heidelberg actually found increased mortality in people who started using vitamins during the study. VITAL wasn't even about vitamins or life span - it showed garlic and grape seed might reduce blood cancers. And as for telomeres, the evidence from the other vitamin studies seems to be that longer telomeres won't protect you from dying earlier.

Increased mortality in people who started using vitamins during the study is probably an example of the sick user effect. People's health falls apart, and suddenly they decide they should do something, so they start taking vitamins. That's a flaw in this kind of study. I thought longer telomeres were associated with longer life, but whatever. I think you've convinced yourself that supplements are useless, and that's ok if you don't want to take anything.

[JLL]

This is an observational study, so how could we say anything about cause and effect?

Most middle-aged (and older) people I know start taking multivitamins because they some kind of problem they want to alleviate. Maybe without the multivitamin they would've been even worse off. We just don't know.