Return to Index
Nutritional Support (General)
Principal Proposed Uses
- Some supplements include very high doses of certain nutrients, such as antioxidants. As described above, when you take nutrients in this fashion, you are using them as drugs rather than nutrients; you are no longer in the world of nutritional supplementation and have passed into the riskier world of megadose treatment.
- We recommend that you use an iron-free multivitamin and mineral supplement unless you have been tested and found to be deficient in iron.
- The minerals calcium and magnesium are very bulky, and few multivitamin/mineral supplements provide the daily requirement. These minerals generally must be taken in the form of additional pills. Note: It isn't possible for your body to absorb a day's worth of calcium in a single dose. At least two doses are necessary.
- Finally, note that food may contain many nonessential substances, such as carotenoids and bioflavonoids, that nonetheless enhance health. For this reason, no nutrient supplement should be regarded as a substitute for a healthy and varied diet.
- Minerals come in many different chemical forms, technically called "salts." For example, you can purchase calcium as calcium carbonate, calcium citrate, calcium orotate, and in half a dozen or more other forms. In some cases, certain salts of minerals are known to be better absorbed than others. This is particularly the case with calcium , as described in the full article.
- When you take zinc , you should balance it with copper .
- There may be advantages to taking certain nutrients at levels a bit higher than the standard recommendations, but each nutrient presents its own issues. More is not necessarily better. See each individual nutrient article for details.
London RS, Bradley L, Chiamori NY. Effect of a nutritional supplement on premenstrual symptomatology in women with premenstrual syndrome: a double-blind longitudinal study. J Am Coll Nutr. 1991;10:494-499.
Reynolds MA, London RS. Efficacy of a multivitamin/mineral supplement in the treatment of the premenstrual syndrome [abstract]. J Am Coll Nutr. 1988;7:416.
Stewart A. Clinical and biochemical effects of nutritional supplementation on the premenstrual syndrome. J Reprod Med. 1987;32:435-441.
Chakmakjian ZH, Higgins CE, Abraham GE. The effect of a nutritional supplement, OptiviteŴ for women, on premenstrual tension syndromes: II. Effect on symptomatology, using a double-blind, cross-over design. J Appl Nutr. 1985;37:12-17.
Schlebusch L, Bosch BA, Polglase G, et al. A double-blind, placebo-controlled, double-centre study of the effects of an oral multivitamin-mineral combination on stress. S Afr Med J. 2000;90:1216-1223.
Carroll D, Ring C, Suter M, et al. The effects of an oral multivitamin combination with calcium, magnesium, and zinc on psychological well-being in healthy young male volunteers: a double-blind placebo-controlled trial. Psychopharmacology (Berl). 2000;150:220-225.
Girodon F, Galan P, Monget AL, et al. Impact of trace elements and vitamin supplementation on immunity and infections in institutionalized elderly patients: a randomized controlled trial. MIN. VIT. AOX. geriatric network. Arch Intern Med. 1999;159:748-754.
Chandra RK, Puri S. Nutritional support improves antibody response to influenza virus vaccine in the elderly. Br Med J (Clin Res Ed). 1985;291:705-706.
Ender PT, DeRussy PK, Caldwell MM, et al. The effect of a multivitamin on the immunologic response to the influenza vaccine in the elderly. Infect Dis Clin Pract. 2001;10:81-85.
Czeizel AE, Metneki J, Dudas I. The effect of preconceptional multivitamin supplementation on fertility. Int J Vitam Nutr Res. 1996;66:55-58.
Benton D. Micro-nutrient supplementation and the intelligence of children. Neurosci Biobehav Rev. 2001;25:297-309
Chandra RK. Effect of vitamin and trace-element supplementation on cognitive function in elderly subjects. Nutrition. 2001;17:709-712.
Wald NJ, et al. Quantifying the effect of folic acid. Lancet. 2001;15;358:2069-2073.
Mertz W. Chromium in human nutrition: a review. J Nutr. 1993;123:626-633.
McCarron DA. Dietary calcium and lower blood pressure: we can all benefit [editorial]. JAMA. 1996;275:1128-1129.
Ervin RB, Kennedy-Stephenson J. Mineral intakes of elderly adult supplement and non-supplement users in the third national health and nutrition examination survey. J Nutr. 2002;132:3422-3427.
Alaimo K, McDowell MA, Briefel RR, et al. Dietary intake of vitamins, minerals and fiber of persons age 2 months and over in the United States: Third National Health and Nutrition Examination Survey, phase 1, 1988-91. Advance Data from Vital and Health Statistics. 1994;258:1-26.
Kant AK, Block G. Dietary vitamin B-6 intake and food sources in the US population: NHANES II, 1976-1980. Am J Clin Nutr. 1990;52:707-716.
van der Wielen RP, de Groot LC, van Staveren WA. Dietary intake of water soluble vitamins in elderly people living in a Western society (1980-1993). Nutr Res. 1994;14:605-638.
Albertson AM, Toblemann RC, Engstrom A, et al. Nutrient intakes of 2- to 10-year-old American children: 10-year trends. J Am Diet Assoc. 1992;92:1492-1496.
Hercberg S, Preziosi P, Galan P, et al. Vitamin status of a healthy French population: dietary intakes and biochemical markers. Int J Vitam Nutr Res. 1994;64:220-232.
Lowik MR, Wedel M, Kistemaker C, et al. Assessment of the adequacy of vitamin C intake in the Netherlands [abstract]. J Am Coll Nutr. 1991;10:544.
Baker B. Vitamin C deficiency common in hospitalized. Fam Pract News. 1995 March:25.
Taylor CA, Hampl JS, Johnston CS. Low intakes of vegetables and fruits, especially citrus fruits, lead to inadequate vitamin C intakes among adults. Eur J Clin Nutr. 2000;54:573-578.
Saltzman JR, Kemp JA, Golner BB, et al. Effect of hypochlorhydria due to omeprazole treatment or atrophic gastritis on protein-bound vitamin B12 absorption. J Am Coll Nutr. 1994;13:584-591.
van Goor L, Woiski MD, Lagaay AM, et al. Review: cobalamin deficiency and mental impairment in elderly people. Age Ageing. 1995;24:536-542.
Pennypacker LC, Allen RH, Kelly JP, et al. High prevalence of cobalamin deficiency in elderly outpatients. J Am Geriatr Soc. 1992;40:1197-1204.
Yao Y, Yao SL, Yao SS, et al. Prevalence of vitamin B 12 deficiency among geriatric outpatients. J Fam Pract. 1992;35:524-528.
Barringer TA, Kirk JK, Santaniello AC, et al. Effect of a multivitamin and mineral supplement on infection and quality of life. A randomized, double-blind, placebo-controlled trial. Ann Intern Med. 2003;138:365-371.
Bogden JD, Bendich A, Kemp FW, et al. Daily micronutrient supplements enhance delayed-hypersensitivity skin test responses in older people. Am J Clin Nutr. 1994;60:437-447.
Berger MM, Spertini F, Shenkin A, et al. Trace element supplementation modulates pulmonary infection rates after major burns: a double-blind, placebo-controlled trial. Am J Clin Nutr. 1998;68:365-371.
Graat JM, Schouten EG, Kok FJ. Effect of daily vitamin E and multivitamin-mineral supplementation on acute respiratory tract infections in elderly persons: a randomized controlled trial. JAMA. 2002;288:715-721.
Utiger RD. The need for more vitamin D. N Engl J Med. 1998;338:828-829.
Sandstead HH. Zinc nutrition in the United States. Am J Clin Nutr. 1973;26:1251-1260.
Prasad AS. Zinc deficiency in women, infants, and children. J Am Coll Nutr. 1996;15:113-120.
Goldenberg RL, Tamura T, Neggers Y, et al. The effect of zinc supplementation on pregnancy outcome. JAMA. 1995;274:463-468.
Stang J, Story MT, Harnack L, et al. Relationships between vitamin and mineral supplement use, dietary intake, and dietary adequacy among adolescents. J Am Diet Assoc. 2000;100:905-910.
Girodon F, Lombard M, Galan P, et al. Effect of micronutrient supplementation on infection in institutionalized elderly subjects: a controlled trial. Ann Nutr Metab. 1997;41:98-107.
Chandra RK. Effect of vitamin and trace-element supplementation on immune responses and infection in elderly subjects. Lancet. 1992;340:1124-1127.
Schoenthaler SJ, Amos S, Doraz W, et al. The effect of randomized vitamin-mineral supplementation on violent and non-violent antisocial behavior among incarcerated juveniles. J Nutr Environ Med. 1977;7:343-352.
Murphy SP, Subar AF, Block G. Vitamin E intakes and sources in the United States. Am J Clin Nutr. 1990;52:361-367.
Ford ES, Sowell A. Serum alpha-tocopherol status in the United States population: findings from the Third National Health and Nutrition Examination study. Am J Epidemiol. 1999;150:290-300.
Jain AL. Influence of vitamins and trace-elements on the incidence of respiratory infection in the elderly. Nutr Res. 2002;22:85-87.
Czeizel AE, Dudas I, Fritz G, et al. The effect of periconceptional multivitamin-mineral supplementation on vertigo, nausea and vomiting in the first trimester of pregnancy. Arch Gynecol Obstet. 1992;251:181-185
Ussher JM, Dewberry C, Malson H, et al. The relationship between health related quality of life and dietary supplementation in British middle managers: a double blind placebo controlled study. Psychol Health. 1995;10:97-111.
Colker CM, Swain M, Lynch L, et al. Effects of a milk-based bioactive micronutrient beverage on pain symptoms and activity of adults with osteoarthritis: a double-blind, placebo-controlled clinical evaluation. Nutrition. 2002;18:388-392.
Schoenthaler SJ, Bier ID. The effect of vitamin-mineral supplementation on juvenile delinquency among American schoolchildren: a randomized, double-blind placebo-controlled trial. J Altern Complement Med. 2000;6:7-17.
Schoenthaler SJ, Amos SP, Doraz WE, et al. Controlled trial of vitamin-mineral supplementation on intelligence and brain function. Pers Individual Differences. 1991;12:343-350.
Schoenthaler SJ, Amos SP, Eysenck HJ, et al. Controlled trial of vitamin-mineral supplementation: effects on intelligence and performance. Pers Individual Differences. 1991;12:351-362.
Schoenthaler SJ, Bier ID. Vitamin-mineral intake and intelligence: a macrolevel analysis of randomized controlled trials. J Altern Complement Med. 1999;5:125-134.
Benton D, Fordy J, Haller J. The impact of long-term vitamin supplementation on cognitive functioning. Psychopharmacology. 1995;117:298-305.
Gesch CB, Hammond SM, Hampson SE, et al. Influence of supplementary vitamins, minerals and essential fatty acids on the antisocial behaviour of young adult prisoners. Randomised, placebo-controlled trial. Br J Psychiatry. 2002;181:22-28.
Farvid MS, Jalali M, Siassi F, et al. The impact of vitamins and/or mineral supplementation on blood pressure in type 2 diabetes. J Am Coll Nutr. 2004;23:272-279.
Houwing RH, Rozendaal M, Wouters-Wesseling W, et al. A randomised, double-blind assessment of the effect of nutritional supplementation on the prevention of pressure ulcers in hip-fracture patients. Clin Nutr. 2003;22:401-405.
Brown SA, Coimbra M, Coberly DM, et al. Oral nutritional supplementation accelerates skin wound healing: a randomized, placebo-controlled, double-arm, crossover study. Plast Reconstr Surg. 2004;114:237-244.
Ramakrishnan U, Aburto N, McCabe G, et al. Multimicronutrient interventions but not vitamin a or iron interventions alone improve child growth: results of 3 meta-analyses. J Nutr. 2004;134:2592-602.
Langkamp-Henken B, Bender BS, Gardner EM, et al. Nutritional formula enhanced immune function and reduced days of symptoms of upper respiratory tract infection in seniors. J Am Geriatr Soc. 2004;52:3-12.
Meguid MM, Shenkin A. Introduction: nutritional supplements and the quest to improve human performance—the need for the strictest standards and rigor when reporting clinical trials. Nutrition. 2003;19:955-956.
Smith R. Validity of Canadian studies: response of editor of BMJ. 2004;328:465.
Allsup SJ, Shenkin A, Gosney MA, et al. Can a short period of micronutrient supplementation in older institutionalized people improve response to influenza vaccine? A randomized, controlled trial. J Am Geriatr Soc. 2004;52:20-24.
McClelland RS, Baeten JM, Overbaugh J, et al. Micronutrient supplementation increases genital tract shedding of HIV-1 in women: results of a randomized trial. J Acquir Immune Defic Syndr. 2004;37:1657-1663.
Wolters M, Hickstein M, Flintermann A, et al. Cognitive performance in relation to vitamin status in healthy elderly German women-the effect of 6-month multivitamin supplementation. Prev Med. 2005;41:253-259.
Avenell A, Campbell MK, Cook JA, et al. Effect of multivitamin and multimineral supplements on morbidity from infections in older people (MAVIS trial): pragmatic, randomised, double blind, placebo controlled trial. BMJ. 2005;331:324-329.
El-Kadiki A, Sutton AJ. Role of multivitamins and mineral supplements in preventing infections in elderly people: systematic review and meta-analysis of randomised controlled trials. BMJ. 2005 Mar 31. [Epub ahead of print]
Benton D, Haller J, Fordy J, et al. Vitamin supplementation for 1 year improves mood. Neuropsychobiology. 1995;32:98-105.
Meyer F, Galan P, Douville P, et al. Antioxidant vitamin and mineral supplementation and prostate cancer prevention in the SU.VI.MAX trial. Int J Cancer. 2005 Mar 30. [Epub ahead of print]
Fry AC, Bloomer RJ, Falvo MJ, et al. Effect of a liquid multivitamin/mineral supplement on anaerobic exercise performance. Res Sports Med. 2006;14:53-64.
Goh YI, Bollano E, Einarson TR, et al. Prenatal multivitamin supplementation and rates of congenital anomalies: a meta-analysis. J Obstet Gynaecol Can. 2006;28:680-689.
Kirby RS. Menopacenutrient therapy: an alternative approach to pharmaceutical treatments for menopause. Int J Fertil Womens Med. 2006;51:125-129.
Sternberg S, Roberts S. Nutritional supplements and infection in the elderly: Why do the findings conflict? Nutr J. 2006 Nov 23. [Epub ahead of print]
McNeill G, Avenell A, Campbell MK, et al. Effect of multivitamin and multimineral supplementation on cognitive function in men and women aged 65 years and over: a randomised controlled trial. Nutr J. 2007 May 2. [Epub ahead of print]
Gariballa S, Forster S. Effects of dietary supplements on depressive symptoms in older patients: A randomised double-blind placebo-controlled trial. Clin Nutr. 2007 Jul 25. [Epub ahead of print]
de Souza Fede AB, Bensi CG, Trufelli DC, et al. Multivitamins do not improve radiation therapy-related fatigue: results of a double-blind randomized crossover trial. Am J Clin Oncol. 2007;30:432-436.
The NEMO Study Group. Effect of a 12-mo micronutrient intervention on learning and memory in well-nourished and marginally nourished school-aged children: 2 parallel, randomized, placebo-controlled studies in Australia and Indonesia. Am J Clin Nutr. 2007;86:1082-1093.
America A, Milling LS. The efficacy of vitamins for reducing or preventing depression symptoms in healthy individuals: natural remedy or placebo? J Behav Med. 2007 Nov 13. [Epub ahead of print]
A randomized, double-masked, placebo-controlled clinical trial of multivitamin supplementation for age-related lens opacities clinical trial of nutritional supplements and age-related cataract report no. 3. Ophthalmology. 2008;115:599-607.e1.
- Reviewer: EBSCO CAM Review Board
- Review Date: 12/2015
- Update Date: 12/15/2015