Effect of a Multivitamin and Mineral Supplement on Infection and Quality of Life

A Randomized, Double-Blind, Placebo-Controlled Trial

  1. Thomas A. Barringer, MD;
  2. Julienne K. Kirk, PharmD;
  3. Amy C. Santaniello, PharmD;
  4. Kristie Long Foley, PhD; and
  5. Robert Michielutte, PhD
  1. From University of North Carolina School of Medicine at Carolinas Medical Center, Charlotte, and Wake Forest University School of Medicine, Winston-Salem, North Carolina.

    Abstract

    Background: Use of multivitamin and mineral supplements is common among U.S. adults, yet few well-designed trials have assessed the reputed benefits.

    Objective: To determine the effect of a daily multivitamin and mineral supplement on infection and well-being.

    Design: Randomized, double-blind, placebo-controlled trial.

    Setting: Primary care clinics at two medical centers in North Carolina.

    Participants: 130 community-dwelling adults stratified by age (45 to 64 years or ≥ 65 years) and presence of type 2 diabetes mellitus.

    Intervention: Multivitamin and mineral supplement or placebo taken daily for 1 year.

    Measurements: Incidence of participant-reported symptoms of infection, incidence of infection-associated absenteeism, and scores on the physical and mental health subscales of the Medical Outcomes Study 12-Item Short Form.

    Results: More participants receiving placebo reported an infectious illness over the study year than did participants receiving multivitamin and mineral supplements (73% vs. 43%; P < 0.001). Infection-related absenteeism was also higher in the placebo group than in the treatment group (57% vs. 21%; P < 0.001). Participants with type 2 diabetes mellitus (n = 51) accounted for this finding. Among diabetic participants receiving placebo, 93% reported an infection compared with 17% of those receiving supplements (P < 0.001). Medical Outcomes Study 12-Item Short Form scores did not differ between the treatment and placebo groups.

    Conclusions: A multivitamin and mineral supplement reduced the incidence of participant-reported infection and related absenteeism in a sample of participants with type 2 diabetes mellitus and a high prevalence of subclinical micronutrient deficiency. A larger clinical trial is needed to determine whether these findings can be replicated not only in diabetic persons but also in any population with a high rate of suboptimal nutrition or potential underlying disease impairment.

    Article and Author Information

    • Acknowledgments: The authors thank Dave Reboussin, PhD, for his assistance in the statistical analysis. Dr. Barringer thanks Geraldine D. Anastasio, PharmD, his original co-investigator who initiated the research project, for her enthusiasm and encouragement to continue the study in her absence.

    • Grant Support: By the Charlotte-Mecklenburg Health Services Foundation, an independent, charitable foundation that supports medical education and research within the Carolinas HealthCare System.

    • Potential Financial Conflicts of Interest: None disclosed.

    • Requests for Single Reprints: Thomas A. Barringer, MD, Department of Family Practice, Carolinas Medical Center, CMC-MP Building, 1350 South Kings Drive, Charlotte, NC 28207; e-mail, tbarringer{at}carolinas.org.

    • Current Author Addresses: Dr. Barringer: Department of Family Practice, Carolinas Medical Center, CMC-MP Building, 1350 South Kings Drive, Charlotte, NC 28207.

    • Drs. Kirk and Michielutte: Department of Family Medicine, Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157.

    • Dr. Santaniello: 8918 Waltham Forest Court, Waxhaw, NC 28173.

    • Dr. Foley: Department of Public Health Sciences, Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157.

    • Author Contributions: Conception and design: T.A. Barringer, J.K. Kirk.

    • Analysis and interpretation of the data: T.A. Barringer, J.K. Kirk, K.L. Foley, R. Michielutte.

    • Drafting of the article: T.A. Barringer, J.K. Kirk, A.C. Santaniello, K.L. Foley.

    • Critical revision of the article for important intellectual content: T.A. Barringer, J.K. Kirk, K.L. Foley, R. Michielutte.

    • Final approval of the article: T.A. Barringer, J.K. Kirk, A.C. Santaniello, R. Michielutte.

    • Provision of study materials or patients: T.A. Barringer, J.K. Kirk, A.C. Santaniello.

    • Statistical expertise: T.A. Barringer, K.L. Foley, R. Michielutte.

    • Obtaining of funding: T.A. Barringer.

    • Administrative, technical, or logistic support: T.A. Barringer, J.K. Kirk.

    • Collection and assembly of data: T.A. Barringer, J.K. Kirk, A.C. Santaniello.

    Summary for Patients

    • Summaries for Patients:The Effect of a Vitamin and Mineral Supplement on Infection and Self-Reported Health Ann Intern Med March 4, 2003 138:I-40
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    1. Ann Intern Med March 4, 2003 vol. 138 no. 5 365-371
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