Effects of Randomized Multivitamin Supplementation on Carotenoids and α-Tocopherol in the COcoa Supplement and...

Adequate intake of carotenoids and vitamin E supports healthy aging, yet evidence is limited on whether multivitamin-multimineral (MVM) supplementation changes serum concentrations over time.

The aim of this investigation was to evaluate the effect of daily MVM supplementation among older adults on serum carotenoid and vitamin E concentrations over a 2-year period.

The COcoa Supplement and Multivitamin Outcomes Study is a large-scale, randomized, placebo-controlled, 2 × 2 factorial trial, designed to test the effects of daily MVM and cocoa extract supplementation for chronic disease prevention. Participants completed semiannual questionnaires and provided optional biospecimen samples at baseline, 1-year, and 2-year follow-up.

Between 2015 and 2020, US adults (women aged 65 years and older, men aged 60 years and older) without major cardiovascular disease or recent cancer were enrolled in the COcoa Supplement and Multivitamin Outcomes Study. This analysis included biospecimen substudy participants with blood samples provided at baseline and ≥1 follow-up timepoint (n = 400; 1 excluded due to unusable sample; final N = 399).

Participants were randomized to receive daily MVM supplementation or a placebo, with or without cocoa extract.

Changes in serum carotenoids and α-tocopherol concentrations were evaluated over the 2-year follow-up.

Multivariable linear mixed models estimated changes in serum biomarker concentrations, comparing MVM with placebo, adjusting for covariates (age, sex, and cocoa extract intervention).

Increases in serum carotenoids and α-tocopherol levels with MVM supplementation emerged at year 1 and persisted through year 2. MVM supplementation led to significantly higher serum concentrations of total carotenoids (percent change: 15.5%; 95% CI, 8.72 to 22.70), lutein (percent change: 17.17%; 95% CI, 7.53 to 27.66), beta carotene (percent change: 46.96%; 95% CI, 35.10 to 59.85), and α-tocopherol (percent change: 29.50%; 95% CI, 22.88 to 36.47) over 2 years compared with placebo. No significant differences were observed for lycopene, β-cryptoxanthin, zeaxanthin, or α-carotene. Cocoa extract supplementation did not modify the effect of MVM on serum carotenoid and vitamin E levels (P ≥ .05).

Daily MVM supplementation increased specific serum carotenoids and α-tocopherol concentrations over 2 years. These findings suggest regular MVM use may support nutritional status in older adults; future research is needed to examine links with aging-related outcomes.