J Acad Nutr Diet. 2026 Jan 24:156299. doi: 10.1016/j.jand.2026.156299. Online ahead of print.
ABSTRACT
BACKGROUND: Adequate intake of carotenoids and vitamin E support healthy aging, yet evidence is limited on whether multivitamin-multimineral (MVM) supplementation changes their serum concentrations over time.
OBJECTIVE: 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.
DESIGN: The COcoa Supplement and Multivitamin Outcomes Study (COSMOS) is a large-scale, randomized, placebo-controlled, 2×2 factorial trial, designed to test the effects of daily MVM and cocoa extract (CE) supplementation for chronic disease prevention. Participants completed semi-annual questionnaires and provided optional biospecimen samples at baseline, 1-year, and 2-year follow-up.
PARTICIPANTS/SETTING: Between 2015 and 2020, US adults (women ≥65 years, men ≥60 years) without major cardiovascular disease or recent cancer were enrolled in COSMOS. This analysis included biospecimen sub-study participants with blood samples provided at baseline and ≥1 follow-up timepoint (N=400; 1 excluded due to unusable sample; final N=399).
INTERVENTION: Participants were randomized to receive daily MVM supplementation or placebo, with or without CE.
MAIN OUTCOME MEASURES: Changes in serum carotenoids and α-tocopherol concentrations were evaluated over the 2-year follow-up.
STATISTICAL ANALYSES: Multivariable linear mixed models estimated changes in serum biomarker concentrations, comparing MVM to placebo, adjusting for covariates (age, sex, and CE intervention).
RESULTS: Increases in serum carotenoids and α-tocopherol 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% confidence interval (CI): 8.72-22.70]), lutein (17.17% [7.53-27.66]), β-carotene (46.96% [35.10-59.85]), and α-tocopherol (29.50% [22.88-36.47]) over two years compared to placebo. No significant differences were observed for lycopene, β-cryptoxanthin, zeaxanthin, or α-carotene. CE supplementation did not modify the effect of MVM on serum carotenoid and vitamin E levels (p≥0.05).
CONCLUSIONS: Daily MVM supplementation increased specific serum carotenoids and α-tocopherol concentrations over two 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.
PMID:41587736 | DOI:10.1016/j.jand.2026.156299