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== Research == Provided that precautions are taken (such as adjusting the vitamin amounts to what is believed to be appropriate for children, pregnant women or people with certain medical conditions), multivitamin intake is generally safe, but research is still ongoing with regard to what health effects multivitamins have. Evidence of health effects of multivitamins comes largely from [[prospective cohort studies]], which evaluate health differences between groups that take multivitamins and groups that do not. Correlations between multivitamin intake and health found by such studies may not result from multivitamins themselves, but may reflect underlying characteristics of multivitamin-takers. For example, it has been suggested that multivitamin-takers may, overall, have more underlying diseases (making multivitamins appear as less beneficial in prospective cohort studies).<ref>{{cite journal | vauthors = Li K, Kaaks R, Linseisen J, Rohrmann S | title = Vitamin/mineral supplementation and cancer, cardiovascular, and all-cause mortality in a German prospective cohort (EPIC-Heidelberg) | journal = European Journal of Nutrition | volume = 51 | issue = 4 | pages = 407–413 | date = June 2012 | pmid = 21779961 | doi = 10.1007/s00394-011-0224-1 | url = https://www.zora.uzh.ch/id/eprint/54308/10/ZORA_NL_54308.pdf | access-date = 2019-07-10 | url-status = live | s2cid = 1692747 | archive-url = https://web.archive.org/web/20191217125933/https://www.zora.uzh.ch/id/eprint/54308/10/ZORA_NL_54308.pdf | archive-date = 2019-12-17 }}</ref> On the other hand, it has also been suggested that multivitamin users may, overall, be more health-conscious (making multivitamins appear as more beneficial in prospective cohort studies).<ref>{{cite journal | vauthors = Seddon JM, Christen WG, Manson JE, LaMotte FS, Glynn RJ, Buring JE, Hennekens CH | title = The use of vitamin supplements and the risk of cataract among US male physicians | journal = American Journal of Public Health | volume = 84 | issue = 5 | pages = 788–792 | date = May 1994 | pmid = 8179050 | pmc = 1615060 | doi = 10.2105/AJPH.84.5.788 }}</ref><ref name="Neuhouser ML 2008">{{cite journal | vauthors = Neuhouser ML, Wassertheil-Smoller S, Thomson C, Aragaki A, Anderson GL, Manson JE, Patterson RE, Rohan TE, van Horn L, Shikany JM, Thomas A, LaCroix A, Prentice RL | title = Multivitamin use and risk of cancer and cardiovascular disease in the Women's Health Initiative cohorts | journal = Archives of Internal Medicine | volume = 169 | issue = 3 | pages = 294–304 | date = February 2009 | pmid = 19204221 | pmc = 3868488 | doi = 10.1001/archinternmed.2008.540 }}</ref> [[Randomized controlled studies]] have been encouraged to address this uncertainty.<ref name=chan2011>{{cite journal | vauthors = Chan AL, Leung HW, Wang SF | title = Multivitamin supplement use and risk of breast cancer: a meta-analysis | journal = The Annals of Pharmacotherapy | volume = 45 | issue = 4 | pages = 476–484 | date = April 2011 | pmid = 21487086 | doi = 10.1345/aph.1P445 | s2cid = 22445157 }}</ref> === Cohort studies === [[File:Wyeth Centrum.jpg|thumb|right|250px|Centrum multivitamins produced by [[Pfizer]], which were used in Physicians' Health Study II]] In February 2009, a study conducted in 161,808 [[postmenopausal]] women from the Women's Health Initiative clinical trials concluded that after eight years of follow-up "multivitamin use has little or no influence on the risk of common cancers, cardiovascular disease, or total mortality".<ref name="Neuhouser ML 2008" /> Another 2010 study in the ''[[Journal of Clinical Oncology]]'' suggested that multivitamin use during [[chemotherapy]] for stage III colon cancer had no effect on the outcomes of treatment.<ref>{{cite journal | vauthors = Ng K, Meyerhardt JA, Chan JA, Niedzwiecki D, Hollis DR, Saltz LB, Mayer RJ, Benson AB, Schaefer PL, Whittom R, Hantel A, Goldberg RM, Fuchs CS | title = Multivitamin use is not associated with cancer recurrence or survival in patients with stage III colon cancer: findings from CALGB 89803 | journal = Journal of Clinical Oncology | volume = 28 | issue = 28 | pages = 4354–4363 | date = October 2010 | pmid = 20805450 | pmc = 2954134 | doi = 10.1200/JCO.2010.28.0362 | author-link1 = Kimmie Ng }}</ref> A very large prospective cohort study published in 2011, including more than 180,000 participants, found no significant association between multivitamin use and mortality from all causes. The study also found no impact of multivitamin use on the risk of cardiovascular disease or cancer.<ref>{{cite journal | vauthors = Park SY, Murphy SP, Wilkens LR, Henderson BE, Kolonel LN | title = Multivitamin use and the risk of mortality and cancer incidence: the multiethnic cohort study | journal = American Journal of Epidemiology | volume = 173 | issue = 8 | pages = 906–914 | date = April 2011 | pmid = 21343248 | pmc = 3105257 | doi = 10.1093/aje/kwq447 }}</ref> A cohort study that received widespread media attention<ref name="NYT-20121017">{{cite news | vauthors = Rabin RC |title=Daily Multivitamin May Reduce Cancer Risk, Clinical Trial Finds |url=https://www.nytimes.com/2012/10/18/health/daily-multivitamin-may-reduce-cancer-risk-clinical-trial-finds.html |date=October 17, 2012 |newspaper=[[New York Times]] |access-date=October 17, 2012 |archive-date=October 18, 2012 |archive-url=https://web.archive.org/web/20121018151130/http://www.nytimes.com/2012/10/18/health/daily-multivitamin-may-reduce-cancer-risk-clinical-trial-finds.html |url-status=live }}</ref><ref name=Winslow>{{cite news| vauthors = Winslow R |title=Multivitamin Cuts Cancer Risk, Large Study Finds|url=https://www.wsj.com/articles/SB10000872396390444868204578062463819724232|access-date=13 December 2012|newspaper=[[The Wall Street Journal]]|date=18 October 2012|archive-date=22 December 2015|archive-url=https://web.archive.org/web/20151222230112/http://www.wsj.com/articles/SB10000872396390444868204578062463819724232|url-status=live}}</ref> is the Physicians' Health Study II (PHS-II).<ref name="JAMA-20121017">{{cite journal | vauthors = Gaziano JM, Sesso HD, Christen WG, Bubes V, Smith JP, MacFadyen J, Schvartz M, Manson JE, Glynn RJ, Buring JE | title = Multivitamins in the prevention of cancer in men: the Physicians' Health Study II randomized controlled trial | journal = JAMA | volume = 308 | issue = 18 | pages = 1871–1880 | date = November 2012 | pmid = 23162860 | pmc = 3517179 | doi = 10.1001/jama.2012.14641 }}</ref> PHS-II was a double-blind study of 14,641 male U.S. physicians initially aged 50 years or older (mean age of 64.3) that ran from 1997 to June 1, 2011. The mean time that the men were followed was 11 years. The study compared total cancer (excluding non-melanoma skin cancer) for participants taking a daily multivitamin ([[Centrum (multivitamin)|Centrum]] Silver by [[Pfizer]]) versus a [[placebo]]. Compared with the placebo, men taking a daily multivitamin had a small but [[statistically significant]] reduction in their total incidence of cancer. In absolute terms, the difference was just 1.3 cancer diagnoses per 1000 years of life. The [[hazard ratio]] for cancer diagnosis was 0.92 with a 95% [[confidence interval]] spanning 0.86–0.998 (P = .04); this implies a benefit of between 14% and .2% over placebo in the confidence interval. No statistically significant effects were found for any specific cancers or for cancer mortality. As pointed out in an editorial in the same issue of the ''[[Journal of the American Medical Association]]'', the investigators observed no difference in the effect whether the study participants were or were not adherent to the multivitamin intervention, which diminishes the [[dose–response relationship]].<ref name="Bach">{{cite journal | vauthors = Bach PB, Lewis RJ | title = Multiplicities in the assessment of multiple vitamins: is it too soon to tell men that vitamins prevent cancer? | journal = JAMA | volume = 308 | issue = 18 | pages = 1916–1917 | date = November 2012 | pmid = 23150011 | doi = 10.1001/jama.2012.53273 }}</ref> The same editorial argued that the study did not properly address the [[multiple comparisons problem]], in that the authors neglected to fully analyze all 28 possible associations in the study—they argue if this had been done, the statistical significance of the results would be lost.<ref name=Bach /> Using the same PHS-II study, researchers concluded that taking a daily multivitamin did not have any effect in reducing [[heart attack]]s and other major cardiovascular events, MI, stroke, and CVD mortality.<ref name="JAMA-20121107">{{cite journal | vauthors = Sesso HD, Christen WG, Bubes V, Smith JP, MacFadyen J, Schvartz M, Manson JE, Glynn RJ, Buring JE, Gaziano JM | title = Multivitamins in the prevention of cardiovascular disease in men: the Physicians' Health Study II randomized controlled trial | journal = JAMA | volume = 308 | issue = 17 | pages = 1751–1760 | date = November 2012 | pmid = 23117775 | pmc = 3501249 | doi = 10.1001/jama.2012.14805 }}</ref> === Systematic reviews and meta-analyses === One major [[meta-analysis]] published in 2011, including previous cohort and case-control studies, concluded that multivitamin use was not significantly associated with the risk of [[breast cancer]]. It noted that one Swedish cohort study has indicated such an effect, but with all studies taken together, the association was not statistically significant.<ref name=chan2011 /> A 2012 meta-analysis of ten randomized, placebo-controlled trials published in the ''Journal of Alzheimer's Disease'' found that a daily multivitamin may improve immediate recall memory, but did not affect any other measure of cognitive function.<ref>{{cite journal | vauthors = Grima NA, Pase MP, Macpherson H, Pipingas A | title = The effects of multivitamins on cognitive performance: a systematic review and meta-analysis | journal = Journal of Alzheimer's Disease | volume = 29 | issue = 3 | pages = 561–569 | year = 2012 | pmid = 22330823 | doi = 10.3233/JAD-2011-111751 | s2cid = 19767652 }}</ref> Another meta-analysis, published in 2013, found that multivitamin-multimineral treatment "has no effect on mortality risk",<ref>{{cite journal | vauthors = Macpherson H, Pipingas A, Pase MP | title = Multivitamin-multimineral supplementation and mortality: a meta-analysis of randomized controlled trials | journal = The American Journal of Clinical Nutrition | volume = 97 | issue = 2 | pages = 437–444 | date = February 2013 | pmid = 23255568 | doi = 10.3945/ajcn.112.049304 | hdl-access = free | doi-access = free | hdl = 10536/DRO/DU:30073126 }}</ref> and a 2013 [[systematic review]] found that multivitamin supplementation did not increase mortality and might slightly decrease it.<ref>{{cite journal | vauthors = Alexander DD, Weed DL, Chang ET, Miller PE, Mohamed MA, Elkayam L | title = A systematic review of multivitamin-multimineral use and cardiovascular disease and cancer incidence and total mortality | journal = Journal of the American College of Nutrition | volume = 32 | issue = 5 | pages = 339–354 | date = 2013 | pmid = 24219377 | doi = 10.1080/07315724.2013.839909 | s2cid = 24230868 }}</ref> A 2014 meta-analysis reported that there was "sufficient evidence to support the role of dietary multivitamin/mineral supplements for the decreasing the risk of age-related cataracts."<ref>{{cite journal | vauthors = Zhao LQ, Li LM, Zhu H, The Epidemiological Evidence-Based Eye Disease Study Research Group EY | title = The effect of multivitamin/mineral supplements on age-related cataracts: a systematic review and meta-analysis | journal = Nutrients | volume = 6 | issue = 3 | pages = 931–949 | date = February 2014 | pmid = 24590236 | pmc = 3967170 | doi = 10.3390/nu6030931 | doi-access = free }}</ref> A 2015 meta-analysis argued that the positive result regarding the effect of vitamins on cancer incidence found in Physicians' Health Study II (discussed above) should not be overlooked despite the neutral results found in other studies. Looking at 2012 data, a study published in 2018 presented meta-analyses on cardiovascular disease outcomes and all-cause mortality. It found that "conclusive evidence for the benefit of any supplement across all dietary backgrounds (including deficiency and sufficiency) was not demonstrated; therefore, any benefits seen must be balanced against possible risks." The study dismissed the benefits of routinely taking supplements of vitamins C and D, beta-carotene, calcium, and selenium. Results indicated taking niacin may actually be harmful.<ref name=philly /><ref name=jourcardio /> In July 2019, another meta-analysis of 24 interventions in 277 trials was conducted and published in ''[[Annals of Internal Medicine]]'', including a total of almost 1,000,000 participants.<ref name=aoim /> The study generally concluded that the vast majority of multivitamins had no significant effect on survival or heart attack risk.<ref>{{cite web |title=Save Your Money: Vast Majority Of Dietary Supplements Don't Improve Heart Health or Put Off Death |url=https://www.hopkinsmedicine.org/news/newsroom/news-releases/save-your-money-vast-majority-of-dietary-supplements-dont-improve-heart-health-or-put-off-death |publisher=Johns Hopkins Medicine |access-date=25 July 2019 |date=2019-07-16 |archive-date=2019-07-25 |archive-url=https://web.archive.org/web/20190725105331/https://www.hopkinsmedicine.org/news/newsroom/news-releases/save-your-money-vast-majority-of-dietary-supplements-dont-improve-heart-health-or-put-off-death |url-status=live }}</ref> The study found a significant effect on heart health in a low-salt diet, and a small effect due to [[omega-3]] and [[folic acid]] supplements.<ref>{{cite web | vauthors = Haridy R |title=Massive meta-study finds most vitamin supplements have no effect on lifespan or heart health |url=https://newatlas.com/vitamins-mineral-supplements-effect-cardiovascular-health-lifespan/60686/ |website=New Atlas |access-date=25 July 2019 |date=2019-07-22 |archive-date=2019-07-25 |archive-url=https://web.archive.org/web/20190725105356/https://newatlas.com/vitamins-mineral-supplements-effect-cardiovascular-health-lifespan/60686/ |url-status=live }}</ref> This analysis supports the results of two early 2018 studies that found no conclusive benefits from multivitamins for healthy adults.<ref name=aha /><ref>{{cite journal | vauthors = Kim J, Choi J, Kwon SY, McEvoy JW, Blaha MJ, Blumenthal RS, Guallar E, Zhao D, Michos ED | title = Association of Multivitamin and Mineral Supplementation and Risk of Cardiovascular Disease: A Systematic Review and Meta-Analysis | journal = Circulation: Cardiovascular Quality and Outcomes | volume = 11 | issue = 7 | pages = e004224 | date = July 2018 | pmid = 29991644 | doi = 10.1161/CIRCOUTCOMES.117.004224 | s2cid = 51615818 | doi-access = free }}</ref> === Expert bodies === A 2006 report by the U.S. [[Agency for Healthcare Research and Quality]] concluded that "regular supplementation with a single nutrient or a mixture of nutrients for years has no significant benefits in the primary prevention of cancer, cardiovascular disease, cataract, age-related macular degeneration or cognitive decline."<ref name="HHS2006">{{cite journal | vauthors = Huang HY, Caballero B, Chang S, Alberg A, Semba R, Schneyer C, Wilson RF, Cheng TY, Prokopowicz G, Barnes GJ, Vassy J, Bass EB | title = Multivitamin/mineral supplements and prevention of chronic disease | journal = Evidence Report/Technology Assessment | issue = 139 | pages = 1–117 | date = May 2006 | pmid = 17764205 | pmc = 4781083 | url = http://www.ahrq.gov/downloads/pub/evidence/pdf/multivit/multivit.pdf | url-status = dead | archive-url = https://web.archive.org/web/20080916040502/http://www.ahrq.gov/downloads/pub/evidence/pdf/multivit/multivit.pdf | archive-date = 2008-09-16 }}</ref> However, the report noted that multivitamins have beneficial effects for certain sub-populations, such as people with poor nutritional status, that vitamin D and calcium can help prevent fractures in older people, and that zinc and antioxidants can help prevent age-related [[macular degeneration]] in high-risk individuals.<ref name=HHS2006 /> A 2017 Cochrane Systematic Review found that multivitamins including vitamin E or beta carotene will not delay the onset of macular degeneration or prevent the disease,<ref>{{cite journal | vauthors = Evans JR, Lawrenson JG | title = Antioxidant vitamin and mineral supplements for preventing age-related macular degeneration | journal = The Cochrane Database of Systematic Reviews | volume = 2017 | issue = 7 | pages = CD000253 | date = July 2017 | pmid = 28756617 | pmc = 6483250 | doi = 10.1002/14651858.CD000253.pub4 }}</ref> however, some people with macular degeneration may benefit from multivitamin supplementation as there is evidence that it may delay the progression of the disease.<ref name="Evans_2017">{{cite journal | vauthors = Evans JR, Lawrenson JG | title = Antioxidant vitamin and mineral supplements for slowing the progression of age-related macular degeneration | journal = The Cochrane Database of Systematic Reviews | volume = 7 | issue = 7 | pages = CD000254 | date = July 2017 | pmid = 28756618 | pmc = 6483465 | doi = 10.1002/14651858.CD000254.pub4 }}</ref>{{Update inline|reason=Updated version https://www.ncbi.nlm.nih.gov/pubmed/37702300|date = October 2024}} Including lutein and zeaxanthin supplements in with a multivitamin does not improve progression of macular degeneration.<ref name="Evans_2017" /> The need for high-quality studies looking at the safety of taking multivitamins has been highlighted.<ref name="Evans_2017" /> According to the [[Harvard School of Public Health]]: "... many people don't eat the healthiest of diets. That's why a multivitamin can help fill in the gaps, and may have added health benefits."<ref>{{cite web|url=http://www.hsph.harvard.edu/nutritionsource/what-should-you-eat/vitamins/|title=Vitamins|date=18 September 2012|website=harvard.edu|access-date=23 March 2018|archive-date=23 March 2018|archive-url=https://web.archive.org/web/20180323032041/https://www.hsph.harvard.edu/nutritionsource/what-should-you-eat/vitamins/|url-status=live}}</ref> The U.S. Office of Dietary Supplements, a branch of the [[National Institutes of Health]], suggests that multivitamin supplements might be helpful for some people with specific health problems (for example, [[macular degeneration]]). However, the Office concluded that "most research shows that healthy people who take an MVM [multivitamin] do not have a lower chance of diseases, such as cancer, heart disease, or diabetes. Based on current research, it's not possible to recommend for or against the use of MVMs to stay healthier longer."<ref name="ods">{{cite web |publisher=Office of Dietary Supplements, [[National Institutes of Health]] |title=Dietary Supplement Fact Sheet: Multivitamin/mineral Supplements |url=http://ods.od.nih.gov/factsheets/MVMS-QuickFacts/ |access-date=March 2, 2012 |archive-date=February 18, 2012 |archive-url=https://web.archive.org/web/20120218082959/http://ods.od.nih.gov/factsheets/MVMS-QuickFacts/ |url-status=live }}</ref> === Life expectancy=== A 2024 study of 390,124 healthy adults found that use of multivitamins did not extend life expectancy.<ref name="jama24">{{cite journal | vauthors = Loftfield E, O'Connell CP, Abnet CC, Graubard BI, Liao LM, Beane Freeman LE, Hofmann JN, Freedman ND, Sinha R | title = Multivitamin Use and Mortality Risk in 3 Prospective US Cohorts | journal = JAMA Network Open | volume = 7 | issue = 6 | pages = e2418729 | date = June 2024 | pmid = 38922615 | pmc = 11208972 | doi = 10.1001/jamanetworkopen.2024.18729 }}</ref> === History and debate === The history of multivitamins begins in the [[Frederick Gowland Hopkins|early 20th]] century when advancements in nutritional science led to the discovery of essential [[Vitamin|vitamins and minerals]]. Initially, multivitamins were designed to respond to widespread nutritional deficiencies.<ref>{{cite journal | vauthors = Martini SA, Phillips M | title = Nutrition and food commodities in the 20th century | journal = Journal of Agricultural and Food Chemistry | volume = 57 | issue = 18 | pages = 8130–8135 | date = September 2009 | pmid = 19719130 | doi = 10.1021/jf9000567 | bibcode = 2009JAFC...57.8130M }}</ref> These supplements were seen as a practical solution to combat malnutrition, improving public health by providing vital nutrients that were otherwise scarce. As the 20th century progressed, the use of multivitamins expanded beyond addressing [[Micronutrient deficiency|deficiencies]]. With the rise of the wellness industry,<ref name="Nichter_2006"/> they became popularized as a convenient way to enhance overall health, even for those with access to sufficient nutrition. However, as marketing strategies evolved, the emphasis shifted from necessity to preventative health and general well-being,<ref>{{cite journal | vauthors = Cardenas D, Fuchs-Tarlovsky V | title = Is multi-level marketing of nutrition supplements a legal and an ethical practice? | journal = Clinical Nutrition ESPEN | volume = 25 | pages = 133–138 | date = June 2018 | pmid = 29779808 | doi = 10.1016/j.clnesp.2018.03.118 }}</ref> often without sound scientific backing. The role of multivitamins has since been increasingly questioned. Some still view them as beneficial, especially in cases of specific deficiencies. A growing body of research suggests that for many people, multivitamins act more as a [[placebo]] than a necessary supplement. This indicates a shift in the [[epistemology]] of vitamins, where people are generally more aware of them and their properties but there is a gap in their knowledge of the scientific research surrounding them Studies have shown that multivitamins can have positive effects on mood and energy,<ref>{{cite journal | vauthors = Sarris J, Cox KH, Camfield DA, Scholey A, Stough C, Fogg E, Kras M, White DJ, Sali A, Pipingas A | title = Participant experiences from chronic administration of a multivitamin versus placebo on subjective health and wellbeing: a double-blind qualitative analysis of a randomised controlled trial | journal = Nutrition Journal | volume = 11 | issue = 1 | pages = 110 | date = December 2012 | pmid = 23241329 | pmc = 3545984 | doi = 10.1186/1475-2891-11-110 | doi-access = free }}</ref><ref>{{cite journal | vauthors = Harris E, Kirk J, Rowsell R, Vitetta L, Sali A, Scholey AB, Pipingas A | title = The effect of multivitamin supplementation on mood and stress in healthy older men | journal = Human Psychopharmacology | volume = 26 | issue = 8 | pages = 560–567 | date = December 2011 | pmid = 22095836 | doi = 10.1002/hup.1245 }}</ref> but there is little evidence to support an increase in general health and life expectancy.<ref>{{cite journal | vauthors = Pocobelli G, Peters U, Kristal AR, White E | title = Use of supplements of multivitamins, vitamin C, and vitamin E in relation to mortality | journal = American Journal of Epidemiology | volume = 170 | issue = 4 | pages = 472–483 | date = August 2009 | pmid = 19596711 | pmc = 2727181 | doi = 10.1093/aje/kwp167 }}</ref><ref>{{cite journal | vauthors = Macpherson H, Pipingas A, Pase MP | title = Multivitamin-multimineral supplementation and mortality: a meta-analysis of randomized controlled trials | journal = The American Journal of Clinical Nutrition | volume = 97 | issue = 2 | pages = 437–444 | date = February 2013 | pmid = 23255568 | doi = 10.3945/ajcn.112.049304 | hdl = 10536/DRO/DU:30073126 | hdl-access = free }}</ref> Under the Dietary Supplement Health and Education Act (DSHEA), passed in 1994 in the United States, the Food and Drug Administration (FDA) is not responsible for testing the risks and efficacy of dietary supplements. Manufacturers are not required to present data on the effectiveness of multivitamins or disclose known side effects to the FDA. Furthermore, manufacturers are not required to test human safety of dietary supplements.<ref>{{cite journal | vauthors = Dodge T | title = Consumers' perceptions of the dietary supplement health and education act: implications and recommendations | journal = Drug Testing and Analysis | volume = 8 | issue = 3–4 | pages = 407–409 | date = 2016 | pmid = 27072844 | doi = 10.1002/dta.1857 }}</ref> === Ethnographic research === [[Ethnography|Ethnographic research]] has investigated possible reasons behind the widespread use of multivitamins in societies where scientific knowledge is dominant, despite the limited empirical evidence supporting new products.<ref name="McCabe_2012">{{Cite journal | vauthors = McCabe M, Fabri A |date= April 2012 |title=Vitamin Practices and Ideologies of Health and the Body |url=https://articlegateway.com/index.php/IJBA/article/view/1170 |journal=International Journal of Business Anthropology |language=en |volume=3 |issue=1 |doi=10.33423/ijba.v3i1.1170 |issn=2155-6237}}</ref><ref name="Nichter_2006">{{cite journal | vauthors = Nichter M, Thompson JJ | title = For my wellness, not just my illness: North Americans' use of dietary supplements | journal = Culture, Medicine and Psychiatry | volume = 30 | issue = 2 | pages = 175–222 | date = June 2006 | pmid = 16841188 | doi = 10.1007/s11013-006-9016-0 }}</ref> The findings reveal various socio-cultural factors contributing to their common use, including: * Harm reduction: The cultural belief that multivitamins can mitigate risks associated with unhealthy lifestyles, conventional medicines, deficient diets, harmful environmental influences, or genetic predispositions.<ref name="McCabe_2012" /> * Personal agency: The desire to gain control over one’s body and well-being.<ref name="McCabe_2012" /><ref name="Nichter_2006" /> * Social proof: The perception of multivitamins’ effectiveness based on the experiences and behavior of friends, family and community members.<ref name="McCabe_2012" /><ref name="Nichter_2006" /> * Social belonging: Marketing strategies that promote identity-building by targeting specific age groups, genders, or personal interests.<ref name="Nichter_2006" /> * [[Biopolitics]]: The pursuit of productivity and reliability, as framed by capitalist societal expectations.<ref name="McCabe_2012" /> From anthropological and psychological perspectives, the widespread consumption of multivitamins can be seen as an example of 'magical thinking,' a form of reasoning that seeks to explain phenomena through non-scientific means, distinct from 'irrational thinking’.<ref name="McCabe_2012" /><ref>{{Cite book | vauthors = Taylor M |title=The Oxford Handbook of the Development of Imagination |date=2013-08-01 |publisher=Oxford Library of Psychology |isbn=9780199983032}}</ref> === ASD Research === In 2019, a systematic review and meta-analysis examining the relationship between ‘maternal multivitamin supplementation’ and children being diagnosed with autism spectrum disorder (ASD) was published in ''Nutritional Research''. The research was conducted in the previous year and involved using the ‘random effects’ model on 9 independent trials consisting of 231,163 children across 4459 cases. The results of this study indicated that pregnant women using multivitamin supplements during the prenatal period reduced the risk of their children being diagnosed with autism compared to their counterparts. Furthermore, the systematic review and meta-analysis found that women who took multivitamins prior to becoming pregnant saw a further reduced risk. The authors recommend further study.<ref>{{cite journal | vauthors = Guo BQ, Li HB, Zhai DS, Ding SB | title = Maternal multivitamin supplementation is associated with a reduced risk of autism spectrum disorder in children: a systematic review and meta-analysis | journal = Nutrition Research | volume = 65 | pages = 4–16 | date = May 2019 | pmid = 30952506 | doi = 10.1016/j.nutres.2019.02.003 }}</ref> In 2021, a similar systematic review and meta-analysis examining the relationship between prenatal multivitamins and children being diagnosed with autism spectrum disorder (ASD) was published in ''Nutrients''. The study involved 904,947 children encompassing 8159 cases. The study concluded that while no distinct association was found, there was substantial evidence of reduced risk in high quality studies, multivitamin use during early pregnancy, tested prospective studies and evidence following the removal of a single outlier study.<ref>{{cite journal | vauthors = Friel C, Leyland AH, Anderson JJ, Havdahl A, Borge T, Shimonovich M, Dundas R | title = Prenatal Vitamins and the Risk of Offspring Autism Spectrum Disorder: Systematic Review and Meta-Analysis | journal = Nutrients | volume = 13 | issue = 8 | date = July 2021 | page = 2558 | pmid = 34444717 | doi = 10.3390/nu13082558 | doi-access = free | pmc = 8398897 }}</ref>
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