One you drop. One you take instead.
In three lines:
3. A daily multi doesn’t reliably cut cancer, heart disease or death in people who already eat well.
2. The U.S. Preventive Services Task Force (USPSTF) says the evidence is insufficient to recommend multivitamin/mineral supplements (MVMs) for preventing cardiovascular disease (CVD) or cancer.
1. Start with food, and supplement only a named gap: vitamin B12 if you’re vegan, prenatal folic acid if you’re planning a pregnancy. Not a Chemist Warehouse “insurance” bottle.
OUT — the once-a-day “just in case”
A Swisse, Blackmores or Centrum-style multi, every morning, just in case something is “missing”.
Here’s what a multi does. A multivitamin/mineral supplement (MVM) raises nutrient intakes when food falls short, according to the NIH Office of Dietary Supplements (NIH ODS). It does not replace the variety of foods that matter for health, because food carries things a tablet doesn’t.
For preventing disease, the reviews are blunt. Large evidence reviews, including the USPSTF package summarised by NIH ODS, find little or no benefit for cardiovascular disease (CVD), cancer or death in the general population. The U.S. Preventive Services Task Force judged the balance of benefits and harms insufficient to recommend MVMs for that job.
Observational noise, and one ancillary cognitive signal in older adults from the COSMOS trial, doesn’t turn a multi into insurance. Park the bottle if the pitch was “cover all bases”, and keep anything a clinician has already named.
IN — food first; fill proven gaps, named forms
Food first. Then, if a gap is real, fill that gap and nothing else:
Vitamin B12, as cyanocobalamin or methylcobalamin, if you’re vegan or eat very little animal food. The usual adult target is about 2.4 mcg/day, from fortified food or a tablet. Over-50s often need a reliable source anyway. That’s NIH ODS and Dietary Guidelines for Americans (DGA) territory.
If you’re capable of pregnancy, that’s folic acid 400–800 mcg/day (the USPSTF and prenatal protocol), not whatever a men’s multi happens to contain.
If your diet is genuinely thin, a basic MVM at around recommended dietary allowance (RDA) levels is optional. It still isn’t cancer cover.
And don’t stack a multi on top of the iron, zinc and vitamin A megadoses from earlier letters without reading the labels first.
ASK (take this to the GP)
“I’ve been taking a daily multivitamin as insurance. Given the NIH ODS and USPSTF findings on chronic disease, should I drop it and supplement only named gaps in my diet, such as B12 if I’m plant-based?”
This swap is not for you if
You’re on a prescribed multi, prenatal or nutrient supplement: keep it.
You have a diagnosed deficiency, malabsorption, bariatric surgery or a clinician-managed restriction.
You’re pregnant or trying to conceive: the prenatal folic acid and anything else your GP or midwife has named matter more than this letter.
Sources
NIH ODS: Multivitamin/mineral Supplements — Health Professional — https://ods.od.nih.gov/factsheets/MVMS-HealthProfessional/
USPSTF: Vitamin, Mineral, and Multivitamin Supplementation to Prevent CVD and Cancer — https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/vitamin-supplementation-to-prevent-cvd-and-cancer-preventive-medication/