Tips

From Other Journals

Multivitamins and Acute Respiratory Infection

Am Fam Physician. 2002 Dec 15;66(12):2321.

Vitamin supplements are widely used in elderly patients, and studies show that multi-vitamins, multivitamins plus minerals, and vitamin E are the most commonly used supplements. Studies have shown that such supplements improve some cellular immune parameters, but evidence about the actual clinical effects is inconclusive. Graat and colleagues conducted a randomized controlled trial to determine the effect of various supplements on the incidence and severity of acute respiratory infections in elderly persons.

Individuals were included if they were at least 60 years of age, had no history of cancer, liver disease, or fat malabsorption, and had not used supplements, immunosuppressive treatments, or certain anticoagulants in the previous two months. Participants were followed for up to 15 months and were randomized to receive a placebo, vitamin E, a multivitamin with minerals, or a multivitamin with minerals and vitamin E. The main outcomes measured were acute respiratory-infection incidence and severity. Participants reported symptoms consistent with acute respiratory infection to the study nurse, who determined whether the participant met criteria for acute respiratory infection. A random subsample of participants had microbiologic and serologic tests for confirmation.

There were 547 persons included in the analysis. Almost all (98 percent) of the participants were noninstitutionalized. The follow-up period for 92 percent of the participants included winter months. In the group that took the multivitamin with minerals, 71 percent had at least one acute respiratory infection. In the group that received vitamin E, 68 percent had an infection. In the group that received the multivitamin with minerals and vitamin E, 66 percent had an infection. In the placebo group, 67 percent had an infection. Patients who were given vitamin E and had a respiratory infection had longer illnesses and statistically and significantly more symptoms than other patients.

The authors conclude that neither multivitamins with minerals nor vitamin E is associated with a lower incidence of acute respiratory-tract infection in elderly patients. Vitamin E was associated with longer duration and increases in symptoms. It may be that elderly persons should be cautious about supplementing their diet with vitamin E, at least as a means of improving immune function.

Graat JM, et al. Effect of daily vitamin E and multivitamin-mineral supplementation on acute respiratory tract infections in elderly persons. A randomized controlled trial. JAMA. August 14, 2002;288:715–21.


Copyright © 2002 by the American Academy of Family Physicians.
This content is owned by the AAFP. A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference. This material may not otherwise be downloaded, copied, printed, stored, transmitted or reproduced in any medium, whether now known or later invented, except as authorized in writing by the AAFP. Contact afpserv@aafp.org for copyright questions and/or permission requests.

Want to use this article elsewhere? Get Permissions


Article Tools

  • Print page
  • Share this page
  • AFP CME Quiz

Information From Industry

Navigate this Article