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The debate around multivitamins (MVs) has been as divisive as pineapple on pizza. Now, I believe that pineapple on pizza is fundamentally wrong. I am also of the belief that nutrients derived from whole foods are likely better than does derived from pharmaceutical companies. However, to repeat a quote often attributed to John Maynard Keynes “When the facts change, I change my mind. What do you do, sir?” Enter the COSMOS trial, stepping into the fray like a peacekeeper, armed with data rather than diplomacy. The study’s latest findings suggest that daily multivitamin-mineral (MVM) supplementation might be the secret sauce to preserving our cognitive zest as we age. But was it enough to change my mind on multivitamins?

From The Farm to The Pharmacy

An ideal multivitamin is derived from whole foods. These not only deliver vitamins and minerals but also fibre that nourishes our microbiome and slows our absorption of sugar. The Iowa Women’s Health Study suggested that regular MVIs might actually increase mortality in older women. This brings us to the COSMOS trial. The initial COSMOS trial was an investigation into whether Centrum Silver or a supplement of cocoa and green tea flavonoids, could improve health outcomes.

COSMOS: A Universe of Data

Sponsored by the titans of industry, Pfizer and Mars Edge, the COSMOS study lasted 3.6-years and included 21,000 participants. The cocoa and green tea flavonoids were found to reduce cardiovascular mortality by 27%. The spotlight then turned to MVIs and their role in our cognitive health. In the later COSMOS-Mind paper, there was no cognitive protection with the consumption of flavonoids. However, there was a trend towards a lower incidence of mild cognitive impairment and dementia in the MVI group.

This latest study featured an ensemble of subsets from the COSMOS trial. There participants had been assessed for cognitive changes over two years. It found that those on the MVI regimen showed modest improvements in global cognitive function and memory. This effect suggested a slowing of cognitive ageing by about two years. A modest but significant victory in the battle against time.

The Ingredient List: A Culinary Adventure

Examine the ingredient list of an MVI you’ll find a melange of fat-soluble vitamins, the B’s and C’s of the vitamin world, and a mineral ensemble. The COSMOS MVI (Centrum Silver) also boasted lutein, which can be beneficial for eye health and lycopene, a constituent of tomatoes that has been linked to lower blood pressure.

To Pop or Not to Pop?

So, should we turn to MVIs as our cognitive shields against the ravages of time? While the risk-benefit ratio of MVIs appears favourable, one can’t help but wonder if we’d be better off investing in a cornucopia of fruits and vegetables. I would prefer supporting our local farmers rather than the pharmaceutical giants.

A Plant-Forward Path to Cognitive Health

In the end, the COSMOS trial adds a few more threads to the ever-expanding tapestry of health research. It whispers, rather than shouts, the potential benefits of MVIs on our cognitive well-being. Perhaps the true takeaway is a reminder of the holistic approach to health. A diet rich in natural vitamins and regular physical activity might just be the recipe for a vibrant mind and body. Where a multivitamin is likely to be of benefit is for those people who are unable to access fresh or frozen fruit and vegetables.

The best multivitamin might just be a sun-ripened tomato from your greenhouse (or Bayley and Sage in my case) or a crisp apple from the local orchard (or Fulham Greens). In the quest for cognitive longevity, it’s not about the pills we pop, but the foods we savour and the lifestyles we embrace.

Dr J Hugh Coyne

Private GP

Coyne Medical