In the presence of insulin, the micronutrient combination tested further enhanced this effect up to 1445% over controls. However, MVMs often have small amounts of certain nutrients, such as calcium, magnesium, and potassium, so supplement users should check product labels. Men and women who reported taking more than one MV or MVM daily at the beginning of the study had an 18% lower risk of developing colon cancer than nonusers. Am J Clin Nutr 2007;85:257S-264S. Cancer Multiple-micronutrient supplementation in pregnant adolescnts in low- and middle-income countries: A systematic review and meta-analysis of individual participant data. Iron is also a nutrient of public health concern for infants ages 611 months who are fed primarily human milk and do not consume enough iron from complementary foods, adolescent females, and people who are pregnant. Based on these two trials, the USPSTF warned that beta-carotene supplementation may increase the risk of lung cancer in people who smoke, have smoked, or have occupational exposure to asbestos [50]. MVMs can also increase the likelihood that users will have intakes of some nutrients that are higher than the ULs [14]. According to results of the National Health and Nutrition Examination Survey, 52% of adults take dietary supplements. Vitamin B12 (Cobalamin) Mechanism and Deficiency. Function: It is necessary for producing energy and hormones. The mechanism of action of resveratrol is complex and not fully understood. Updated evidence report and systematic review for the US Preventive Services Task Force. This is a fact sheet intended for health professionals. Here are some of the key benefits of consuming red cabbage: Rich in nutrients: Red cabbage is a good source of vitamins and minerals, including vitamin C, vitamin K, vitamin A, potassium, calcium, and iron. Secondary metabolites. Some published reports of studies of dietary supplements use the generic term "multivitamins" to include products with and without minerals. Pharmacodynamics. This fact sheet by the National Institutes of Health (NIH) Office of Dietary Supplements (ODS) provides information that should not take the place of medical advice. Am J Clin Nutr 2022;115:1501-10. These beneficial effects include a significant increase of glucose uptake by skeletal muscle cells of up to 450%. Vitamins are organic and can be broken down by heat, air, or acid. No U.S. government health agency, private health group, or health professional organization promotes regular use of MVMs. The trial in the United Kingdom that compared an MVM to a placebo found no beneficial or harmful effect of the MVM on preterm births, birth at a smaller size than normal gestational age, or low birth weight. Large reserve pool in the liver. Water and some water-soluble vitamins are absorbed by diffusion. The FNB and DGA agree that fully and partially breastfed infants should receive a supplement containing approximately 400 IU (10 mcg)/day vitamin D beginning in the first week of life [54,59]. Both the men's and women's One a Day 50+ multivitamins, which Miller and Sonpal recommend, contain calcium and vitamin D, a powerful combo for keeping aging bones strong. Studies on the association between MVM use and cancer-related deaths include one that followed 7,728 women in the Women's Health Initiative who had invasive breast cancer for an average of 7.1 years after their diagnosis [22]. Taking a daily dose of a basic MVM is unlikely to pose a health risk for most people. Neither baseline use nor changes in use of MVMs over time were associated with changes in the long-term risk of major CVD events, MI, stroke, cardiac revascularizations, or death from CVD. [, Sesso HD, Rist PM, Aragaki AK, Rautiainen S, Johnson LG, Friedenberg G, et al. After the investigators followed participants for up to 20 additional years, when participants were no longer taking the study supplement, the use of the MVMs during the RCT did not result in lower rates of total mortality or mortality from any cause of death examined, including cancer, heart disease, and stroke [45]. Otten JJ, Hellwig JP, Meyers LD (editors). MVMs providing nutrients in recommended amounts do not ordinarily interact with medications, with one important exception. A total of 38 articles were included in this review, which includes the radioprotective effect of vitamins from ex vivo, in vitro and in vivo studies. [, Cowan AE, Jun S, Gahche JJ, Tooze JA, Dwyer JT, Eicher-Miller HA, et al. The SU.VI.MAX study: a randomized, placebo-controlled trial of the health effects of antioxidant vitamins and minerals. Multinutrients for the treatment of psychiatric symptoms in clinical samples: A systematic review and meta-analysis of randomized controlled trials. [. If you have questions about affording vitamin supplements, contact CF Foundation Compass by calling 844-COMPASS, Monday through Friday, 9 a.m. until 7 p.m. For guidance from NCCIH on using PubMed, see How To Find Information About Complementary Health Approaches on PubMed. Am J Clin Nutr 2007;85:308S-13S. Well, different vitamins and minerals in a prenatal vitamin work in different ways. [, Prentice RL. Approximately 48% of the men and 52% of the women in this study reported taking an MV or MVM. Calciumade provides bone and joint care because it has high levels of elemental calcium carbonate that helps strengthen bones, Vitamin D 3 for better calcium absorption, and minerals (magnesium, zinc, and manganese) that help in making joints flexible. Multivitamin use and the risk of mortality and cancer incidence: the Multiethnic Cohort Study. Natural Medicines Comprehensive Database. Multivitamins in the prevention of cancer and cardiovascular disease: The COcoa Supplement and Multivitamin Outcomes Study (COSMOS) randomized clinical trial. Multivitamins in the prevention of cardiovascular disease in men: the Physicians' Health Study II randomized controlled trial. Multivitamin and iron may also be used for . New technologies have allowed innovators to discover the mechanisms of action behind the efficacy of specific strains and bacteria-enhancing combinations, through advanced assay analysis, translational models, and even deep dives into public health data. However, the study showed that beta-carotene was not a required ingredient; the original AREDS formulation without beta-carotene provided the same protective effect on reducing the risk of advanced AMD as the AREDS2 formulation. Results from several studies demonstrate both the use of MVMs for nutritional insurance by some individuals and the potential of MVMs to lead to excessive intakes for others. MVMs and MVs accounted for 14% of all purchases of supplements and 38% of all sales of vitamin and mineral supplements in the United States in 2019 [4]. The mineral fluoride not only helps bone formation but also keeps dental cavities from starting or worsening. Absorption of vitamins in the intestine is critical in avoiding deficiency states, and impairment of . Approximately 7476% of the men and 7275% of the women had adequate intakes on average from food alone of the 17 nutrients examined, but use of MVMs increased the prevalence of adequacy to 84% for the men and 83% for the women. Clinical trials, where individuals are randomly assigned to take the dietary supplement or a placebo, are better than observational studies for determining whether MVMs might affect disease risk. Abdominal pain. The rate of death from breast cancer (6.7% of the cohort) was 30% lower among the MVM users than nonusers. Several epidemiological studies and small RCTs have suggested associations between higher intakes of antioxidants or zinc and reduced risk of AMD, although not consistently [30]. The USPSTF advises people who are planning to become or capable of becoming pregnant to take a dietary supplement providing 400 to 800 mcg/day of folic acid daily [55]. Taking a basic MVM that provides nutrients in amounts that are approximately the same as recommended intakes should be safe for healthy people. 2013;309:2005-15. Vitamin, mineral, and multivitamin supplementation to prevent cardiovascular disease and cancer. However, MVMs cannot take the place of the variety of foods that are important to a healthy diet, because foods provide other nutrients and components that have benefits for health. The FNB advises people older than 50 years to obtain recommended amounts of vitamin B12, mainly from fortified foods or dietary supplements. MVMs providing nutrients at or up to 100% DV do not typically interact with medications. RCTs Studies of the association between MVM use and CVD outcomes have focused on several outcomes, including cardiovascular events and mortality. The known vitamins include A, C, D, E, and K, and the B vitamins: thiamin (B1), riboflavin (B2), niacin (B3), pantothenic acid (B5), pyridoxal (B6), cobalamin (B12), biotin, and folate/folic acid. Simply stated, dietary supplements arent required to be standardized in the United States. An earlier analysis of 20112014 NHANES data found that 31.2% of the U.S. adult population aged 19 years and older reported taking an MVM in the past 30 days [2]. For more information on safe upper levels of nutrients, visit the NIH Office of Dietary Supplements at: Smokers, and possibly former smokers, should avoid MVM products that provide more than 100% DV for vitamin A (either as preformed retinol or beta-carotene or some combination of the two) because two studies have linked high supplemental doses of these nutrients with an increased risk of lung cancer insmokers. Your OB's Choice for a Healthy Pregnancy. Ann Intern Med 2013;159:797-805. It is water-soluble. Improve health or prevent chronic disease This study included 4,203 participants aged 5085 years who had intermediate AMD in both eyes or intermediate AMD in one eye and advanced AMD in the other eye. Nausea. A review of 16 RCTs of MVs and MVMs (containing more than four nutrients including, in most cases, at least one mineral) in 1,719 participants who had at least one of six types of psychiatric symptoms (depression, post-disaster stress, antisocial behavior, behavioral deficits in dementia, attention-deficit/hyperactivity disorder, or autism) found that the supplements provided no clear reduction in symptoms [47]. Whether you are stacking different types of natural nootropics, synthetic . Minerals, vitamins, and an immunity booster derived from various plant extracts are included. Observational studies Wagner CL, Greer FR, and the Section on Breastfeeding and Committee on Nutrition. The vitamin A UL during pregnancy is 2,800 mcg/day for adolescents and 3,000 mcg/day for women [66]. View in Scopus Google . The model comprises an oxygenation that is coupled to carbon-carbon bond . The DGA does not mention MVMs, but it does recommend that Americans choose healthy, nutrient-dense food and beverages. Therapeutic Vitamins/Minerals Capsule - Uses, Side Effects, and More Generic Name(S): multivitamin with min no.7-FA, multivitamin,tx-minerals View Free Coupon [. National Institutes of Health state-of-the-science conference statement: multivitamin/mineral supplements and chronic disease prevention. How much vitamin D, iron, and zinc . A third CVD outcomes study prospectively followed a cohort of 37,193 women ages 45 and older (mean age 54 years) participating in the Women's Health Study who were users (38%) or nonusers (62%) of MVMs (including "a wide range of lower-dose vitamins and minerals") for an average of 16.2 years. Dietary supplements are commonly taken during pregnancy to increase nutrient intakes, especially of key nutrients, such as iron and folic acid. Men. An analysis by the National Health and Nutrition Examination Survey (NHANES) of data collected from 2003 to 2006 found 33% of the U.S. population ages 1 year and older took an MVM supplement in a given month. Effects of a combination of beta carotene and vitamin A on lung cancer and cardiovascular disease. When you combine at least two or more of these brain-enhancing formulas, what you get is called a stack. Rosenberg IH. J Nutr 2021;151:1976-82. The NCCIH Clearinghouse provides information onNCCIHand complementary and integrative health approaches, including publications and searches of Federal databases of scientific and medical literature. Taking excess amounts of vitamin A (preformed retinol form, not as beta-carotene) during pregnancy has been shown to increase the risk of birth defects. Multivitamins with iron are used to provide vitamins and iron that are not taken in through the diet. The products provided an average of 14 nutrients, although the products with 3 nutrients in 5 trials did not contain a mineral. Vitamin D production in the skin under the influence of sunlight (UVB) is maximized at levels of sunlight exposure that do not burn the skin. Nutrients 2018, 10, 248. USES: This medication is a multivitamin product used to treat or prevent vitamin deficiency due to poor diet, certain illnesses, or during pregnancy. From Sources and Bioavailability to Cardiovascular-Health Benefits and Molecular Mechanisms of Action - NCBI. [, Rautiainen S, Lee I-M, Rist PM, Gaziano JM, Manson JE, Buring JE, Sesso HD. A randomized, placebo-controlled, clinical trial of high-dose supplementation with vitamins C and E, beta carotene, and zinc for age-related macular degeneration and vision loss: AREDS report no. Supplement Business Report 2021. Participants completed standardized cognitive tests administered over the telephone at baseline and annually for 3 years. The fat-soluble group includes the Vitamins A, D, E and K, while vitamins of the B complex (B1, B2, B6, B12, niacin, pantothenic . The studies included a total of 2,019,862 participants with a mean age of 57.8 years and had a mean duration of 11.6 years. Nutrition intervention trials in Linxian, China: Multiple vitamin/mineral supplementation, cancer incidence, and disease-specific mortality among adults with esophageal dysplasia. Instead, vitamins serve as chemical partners for the enzymes involved in the body`s metabolism, cell production, tissue repair, and other vital processes. U.S. Preventive Services Task Force. Brand Name: Generic Name: 32 Multivitamins & Multiminerals Dosage form: Tablet Indications: For the prevention and treatment of vitamins & mineral deficiencies as a complete daily nutritional supplement. Multivitamins/multiminerals (MVMs) are the most frequently used dietary supplements, with close to half of American adults taking them. However, some people who dont get enough vitamins and minerals from food alone, or who have certain medical conditions, might benefit from taking one or more of these nutrients found in single-nutrient supplements or in MVMs. The DGA also recommends obtaining recommended amounts of vitamin B12 primarily from fortified foods or dietary supplements, but only for people ages 60 and older. Multivitamin use and the risk of cardiovascular disease in men. Depending on ingredients in the formulaiton may support metabolic functions as well as protein and DNA synthesis. "Vitamin D and . Know the Science features a variety of materials, including interactive modules, quizzes, and videos, as well as links to informative content from Federal resources designed to help consumers make sense of health information. [, Bird JK, Murphy RA, Ciappio ED, McBurney MI. MVM supplementation modestly but significantly reduced users' risk of developing cancer by 8% but did not reduce the risk of any type of cancer (e.g., of the prostate or colon) or overall cancer mortality [39]. The use of MVs or MVMs had no effect on all-cause mortality or on mortality due to CVD or cancer. [. This page specifically discusses the use of multivitamins, which typically contain about 26 different vitamins and minerals, and often provide 100% of the Recommended Daily Allowance of these micronutrients. What is known about the safety of multivitamin-multimineral supplements for the generally healthy population? J Nutr 2015;572-8. [, Murphy SP, White KK, Park S-Y, Sharma S. Multivitamin-multimineral supplements' effect on total nutrient intake. There is no one single thing that makes it work. Vitamin (Common Names) Recommended Dietary Allowance (RDA) or Daily Adequate Intake (AI)*. Am J Clin Nutr 2015;101:144-52. Therefore, the folic acid intakes of pregnant people who take these supplements and consume any foods fortified with this nutrient exceed the UL for this nutrient (1,000 mcg), even though many do not consume recommended amounts of folate from dietary sources alone [18]. An analysis of dietary supplement use in the United States from the 20172018 National Health and Nutrition Examination Survey (NHANES) found that MVMs (defined as products containing three or more vitamins and at least one mineral) were the most commonly consumed supplement. 1. A 5000Units (40% as beta carotene), thiamine 1.5mg, riboflavin 1.7mg, niacinamide 20mg, pantothenic acid 10mg, pyridoxine 2mg, Vit. Challenges and opportunities in the translation of the science of vitamins. Use rates by sex and age are 19.5% for men and 26.1% for women ages 1930 years, 25.1% for men and 33.0% for women ages 3150 years, 34.5% for men and 36.2% for women ages 5170 years, and 40.9% for men and 44.0% for women ages 71 years and older. Theres no standard or regulatory definition for MVMs, or any dietary supplement, as to what nutrients they must contain or at what levels. Observational studies [, Baker LD, Manson JE, Rapp SR, Sesso HD, Gaussoin SA, Shumaker SA, et al. Vit. MVM supplementation resulted in 13% lower odds of low birth weight, 12% lower odds of preterm birth, and 14% lower odds of small size for gestational age than iron and folic acid supplementation alone. NCCIH has provided this material for your information. Common side effects may include: upset stomach . Dietary vitamins and minerals play ubiquitous roles throughout the human body by serving as veritable "helping hands" (e.g. [, Jenkins DJA, Spence JD, Giovannucci EL, Kim Y-I, Josse RG, Vieth R, et al. Take your multivitamin with a full glass of water. Effects of multivitamin supplement on cataract and age-related macular degeneration in a randomized trial of male physicians. The use of MVMs resulted in lower odds of low birth weight (less than 2,500 g) by 12%, birth at a smaller size than normal for gestational age by 8%, and premature births (before week 37 of pregnancy) by 10% than use of supplements containing iron with or without folic acid alone or placebo. [, Lamas GA, Boineau R, Goertz C, Mark DB, Rosenberg Y, Stylianou M, et al. [, Neuhouser ML, Wassertheil-Smoller S, Thomson C, Aragaki A, Anderson GL, Manson JE, et al. Inflammation is a response of a tissue to some injury that includes . Ann Intern Med 2013;159:806-14. N Engl J Med 1996;334:1150-5. Vitamins and Minerals for Layer Poultry have been divided into two groups based on their solubility in lipids or in water. In the Age-Related Eye Disease Study (AREDS), investigators randomized 4,757 individuals aged 5580 years who had varying degrees of AMD, cataract, or both conditions to receive a placebo or a daily supplement containing high doses of vitamin C (500 mg), vitamin E (400 IU), beta-carotene (15 mg), zinc (80 mg), and copper (2 mg) [30,31]. [, Age-Related Eye Disease Study Research Group. The studies included a total of 91,074 healthy adults (average age 62 years) taking the MVs or MVMs for an average of 43 months, and the investigators reported 8,794 deaths. One RCT randomized 1,708 participants aged 50 years and older who had had an MI at least 6 weeks earlier to take a daily MVM containing 27 nutrients (many in doses higher than recommended amounts) for a median of 31 months (range 13 to 60 months) or a placebo as well as their standard medications. . During the study, 4,517 died of colon cancer. B12 6mcg, biotin 30mcg, folic . Impact of frequency of multi-vitamin/multi-mineral supplement intake on nutritional adequacy and nutrient deficiencies in U.S. adults. M. charantia maintains hypoglycemic effects through antioxidant effects promoting -cell protection and the decrease in glucose absorption from the intestines and glucose production from the liver by increasing hepatic glycogen and decreasing . 1. It is reasonably priced, and there's enough product to last a single cat about a month. Absorption of Vitamins. Multivitamins, vision are available under the following . [, Bailey RL, Fakhouri TH, Park Y, Dwyer JT, Thomas PR, Gahche JJ, et al. Nutrition 2017;36:60-6. Macrocytic Megaloblastic Anemia. NIH State-of-the-Science Panel. Formulations for children, adult men and women, pregnant people, and seniors typically provide different amounts of the same vitamins and minerals to meet the needs of these populations. In 2006, researchers reviewed 63 published RCTs between 1966 and early 2006 that evaluated the potential impacts of MVs and MVMs and individual nutrient supplements on health and on the risk of certain medical conditions (cancer; age-related sensory loss; and cardiovascular, endocrine, neurologic, musculoskeletal, gastroenterologic, renal, and pulmonary diseases) [7]. Multivitamins and minerals are also used to treat vitamin or mineral deficiencies caused by illness, pregnancy, poor nutrition, digestive disorders, certain medications, and many other conditions. Circ Cardiovasc Qual Outcomes 2018; 11(7):e004224. Use of MVs or MVMs (not further defined) was associated with an 11% lower risk of colon cancer mortality than among nonusers. Many foods also have fiber and other substances that can provide health benefits. [, Jacobs EA, Connell CJ, Patel AV, Chao A, Rodriguez C, Seymour J, et al. Minerals (especially taken in large doses) can cause side effects such as tooth staining . [, Li J-Y, Taylor PR, Li B, Dawsey S, Wang G-Q, Ershow AG, et al. However, if you consume fortified foods and beverages (such as cereals or drinks with added vitamins and minerals) along with dietary supplements, you should make sure that your total intake of vitamins and minerals is not more than the safe upper limits for any nutrients. The COcoa Supplement and Multivitamin Outcomes Study (COSMOS) was a subsequent clinical trial to investigate whether MVMs might help prevent cancer and CVD in both men and women [42]. Side effects of multivitamins include: Constipation. J Acad Nutr Diet 2018;118:2162-73. In general, MVMs might help people who do not eat a nutritious variety of foods to obtain adequate amounts of essential nutrients. [, US Preventive Services Task Force. The. JAMA. U.S. Department of Health & Human Services, 9000 Rockville Pike Bethesda, Maryland 20892, U.S. Department of Health and Human Services. U.S. sales of all dietary supplements totaled an estimated $55.7 billion in 2020, including $21.2 billion for all supplements containing vitamins, minerals, or both, of which $8.0 billion was for MVMs and MVs [4]. Most have not found an effect of MVM use on any of the health outcomes measured. Multivitamins, vision are an over-the-counter (OTC) product used to reduce the risk of vision loss among moderate to advanced age-related macular degeneration (AMD) patients and as an ocular (eye) vitamin supplement. American College of Obstetrics and Gynecologists. Because people with healthier diets and lifestyles are more likely to use dietary supplements, attributing health benefits that are distinct from the benefits of healthy behaviors to the use of supplements is difficult [13]. Lim J, Weinstein SJ, Liao LM, Sinha R, Huang J, Albanes D. Multivitamin use and overall and site-specific cancer risks in the National Institutes of Health-AARP Diet and Health Study. Enzymes for detoxification of various mycotoxins: origins and mechanisms of catalytic action. However, one study in this meta-analysis found a 19% higher risk of breast cancer in 25.5% of 35,329 Swedish women who reported taking an MV or MVM (in most cases nutrients in amounts close to RDA levels) than in women who did not take these supplements over an average of 9.5 years [21]. Studies that have examined associations of MVMs with CVD risk include the Physicians Health Study I. It is found in various plants, including grapes, berries, peanuts, and red wine. Read the label of any multivitamin product you take to make sure you are aware of what it contains. However, supplement use increased the proportion of pregnant people with some intakes of iron (27.9%) and folic acid (33.4%) above the UL. Multivitamins in the prevention of cancer in men: the Physicians' Health Study II randomized controlled trial. In Canada, almost all prenatal MVM supplements provide 1,000 mcg/day of folic acid. Disclaimer: This content has been produced purely for informational and educational purposes only and is never intended to be used as a substitute for professional medical guidelines including diagnosis, advice, and treatment. The trials included a total of 15,283 pregnant adolescents and young adults from low- or middle-income countries in Africa and Asia. * This fact sheet focuses primarily on these basic, broad-spectrum MVMs. Among women, taking a daily MV or MVM did not affect their overall risk of developing cancer except for oropharyngeal cancer, which increased by 46%. Do not take more . Vitamins and minerals are essential for bodily functions such as helping to fight infection, wound healing, making our bones strong and regulating hormones. Telecommunications relay service (TRS): 7-1-1, Email: [email protected] (link sends email). Iron is necessary for the production of hemoglobin. Obtaining sufficient amounts of folic acid in the periconceptual period reduces the risk of neural tube defects in newborns. Many of these products contain numerous ingredients in varied combinations and amounts. Vitamins and minerals serve crucial functions in almost all bodily processes and must be obtained from foods or supplements, as our bodies are unable to make them. They are also used to treat iron or vitamin deficiencies caused by illness, pregnancy, poor nutrition, digestive disorders, and many other conditions. How to use Theragran-M oral. Pediatrics 2008;122:1142-52. Therefore, these terms refer to products that have widely varying compositions [5]. What is the prenatal vitamins mechanism of action? For example, a manufacturer might label a product containing vitamins C and E, selenium, zinc, and beta-carotene as an antioxidant formula rather than an MVM. Am J Epidemiol 2011;173:906-14. Vitamins and minerals are essential substances that our bodies need to develop and function normally. MVMs taken once a day that contain all or most vitamins and minerals, most in amounts that do not exceed the Daily Values (DVs), Recommended Dietary Allowances (RDAs), or Adequate Intakes (AIs) for these nutrients. 1 Supplement use is typically a safe and effective method of maintaining a healthy body . Other observational data on multiple outcomes come from a cross-sectional analysis of data from participants in the 2012 National Health Interview Survey. What Is Complementary, Alternative, or Integrative Health? Long-term multivitamin supplementation and cognitive function in men: A randomized trial. This study prospectively followed 18,530 male physicians aged 40 years and older, of whom 20% reported taking an MV or MVM for an average of 12.2 years [24]. Molecules, 24 (2019), p. 2362, 10.3390/molecules24132362. The Physicians Health Study II was the longest clinical trial to investigate whether MVMs might help prevent chronic disease. When your child needs vitamin D, iron, and zinc. Obimin Plus is a pre- and postnatal supplement to help provide adequate supply of vitamins, minerals and DHA and EPA, during pregnancy and lactation. Myoglobin helps your muscle cells store oxygen. cofactors and coenzymes) in biological processes. Espaol (Spanish) | Print. Participants in these studies used a wide variety of MVMs containing different combinations and amounts of nutrients. Common side effects may include: upset stomach; Helps strengthen bones and make joints flexible. The DGA adds that the use of some medications (such as proton pump inhibitors) can decrease absorption of vitamin B12 in foods [54]. Website: https://pubmed.ncbi.nlm.nih.gov/. [, Bailey RL, Pac SG, Fulgoni III VL, Reidy KC, Catalano PM. Phytochemicals present in honey can mitigate the primary mechanisms of oxidative stress and are deliberated as nutraceutical food responsible for mitigating risk factors for cancer and cardiovascular diseases. MVM and MV supplements have no standard or regulatory definition, such as what nutrients they must contain or in what amounts.
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