The adult vitamin and mineral supplement maze.
OBJECTIVE
The content and daily cost of 14 popular multi-vitamin/ multi-mineral (MVMM) supplements promoted for adults 50 years of age or older in the United States were compared in order to provide pharmacists with objective information, enabling them to make more informed recommendations for these products.


METHODS
The labeled ingredients for MVMM products contained on Drug Topic's "Top 200" over-the-counter product list and for several other popular brands were compared with the Institute of Medicine's (IOM) recommendations for the Dietary Reference Intake (DRI) of micronutrients.


RESULTS
DRIs for micronutrients are generally the same for adults between ages 31 to 70. However, vitamin B6, vitamin D, and calcium have increased daily DRIs for adults 50 years of age or older, and the DRI for vitamin D for those 70 years of age and older is higher. All products reviewed met IOM's recommendations for vitamin B6 and vitamin D for individuals 70 years of age or older. No product contained the daily DRI for calcium, particularly products designed for men. The cost and number of tablets per daily dose for MVMM varies and may affect product selection.


CONCLUSIONS
The most significant difference among MVMM products is the calcium content. IOM's recommendations for calcium are the same for both genders 50 years of age or older, but products developed for men contain very low amounts of calcium compared with products for women. Individuals who have a low dietary intake of vitamin D and calcium should take additional supplements with a daily MVMM. Formulations change frequently, and pharmacists should read labeling before making any specific product recommendations.
Mackowiak
Elaine D
ED
Temple University School of Pharmacy, Philadelphia, PA, USA. elaine.mackowiak@temple.edu
Bernstein
Yelena
Y
Paul
Stephen H
SH
D000328:Adult; D000367:Age Factors; D000368:Aged; D002626:Chemistry, Pharmaceutical; D003157:Community Pharmacy Services; D019587:Dietary Supplements / Q000191:economics; D016527:Drug Costs; D004348:Drug Labeling; D019317:Evidence-Based Medicine; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008903:Minerals / Q000191:economics / Q000627:therapeutic use*; D004366:Nonprescription Drugs / Q000191:economics / Q000627:therapeutic use*; D018673:Nutrition Policy; D017410:Practice Guidelines as Topic; D012737:Sex Factors; D014481:United States; D014815:Vitamins / Q000191:economics / Q000627:therapeutic use*
D008903:Minerals; D004366:Nonprescription Drugs; D014815:Vitamins