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Comment by coldtea | Hacker News Reader

>In this cohort study of 390 124 generally healthy adults with more than 20 years of follow-up, daily multivitamin use was not associated with a mortality benefit.

Aren't most of them the kind of people that are generally middle class and above types, with access to better nutrition and healthcare, and the associated mindset for health improvement, that's a prerequisite to consistently buy and consume multivitamins?

That is, the kind of people to not have many vitamin deficiencies to begin with, compared to some working class person who can't afford time to cook, nor had such ideals instilled upon them since childhood, and eats fast food and microwaved stuff 24/7...

I'd like to see how e.g. adding multivitamins to industrial foodstuff consumed by poorer families, in the school lunches of poor districts, and so on, improves or doesn't improve health outcomes...

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> Participants were adults in the National Institutes of Health–AARP Diet and Health Study (NIH-AARP) cohort; the PLCO Cancer Screening Trial cohort; and the Agricultural Health Study (AHS) cohort (eFigure 1 in Supplement 1). The NIH-AARP Diet and Health Study began in 1995 to 1996, when questionnaires were mailed to current AARP members who were aged 50 to 71 years and resided in 1 of 2 US metropolitan areas or 6 states.

> The PLCO study was a randomized cancer-screening trial that enrolled 154 887 participants at 10 US centers between 1993 and 2001.23 Participants were aged 55 to 74 years at baseline.

> The AHS enrolled 52 394 licensed pesticide applicators, 4916 commercial pesticide applicators, and 32 345 spouses of private applicators who were aged 18 years or older from Iowa and North Carolina from 1993 to 1997.

That sounds like more a broader approach then just "middle class and above types".

> by pooling data from 3 large cohorts, we could explore heterogeneity across key population subgroups, including understudied sociodemographic subgroups, which was identified as a research gap in the 2022 USPSTF review.3 In stratified analyses, we found no evidence of effect modification by race and ethnicity, education, or diet quality.

I do believe you’re describing food fortification, which the US performs liberally: https://en.m.wikipedia.org/wiki/Food_fortification#United_St...

I’d honestly be curious to see if this study accounted for socio-economic class and overall policy around food enrichment or fortification in the regions the participants lived in. I’d expect multivitamins to have a more noticeable impact in places where food wasn’t enriched.

Vitamins are naturally present in good non-processed food.

Fortification is only required in processed food.

Not disputing that, but the line gets blurry when you consider things like golden rice (https://en.wikipedia.org/wiki/Golden_rice) as a method of food fortification.

The purpose for golden rice touches on a big consideration for nutritional policy: diets aren't always diverse and don't always include enough sources of nutrition. History is rife with stuff like beriberi or scurvy due to cultural norms or inability to find varied sources of nutrition.

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