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Carotenoids and Retinoids (Poster Session)

(P01-003-24) Effect of Randomized Multivitamin and Cocoa Extract Supplementation on Serum Carotenoids and Vitamin E in the COSMOS Trial

Sunday, June 30, 2024
11:45 AM – 12:45 PM CT
Location: Poster Board 371

    Presenting Author(s)

  • Cami N. Christopher, MPH

    PhD Student
    Harvard University
    Boston, Massachusetts, United States

    • Co-Author(s)

  • John W. Erdman, Jr., PhD

    Professor Emeritus
    University of Illinois at Urbana-Champaign
    Urbana, Illinois, United States

  • EK

    Eunjung Kim

    Brigham and Women’s Hospital and Harvard Medical School, United States

  • MB

    Molly Black, Vet Tech

    Veterinary Technician
    University of Illinois at Urbana-Champaign
    Urbana, Illinois, United States

  • PR

    Pamela M. Rist

    Brigham and Women’s Hospital and Harvard Medical School, United States

  • JoAnn E. Manson, MD, DrPH

    Chief, Division of Preventive Medicine
    Brigham and Women's Hospital
    Boston, Massachusetts, United States

  • HS

    Howard D. Sesso, ScD, MPH

    Associate Professor
    Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Department of Epidemiology, Harvard T.H. Chan School of Public Health
    Boston, Massachusetts, United States

Disclosure(s):
Cami N. Christopher, MPH: No relevant financial relationship(s) with ineligible companies to disclose.


Objectives: Dietary carotenoids and vitamin E support overall health, but evidence is limited on how daily multivitamin-multimineral (MVM) supplementation changes serum carotenoid or vitamin E levels over time. We evaluated the impact of a daily MVM supplement on serum carotenoid and vitamin E levels over 2 years and whether concurrent intake of a cocoa extract (CE) supplement modified these levels.

Methods: Participants were enrolled in the COcoa Supplement and Multivitamin Outcomes Study (COSMOS), a randomized, placebo-controlled, 2x2 factorial trial testing a daily MVM (Centrum Silver) and CE supplement (containing 500 mg/d flavanols) for chronic disease prevention in 21,442 older adults. 399 COSMOS participants provided blood samples at baseline, year 1, and year 2 with measures of carotenoids and α-tocopherol. In intention-to-treat analyses, linear mixed models assessed the effect of MVM use, adjusting for age, sex, and the CE intervention.

Results: A daily MVM supplement vs placebo increased serum carotenoids including lycopene, lutein, and β-carotene, and α-tocopherol – which were all included in the MVM formulation. Increases in serum carotenoids and α-tocopherol following MVM supplementation emerged at year 1 and persisted into year 2. At 2 years, compared to placebo the MVM group significantly increased levels of total serum carotenoids (MVM: 14.6% vs Placebo: -0.73%), lycopene (4.32% vs -1.30%), lutein (20.2% vs 2.64%), β-carotene (42.5% vs -3.02%), and α-tocopherol (23.8% vs -4.42%), all p< 0.05. Other serum carotenoids including β-cryptoxanthin, zeaxanthin, and α-carotene, did not differ over 2 years between groups (p >0.05). CE supplementation did not significantly modify observed changes in serum carotenoid or α-tocopherol levels with MVM use.

Conclusions: Daily MVM supplementation was associated with significant increases in individual serum carotenoids and α-tocopherol levels over time that were not modified by the CE intervention. Assessment of carotenoid and vitamin E status may serve as valuable markers for MVM adherence and healthy dietary patterns. Future studies should address whether these changes in nutritional status may explain improvements in aging-related health outcomes.

Funding Sources: COSMOS is supported by grants from Mars Edge and the National Institutes of Health. Haleon provided support of study pills and packaging.