I’m a big fan of the Â鶹´«Ă˝ podcast Change Your Mind, on which my erstwhile colleagues Cat de Lange and Helen Thomson discuss “all the brain health advice you really need to know”. One recent episode is well worth a listen if you’re interested in keeping your brain healthy. Cat and Helen invited JoAnn Manson, who is head of preventative medicine at Brigham and Women’s Hospital in Massachusetts, to the podcast to discuss her research on multivitamin supplements and brain health. She described how she and her colleagues found that people over 60 who take a daily multivitamin show over two to three years.
For me, that was a marmalade dropper. On the issue of supplements, I’m a hardened sceptic. Based on a Â鶹´«Ă˝ feature I edited many years ago, as well as a recent update by another ex-colleague, Alison George, my informed opinion is that very few supplements work and some are positively harmful. I make an exception for vitamin D because I live too far north to make enough on my own from the feeble winter sunshine. But once the clocks have gone forward, I stop taking it. I would also take folic acid if I were female and trying for a baby (I’m neither), long-chain polyunsaturated fatty acids if I didn’t eat oily fish weekly and vitamin B12 if I were a vegan. But as for the rest, I don’t waste my money.
For people who are willing to shell out for supplements, there are myriad opportunities. One of the thriving markets is in anti-ageing. Although very few if any have been scientifically validated, I’m slightly less sceptical. A few years ago, I took an anti-ageing supplement called alpha-ketoglutarate for six months for a story I was doing. I had my biological age measured before and after, and it went down. But that is hardly solid data of the sort you get from a clinical trial.
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Of that, there is plenty, and it doesn’t cast anti-ageing supplements in a good light. I found a gold mine of information in an academic book published earlier this year called . Under the guidance of the eminent biogerontologist Suresh Rattan at Aarhus University in Denmark, an expert panel rated the evidence for more than 250 compounds with supposed anti-ageing effects. These ranged from vitamins and minerals to plant extracts, traditional medicines, probiotics and hormone supplements, plus some much-hyped compounds I often hear bigged up in anti-ageing circles: NAD+, coenzyme Q10, spermidine and D&Q, or dasatinib and quercetin. Interestingly, they didn’t look at the evidence for alpha-ketoglutarate.
Suffice to say that none of them met the highest standard of evidence, which Rattan defines as “solid, reproducible and trustworthy”. A few reached a secondary level, but, on the whole, the authors recommend obtaining these compounds from food. “At present using one or more nutritional and other supplements… is mostly an act of faith and hope”, rather than being based on strong scientific evidence-based data, the book concludes.
But it also says that more research is needed. So, I had a look at Manson’s. Her results come from a clinical trial she and her colleagues ran between 2015 and 2023 called (Cocoa Supplement and Multivitamin Outcomes Study). The trial recruited more than 21,000 people aged over 60 and gave one group of them a daily multivitamin plus cocoa extract, which contains flavonoid compounds thought to be beneficial for some age-related conditions. Other groups received just a multivitamin, just cocoa extract or nothing. The principal goal of the trial was to test whether the multivitamin/cocoa cocktail would reduce the risk of cardiovascular disease and cancer. It didn’t, but the researchers still found nuggets of useful information in the data.
One of these was the effect on brain health, as discussed on the podcast. Another, which was published earlier this year, looked at the . A subgroup of 958 participants had their biological age measured at the start of the trial and then again two years later. Those who received the daily multivitamin aged, on average, more slowly than those who did not (the cocoa extract had no effect). The effect was relatively modest – a month or two over the two years – but over the course of longer periods that could really add up.
Another study adds weight to the idea that supplements can slow down ageing. Last year, a team including researchers at the University of Zurich in Switzerland published a study on omega-3 fatty acid supplementation in people aged 70 to 91. The traditional verdict on these supplements has been that they aren’t worth taking unless your diet is deficient in the main sources of omega-3, which are oily fish, flaxseed, chia seeds and walnuts. The Zurich research challenges that. Over the course of three years, the people who took the supplement aged biologically three months less, on average, than those who took a placebo. Adding vitamin D and strength training increased the benefit to four months.
So, have I changed my mind about supplements? Not yet. Both studies rely on biological age measurements, which are notoriously unreliable. Neither found any meaningful change in the health of their participants, and slowing down biological ageing doesn’t necessarily correspond to what really matters: an increase in healthspan. It is also possible, Manson told the podcast, that the participants in her study were deficient in one or more vitamins, and the multivitamin supplement merely corrected for that.
But it’s a start. As Daniel Belsky and Calen Ryan at Columbia University in New York wrote in , “Evidence that simple multi-vitamin supplementation can slow aging, even slightly, would have substantial implications, including for public health guidelines.” We’re not quite there yet, but if and when we are, I’m heading to the pharmacy.
