Daily Multivitamin Supplementation and Biological Ageing: Evidence from the COSMOS Randomized Trial

A study recently published in Nature Medicine has examined whether daily multivitamin supplementation can influence biological ageing. The findings, derived from the COcoa Supplement and Multivitamin Outcomes Study (COSMOS), suggest that regular multivitamin use may modestly slow the progression of certain molecular ageing markers.

 

Ageing-related conditions represent a major component of the global burden of disease among adults. Biological ageing refers to the gradual decline in physiological resilience and functional capacity of the body’s systems. This process does not occur at the same rate in all individuals and can be influenced by genetic, environmental, and lifestyle factors.

 

Although multivitamin–multimineral supplementation has previously been investigated for its potential benefits in several chronic diseases, its possible role in modifying biological ageing mechanisms has remained uncertain.

 

The present analysis included nearly one thousand participants enrolled in the COSMOS randomized clinical trial. The average age of participants was approximately 70 years, with women representing about half of the study population. Most participants were of White ethnicity.

 

Participants were randomly assigned to receive one of four daily intervention combinations for two years: multivitamin plus cocoa extract, multivitamin plus placebo cocoa extract, cocoa extract plus placebo multivitamin, or placebo supplements for both interventions.

 

The primary focus of the analysis was on epigenetic ageing markers, often referred to as epigenetic clocks. These biomarkers estimate biological age using DNA methylation patterns, which regulate gene activity without altering the underlying DNA sequence.

 

Results indicated that individuals receiving daily multivitamin supplementation demonstrated a slower progression in several second-generation epigenetic ageing clocks compared with participants receiving placebo. While the magnitude of the effect was modest, the difference was statistically significant.

 

The investigators also observed that participants with higher levels of biological ageing at baseline appeared to benefit more from supplementation. In contrast, cocoa extract supplementation did not show measurable effects on the epigenetic ageing markers analysed.

 

The authors note that multivitamin supplementation represents a relatively low-cost and widely accessible intervention. However, they emphasise that additional research is needed to determine whether the observed changes in molecular ageing markers translate into clinically meaningful improvements in long-term health outcomes.

 

Further studies will also be necessary to assess whether similar effects may occur in other age groups and populations.

 

 

 

 

Reference

 

 

Li S et al. Effects of daily multivitamin–multimineral and cocoa extract supplementation on epigenetic aging clocks in the COSMOS randomized clinical trial. Nature Medicine. 2026. doi:10.1038/s41591-026-04239-3.