Daily Multivitamin Linked to Modest Slowing of Biological Aging in New Study

Daily multivitamin supplementation was associated with modest slowing of biological aging markers in older adults over a 2-year period, according to findings from an ancillary analysis of the COcoa Supplement and Multivitamin Outcomes Study (COSMOS) published in Nature Medicine. The randomized clinical trial analysis evaluated DNA methylation–based epigenetic clocks to assess whether multivitamin–multimineral (MVM) supplementation or cocoa flavanol supplementation influenced the pace of biological aging.

Researchers analyzed blood samples from 958 participants (482 women and 476 men) with a mean chronological age of approximately 70 years. Participants were randomized to one of four groups: daily cocoa extract plus multivitamin, cocoa extract plus placebo, multivitamin plus placebo, or double placebo. The multivitamin used in the trial was Centrum Silver.

Compared with placebo, daily multivitamin supplementation was associated with modest reductions in the rate of increase of second-generation epigenetic clocks. Investigators observed a between-group difference in yearly change of −0.113 years (95% CI, −0.205 to −0.020; P = .017) for PCGrimAge and −0.214 years (95% CI, −0.410 to −0.019; P = .032) for PCPhenoAge. Across all five epigenetic clocks assessed—including PCHannum, PCHorvath, PCPhenoAge, PCGrimAge, and DunedinPACE—the observed changes corresponded to approximately four months less biological aging over the two-year study period.

The effect of multivitamin supplementation appeared more pronounced among participants who had accelerated biological aging at baseline. In this subgroup, the effect on PCGrimAge was −0.236 (95% CI, −0.380 to −0.091), compared with −0.013 (95% CI, −0.130 to 0.104) among participants with normal or decelerated biological aging (P = .018 for interaction).

Cocoa extract supplementation (500 mg cocoa flavanols per day, including 80 mg (−)-epicatechin) did not significantly affect any of the five epigenetic clocks evaluated.

“There is a lot of interest today in identifying ways to not just live longer, but to live better,” said senior author Howard Sesso, ScD, MPH, associate director of the Division of Preventive Medicine in the Mass General Brigham Department of Medicine. “It was exciting to see benefits of a multivitamin linked with markers of biological aging. This study opens the door to learning more about accessible, safe interventions that contribute to healthier, higher-quality aging.”

Epigenetic clocks estimate biological age by measuring patterns of DNA methylation—chemical modifications that influence gene expression and change with aging. These biomarkers have been associated with mortality risk and age-related disease outcomes.

The investigators noted that although the effects of multivitamin supplementation on epigenetic aging were statistically significant, they were relatively small, and further studies are needed to determine whether changes in biological aging markers translate into measurable clinical benefits. Future analyses from the COSMOS program will evaluate whether improvements in biological aging markers help explain previously reported associations between multivitamin use and outcomes such as cognitive function, cancer incidence, and cataracts.

“We plan to do follow-up research to determine if the slowing of biological aging—observed through these five epigenetic clocks, and additional or new ones—persists after the trial ends,” said co-author Yanbin Dong, MD, PhD, director of the Georgia Prevention Institute at the Medical College of Georgia at Augusta University.

COSMOS is an investigator-initiated randomized clinical trial supported by the National Institutes of Health and industry partners providing study supplements and infrastructure support. The authors reported that neither company had a role in the trial design, conduct, data collection, analysis, or manuscript preparation.

While the findings suggest daily multivitamin supplementation may modestly influence biological aging biomarkers, investigators emphasized that additional research is needed to determine the clinical significance of these effects in aging-related chronic conditions.

References:

1. Li S, Hamaya R, Pereira AC, et al. Effect of daily multivitamin-mineral and cocoa extract supplementation on epigenetic clocks of biological aging: 2-year findings from the COSMOS randomized clinical trial. Nat Med. 2026. doi:10.1038/s41591-026-04239-3.
2. COSMOS trial results show daily multivitamin use may slow biological aging. News release. Mass General Brigham. March 9, 2026. Accessed March 11, 2026. https://www.eurekalert.org/news-releases/1118757