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In the news: Multivitamins May Slow Biological Aging: New COSMOS Findings

Multivitamins Slow Biological Aging

New results from the COSMOS study provide the first evidence from a large-scale, long-term, randomized controlled trial that multi-vitamin and mineral supplementation potentially slows biological aging among older adults(1,2).

The findings were presented in March at the 2025 American Heart Association Epidemiology, Prevention, Lifestyle and Cardiometabolic Scientific Sessions (Brain and Aging) held in New Orleans.

Background on the COSMOS Trial

The Cocoa Supplement and Multivitamin Outcomes Study (COSMOS) is a Harvard based, randomized, double-blind, placebo-controlled trial testing a cocoa extract supplement (containing 500 mg/d flavanols), and a multivitamin supplement in the maintenance of cardiovascular health and cancer risk in a total of 21,442 participants, including 12,666 women aged ≥65 years and 8,776 men aged ≥60 years with a median of 3.6 years of treatment and follow-up.

These interventions have both already shown favorable results in prior research studies and are well-tolerated and safe.

Multis Benefit Cognition in COSMOS

Another major goal of COSMOS is to test the effect of the interventions on slowing cognitive decline and aging-related conditions.

A previous study(3), based on detailed in-person cognitive testing of 573 participants of COSMOS together with a meta-analysis analysis of three separate placebo-controlled cognitive studies from COSMOS, found a strong and consistent benefit of the multivitamins for both memory and global cognition, each with a P value < .001.

New Findings: Multis Slow Biological Aging

In addition to slowing cognitive decline, multivitamins have been shown to reduce the risks of several chronic conditions including a lower risk of cataract in the Physicians Health Study II.

Thus, the COSMOS investigators decided to examine whether a delay in biological aging might be responsible for –or contribute to – the chronic disease risk reduction seen in these clinical trials.

The new study included about 950 older, randomly selected COSMOS participants (average age of 70.2 years) who had baseline, 1-year, and 2-year blood tests available.

Biological aging was assessed using 5 different epigenetic clocks. Epigenetic clocks are tools that use changes in DNA methylation to estimate biological age. DNA methylation is a biological process where methyl groups are added to DNA, changing how a DNA segment functions.

In this study two of the epigenetic clocks were 1st generation (predicting chronological age based on DNA methylation patterns at specific CpG sites). Two more were 2nd generation (based on DNA methylation patterns but incorporating factors like blood chemistry and other health-related biomarkers). The 5th epi-genetic clock (DunedinPACE) measures the pace of aging by analyzing DNA methylation patterns in blood.

A signal for slower aging was seen in all five of the epigenetic clocks in the multi group compared with the placebo arm. For the two 2nd generation clocks, there was significant slowing of aging with the multi vs. placebo, with about 10-20% slower aging with the daily multi use over the 2-year study period. According to study co-investigator Dr. JoAnn Manson, “that equated to abut 4 months of aging that seemed to be averted or prevented. Among participants who had accelerated aging at baseline the reported benefits were even greater.”

References

1. Sidlong L, et al. Effect of a daily multivitamin on 2-year changes in DNA methylation measures of biological aging: finding from the COSMOS randomized clinical trial. AHA EPI/Lifestyle Sci Session, 03.A Aging and Brain Health, ID 008, March 7, 2025.
2. Manson JE. Multivitamins slow biological aging in a large trial. Medscape. March 24, 2025
3. Vyas CM, et al, Effect of multivitamin-mineral supplementation versus placebo on cognitive function: results from the clinic subcohort of COSMOS randomized clinical trial and meta-analysis of 3 cognitive studies within COSMOS. Am J Clin Nutr. 119:692-701, 2024.