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In Reply: We agree with Dr Chandra and with Dr Girodon and colleagues that the composition of the multivitamin-mineral supplement may have contributed to our null findings. We chose to use a commercially available supplement with only the micronutrients reported to be relevant to the immune response, and which are often suboptimal in the elderly population. For minerals, we included 50% of the RDA for elderly persons because of safety reasons: therapeutic and toxic levels of some minerals, such as copper, zinc, and iron, are reported to be close to one another.¹

It is unclear whether our micronutrient supplement would have resulted in beneficial effects on infectious diseases in an elderly population with optimal nutritional status, such as ours. Thus, we cannot rule out the possibility that higher levels of certain micronutrients might decrease the incidence of disease. However, we did find evidence of serious adverse effects when vitamin E . . . [Full Text of this Article]

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