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To the Editor: Ms Graat and colleagues¹ found that multivitamin supplements did not prevent acute respiratory tract infections in healthy elderly persons. The authors used a multivitamin and trace-element preparation that contained recommended daily allowances (RDAs) of vitamins but only 25% to 50% of the RDAs for minerals. The RDAs, however, are intended to prevent nutritional deficiency, and may be too low to produce further benefits.^2-3 Other studies, using nutrients in amounts based on physiological dose-response curves and immune responses, have found beneficial effects.^4-5

I believe that most older individuals would benefit from the regular use of a multivitamin and mineral supplement that is based on the evidence of dose-response curves rather than the theoretical RDAs.

AUTHOR INFORMATION
Financial Disclosure: Dr Chandra holds a US patent for a multinutrient preparation marketed as TALISMAN in 2 provinces in Canada.

Ranjit Kumar Chandra, MD
Université Internationale des Sciences de la Santé
Crans-sur-Sierre, Switzerland

1. Graat JM, Schouten EG, Kok FJ. Effect of daily vitamin E and multivitamin-mineral supplementation on acute respiratory tract infections in elderly persons: a randomized controlled trial. JAMA. 2002;288:715-721. FREE FULL TEXT 2. Chandra RK. Graying of the immune system: can nutrient supplements improve immunity in the elderly? JAMA. 1997;277:1398-1399. FULL TEXT | PUBMED 3. Hoffer LJ. Nutritional supplements and health. Ann RCPS Can. 1996;29:11-16. 4. Chandra RK. Effect of vitamin and trace-element supplementation on immune responses and infection in elderly subjects. Lancet. 1992;340:1124-1127. FULL TEXT | ISI | PUBMED 5. Jain AM. Influence of vitamins and trace-elements on the incidence of respiratory infection. Nutr Res. 2002;22:85-87. FULL TEXT

Letters Section Editor: Stephen J. Lurie, MD, PhD, Senior Editor.

JAMA. 2003;289:173.

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