Trial reportNature medicine2026
Effects of daily multivitamin-multimineral and cocoa extract supplementation on epigenetic aging clocks in the COSMOS randomized clinical trial.
Trial report in Nature medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
16 citing papers in PubMed.
- Epigenetic aging biomarkers in dietary geroscience: feasibility, participant perceptions, and trial design considerations.GeroScience · 2026Trial
- Effects of daily multivitamin-multimineral supplementation on metabolomic profiles: 2-year findings from the COSMOS randomized clinical trial.GeroScience · 2026Trial
- Micronutrients and omega-3 PUFAs to promote healthy ageing: informing a physiology-based complementation strategy.GeroScience · 2026Review
- Putting epigenetic aging clocks on trial.Nature medicine · 2026Article
- Natural-Product-Derived Antioxidants and DNA Methylation-Based Epigenetic Aging: A Systematic Review of Human Intervention Studies.Antioxidants (Basel, Switzerland) · 2026Review
- Integrating biological aging into clinical practice: a review and path forward for precision longevity medicine.GeroScience · 2026Review
- Vitamin C as a Potential Geroprotector: Interactions with Aging Hallmarks and Implications for Healthy Longevity.Nutrients · 2026Review
- The Therapeutic Architecture of Chlorogenic Acids: Molecular Mechanisms in Chronic Disease Prevention.Nutrients · 2026Review
- Reconfiguring biofortification strategies to transform food systems and address micronutrient deficiency of the 21st century.Journal of integrative plant biology · 2026Review
- The Divergent Effects of Nicotinamide Riboside and High-Intensity Exercise Training on Skeletal Muscle Epigenetic Aging.Aging cell · 2026Article
- The Impact of Nutrition on DNA Methylation: Methodological Challenges in Understanding Cause and Effect.Nutrients · 2026Review
- An epigenetic speedometer to measure Pace of Aging: FraminghamPACE.medRxiv : the preprint server for health sciences · 2026Article
- Biological aging clocks in health and disease.Nature medicine · 2026Review
- Metabolic Crosstalk Between Host and Tumor as a Circuit of Resilience in Cancer Therapy.Cells · 2026Review
- A to Z of Health: An Evidence-Based Narrative Review of Multivitamin-Multimineral and Nutraceutical Supplementation.Cureus · 2026Review
- Turning back time: a comprehensive list of interventions that decrease next-generation epigenetic aging clocks in humans.Frontiers in genetics · 2026Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors.
Funding
Abstract
Large-scale randomized trials have found that multivitamin-multimineral (MVM) supplements and cocoa flavanols may benefit several age-related chronic conditions among older adults, but it remains unclear whether these two supplements directly slow the biological aging process. This prespecified ancillary study evaluated the 2-year effect of a daily MVM (Centrum Silver) and cocoa extract (500 mg cocoa flavanols per day, including 80 mg (-)-epicatechin) on five DNA methylation measures of biological aging (PCHannum, PCHorvath, PCPhenoAge, PCGrimAge and DunedinPACE) among 958 participants (482 women and 476 men) in the COcoa Supplement and Multivitamin Outcomes Study (COSMOS). Compared with placebo, daily MVM supplementation modestly reduced the rate of increase of second-generation epigenetic clocks, with a between-group difference in yearly change of -0.113 years (95% confidence interval (CI) -0.205 to -0.020; P = 0.017) for PCGrimAge and -0.214 years (-0.410 to -0.019; P = 0.032) for PCPhenoAge. MVM had a stronger effect on PCGrimAge among those with accelerated biological aging at baseline (-0.236 [-0.380 to -0.091]) compared with those with normal or decelerated biological aging (-0.013 [-0.130 to 0.104]; P = 0.018 for interaction). Cocoa extract did not have an effect on the five epigenetic clocks tested. Although the statistically significant but small effects of daily MVM supplementation on slowing biological aging are encouraging, additional studies are needed to determine the clinical relevance of daily MVM supplementation on epigenetic clocks and whether such effects can help explain the beneficial effects of MVM supplementation on aging-related chronic conditions.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.