Letters Section Editor: Stephen J. Lurie,
MD, PhD, Senior Editor.
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
Graat JM, Schouten EG, Kok FJ. Vitamin Supplementation in Elderly Persons. JAMA. 2003;289(2):173. doi:10.1001/jama.289.2.173-a