This systematic review and meta-analysis focused on randomized controlled trials (RCT) of multinutrients consisting of at least four vitamins and/or minerals as interventions for participants with psychiatric symptoms. A systematic search identified 16 RCTs that fit the inclusion criteria (n = 1719 participants) in six psychiatric categories: depression, post-disaster stress, antisocial behavior, behavioral deficits in dementia, attention-deficit/hyperactivity disorder, and autism. Grading of Recommendations, Assessment, Development and Evaluations (GRADE) was used to rate the evidence base. Significant clinical benefit was assessed using minimal clinically important differences (MIDs). Due to heterogeneity in participants, multinutrient formulas, outcome measures, and absence of complete data, only the Attention-Deficit/Hyperactivity Disorder (ADHD) category was eligible for meta-analyses. In ADHD populations, statistically and clinically significant improvements were found in global functioning, Mean Difference (MD) −3.3, p = 0.001, MID −3.26; Standardized Mean Difference (SMD) −0.49 p = 0.001 MD −0.5), clinician ratings of global improvement (MD −0.58, p = 0.001, MID −0.5) and ADHD improvement (MD −0.54, p = 0.002, MID −0.5), and clinician (but not observer) measures of ADHD inattentive symptoms (MD −1.53, p = 0.05, MID −0.5). Narrative synthesis also revealed a pattern of benefit for global measures of improvement, for example: in autism, and in participants with behavioral deficits in dementia. Post-natural disaster anxiety and the number of violent incidents in prison populations also improved. Broad-spectrum formulas (vitamins + minerals) demonstrated more robust effects than formulas with fewer ingredients. This review highlights the need for robust methodology-RCTs that report full data, including means and standard deviations for all outcomes-in order to further elucidate the effects of multinutrients for psychiatric symptoms.

This perspective article is a product of a workshop of experts convened by the Institute for the Advancement of Food and Nutrition Sciences (IAFNS), a nonprofit organization that brings together scientists from government, academia, and industry to catalyze science relevant to food and nutrition for public benefit. An expert group was convened in March 2022 to discuss the current issues surrounding cognitive task selection in nutrition research, with a focus on solutions toward informing dietary guidance for cognitive health, to address a gap identified in the 2020 United States Dietary Guidelines Advisory Committee report, specifically the “considerable variation in testing methods used, [and] inconsistent validity and reliability of cognitive testing methods.” To address this issue, we first undertook an umbrella review of relevant reviews already undertaken; these indicate agreement on some of the issues that affect heterogeneity in task selection, and on many of the fundamental principles underlying the selection of cognitive outcome measures. However, resolving the points of disagreement is critical to ensuring a meaningful impact on the issue of heterogeneity in task selection; these issues hamper the evaluation of existing data for informing dietary guidance. This summary of the literature is therefore followed by the expert group’s perspective in the form of a discussion of potential solutions to these challenges, with the aim of building on the work of previous reviews in the area and advancing dietary guidance for cognitive health.