Iron Supply of Multivitamins-Multiminerals Commercialized Online by Amazon in Western and Southern Europe: A Labeling Analysis

Abstract

Background. In high-income countries, shopping for non-prescription multivitamin-multimineral supplements has tremendously increased. Objective and Methods. The purpose of this labeling analysis is to inform on the daily elemental iron (with or without vitamin C) supply provided by multivitamin-multimineral supplements sold online by Amazon in Western and Southern Europe (amazon.es^®, amazon.de^®, amazon.it^®, and amazon.fr^®). Results. We identified 298 iron-containing multivitamin-multimineral preparations sold by Amazon marketplaces: 153 preparations sourced from amazon.de^®, 68 from amazon.fr^®, 54 from amazon.it^®, and 23 from amazon.es^®. The daily iron dose provided by these preparations was 14 [5-14] mg (median and interquartile range), with no differences among the marketplaces. Approximately 90% (n = 265) of the preparations contained ferrous iron. Moreover, 85% (n = 253) of the preparations were fortified with vitamin C in a dose of 80 [40-100] mg daily. Conclusions. The median supply of iron (about 14 mg) and vitamin C (80 mg) in iron-containing multivitamin-multimineral preparations offered on Amazon platforms in Western and Southern Europe falls below that currently recommended for iron deficiency in review articles, namely 100 mg of iron and 500 mg of vitamin C per day. The iron supply of iron-containing multivitamin-multimineral preparations falls also below the dose of 30-60 mg advocated to prevent iron deficiency in menstruating women.

Keywords: Amazon; iron; multiminerals; multivitamins.

Figure 1

Daily iron supply provided by 298 iron-containing multivitamin–multimineral preparations sold by amazon.de^®, amazon.fr^®, amazon.it^®, and amazon.es^®. The preparations are subdivided into three different groups according to the suggested daily dose of iron, namely 2–9 mg, 10–19 mg, and 20–50 mg daily. Ferrous (Fe²⁺) iron- and ferric (Fe³⁺) iron-containing preparations are presented separately.