In July 2019, another meta-analysis of 24 interventions in 277 trials was conducted and published in Annals of Internal Medicine, including a total of almost 1,000,000 participants. The study generally concluded that the vast majority of multivitamins had no significant effect on survival or heart attack risk. The study found a significant effect on heart health in a low-salt diet, and a small effect due to omega-3 and folic acid supplements. This analysis supports the results of two early 2018 studies that found no conclusive benefits from multivitamins for healthy adults.