Vitamin Supplements and Outcomes

EA O’Connor et al. JAMA. 2022;327(23):2334-2347. doi:10.1001/jama.2021.15650. Full text -open access: Vitamin and Mineral Supplements for the Primary Prevention of Cardiovascular Disease and Cancer. Updated Evidence Report and Systematic Review for the US Preventive Services Task Force

Key findings:

  • In pooled analyses, multivitamin use was significantly associated with a lower incidence of any cancer (odds ratio [OR], 0.93 [95% CI, 0.87-0.99]…However, the evidence for multivitamins had important limitations
  • Limited evidence suggested some supplements may be associated with higher risk of serious harms (hip fracture [vitamin A], hemorrhagic stroke [vitamin E], and kidney stones [vitamin C, calcium])
  • Vitamin and mineral supplementation was associated with little or no benefit in preventing cancer, cardiovascular disease, and death, with the exception of a small benefit for cancer incidence with multivitamin use.

Summary of this study –USA Today (6/30/22): Are common multivitamins worth the money? New study explores the benefits, harms. In this “massive meta-analysis from JAMA of 84 studies on vitamins and supplements, …

  • Beta-carotene: supplementation associated with increased risk of lung cancer and cardiovascular mortality.
  • Vitamins D and E: not associated with increased or decreased risk of all-cause mortality, cardiovascular disease or cancer. In summary, no benefit.
  • Based on these findings, the United States Preventive Services Taskforce 1) recommends against the use of beta-carotene or vitamin E supplements for the prevention of cardiovascular disease or cancer and 2) states that there’s insufficient evidence to assess the benefits or harms of multivitamins or other single or paired nutrient supplements for the prevention of cardiovascular disease or cancer.
  • Americans spent $50 billion on multivitamins and supplements in 2021.

My take: Most people will not benefit from vitamin supplements and should focus on developing a healthy diet. Certain populations, including pregnant women and those with intestinal disorders, do need additional vitamins.

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