Vitamins to prevent cancer and cardiovascular disease: No, says USPSTF

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For most vitamin and mineral supplements, there is not enough evidence to recommend them for or against taking them to prevent cancer and cardiovascular disease (CVD), according to the working group’s new draft recommendations. of US Prevention Services

Although the evidence for most vitamin and mineral supplements is not yet clear, there is evidence that two products do not reduce the risk of these diseases. The working group found no advantage vitamin E., and actually found damage associated with the dam Beta carotene.

“The working group recommends the use of vitamin E or beta-carotene for the prevention of heart disease and cancer,” said working group member John Wong, MD, vice president of clinical affairs, head of the clinical decision making and a primary care physician at the Department of Medicine at Tufts Medical Center, Boston, Massachusetts.

“Evidence shows that it has no benefit from taking vitamin E and that beta-carotene can be harmful because it increases the risk of lung cancer in people who are already at risk, such as those who smoke, and also increases the risk of dying for heart disease or stroke“he said in a statement.

The current draft recommendation remains unchanged from previous guidelines published in 2014.

Work team recommendations apply to nonpregnant adults living in the community. They do not apply to people with known or suspected nutritional deficiencies or special nutritional needs. The working group has an independent recommendation for women who are planning or may become pregnant and recommends the use of folic acid supplements.

Two main causes of death

Cardiovascular disease and cancer are the two leading causes of death in the United States and, combined, account for about half of all deaths, according to the working group. Inflammation and oxidative stress play a role in both diseases and dietary supplements can have anti-inflammatory and antioxidant effects. This has served as a foundation for studying the use of dietary supplements as a means to prevent cardiovascular disease and cancer.

“Because heart disease and cancer are the two leading causes of death in the United States, we want to examine whether taking vitamins and minerals helps prevent these important diseases,” explained Chyke Doubeni, a member of the working group, MBBS , MPH, GP and inaugural director of the Mayo Clinic Center for Health Equity and Community Engagement Research, Rochester, Minnesota, in a statement. “However, there is not enough evidence to know whether taking vitamin, mineral and multivitamin supplements prevents these conditions, so the working group calls for more research.”

Key recommendations

To update the 2014 recommendation statement, the working group conducted a review of the evidence on the effectiveness of supplementation with single nutrients, functionally related nutrient pairs, or multivitamins to reduce the risk of cardiovascular disease, cancer, and mortality. in the general adult population. They also examined the possible harms of using supplements.

His main discoveries are:

  • There is adequate evidence that beta-carotene supplements and vitamin E supplements do not provide any benefit in the prevention of CVD or cancer.

  • Adequate evidence has shown that beta-carotene causes minor damage in increasing the risk of lung cancer in people at higher risk.

  • There is adequate evidence that vitamin E and multivitamins cause minor harm.

  • There is a lack of evidence on the benefits of multivitamin supplements to prevent cardiovascular disease or cancer.

  • There is no inadequate evidence on the benefits of supplementing with individual or paired nutrients (other than beta-carotene and vitamin E) to prevent cardiovascular disease or cancer.

  • Evidence is limited for damage from supplementation with individual or paired nutrients (other than beta-carotene or vitamin E).

The working group noted that more research is needed to understand the effects of vitamin, mineral and multivitamin supplementation on CVD and cancer outcomes, as well as to understand whether it is treated or not. vitamin D. supplementation has an effect on cancer mortality.

Additional research is also needed to test whether there is heterogeneity between specific populations or by basal nutrient level, especially among individuals without known deficiencies.

As for the recommendations of other organizations, the Task For points to the U.S. Department of Health and Human Services’ 2020-2025 dietary guidelines, which suggest that nutritional needs should be met primarily by food and beverages, specifically nutrient-dense foods and beverages. The American Heart Association also recommends that healthy people get an adequate amount of nutrients by eating a variety of foods in moderation, rather than taking supplements.

The draft statement of recommendation and the draft review of evidence have been posted for public comment. Working group website. Comments can be sent here from May 4 to June 1, 2021.

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