Vitamin and mineral supplementation associated with minimal to no benefit in the primary preventing of cardiovascular disease and cancer – US Preventative Services Task Force

1. Vitamin and mineral supplementation was associated with minimal to no benefit in preventing cancer, cardiovascular disease, and death.

2. Multivitamin use was associated with a minute benefit for cancer incidence. In individuals at high risk of lung cancer, beta carotene was associated with an increased risk of lung cancer and other harmful outcomes.

Evidence Rating Level: 1 (Excellent)

Study Rundown: Vitamin and mineral supplementation have been proposed as a preventative strategy for both cardiovascular disease and cancer – the 2 leading causes of death in the US. This systematic review serves as an updated evidence report by the US Preventative Services Task Force and reviews current evidence on the benefits and harms of vitamin and mineral supplementation in healthy adults without cardiovascular disease or cancer and with no known vitamin or mineral deficiencies. Key outcomes include all-cause mortality, composite cardiovascular disease events, any cancer incidence, serious harms. Overall, vitamin and mineral supplementation was associated with minimal to no benefit in preventing cancer, cardiovascular disease, and death. Multivitamin use was associated with a minute benefit for cancer incidence. In individuals at high risk of lung cancer, beta carotene was associated with an increased risk of lung cancer and other harmful outcomes. A limitation of this study was that not all supplements were included in this review (e.g., folic acid) owing to a focus on cardiovascular disease and cancer prevention.

Click to read the study in JAMA

Click to read an accompanying editorial in JAMA

Relevant Reading: Vitamin, mineral, and multivitamin supplements for the primary prevention of cardiovascular disease and cancer: US Preventive Services Task Force recommendation statement

In-Depth [systematic review and meta-analysis]: This review included 84 studies (N=739 803) across randomized clinical trials (RCTs) and observational studies examining vitamin or mineral use among adults without cardiovascular disease or cancer from MEDLINE, PubMed, Cochrane Library, and Embase between 2013-2022. In pooled analyses, multivitamin use was significantly associated with a lower incidence of any cancer (OR, 0.93 [95%CI, 0.87-0.99]; 4 RCTs [n=48 859]; ARD range, −0.2% to −1.2%) and lung cancer (OR, 0.75 [95%CI, 0.58-0.95]; 2 RCTs [n=36 052]; ARD, 0.2%). Beta carotene was significantly associated with an increased risk of lung cancer (OR, 1.20 [95%CI, 1.01-1.42]; 4 RCTs [n=94 830]; ARD range, −0.1% to 0.6%) and cardiovascular mortality (OR, 1.10 [95%CI, 1.02-1.19]; 5 RCTs [n=94 506] ARD range, −0.8%to 0.8%). Vitamin D and E use were not significantly associated with all-cause mortality, cardiovascular disease, or cancer outcomes.

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