In the news: the ineffectiveness of vitamin supplements

New analyzes and recommendations from the US Preventive Services Task Force (USPSTF) cast doubt on the effectiveness of vitamin and mineral supplements. Assessing the Global Dietary Supplement Market more than $140 billion, the USPSTF’s findings, along with new data on the role of vitamins in several pathologies, have garnered much attention this week. In particular, an analysis of 84 studies by the USPSTF showed minimal benefit and serious concerns.

Vitamin E and be that carotene don’t die advised

The USPSTF does not specifically recommend the use of vitamin E and beta-carotene for the prevention of heart disease, stroke, and cancer. [1,2] “We recognize that more than half of Americans take some form of vitamin supplement every day, and 30% take a combination of vitamins and minerals,” the researcher said. Dr. John WongUSPSTF member, to Medscape Cardiology. “We looked for evidence, looking at a total of 84 studies. However, we have not found sufficient evidence for or against the use of any vitamins other than beta-carotene and vitamin E, which we do not recommend. no take it,” he added.

A wording together with the declaration, Dr. Jenny Jia, Natalie Cameron and Jeffrey Linder from Northwestern University Feinberg School of Medicine In Chicago, note that the results included 52 additional studies that were not present when the 2014 study was conducted. the latest USPSTF recommendation has been published. [3]. In response to this new data, Dr. Perry Wilson (Yale School of Medicine) has remembered “nephrological” saying: “Vitamins just make expensive urine.” He cast serious doubt on the significance of one benefit found by the USPSTF, that multivitamins were associated with a 7% relative reduction in cancer incidence. Dr. Wilson explains that “Relative risk actually tends to overestimate the magnitude of exposure. In absolute terms, multivitamins reduced the number of cancers by about 0.2%. This means that 500 people would need to be treated with multivitamins to prevent 1 case of cancer. » [4]

Vitamin C : disappointing data in septic shock

According to an article published New England Journal of Medicine, patients with septic shock who received vitamin C infusions were more likely to die or have more severe organ failure than those who received a placebo. These results come from iThe LOVIT study [5]a randomized, placebo-controlled trial involving 863 patients in Canada, New Zealand, France, and other countries.

In the study, 872 patients were randomized to either an infusion of vitamin C every 6 hours for 4 days (n=435) or a placebo (n=437). After 28 days, 191 of 429 patients (44.5%) in the vitamin C group had died or had permanent organ failure, compared with 167 of 434 (38.5%) in the placebo group. This corresponds to a therapeutic effect of 1.21 (p = 0.01). “This is an unexpected result and secondary analyzes (which included assessment of 5 biomarkers of tissue dysoxia, inflammation and endothelial damage measured up to 7e day) did not identify the mechanism of the negative effect,” explained the researchers, led by Prof. Francois Lamontagne (University of Sherbrooke, Quebec) and Professor Neill Adikhari (University of Toronto, Ontario).

Vitamin D deficiency

However, the effects of vitamin deficiency remain important. Vitamin D deficiency has recently been found to significantly increase the risk of miscarriage. To analysis out of 10 studies [6]in women who are vitamin D deficient (<50 nmol/L), persileidimo rizika buvo beveik dvigubai didesnė nei toms, kurių vitamino D kiekis buvo pakankamas (>75 nmol/L; OR 1.94; 95% CI, 1.25–3.02). Low vitamin D levels have also recently been associated with a higher incidence of diabetic foot ulcers in older patients. preliminary preprint study. [7]

On the other hand, As a reminderVitamin D supplementation has been shown to be ineffective in reducing the risk of developing type 2 diabetes in the general population with prediabetes. New discoveries come from DPVD upcoming trial [Diabetes Prevention with active Vitamin D] was performed on more than 1,200 glucose-intolerant Japanese participants. [8] Treatment with 0.75 μg/d eldecalcitol, an active vitamin D analog, for 3 years did not protect from prediabetes to type 2 diabetes, nor did it improve the rate of regression to normoglycemia compared with placebo.

Towards evidence-based prevention measures

Almost 60% of the American population (and 46% French) use certain food supplements, often for the prevention of cardiovascular diseases. Editorial to writers who commented on the USPSTF report [3]these data support that the best strategy is not to focus on vitamin supplements, but to reinforce low-risk, high-benefit measures such as a healthy diet, regular exercise, maintaining a healthy weight, and smoking cessation.

Subscribe newsletters from Medscape: select your options.

Follow up Medscape in French enabled Twitter, Facebook and LinkedIn.

Follow up | Medscape Cardiology in french on Twitter.

Leave a Comment