Perspective:

The antioxidant supplement story continues to evolve with no evidence of benefit for cancer or cardiovascular disease risk reduction from beta carotene, folate, vitamin E, selenium, or vitamin C, and increased risk of lung cancer with high-dose beta carotene and risk of polyps with high-dose folate. Yet so many patients take large doses, some of which is prescribed by well-intended physicians including specialists in aging/dementia, ophthalmology, and urology. The authors concluded with the following message for providers and the public: ‘The lack of benefit from dietary supplementation with vitamin E or other agents with respect to preventing common health conditions and cancers or improving overall survival, and their potential harm, underscore the need for consumers to be skeptical of health claims for unregulated over-the-counter products in the absence of strong evidence of benefit demonstrated in clinical trials.’ Clearly, long-term implications of taking nutraceuticals and dietary supplements are not known and very hard to assess.