Vitamin, Mineral, and Multivitamin Supplements for the Primary Prevention of Cardiovascular Disease and Cancer: U.S. Preventive Services Task Force Recommendation Statement

May 22, 2014
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Authors:
Moyer VA, on behalf of the U.S. Preventive Services Task Force.
Citation:
Ann Intern Med 2014;160:558-564.
Summary By:
Elizabeth A. Jackson, MD, FACC

Study Questions:

What are the updates from the 2003 U.S. Preventive Services Task Force (USPSTF) recommendations on vitamin supplements to prevent cardiovascular disease and cancer?

Methods:

The updated USPSTF recommendations pertain to healthy adults, generally over the age of 50 years, without special nutritional needs. These recommendations are not for children; pregnant women were not considered in these recommendations, nor were adults who are chronically ill or hospitalized or have a known nutritional deficiency. The USPSTF reviewed the evidence on the efficacy of multivitamin or mineral supplements in the general adult population for the prevention of cardiovascular disease and cancer.

Conclusions:

The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of multivitamins for the prevention of cardiovascular disease or cancer.

The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of single- or paired-nutrient supplements (except beta-carotene and vitamin E) for the prevention of cardiovascular disease or cancer.

The USPSTF recommends against beta-carotene or vitamin E supplements for the prevention of cardiovascular disease or cancer. Beta-carotene has been shown to increase the risk for lung cancer in adults at increased risk for this cancer; for example, among smokers). The USPSTF found adequate evidence that vitamin E does not reduce the risk for cardiovascular disease or cancer.

Perspective:

Given that adults spend an estimated 28.1 billion dollars on supplements in the US, the amount of evidence for benefit related to leading causes of mortality is extremely limited. Clinicians can share the USPSTF recommendations with their patients and emphasize this evidence-based recommendation for cost-effective prevention of cardiovascular disease and cancer.

Keywords: Vitamins, Neoplasms, Dietary Supplements, Minerals, Cardiovascular Diseases, Malnutrition, Primary Prevention


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