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Vitamin, Mineral, and Multivitamin Supplements to Prevent Cardiovascular Disease and Cancer: Recommendations From the U.S. Preventive Services Task Force FREE

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The full report is titled “Vitamin, Mineral, and Multivitamin Supplements for the Primary Prevention of Cardiovascular Disease and Cancer: U.S. Preventive Services Task Force Recommendation Statement.” It is in the 15 April 2014 issue of Annals of Internal Medicine (volume 160, pages 558-564). The author is V.A. Moyer, on behalf of the U.S. Preventive Services Task Force.

This article was published online first at www.annals.org on 25 February 2014.

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Ann Intern Med. 2014;160(8):I-24. doi:10.7326/P14-9012
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Who developed these recommendations?

The U.S. Preventive Services Task Force (USPSTF) developed these recommendations. The USPSTF is a group of health experts that reviews published research and makes recommendations about preventive health care.

What is the problem and what is known about it so far?

Cardiovascular disease (CVD) and cancer are common problems for Americans. Shortages of antioxidant vitamins (vitamins A, C, and E; beta-carotene; and folic acid) are associated with the blood vessel changes that occur in CVD. Therefore, people have thought that taking these vitamins might decrease the risk for CVD. Information also suggests that these vitamins might decrease a person's risk for cancer.

Many studies have examined associations between particular vitamins and CVD and cancer. The studies vary in quality, and their results often conflict. In 2003, the USPSTF recommended that people should not take beta-carotene supplements to decrease their risk for CVD or cancer. At that time, the USPSTF concluded that there was not enough known to be able to make a recommendation for or against taking vitamins A, C, or E; multivitamins with folic acid; or combinations of these vitamins for the primary purpose of preventing CVD or cancer. The USPSTF wanted to update these recommendations on the basis of information that has become available since 2003.

How did the USPSTF develop these recommendations?

The USPSTF reviewed published studies to evaluate whether taking vitamin or mineral supplements prevents CVD and cancer in the general adult population.

What did the authors find?

The USPSTF found inadequate evidence to assess the balance of benefits and harms of supplements of single or paired vitamins, multivitamins, or minerals to prevent CVD or cancer. Only 2 vitamin supplements, beta-carotene and vitamin E, have sufficient evidence to weigh the balance of benefits and harms. Beta-carotene supplements have been associated with an increased risk for cancer in smokers, so the harms outweigh the benefits. Large, high-quality studies show that vitamin E supplements have no effect on CVD, cancer, or death rates. The USPSTF concludes that there is no benefit of vitamin E supplements to prevent these conditions.

What does the USPSTF recommend that patients and doctors do?

The USPSTF recommends that people do not take beta-carotene or vitamin E supplements to decrease their risk for CVD or cancer. The USPSTF concludes that there is not enough evidence to assess the balance of benefits and harms of taking other single or paired vitamin or mineral supplements or multivitamins to prevent CVD and cancer.

What are the cautions related to these recommendations?

These recommendations focus only on healthy adults without special nutritional needs. They do not apply to children, women who are or may become pregnant, or people who are chronically ill or have a known nutritional deficiency.





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