High-Dosage Vitamin E Supplementation and All-Cause Mortality

Simin Nikbin Meydani; Joseph Lau; Gerard E. Dallal; Mohsen Meydani

doi:10.7326/0003-4819-143-2-200507190-00023

Letters |19 July 2005

High-Dosage Vitamin E Supplementation and All-Cause Mortality

Simin Nikbin Meydani, DVM, PhD; Joseph Lau, MD; Gerard E. Dallal, PhD; Mohsen Meydani, DVM, PhD

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TO THE EDITOR:

Miller and colleagues (1) reported that supplemental intake of vitamin E at dosages greater than 150 IU/d progressively increases all-cause mortality. There are several problems with their analysis and interpretation of the data. The harmful effect above 150 IU/d is an artifact of the model they chose to fit. When researchers fit a quadratic-linear spline, the result must be a quadratic-linear spline regardless of whether the data behave that way. In another reasonable model, the favorable response to vitamin E is constant until a certain dose, above which the change in all-cause mortality risk difference is linear. The constant response to vitamin E persists up to a dosage of 330 IU/d, and the risk difference favors vitamin E until the dosage is 400 IU/d. The sum of weighted squared differences between observed and predicted all-cause mortality risk differences shows that this model fits the data better than does the quadratic-linear spline.

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2005 American College of Physicians

Letters |19 July 2005

High-Dosage Vitamin E Supplementation and All-Cause Mortality

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Letters |19 July 2005

High-Dosage Vitamin E Supplementation and All-Cause Mortality

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