MD, PhD, MAE, FMedSci, FRSB, FRCP, FRCPEd.

If you have been following my blog for a while, you probably know the answer to this question. A recent article published in JAMA re-emphasizes it in an exemplary fashion:

According to National Health and Nutrition Examination Survey data, 52% of surveyed US adults reported using at least 1 dietary supplement in the prior 30 days and 31% reported using a multivitamin-mineral supplement. The most commonly cited reason for using supplements is for overall health and wellness and to fill nutrient gaps in the diet. Cardiovascular disease and cancer are the 2 leading causes of death and combined account for approximately half of all deaths in the US annually. Inflammation and oxidative stress have been shown to have a role in both cardiovascular disease and cancer, and dietary supplements may have anti-inflammatory and antioxidative effects.

Objective  To update its 2014 recommendation, the US Preventive Services Task Force (USPSTF) commissioned a review of the evidence on the efficacy of supplementation with single nutrients, functionally related nutrient pairs, or multivitamins for reducing the risk of cardiovascular disease, cancer, and mortality in the general adult population, as well as the harms of supplementation.

Population  Community-dwelling, nonpregnant adults.

Evidence Assessment  The USPSTF concludes with moderate certainty that the harms of beta carotene supplementation outweigh the benefits for the prevention of cardiovascular disease or cancer. The USPSTF also concludes with moderate certainty that there is no net benefit of supplementation with vitamin E for the prevention of cardiovascular disease or cancer. The USPSTF concludes that the evidence is insufficient to determine the balance of benefits and harms of supplementation with multivitamins for the prevention of cardiovascular disease or cancer. Evidence is lacking and the balance of benefits and harms cannot be determined. The USPSTF concludes that the evidence is insufficient to determine the balance of benefits and harms of supplementation with single or paired nutrients (other than beta carotene and vitamin E) for the prevention of cardiovascular disease or cancer. Evidence is lacking and the balance of benefits and harms cannot be determined.

Recommendation  The USPSTF recommends against the use of beta carotene or vitamin E supplements for the prevention of cardiovascular disease or cancer. (D recommendation) The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of the use of multivitamin supplements for the prevention of cardiovascular disease or cancer. (I statement) The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of the use of single- or paired-nutrient supplements (other than beta carotene and vitamin E) for the prevention of cardiovascular disease or cancer. (I statement)

The report also elaborates on potential harms:

For many of the vitamins and nutrients reviewed, there was little evidence of serious harms. However, an important harm of increased lung cancer incidence was reported with the use of beta carotene by persons who smoke tobacco or have occupational exposure to asbestos.

Excessive doses of vitamin supplements can cause several known adverse effects; for example, moderate doses of vitamin A supplements may reduce bone mineral density, and high doses may be hepatotoxic or teratogenic. Vitamin D has potential harms, such as a risk of hypercalcemia and kidney stones, when given at high doses. The potential for harm from other supplements at high doses should be carefully considered.

There is nothing new here, of course. I (and others) have been trying to get these points across for many years. But it is nevertheless most gratifying to see the message repeated by a top journal such as JAMA. I hope JAMA is more successful than I was in changing the behavior of the often all too gullible public!

25 Responses to Do Vitamin, Mineral, and Multivitamin Supplements Prevent Cardiovascular Disease and Cancer?

  • Evidently for a healthy person, supplementing is unnecessary by definition*, but if deficient then evidently, yes, supplementing will help prevent future problems.

    *assuming “hypoascorbemia” does not exist, but it did for me: since taking 10g / day of l-ascorbic acid / (in evenly-spread 1,000mg doses), It’s completely unbelievable – no more sinusitis 🙂 and I got my sense of smell back again – sure I can’t *prove* it, just sayin’.

    ***********************************************
    Vitamin A – I read somewhere about shipwrecked sailors, in the arctic who eventually ate polar bear liver – bad idea…

    • @Old Bob

      good point Bob
      And beyond that, when we are evaluating if supplements PREVENT disease, what is the level of success are we measuring ? … 100% 75% 50% success of benefit ?
      Therin lies a variable that is loosely defined. Nothing is one hundred percent, especially preventative medicine. Does CONmed offer any tablets that will prevent disease from occurring ?

      I accept the use of supplements for those that need them (as Bob indicated). However, better to obtain these vitamins and minerals directly from consuming foods if at all possible.

      • PREVENTION = reduction of incidence of a condition! that’s how it’s normally evaluated.

      • James Joromat wrote “Nothing is one hundred percent, especially preventative medicine.”

        Eradication is the reduction of an infectious disease’s prevalence in the global host population to zero.

        Two infectious diseases have successfully been eradicated: smallpox in humans and rinderpest in ruminants. There are four ongoing programs, targeting the human diseases poliomyelitis (polio), yaws, dracunculiasis (Guinea worm), and malaria. Five more infectious diseases have been identified as of April 2008 as potentially eradicable with current technology by the Carter Center International Task Force for Disease Eradication—measles, mumps, rubella, lymphatic filariasis (elephantiasis) and cysticercosis (pork tapeworm).
        https://en.m.wikipedia.org/wiki/Eradication_of_infectious_diseases

      • @Roger

        Does regular medicine offer any tablets that will prevent disease from occurring ?

        Yes, albeit in the form of injections, not tablets. This is called ‘vaccination’, and it is hugely successful in preventing over a dozen pretty nasty diseases.

        Supplements generally don’t prevent disease in any significant way, barring some exceptions (e.g. extra folic acid and iron are recommended for pregnant women). The only ones really benefiting from the use of supplements is the $180bn supplement industry a.k.a. Big Pharma. This enormous financial success for a basically useless product group just goes to show that there are lots of gullible people around, especially in alternative circles: not only can they be easily fooled into believing that they need supplements, they don’t even realize that these supplements are made by the same Big Pharma companies that they hate so much.

        • Richard Rasker wrote “Yes, albeit in the form of injections, not tablets.”

          Some vaccines are administered orally; some others via a nasal spray.

        • Richard,

          This enormous financial success for a basically useless product group just goes to show that there are lots of gullible people around, especially in alternative circle

          You don’t have to go far very to find useless products. You only have to walk into any pharmacy in the UK – I would think that 90% of what they have on their shelves comes into this category.

          • you mean the OTC shelves, I guess.

          • @ Dr Julian – Pete – Richard

            I was almost certain that at least a couple posters here would lobby for the vaccines as a retort to my claim.
            The truth is that all vaccines are PROCEEDURES that must be administered … not a pill. Yes, the public would prefer a pill that does not need medical intervention. Food supplements may not directly prevent any disease, but they can assist the immune system to do the job.

            I am not against all vaccines, in fact I prescribe to more vaccines than I don’t. So I would not argue that there are some worthy vaccines that will in MOST cases prevent disease with good efficacy and relatively good safety …. as was indicated.
            I do argue against the mRNA vaccines because the safety is in question. Not only the safety, but he efficacy is terrible. A vaccine that is effective for only a few months and needs to be re-administered again and again is not a good vaccine. The Pfizer and Moderna vaccines should be removed from the market.

            I don’t like taking vitamin pills or supplements because I don’t REALLY know what’s in them, that’s the biggest reason I don’t consume them. Not because I don’t believe that additional vitamin D or Zinc wouldn’t benefit me at times.

          • James Joromat says:

            I am not against all vaccines, in fact I prescribe to more vaccines than I don’t……I do argue against the mRNA vaccines because the safety is in question. Not only the safety, but he efficacy is terrible.

            I don’t like taking vitamin pills or supplements because I don’t REALLY know what’s in them, that’s the biggest reason I don’t consume them.

            But you are okay with some vaccines? How do you know what is in the vaccines that you say you subscribe to?

            Wake up and smell the coffee, Joromat. You are an antivaxxer thru and thru. You just don’t know that yet and/or you don’t want to be labeled as one. Therefore, you make risibly idiotic arguments to obfuscate the fact that you are one big antivaxxer. I am an antivaxxer myself and wear that badge proudly. Old Bobby is one too.

            Joromat, I want you to stop deluding yourself and quit whining about what people see you as and come out as a proud antivaxxer. It is time us antivaxxers band together and take down the Vaccine Industrial Complex.

          • I was almost certain that at least a couple posters here would lobby for the vaccines as a retort to my claim.

            This is not ‘lobbying’ for vaccines. You ask if regular medicine offers something to prevent disease. The answer is a simple ‘yes’: vaccines prevent disease. (I suspect that you just asked this question in order to veer off-topic with your inane ramblings about mRNA vaccines.)

            Food supplements may not directly prevent any disease, but they can assist the immune system to do the job.

            Nope, they don’t. A normal, healthy diet is all you need for an optimally functioning immune system. There are no supplements or treatments that can in any way ‘help’ or even ‘boost’ the immune system(*). I think that a ‘boosted’ (i.e. more active and alert) immune system is undesirable – because this is called ‘allergy’ or ‘auto-immune disorder’.

            *: Apart again from vaccines again, which ‘boost’ the immune system in a highly specific manner.

      • However, better to obtain these vitamins and minerals directly from consuming foods if at all possible.

        Absolutely. Been shown time and again.

        Apart from eating husky dog liver. Rather too good a natural source of Vitamin A. https://en.wikipedia.org/wiki/Xavier_Mertz

      • James Joromat,

        And beyond that, when we are evaluating if supplements PREVENT disease, what is the level of success are we measuring ? … 100% 75% 50% success of benefit ?

        Generally prevention studies are looking for ANY measurable reduction in the incidence of the problem under investigation.

        However, if you don’t specify what you are looking for in advance, and just look for all differences between the test and the control group at the end of the trial, then the behaviour of random numbers make it very likely that you will find at least some “statistically significant” benefits that are entirely due to chance.

      • @James Joromat

        You and Old Bobby raise great points and you two are not shy in your criticisms of Medical Industrial Complex a.k.a CONMed. You two are the sharpest minds around and tend to think on the same binary wavelength. Keep up the great work fellas, you two are going places!

        To further your point, James Joromat, measuring the level of success is actually very simple and can be easily understood by simpletons. Does the remedy work on oneself or not? That is the only question that matters. Doesn’t matter if it worked in 70% of population who took the remedy in some RCT run by some nameless, faceless, Fauci-worshiping scientists in lab coats, in some far far away laboratory. Alt-med practitioners on the other hand treat individual patients, customize remedies for each individual person, if it doesn’t work, they will tweak the remedy ever so slightly until it works. I call that “in-your-face medicine” (as opposed to “in-the-lab medicine”) where you get to see the logic behind the customization of remedy as the practitioner tries to figure out what works for you; therefore alt-med is simple, and superior compared to CONmed.

        Of course, CONmed offers tablets to “prevent” diseases, that is what they say. But how do we know the truth when the data is not reported accurately? Either it is cooked up by the scientists or by the crooked media that reports it. There is money to be made every step of the way and a lot riding for the investors. They say truth is out there, but so are the lies and you will never be able to distinguish between the two, Joromat!
        I will go one step further and ask, Does CONmed sell a single tablet that will cure all my current illnesses and prevent future diseases? But you know the answer to that, don’t you, Joromat? The answer is a resounding NO. Therefore, CONmed is worthless in my humble opinion. So, you and Bob are wasting time beating the rotting corpse of CONmed horse.

      • I think you’ll find all the people taking blood pressure medication and statins will tell you that the preventative effects of medicine are far from a con.

    • Old Bob,

      *assuming “hypoascorbemia” does not exist, but it did for me: since taking 10g / day of l-ascorbic acid / (in evenly-spread 1,000mg doses), It’s completely unbelievable – no more sinusitis 🙂 and I got my sense of smell back again – sure I can’t *prove* it, just sayin’.

      It does exist. It’s called scurvy, and ascorbic acid gets its name from the fact that it prevents scurvy (a-scorbutic, “a-” or “an-” being a Greek prefix meaning “not”; “scorbutic” is the adjectival form of “scurvy”). Scurvy was once the scourge of seafarers, killing a great many of them, but it is now almost unheard of as it is very easy to get adequate amounts of vitamin C from your normal diet. I have seen only one case in my career – this was a schizophrenic man living alone and eating a very poor and restricted diet.

      Most medical problems get better of their own accord, but it is very common for people to attribute such an improvement to whatever they did with the intention of treating them. That is one reason why anecdotes are an unreliable source of medical information, however, plausible they seem.

  • James Joromat on Thursday 23 June 2022 at 13:08 said:

    “…I was almost certain that at least a couple posters here would lobby for the vaccines…”

    I’m not: the “safe and effective(TM)” is wearing off:
    https://rumble.com/v19h3ww-secret-cdc-director-briefing-video-the-real-story-behind-the-covid-vax.html

    • @Old Bob
      Please stop pushing your off-topic antivaccine propaganda.
      https://edzardernst.com/rules/:

      5. Comments must be on-topic.

    • Old Bobby,

      I’m not: the “safe and effective(TM)” is wearing off:
      https://rumble.com/v19h3ww-secret-cdc-director-briefing-video-the-real-story-behind-the-covid-vax.html

      Ah yes, nothing supports your argument like a video promoted by Steve Kirsch, the patron saint of The Church of Antivaxxerism, to which you, Joromat and I belong to, unwittingly. Kirsch is intellectually gifted at making simplistic arguments: https://www.mcgill.ca/oss/article/critical-thinking/steve-kirsch-and-seduction-simplicity that even a mere simpleton can process, regurgitate and barf all over. Oh boy! he has a huge following on the internet and people swear by his genius and are willing to jump off a cliff if he tells them that jumping off a cliff cures covid. In fact, Kirsch is funding research on whether jumping off cliffs cures covid. I am waiting on the edge of a cliff with anticipation for the results, which I am sure would be in favor of rejecting null hypothesis. Would you and Joromat join me? We can all jump together as soon as Kirsch’s research confirms that going the way of the lemmings’ is the way to cure covid.

      • Honest Ape on Thursday 23 June 2022 at 22:12 said:

        “…Kirsch is intellectually gifted at making simplistic arguments… that even a mere simpleton can process…”

        Such as “safe and effective”

        • Old Bob says:

          Such as “safe and effective”

          Exactly Bobby! That is what Daddy Steve says about Ivermectin. Thanks for stating the obvious, Bobby Old Timer.

          • That’s oversimplifying.

          • That’s oversimplifying.

            Touché, Bygone Bob. An ape like me doesn’t understand intricacies of drug research done by world renowned pharma experts like Steve Kirsch. Therefore, I will let Daddy Kirsch break it down to you, in a way that even the dumbest Dodo of the pack can understand clearly. I truly hope you not dumber than the dumbest Dodo and can grasp the essence of the following sentence from Kirsch’s website: https://www.treatearly.org/promising-drugs

            The most effective early treatment protocols, such as those used by Dr. Fareed and Tyson, are over 99% effective and extremely safe

          • We dodo see approaching ape
            We stop, stare and gape
            He come for dinner
            But we just ate

          • Little did the dodos know that they are going to be on ape’s dinner plate.
            For they kept gawking at the ape, without realizing that it is a little bit too late.

            Hence the phrase, going the way of the dodo!

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