Weird Medicine Healthcare for the Rest of Us

February 4, 2017

Dietary Supplements and Risk of Cause-Specific Death, Cardiovascular Disease, and Cancer

Filed under: Steve's Blog — Tags: , , , , — dr steve @ 2:19 pm

Here’s a nice article doing some actual SCIENCE on dietary supplements and health.  People ask me all the time, “do dietary supplements work?”  My first question is always “what do you want to accomplish?”  If you say,  “I want to take Vitamin D to prevent rickets,”  I’m all in!  If you say “I want to take Vitamin C to prevent the common cold,” I can’t find any decent data to support it.

So we have to define our endpoints (what do we want to accomplish) then study how various supplements help us reach those endpoints.  Sometimes, as in the case of “antioxidants,” the data may surprise and dismay us.  Other times, we may see a positive result and be able to make general statements about certain supplements.  Read this abstract and I’ll see you at the end for a brief analysis!  [Emphasis added below]

Dietary Supplements and Risk of Cause-Specific Death, Cardiovascular Disease, and Cancer: A Systematic Review and Meta-Analysis of Primary Prevention Trials1,2,3

Abstract

Our aim was to assess the efficacy of dietary supplements in the primary prevention of cause-specific death, cardiovascular disease (CVD), and cancer by using meta-analytical approaches. Electronic and hand searches were performed until August 2016. Inclusion criteria were as follows: 1) minimum intervention period of 12 mo; 2) primary prevention trials; 3) mean age >18 y; 4) interventions included vitamins, fatty acids, minerals, supplements containing combinations of vitamins and minerals, protein, fiber, prebiotics, and probiotics; and 5) primary outcome of all-cause mortality and secondary outcomes of mortality or incidence from CVD or cancer. Pooled effects across studies were estimated by using random-effects meta-analysis. Overall, 49 trials (69 reports) including 287,304 participants met the inclusion criteria. Thirty-two trials were judged as low risk–, 15 trials as moderate risk–, and 2 trials as high risk–of-bias studies.

Supplements containing vitamin E (RR: 0.88; 95% CI: 0.80, 0.96) significantly reduced cardiovascular mortality risk, whereas supplements with folic acid reduced the risk of CVD (RR: 0.81; 95% CI: 0.70, 0.94). Vitamins D, C, and K; selenium; zinc; magnesium; and eicosapentaenoic acid showed no significant risk reduction for any of the outcomes. On the contrary, vitamin A was linked to an increased cancer risk (RR: 1.16; 95% CI: 1.00, 1.35). Supplements with beta-carotene showed no significant effect; however, in the subgroup with betacarotene given singly, an increased risk of all-cause mortality by 6% (RR: 1.06; 95% CI: 1.02, 1.10) was observed. Taken together, we found insufficient evidence to support the use of dietary supplements in the primary prevention of cause-specific death, incidence of CVD, and incidence of cancer. The application of some supplements generated small beneficial effects; however, the heterogeneous types and doses of supplements limit the generalizability to the overall population.

So, given this meta-analysis, if you want to try to reduce your risk of cardiovascular disease, Now Foods Advanced Gamma E Complex, Soft-gels, 120-Count  and Nature Made Folic Acid 400mcg, 250 Tablets (Pack of 3) may be worth a shot. Otherwise, at least for the supplements and outcomes they measured, no other supplements provided a positive effect, and some made things worse (beta carotene and vitamin A, basically).

We’ll stay on this; we’re always looking for new evidence to make your (our) lives better!

 

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Steve

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