Vitamins: Can They Help Prevent Heart Disease And Cancer?

January 22, 2023 at 8:36 p.m.


I must admit that I am a semi-hypochondriac and thus consume a variety of vitamin and mineral supplements.  (The term semi-hypochondriac  may be misused in this context because hypochondriac is  an absolute adjective, and thus not modifiable.)  Whatever the definition, the cause of my affliction may be due to my age, pharmacy background, gullibility and the empiric reliance on the benefits derived from any nutraceutical.  

Examples of the products I take almost daily include Vitamin B12, Vitamin B Complex, Turmeric, Omega-3 Fatty Acids, Lung Support, Heart Support and Kor Shots containing Vitamin C, resveratrol, zinc, elderberries and Goji powder. Much of my intake stems from the list of essential vitamins and minerals found in the literature.  They are essential substances that our bodies need to develop and function normally. The known vitamins include A, C, D, E and K, and the B vitamins: thiamin (B1), riboflavin (B2), niacin (B3), pantothenic acid (B5), pyridoxal (B6), cobalamin (B12), biotin, and folate/folic acid. A number of minerals are essential for health: calcium, phosphorus, potassium, sodium, chloride, magnesium, iron, zinc, iodine, sulfur, cobalt, copper, fluoride, manganese and selenium.

The Dietary Guidelines for Americans 2015–20 recommends that people should aim to meet their nutrient requirements through a healthy eating pattern that includes nutrient-dense forms of foods.

Recent Evidence

My faith in all that I take each day was diminished somewhat  by an article from a recent publication in the Journal of the American Medical Association. It contained a recommendation statement from the US Preventative Services Task Force (USPSTF) titled Vitamin, Mineral, and Multivitamin Supplementation to Prevent Cardiovascular Disease and Cancer.  A summary of the recommendation in bullet points is as follows:

 • Adequate evidence that supplementation with beta carotene provides no benefit in preventing cardiovascular disease or cancer. (Beta-carotene belongs to a group of colored pigments called carotenoids. It's converted to vitamin A in the body and found in many fruits and vegetables.)                

• Adequate evidence that supplementation with vitamin E provides no benefit in preventing cardiovascular disease or cancer.

• Inadequate evidence on the benefits of supplementation with multivitamins in preventing cardiovascular disease or cancer.

• Inadequate evidence on the benefits of supplementation with single or paired nutrients (other than beta carotene and vitamin E) in preventing cardiovascular disease or cancer.

Safety

 Harms of preventive medication:

• Adequate evidence that beta carotene causes small harms in increasing the risk for lung cancer in persons at increased risk.

• Adequate evidence that vitamin E causes at most small harms.

• Adequate evidence that multivitamins cause at most small harms.

• Inadequate evidence on the harms of supplementation with single or paired nutrients (other than beta carotene or vitamin E).

USPSTF Assessment

• The USPSTF concludes with moderate certainty that the harms of beta carotene supplementation for the prevention of cardiovascular disease or cancer outweigh the benefits.

• The USPSTF 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.

• 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.

Side Effects

You are most likely to have side effects from dietary supplements if you take them at high doses or instead of prescribed medicines, or if you take many different supplements. Some supplements can increase the risk of bleeding or, if taken before surgery, can change your response to anesthesia. Supplements can also interact with some medicines in ways that might cause problems. Here are a few examples:

•    Vitamin K can reduce the ability of the blood thinner warfarin to prevent blood from clotting.

•    St. John’s wort can speed the breakdown of many medicines and reduce their effectiveness (including some antidepressants, birth control pills, heart medications, anti-HIV medications and transplant drugs).

•    Antioxidant supplements, such as vitamins C and E, might reduce the effectiveness of some types of cancer chemotherapy.

Final Thoughts

Based on the report from the US Preventive Services Task Force, 52% of all surveyed U.S. adults reported using at least one dietary supplement in the prior 30 days and 31% reported using a multivitamin-mineral supplement. The most common cited reason is for overall health and wellness to fill the nutrient gaps in their diet.  

Cardiovascular disease and cancer are the two leading causes of death and combined account for more than half of all deaths in the US annually. The report noted that additional studies should be of sufficient duration to detect an effect on these outcomes.  Thus, I will continue to consume my regular supplements with lesser expectations.

Max Sherman is a medical writer and pharmacist retired from the medical device industry. His new book “Science Snippets” is available from Amazon and other book sellers. It contains a number of previously published columns.  He can be reached by email at  [email protected]

I must admit that I am a semi-hypochondriac and thus consume a variety of vitamin and mineral supplements.  (The term semi-hypochondriac  may be misused in this context because hypochondriac is  an absolute adjective, and thus not modifiable.)  Whatever the definition, the cause of my affliction may be due to my age, pharmacy background, gullibility and the empiric reliance on the benefits derived from any nutraceutical.  

Examples of the products I take almost daily include Vitamin B12, Vitamin B Complex, Turmeric, Omega-3 Fatty Acids, Lung Support, Heart Support and Kor Shots containing Vitamin C, resveratrol, zinc, elderberries and Goji powder. Much of my intake stems from the list of essential vitamins and minerals found in the literature.  They are essential substances that our bodies need to develop and function normally. The known vitamins include A, C, D, E and K, and the B vitamins: thiamin (B1), riboflavin (B2), niacin (B3), pantothenic acid (B5), pyridoxal (B6), cobalamin (B12), biotin, and folate/folic acid. A number of minerals are essential for health: calcium, phosphorus, potassium, sodium, chloride, magnesium, iron, zinc, iodine, sulfur, cobalt, copper, fluoride, manganese and selenium.

The Dietary Guidelines for Americans 2015–20 recommends that people should aim to meet their nutrient requirements through a healthy eating pattern that includes nutrient-dense forms of foods.

Recent Evidence

My faith in all that I take each day was diminished somewhat  by an article from a recent publication in the Journal of the American Medical Association. It contained a recommendation statement from the US Preventative Services Task Force (USPSTF) titled Vitamin, Mineral, and Multivitamin Supplementation to Prevent Cardiovascular Disease and Cancer.  A summary of the recommendation in bullet points is as follows:

 • Adequate evidence that supplementation with beta carotene provides no benefit in preventing cardiovascular disease or cancer. (Beta-carotene belongs to a group of colored pigments called carotenoids. It's converted to vitamin A in the body and found in many fruits and vegetables.)                

• Adequate evidence that supplementation with vitamin E provides no benefit in preventing cardiovascular disease or cancer.

• Inadequate evidence on the benefits of supplementation with multivitamins in preventing cardiovascular disease or cancer.

• Inadequate evidence on the benefits of supplementation with single or paired nutrients (other than beta carotene and vitamin E) in preventing cardiovascular disease or cancer.

Safety

 Harms of preventive medication:

• Adequate evidence that beta carotene causes small harms in increasing the risk for lung cancer in persons at increased risk.

• Adequate evidence that vitamin E causes at most small harms.

• Adequate evidence that multivitamins cause at most small harms.

• Inadequate evidence on the harms of supplementation with single or paired nutrients (other than beta carotene or vitamin E).

USPSTF Assessment

• The USPSTF concludes with moderate certainty that the harms of beta carotene supplementation for the prevention of cardiovascular disease or cancer outweigh the benefits.

• The USPSTF 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.

• 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.

Side Effects

You are most likely to have side effects from dietary supplements if you take them at high doses or instead of prescribed medicines, or if you take many different supplements. Some supplements can increase the risk of bleeding or, if taken before surgery, can change your response to anesthesia. Supplements can also interact with some medicines in ways that might cause problems. Here are a few examples:

•    Vitamin K can reduce the ability of the blood thinner warfarin to prevent blood from clotting.

•    St. John’s wort can speed the breakdown of many medicines and reduce their effectiveness (including some antidepressants, birth control pills, heart medications, anti-HIV medications and transplant drugs).

•    Antioxidant supplements, such as vitamins C and E, might reduce the effectiveness of some types of cancer chemotherapy.

Final Thoughts

Based on the report from the US Preventive Services Task Force, 52% of all surveyed U.S. adults reported using at least one dietary supplement in the prior 30 days and 31% reported using a multivitamin-mineral supplement. The most common cited reason is for overall health and wellness to fill the nutrient gaps in their diet.  

Cardiovascular disease and cancer are the two leading causes of death and combined account for more than half of all deaths in the US annually. The report noted that additional studies should be of sufficient duration to detect an effect on these outcomes.  Thus, I will continue to consume my regular supplements with lesser expectations.

Max Sherman is a medical writer and pharmacist retired from the medical device industry. His new book “Science Snippets” is available from Amazon and other book sellers. It contains a number of previously published columns.  He can be reached by email at  [email protected]

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