Vitamin, Mineral, and Multivitamin Supplements for the Primary Prevention of Cardiovascular Disease and Cancer PDF Download
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Author: Stephen P. Fortmann
Publisher:
ISBN:
Category :
Languages : en
Pages : 178
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Book Description
BACKGROUND: In the United States, dietary supplements are commonly used to prevent chronic diseases, including cardiovascular disease (CVD) and cancer. PURPOSE: To systematically review evidence for the use of multivitamins or single nutrients and functionally related nutrient pairs for the prevention of CVD and cancer in the general population (primary prevention). METHODS: We searched MEDLINE, EMBASE, Cochrane Database of Systematic Reviews, the Database of Abstracts of Reviews of Effects, and Cochrane Central Register of Controlled Trials to identify literature that was published between 2005 and January 29, 2013. We also examined the references from the previous reviews and other relevant reviews to identify additional studies; we also searched Web sites of government agencies and other organizations for grey literature. Two investigators independently reviewed identified abstracts and full-text articles against a set of a priori inclusion and quality criteria. One investigator abstracted data into an evidence table and a second investigator checked these data. We qualitatively and quantitatively synthesized the results for the four key questions and grouped the included studies by study supplement. We conducted meta-analyses using Mantel-Haenzel fixed effects models for overall cancer incidence, CVD incidence, and all-cause mortality. RESULTS: We included 103 articles representing 26 unique studies. Very few studies examined the use of multivitamin supplements. Two trials showed a protective effect against cancer in men; only one of these trials included women and found no effect. No effects of treatment were seen on CVD or all-cause mortality. Beta-carotene showed a negative effect on lung cancer incidence and mortality among individuals at high risk for lung cancer at baseline (i.e., smokers and asbestos-exposed workers); this effect was persistent even when combined with vitamin A or E. Trials of vitamin E supplementation showed mixed results and altogether had no overall effect on cancer, CVD, or all-cause mortality. Only one of two included selenium trials showed a beneficial effect for colorectal and prostate cancer; however, this trial included a small sample size. The few studies addressing folic acid, vitamin C, and vitamin A showed no effect on CVD, cancer, and mortality. Vitamin D and/or calcium supplementation also showed no overall effect on CVD, cancer, and mortality. Harms were infrequently reported and aside from limited paradoxical effects for some supplements, were not considered serious. CONCLUSIONS: There are a limited number of trials examining the effects of dietary supplements on the primary prevention of CVD and cancer; the majority showed no effect in healthy populations. Clinical heterogeneity of included studies limits generalizability of results to the general primary care population. Results from trials in at-risk populations discourage additional studies for particular supplements (e.g., beta-carotene); however, future research in general primary care populations and on other supplements is required to address research gaps.
Author: Stephen P. Fortmann
Publisher:
ISBN:
Category :
Languages : en
Pages : 178
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Book Description
BACKGROUND: In the United States, dietary supplements are commonly used to prevent chronic diseases, including cardiovascular disease (CVD) and cancer. PURPOSE: To systematically review evidence for the use of multivitamins or single nutrients and functionally related nutrient pairs for the prevention of CVD and cancer in the general population (primary prevention). METHODS: We searched MEDLINE, EMBASE, Cochrane Database of Systematic Reviews, the Database of Abstracts of Reviews of Effects, and Cochrane Central Register of Controlled Trials to identify literature that was published between 2005 and January 29, 2013. We also examined the references from the previous reviews and other relevant reviews to identify additional studies; we also searched Web sites of government agencies and other organizations for grey literature. Two investigators independently reviewed identified abstracts and full-text articles against a set of a priori inclusion and quality criteria. One investigator abstracted data into an evidence table and a second investigator checked these data. We qualitatively and quantitatively synthesized the results for the four key questions and grouped the included studies by study supplement. We conducted meta-analyses using Mantel-Haenzel fixed effects models for overall cancer incidence, CVD incidence, and all-cause mortality. RESULTS: We included 103 articles representing 26 unique studies. Very few studies examined the use of multivitamin supplements. Two trials showed a protective effect against cancer in men; only one of these trials included women and found no effect. No effects of treatment were seen on CVD or all-cause mortality. Beta-carotene showed a negative effect on lung cancer incidence and mortality among individuals at high risk for lung cancer at baseline (i.e., smokers and asbestos-exposed workers); this effect was persistent even when combined with vitamin A or E. Trials of vitamin E supplementation showed mixed results and altogether had no overall effect on cancer, CVD, or all-cause mortality. Only one of two included selenium trials showed a beneficial effect for colorectal and prostate cancer; however, this trial included a small sample size. The few studies addressing folic acid, vitamin C, and vitamin A showed no effect on CVD, cancer, and mortality. Vitamin D and/or calcium supplementation also showed no overall effect on CVD, cancer, and mortality. Harms were infrequently reported and aside from limited paradoxical effects for some supplements, were not considered serious. CONCLUSIONS: There are a limited number of trials examining the effects of dietary supplements on the primary prevention of CVD and cancer; the majority showed no effect in healthy populations. Clinical heterogeneity of included studies limits generalizability of results to the general primary care population. Results from trials in at-risk populations discourage additional studies for particular supplements (e.g., beta-carotene); however, future research in general primary care populations and on other supplements is required to address research gaps.
Author: U.s. Department of Health and Human Services
Publisher: CreateSpace
ISBN: 9781494489397
Category : Medical
Languages : en
Pages : 192
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Book Description
Vitamins (e.g., vitamin A, B, C, D, and E) are organic compounds that are essential to maintaining health. Minerals, on the other hand, are inorganic substances that humans need to maintain their health (e.g., calcium, iron, zinc). Multivitamin and/or multimineral supplements contain three or more vitamins and/or minerals without herbs, hormones, or drugs. The U.S. Food and Nutrition Board of the Institute of Medicine has also determined that each of these components is present at a dose less than the tolerable upper intake level. We refer to multivitamin/multimineral supplements as multivitamins because this is how they are marketed and sold. We do not consider other essential nutrients, such as essential fatty acids, to be vitamins or minerals. Between 1941 and 1994, the Recommended Dietary Allowances (RDAs) of the United States and the Dietary Standards/Recommended Nutrient Intakes (RNIs) of Canada dictated the nutrition polices of their respective countries. By the 1990s, however, concerns about the accuracy of the RDAs and RNIs in both countries arose as nutritional research advanced and measurement of nutrients improved. In 1997, the Food and Nutrition Board published a broader set of dietary reference values called Dietary Reference Intakes (DRIs). DRIs expanded upon and replaced RDAs and RNIs with four categories of intakes intended to help individuals optimize their health, prevent disease, and avoid consuming too much of a specific nutrient. Most commercially available supplements generally contain vitamins and/or minerals at doses that are close to the recommended dietary allowance, but are still below the tolerable upper intake levels set by the U.S. Food and Nutrition Board. This systematic review was conducted to help the Agency for Healthcare Research and Quality (AHRQ) update its recommendation on the use of multivitamins for the prevention of cardiovascular disease (CVD) and cancer in the general population. The U.S. Preventive Services Task Force (USPSTF) will use this review to update its 2003 recommendations on routine vitamin supplementation to prevent chronic diseases. This review addresses the benefits and harms of single, paired, and multiple vitamins and/or minerals as primary prevention for CVD and cancer in the general population without nutritional deficiencies or existing chronic diseases.
Author: Elizabeth A. O'Connor
Publisher:
ISBN:
Category :
Languages : en
Pages : 0
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Book Description
OBJECTIVE: To review the benefits and harms of vitamin and mineral supplementation in healthy adults to prevent cardiovascular disease (CVD) and cancer. DATA SOURCES: MEDLINE, PubMed (publisher-supplied records only), the Cochrane Central Register of Controlled Trials (CENTRAL), the Cochrane Database of Systematic Reviews, and Embase, between January 2013 and February 1, 2022. Additionally, we evaluated all studies included in the prior USPSTF review for inclusion in the current review. STUDY SELECTION: We reviewed 17,459 unique citations and 379 full-text articles against a priori inclusion criteria. We included English-language randomized clinical trials (RCTs) of vitamin or mineral use among persons without CVD or cancer reporting all-cause mortality, CVD, cancer, or adverse outcomes as well as observational cohort studies examining serious harms of supplement use. Critical appraisal was completed independently by two investigators. Data were extracted from studies by one reviewer and checked by a second. DATA ANALYSIS: We conducted quantitative pooling when at least three studies of the same supplement reported the same outcome. Because most outcomes occurred in less than 10 percent of the study sample, we typically used methods appropriate for rare events, including a fixed effects Mantel-Haenszel model or a random effects restricted maximum likelihood model using Peto odds ratio. Stratified or subgroup analyses and meta-regression were used to explore effect modification for trials of vitamin D, which had the largest body of evidence. RESULTS: A total of 84 studies (n=739,803) were included. Pooled effects indicated that multivitamin use may be associated with a reduced risk of incidence of any cancer (OR, 0.93 [95 % CI, 0.87 to 0.99]; 4 RCTs; n=48,859; I2=0%; range in absolute risk difference among adequately powered trials, −0.2% to −1.2%) and lung cancer (OR, 0.75 [95% CI, 0.58 to 0.95]; 2 RCTs, n=36,052; I2=30%; absolute risk difference, 0.2%). However, the evidence for multivitamins had important limitations, including only three adequately powered trials, one with a median of only 3.6 years of multivitamin use and another that was limited to antioxidants. Pooling of studies of vitamin D with or without calcium showed no association with all-cause mortality (OR, 0.96 [95% CI, 0.91 to 1.02]; 27 RCTs [n=117,082]; I2=0%), CVD (e.g., composite CVD events: OR, 1.00 [0.95 to 1.05]; 7 RCTs [n=74,925]; I2=0%), or cancer outcomes (e.g. any cancer incidence: OR, 0.98 [0.92 to 1.03]; 19 RCTs [n=86,899]; I2=0%). Beta-carotene, with or without vitamin A, was associated with an increased risk of cardiovascular mortality (OR 1.10 [95% CI, 1.02 to 1.19]; 5 RCTs [n=94,506]; I2=0%; range in absolute risk difference −0.8% to 0.8%), and lung cancer (OR 1.20 [95% CI, 1.01 to 1.42]; 4 RCTs [n=94,830]; I2=38.8%; range in absolute risk difference −0.1% to 0.6%). In addition, we found less robust evidence that folic acid was associated with an increased risk of cancer incidence. We found clear evidence that vitamin E (with or without vitamin C or selenium) offers no benefit for all-cause mortality (OR, 1.02 [95% CI, 0.97 to 1.07]; 9 RCTs [n=107,772]; I2=0%), CVD events (OR, 0.96 [95% CI, 0.90 to 1.04]; 4 RCTs [n=62,136]; I2=0%), and cancer (OR, 1.02 [95% CI, 0.98 to 1.08]; 5 RCTs [n=76,777]; I2=0%), and more equivocal evidence that multivitamins (antioxidant-focused or broad spectrum), vitamin A (without beta-carotene), vitamin C, calcium (without vitamin D), and selenium also had no impact on all-cause mortality, CVD, and cancer. There was also weak evidence that supplements increased the risk of some other serious harms, such as hip fracture (vitamin A), hemorrhagic stroke (vitamin E), and kidney stones (vitamin C, calcium). Several supplements were associated with an increased risk of some minor and reversible adverse outcomes, such as skin yellowing (beta-carotene) and gastrointestinal symptoms (calcium). LIMITATIONS: Some studies lacked full outcome ascertainment or had insufficient followup or power for the main review outcomes; varied background interventions (primarily due to factorial designs) may cloud supplement effects; people of color were minimally represented. Most supplements had too few studies to explore effect modification. CONCLUSIONS: Vitamin and mineral supplementation provides little to no benefit in preventing cancer, CVD, and death, with the exception of a possible small benefit for cancer incidence with multivitamin use, where lung cancer showed the largest benefit. Beta-carotene is associated with increased risk of lung cancer and other harmful outcomes in persons at high risk of lung cancer. Data were absent or insufficient to draw conclusions for any of the B vitamins, iron, zinc, or magnesium.
Author:
Publisher:
ISBN:
Category : Dietary supplements
Languages : en
Pages : 8
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Book Description
"This report provides estimates of dietary supplement use for specific population groups over time. In addition to overall use of dietary supplements, this report focuses on estimates for specific nutrients consumed through dietary supplement use."--Cover.
Author: Wendy Jenkins
Publisher: Academic Press
ISBN: 0128105119
Category : Medical
Languages : en
Pages : 238
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Book Description
The Portfolio Diet for Cardiovascular Disease Risk Reduction: An Evidence Based Approach to Lower Cholesterol through Plant Food Consumption examines the science of this recommended dietary approach to reduce cholesterol in addition to other risk factors for cardiovascular disease. With a thorough examination into the scientific rationale for the use of this diet, discussions are included on the experimental findings both for the diet as a whole, and its four principle food components: nuts and seeds, plant based protein, viscous fibers, and plant-sterol-enriched foods. Environmental and ethical considerations of the diet are also discussed, showing the ramifications of food choice on health and beyond. Referenced with data from the latest relevant publications and enhanced with practical details (including tips, dishes, and menus), the reader is enabled to meet the goals of cholesterol lowering and cardiovascular disease risk reduction while also taking the health of the planet into consideration. Provides the scientific basis for the selection of the foods included in the Dietary Portfolio and the experimental evidence demonstrating cholesterol lowering and cardiovascular risk factor reduction Provides an understanding of the current guidelines for lowering cholesterol and other risk factors of cardiovascular disease, explaining how the Dietary Portfolio effects these components and compares to other diet based approaches Provides a holistic view of the Dietary Portfolio by investigating issues of sustainability and ethics in the food system Allows readers to acquire the skills to successfully construct a potent cholesterol-lowering diet Includes tips, recipes and meal planning aids
Author: Alan J. Sinclair
Publisher: John Wiley & Sons
ISBN: 1119954142
Category : Medical
Languages : en
Pages : 3453
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Book Description
This new edition of the comprehensive and renowned textbook Principles and Practice of Geriatric Medicine offers a fully revised and updated review of geriatric medicine. It covers the full spectrum of the subject, features 41 new chapters, and provides up-to-date, evidence-based, and practical information about the varied medical problems of ageing citizens. The three editors, from UK, USA and France, have ensured that updated chapters provide a global perspective of geriatric medicine, as well as reflect the changes in treatment options and medical conditions which have emerged since publication of the 4th edition in 2006. The book includes expanded sections on acute stroke, dementia, cardiovascular disease, and respiratory diseases, and features a new section on end-of-life care. In the tradition of previous editions, this all-encompassing text continues to be a must-have text for all clinicians who deal with older people, particularly geriatric medical specialists, gerontologists, researchers, and general practitioners. This title is also available as a mobile App from MedHand Mobile Libraries. Buy it now from Google Play or the MedHand Store. Praise for the 4th edition: "...an excellent reference for learners at all clinical and preclinical levels and a useful contribution to the geriatric medical literature." —Journal of the American Medical Association, November 2006 5th edition selected for 2012 Edition of Doody's Core TitlesTM
Author: Taylor C. Wallace
Publisher: CRC Press
ISBN: 1498760309
Category : Medical
Languages : en
Pages : 406
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Book Description
The supplement market continues to grow annually with more than half of the population using these products for reasons spanning from health maintenance to disease prevention and/or treatment. Dietary Supplements in Health Promotion presents clear and concise evidence on how dietary supplements may contribute to maintaining health status. The book
Author: Jessica S. Coviello
Publisher: Lippincott Williams & Wilkins
ISBN: 1975142233
Category : Medical
Languages : en
Pages : 628
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Book Description
The Third Edition of Health Promotion and Disease Prevention in Clinical Practice reflects a clinically-focused, team-based approach to health promotion conversations. This practical reference incorporates the latest guidelines from major organizations, including the U.S. Preventive Services Task Force, and offers a complete overview of how to help patients adopt healthy behaviors and deliver recommended screening tests and immunizations. Packed with realistic strategies throughout, it offers expert guidance on counseling patients about exercise, nutrition, tobacco use, substance use, sexually transmitted infections, depression, and more.
Author: Adrianne Bendich
Publisher: Springer
ISBN: 331922431X
Category : Medical
Languages : en
Pages : 913
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Book Description
This newly expanded and updated fifth edition will be the largest and most comprehensive of the five editions and new topics and chapter authors have been added. The authors have created the most comprehensive and up-to-date review of the nutritional strategies available for the prevention of disease and the promotion of health through nutrition. Patients are looking for credible information from their health care providers about a whole range of subjects covered here, including ß-carotene, lycopene, antioxidants, folate, and the myriad of bioactive phytochemicals found in garlic and other foods. With sections on cardiovascular disease, diabetes, and pregnancy among many others, this volume will be of great value to practicing health professionals, including physicians, nutritionists, dentists, pharmacists, dieticians, health educators, policy makers, health economists, regulatory agencies and research investigators. An entire section covers nutrition transitions around the world including Eastern Europe, Latin America and Asia as well as goals for preventive nutrition in developing countries. Preventive Nutrition: The Comprehensive Guide for Health Professionals, 5th Ed. is an important resource for thousands of health professionals who have been utilizing the previous editions since 1997.
Author: David H. Alpers
Publisher: Lippincott Williams & Wilkins
ISBN: 1496310004
Category : Medical
Languages : en
Pages : 677
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Book Description
Meant for quick retrieval of vital information regarding the management of nutritional issues in patients with gastroenterological problems--either primary or as the consequence of other medical disorders, such as diabetes, hyperlipidemia and obesity. The book addresses normal physiology and pathophysiology, and offers chapters on diseases that can lead to specific nutritional problems. The clinical focus is on therapeutic nutrition and dietary management.
