Cardio-Oncology Resource Center

Cardio-Oncology Resource Center

Disclosures: Mangione reports no relevant financial disclosures. Please see the USPSTF conflict of interest disclosures site for the other authors’ relevant financial disclosures.
June 21, 2022
3 min read
Save

USPSTF: No benefit of beta carotene, vitamin E, multivitamins in CVD, cancer prevention

Disclosures: Mangione reports no relevant financial disclosures. Please see the USPSTF conflict of interest disclosures site for the other authors’ relevant financial disclosures.
You've successfully added to your alerts. You will receive an email when new content is published.

Click Here to Manage Email Alerts

We were unable to process your request. Please try again later. If you continue to have this issue please contact customerservice@slackinc.com.

The U.S. Preventive Services Task Force issued a recommendation statement against the use of beta carotene or vitamin E supplements for the prevention of CVD or cancer.

The recommendations in this statement, published in JAMA, are consistent with those of the 2014 USPSTF recommendation statement on vitamin, mineral and multivitamin supplements for the prevention of CVD and cancer.

Graphical depiction of data presented in article
Data were derived from US Preventive Services Task Force. JAMA. 2022;doi:10.1001/jama.2022.8970.

“The USPSTF again concludes that the evidence is insufficient to assess the balance of benefits and harms of multivitamins and single- or paired-nutrient supplements (except beta carotene and vitamin E) for the prevention of cardiovascular disease or cancer. The USPSTF again recommends against the use of beta carotene or vitamin E supplements for the prevention of cardiovascular disease or cancer,” Carol M. Mangione, MD, MSPH, chief of the division of general internal medicine and health services research; Barbara A. Levey, MD, and Gerald S. Levey, MD, endowed chair in medicine; distinguished professor of medicine at the David Geffen School of Medicine at the University of California, Los Angeles; and chair of the USPSTF, and colleagues wrote.

Vitamin, mineral and multivitamin supplementation

The USPSTF rationale for this recommendation is as follows:

  • there is adequate evidence that beta carotene supplements provide no benefit in the prevention of CVD or cancer;
  • there is adequate evidence that vitamin E supplements provide no benefit in the prevention of CVD or cancer;
  • evidence is inadequate regarding the benefits of supplementation with multivitamins for the prevention of CVD or cancer; and
  • evidence is inadequate regarding the benefits of supplementation with single or paired nutrients, other than beta carotene and vitamin E, for the prevention of CVD or cancer.

The Task Force added that there exists adequate evidence that beta carotene may increase risk for lung cancer among those already at elevated risk.

There is also evidence that vitamin E causes and multivitamins may cause, at most, small harms; however, evidence is inadequate to discern the harms of supplementation with single or paired nutrients, according to the statement.

Carol M. Mangione

“Persons who have an acute or chronic illness may require additional vitamin, mineral, or multivitamin supplementation as part of management of their condition, which goes beyond supplementation for the prevention purposes addressed by this recommendation,” the USPSTF wrote. “In addition, the USPSTF clarified that persons who experience food insecurity are among the populations of interest for the research gap on whether the effects of vitamin, mineral, and multivitamin supplementation on cardiovascular disease and cancer outcomes differ across specific populations.”

The HHS and the American Heart Association both recommend healthy individuals receive adequate nutrition primarily from a variety of healthy foods and beverages, rather than supplements.

This USPSTF recommendation is intended to only apply to adults who are community-dwelling and nonpregnant, according to the statement. It does not apply to children, those who are pregnant, those who may become pregnant or individuals with a chronic illness, those who are hospitalized or those with a nutritional deficiency.

The USPSTF added that it separately recommends all individuals who are capable of or planning for pregnancy take a daily supplement of 0.4 to 0.8 mg of folic acid.

Please see the statement and supporting evidence document for complete details on this USPSTF recommendation.

‘Beyond wasted money ... a potentially harmful distraction’

In a related editorial, Jenny Jia, MD, MSc, instructor of medicine at the Northwestern University Feinberg School of Medicine, and colleagues discussed how vitamin and mineral supplements may represent a distraction from evidence-based CVD and cancer prevention strategies.

“The substantial marketing budget of the supplement industry generates interest, attention, and billions of dollars in revenue,” the authors of the editorial wrote. “Most people view supplements as, at worst, benign preventive products. However, in the U.S., dietary supplements are relatively unregulated and required to disclaim that health claims have ‘not been evaluated by the Food and Drug Administration’ and they are ‘not intended to diagnose, treat, cure, or prevent any disease.’”

“Beyond wasted money, the focus on supplements might be viewed as a potentially harmful distraction. Rather than focusing money, time, and attention on supplements, it would be better to emphasize lower-risk, higher-benefit activities,” the authors of the editorial wrote. “Health systems and health care professionals should focus on evidence-based preventive services recommended by the USPSTF, including controlling high blood pressure and behavioral counseling to encourage physical activity and a healthy diet.”

References: