USPSTF advises against vitamin E, beta-carotene supplements for CVD, cancer prevention
The U.S. Preventive Services Task Force announced that supplementation with vitamin E provides no benefit and the harms of beta-carotene supplementation outweigh any benefits for the prevention of CVD and cancer.
As a result, the USPSTF issued a draft recommendation advising against beta-carotene and vitamin E supplements for the prevention of these diseases (D recommendation).
In addition, the USPSTF said there is not enough evidence to determine the balance of harms and benefits of supplementation with multivitamins (I recommendation) and single or paired nutrients (I recommendation) for CVD and cancer prevention.
“Because heart disease and cancer are the two leading causes of death in the U.S., we want to look at whether taking vitamins and minerals help prevent these important diseases,” Chyke Doubeni, MD, MPH, a task force member and inaugural director of the Mayo Clinic Center for Health, Equity and Community Engagement Research, said in a press release. “However, there is not enough evidence to know if taking vitamin, mineral and multivitamin supplements prevent these conditions, so the task force is calling for more research.”
The draft recommendation does not apply to people who are or who may become pregnant, according to the recommendation statement. For these individuals, the task force previously issued a separate statement that recommends folic acid supplements.
According to a related evidence review, previous research has linked beta-carotene supplementation to several adverse events.
“Beta-carotene can be harmful because it increases the risk of lung cancer in people already at risk, such as those who smoke, and also increases the risk of dying from heart disease or stroke,” USPSTF member John Wong, MD, chief scientific officer and vice chair for Clinical Affairs, chief of the division of clinical decision making, and a primary care clinician in the department of medicine at Tufts Medical Center, said in the release.
Elizabeth A. O’Connor, PhD, associate director of the Kaiser Permanente Research Affiliates Evidence-based Practice Center, and colleagues wrote in the evidence review that more research is needed to investigate the effects of vitamin D, vitamin C and folic acid administered with other B vitamins on CVD and cancer prevention.
“The evidence base demonstrating no benefit of vitamin E on cancer and CVD is robust and does not warrant resource investment in major new de novo studies,” they wrote. “Given the risks identified for beta-carotene, we see no need for further research on the role of beta-carotene in CVD and cancer prevention, nor, by extension, for vitamin A.”
The public can comment on the draft recommendation on the USPSTF’s website through June 1.
References:USPSTF Bulletin. Task Force issues draft recommendation statement on vitamin, mineral and multivitamin supplements to prevent heart disease and cancer. https://www.uspreventiveservicestaskforce.org/uspstf/sites/default/files/file/supporting_documents/vitamin-suppl-cvd-cancer-prev-draft-rec-bulletin.pdf. Accessed May 4, 2021.
O’Connor EA, et al. Vitamin and mineral supplements for the primary prevention of cardiovascular disease and cancer: A systematic evidence review for the U.S. Preventive Services Task Force. https://www.uspreventiveservicestaskforce.org/uspstf/document/draft-evidence-review/vitamin-supplementation-to-prevent-cvd-and-cancer-preventive-medication. Accessed May 4, 2021.
USPSTF. Vitamin, mineral, and multivitamin supplementation to prevent cardiovascular disease and cancer: U.S. Preventative Services Task Force draft recommendation statement. https://www.uspreventiveservicestaskforce.org/uspstf/draft-recommendation/vitamin-supplementation-to-prevent-cvd-and-cancer-preventive-medication. Accessed May 4, 2021.