Supplements of no benefit in preventing or alleviating cardiovascular disease. From the Journal of the American College of Cardiology:
“The authors
identified individual randomized controlled trials from previous meta-analyses
and additional searches, and then performed meta-analyses on
cardiovascular disease outcomes and all-cause mortality. The authors assessed
publications from 2012, both before and including the U.S. Preventive Service
Task Force review. Their systematic reviews and meta-analyses showed generally
moderate- or low-quality evidence for preventive benefits (folic acid for total
cardiovascular disease, folic acid and B-vitamins for stroke), no effect
(multivitamins, vitamins C, D, β-carotene, calcium, and selenium), or
increased risk (antioxidant mixtures and niacin [with a statin] for all-cause
mortality). Conclusive evidence for the benefit of any supplement across all
dietary backgrounds (including deficiency and sufficiency) was not
demonstrated; therefore, any benefits seen must be balanced against possible
risks………
“Furthermore,
overall health benefits were expected for multivitamin and multi-mineral use
that also might have been reflected in reduced cardiovascular disease risk. It
has often been noted that a significant proportion of Western diets are not
optimal, and it has been reasoned that supplementation could rectify potential
deficiencies. If there are no potential adverse effects to supplementation,
then it can be argued that some benefits might have been seen, but as yet, they
have not.”
Omega-3 Fatty Acid Supplement of very
little to no benefit for people with cardiovascular Disease:
“Question: Does
supplementation with marine-derived omega-3 fatty acids have any associations
with reductions in fatal or nonfatal coronary heart disease in people at high
risk of cardiovascular disease?
“Findings: This
meta-analysis of 10 trials involving 77 917 participants demonstrated that
supplementation with marine-derived omega-3 fatty acids for a mean of 4.4 years
had no significant association with reductions in fatal or nonfatal coronary
heart disease or any major vascular events.
“Meaning: The
results provide no support for current recommendations to use omega-3 fatty
acid supplements for the prevention of fatal coronary heart disease (CHD) or any cardiovascular disease in
people who have or at high risk of developing cardiovascular disease……
“This
meta-analysis of 10 randomized clinical trials, involving 77 917
participants, demonstrated that randomization to trial arms with omega-3 FA
supplementation for a mean of 4.4 years had no significant effect on either of
fatal coronary heart disease, nonfatal myocardial infarction (MI), stroke,
revascularization events, or any major vascular events. Importantly, this
meta-analysis also demonstrated no significant effect on major vascular events
in any particular subgroups, including prior vascular disease, diabetes, lipid
levels, or statin use. Likewise, the present meta-analysis showed no
significant association of omega-3 FA supplementation with all-cause mortality
or cancer……..
“The 2016
European Society of Cardiology and European Atherosclerosis Society guidelines
for prevention of cardiovascular disease indicated that it is debatable
whether omega-3 FAs may exert a protective effect, and the 2016 guidelines on
the management of dyslipidaemia indicated that more evidence on the efficacy of
omega-3 FA supplements for prevention of clinical outcomes is needed to justify
their prescription. In contrast, the American Heart Association recommended that the use of omega-3 FAs for
prevention of CHD is probably justified in individuals with prior CHD and those
with heart failure and reduced ejection fractions. However, the results of the
present meta-analysis provide no support for the recommendations to use
approximately 1 g/d of omega-3 FAs in individuals with a history of CHD for the
prevention of fatal CHD, nonfatal MI, or any other vascular events.”
Death and supplements:
“In 2007, researchers from the National Cancer Institute examined 11,000
men who did or didn't take multivitamins. Those who took multivitamins were
twice as likely to die from advanced prostate cancer.
“In 2008, a review of all existing studies involving more than 230,000
people who did or did not receive supplemental antioxidants found that vitamins
increased the risk of cancer and heart disease.
“On October
10, 2011, researchers from the University of Minnesota evaluated 39,000 older
women and found that those who took supplemental multivitamins, magnesium,
zinc, copper, and iron died at rates higher than those who didn't. They
concluded, ‘Based on existing evidence, we see little justification for the
general and widespread use of dietary supplements.’"…….
“Researchers
from the Cleveland Clinic published the results of a study of 36,000 men who
took vitamin E, selenium, both, or neither. They found that those receiving
vitamin E had a 17 percent greater risk of prostate cancer. In response to the
study, Steven Nissen, chairman of cardiology at the Cleveland Clinic, said, ‘The
concept of multivitamins was sold to Americans by an eager nutraceutical
industry to generate profits. There was never any scientific data supporting
their usage.’ On October 25, a headline in the Wall
Street Journal asked, ‘Is This the End of Popping Vitamins?’
Studies haven't hurt sales. In 2010, the vitamin industry grossed $28 billion,
up 4.4 percent from the year before. ‘The thing to do with [these reports] is
just ride them out,’ said Joseph Fortunato, chief executive of General
Nutrition Centers. ‘We see no impact on our business.’"
Vitamin D supplements do not prevent
cancer or cardiovascular disease:
“Long
recognized as important for bone health, vitamin D has attracted recent
interest for its possible non-skeletal benefits. Many primary care clinicians
now include blood tests to measure vitamin D concentrations as part of routine
laboratory work and recommend vitamin D supplements, often at high doses, to
their patients for the possible prevention of cancer, cardiovascular disease
(CVD), diabetes, autoimmune disorders, cognitive decline, and other conditions.
Thus, screening rates and sales of vitamin D supplements have increased
substantially in recent years.
“However,
clinical enthusiasm for supplemental vitamin D has outpaced available evidence
on its effectiveness and threatens to jeopardize the ability of researchers to
conduct randomized trials in ‘usual-risk’ populations. Based on its recent
systematic reviews of the literature, the US Preventive Services Task Force
(USPSTF) concluded that data are insufficient to recommend vitamin D screening
in routine clinical practice or to assess the effectiveness and
overall balance of benefits and risks of supplemental vitamin D taken for the
primary prevention of cancer and CVD. In an earlier review, the Institute of
Medicine (IOM) reached the same conclusion—namely, whether supplemental vitamin
D lowers risk of non-skeletal health outcomes, and what dose might be required
to do so, is uncertain.”
Some evidence for folic acid:
“The
exception is supplemental folic acid for women of child-bearing potential,
Appel says. ‘Folic acid prevents neural tube defects in babies when women take
it before and during early pregnancy. That’s why multivitamins are recommended
for young women.’ The Centers for Disease Control and Prevention recommends
that all women of reproductive age get 400 micrograms of folic acid daily. The
amount of iron in a multivitamin may also be beneficial for women of
child-bearing potential, Appel adds.”
Some evidence Vitamin D supplements “may”
reduce the risk of osteoporosis for those who can’t get any sun:
“Vitamin D
supplementation, however, is an open area of investigation, particularly in
deficient persons. Clinical trials have been equivocal and sometimes
contradictory. For example, supplemental vitamin D, which might prevent falls
in older persons, reduced the risk for falls in a few trials, had no effect in
most trials, and increased falls in 1 trial. Although future studies are needed
to clarify the appropriate use of vitamin D supplementation, current widespread
use is not based on solid evidence that benefits outweigh harms.”
The supplement industry wants
consumers to be ignorant of the hard science of how supplements are absorbed
and distributed:
Consumers
assume that when they take a supplement, it is automatically and effectively absorbed
into the body and travels the path it needs to reach the target area. Not so fast……….
“What you
swallow does not automatically equal what your body will absorb. Whether or not
a drug or supplement is absorbed depends on the route of administration, the
formulation (capsule/tablet/liquid/raw material), the chemical properties of
the substance, and other factors (like food in the stomach). It needs to
survive being dispersed in stomach acids and digestive enzymes. It must then
dissolve fully into gastric juices (particulate matter is not absorbed by the
body), and then the substance must cross cell membranes – just to enter
bloodstream. Not all substances are absorbed. Drugs like insulin must be
injected because they are destroyed in the stomach. Even if it makes it as far
as absorption, a substance then needs to survive the ‘first pass effect’, which
is passage of blood through the liver before it reaches the rest of the body.
In the liver, enzymes attempt to eliminate and metabolize molecules,
deactivating anything foreign or unwanted.”
If absorbed
properly, there is the complex task of reaching its preferred destination:
“You cannot
simply assume a substance will reach any part of the body to any significant
degree. A substance may adhere to proteins in the blood, reducing the ‘free’
amount that is available for distribution to other cells. Not all chemicals,
(drugs and supplements alike) are distributed equally to all parts of the body
– some may deposit more readily in fat tissue, for example. The blood-brain
barrier blocks most foreign molecules from reaching the brain.”
Additional Info
Older Americans Are ‘Hooked’ on Vitamins https://www.nytimes.com/2018/04/03/well/older-americans-vitamins-dietary-supplements.html
Why Are So Many People Popping Vitamin D? https://www.nytimes.com/2017/04/10/health/vitamin-d-deficiency-supplements.html?smid=tw-nytimeswell&smtyp=cur&_r=0
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Jerry De Luca is a Christian freelance writer who loves perusing dozens of interesting and informative publications. When he finds any useful info he summarizes it, taking the main points, and creates a (hopefully) helpful blog post.
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