National Institutes of Health State-of-the-Science Conference Statement: Multivitamin/Mineral Supplements and Chronic Disease Prevention

Panel, Nih State-of-the-Science

doi:10.7326/0003-4819-145-5-200609050-00136

Cited by 94 publications

(27 citation statements)

References 11 publications

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“…In this analysis, we followed the National Institutes of Health definition, which defined MVM as dietary supplements comprising >3 vitamin and mineral ingredients. 10 Supplements containing herbs, hormones, or drugs were excluded from the analysis. We included studies that assessed MVM supplement use by a questionnaire or in a follow-up office visit.…”

Section: Definition Of Mvm Use and Cardiovascular Outcomementioning

confidence: 99%

“…7,9 Based on the weak and controversial benefit of MVM supplements, the US Preventive Services Task Force and the National Institutes of Health recommend against the routine use of MVM supplements for the purpose of chronic disease prevention, including CVD. 10,11 However, the prevalence of MVM supplementation in the general population remains high; for example, the National Health and Nutrition Examination Survey 2011 to 2012 data showed ≈30% of the population in the United States as using MVM supplements. 1,12,13 According to projections from 1 financial report, the global nutritional supplement industry is expected to reach $278 billion USD by 2024.…”

mentioning

confidence: 99%

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Association of Multivitamin and Mineral Supplementation and Risk of Cardiovascular Disease

Kim

Choi

Kwon

et al. 2018

Circ: Cardiovascular Quality and Outcomes

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BACKGROUND:Multiple studies have attempted to identify the association between multivitamin/mineral (MVM) supplementation and cardiovascular disease (CVD) outcomes, but the benefits remain controversial. We performed a systematic review and meta-analysis of the associations between MVM supplementation and various CVD outcomes, including coronary heart disease (CHD) and stroke. METHODS AND RESULTS:We conducted a comprehensive search of Medline, Embase, and the Cochrane Library for studies published between January 1970 and August 2016. We included clinical trials and prospective cohort studies in the general population evaluating associations between MVM supplementation and CVD outcomes. Data extraction and quality assessment were independently conducted by 2 authors, and a third author resolved discrepancies. Eighteen studies with 2 019 862 participants and 18 363 326 person-years of follow-up were included in the analysis. Five studies specified the dose/type of MVM supplement and the rest did not. Overall, there was no association between MVM supplementation and CVD mortality (relative risk [RR], 1.00; 95% confidence interval [CI], 0.97-1.04), CHD mortality (RR, 1.02; 95% CI, 0.92-1.13), stroke mortality (RR, 0.95; 95% CI, 0.82-1.09), or stroke incidence (RR, 0.98; 95% CI, 0.91-1.05). There was no association between MVM supplements and CVD or CHD mortality in prespecified subgroups categorized by mean follow-up period, mean age, period of MVM use, sex, type of population, exclusion of patients with history of CHD, and adjustment for diet, adjustment for smoking, adjustment for physical activity, and study site. In contrast, MVM use did seem to be associated with a lower risk of CHD incidence (RR, 0.88; 95% CI, 0.79-0.97). However, this association did not remain significant in the pooled subgroup analysis of randomized controlled trials (RR, 0.97; 95% CI, 0.80-1.19). CONCLUSIONS:Our meta-analysis of clinical trials and prospective cohort studies demonstrates that MVM supplementation does not improve cardiovascular outcomes in the general population.

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Section: Definition Of Mvm Use and Cardiovascular Outcomementioning

confidence: 99%

mentioning

confidence: 99%

Association of Multivitamin and Mineral Supplementation and Risk of Cardiovascular Disease

Kim

Choi

Kwon

et al. 2018

Circ: Cardiovascular Quality and Outcomes

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“…In the United States the use of dietary supplements has increased substantially over the past several decades 1,2,3 , reaching approximately one-half of adults in 2000 and annual sales of over $20 billion. 1,3 We reported that 66% of women participating in the Iowa Women's Health Study (IWHS) used at least one dietary supplement daily in 1986 at average age 62 years, while in 2004, the proportion increased to 85%.…”

Section: Introductionmentioning

confidence: 99%

“…1,3 We reported that 66% of women participating in the Iowa Women's Health Study (IWHS) used at least one dietary supplement daily in 1986 at average age 62 years, while in 2004, the proportion increased to 85%. 2 Moreover, 27% of women reported using four or more supplemental products in 2004.…”

Section: Introductionmentioning

confidence: 99%

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Dietary Supplements and Mortality Rate in Older Women

Mursu

Robien

Harnack³

et al. 2011

Arch Intern Med

294

181

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Background Although dietary supplements are commonly taken to avoid chronic disease, long-term health consequences of many compounds are unknown. Methods We assessed the use of vitamin and mineral supplements in relation to total mortality in 38 772 older women in the Iowa Women's Health Study, mean age 61.6 years at baseline in 1986. Supplement use was self-reported in 1986, 1997 and 2004. Through December 31, 2008, 15 594 deaths (40.2%) were identified through the State Health Registry of Iowa and the National Death Index. Results In multivariable adjusted proportional hazards regression models, the use of multivitamins (Hazard Ratio (HR), 1.06 [95% CI, 1.02-1.10], Absolute Risk Increase (ARI), 2.4%), vitamin B6 (HR, 1.10 [95% CI, 1.01-1.21], ARI, 4.1%), folic acid (HR, 1.15 [95% CI, 1.00-1.32], ARI, 5.9%), iron (HR, 1.10 [95% CI, 1.03-1.17], ARI, 3.9%), magnesium (HR, 1.08 [95% CI, 1.01-1.15], ARI, 3.6%), zinc (HR, 1.08 [95% CI, 1.01-1.15], ARI, 3.0%) and copper (HR, 1.45 [95% CI, 1.20-1.75], ARI, 18.0%) were associated with increased risk of total mortality when compared with corresponding nonusers, while calcium was inversely related (HR, 0.91 [95% CI, 0.88-0.94], Absolute Risk Reduction (ARR), 3.8%). Findings for iron and calcium were replicated in separate shorter-term analyses (10-year, 6-year and 4-year follow-up) each with about 15% dead, starting in 1986, 1997, and 2004. Conclusion In older women several commonly used dietary vitamin and mineral supplements may be associated with increased total mortality risk, most strongly supplemental iron, while calcium, in contrast to many studies, was associated with decreased risk.

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Multivitamin Use and Risk of Cancer and Cardiovascular Disease in the Women's Health Initiative Cohorts

Neuhouser¹,

Wassertheil‐Smoller²,

Thomson³

et al. 2009

Arch Intern Med

180

113

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Context Millions of postmenopausal women use multivitamins, often believing that supplements prevent chronic diseases such as cancer and cardiovascular disease. Objective To examine associations between multivitamin use and risk of cancer, cardiovascular disease and mortality in postmenopausal women. Design, Setting and Participants 161,808 participants from the Women’s Health Initiative Clinical Trials (n=68,132 in three overlapping trials of hormone therapy, dietary modification and calcium-vitamin D) or Observational Study (n=93,676). Detailed data were collected on multivitamin use at baseline and follow-up time points. Study enrollment occurred between 1993–1998; women were followed for a median of 8.0 years in the clinical trials and 7.9 years in the observational study. Disease endpoints were collected through 2005. Outcome Measures Cancers of the breast (invasive), colon/rectum, endometrium, kidney, bladder, stomach, ovary and lung; cardiovascular disease (myocardial infarction, stroke, venous thrombosis); and total mortality. Results 41.5% of participants used multivitamins. After a median of 8.0 years of follow-up in the CT and 7.9 years in the OS, 9,619 cases of breast, colorectal, endometrium, kidney, bladder, stomach lung or ovary cancer; 8,751 CVD events and 9,865 deaths were reported. Multivariate-adjusted analyses revealed no association of multivitamins with risk of cancer (breast HR=0.98, 95%CI 0.91–1.05; colorectal HR = 0.99, 95% CI 0.88–1.11; endometrial HR = 1.05, 95%CI= 0.90–1.21; lung HR = 1.0, 95% CI=0.88–1.13; ovary HR = 1.07, 95%CI =0.88–1.29); CVD (MI HR= 0.96, 95%CI= 0.89–1.03; stroke HR = 0.99, 95%CI =0.91–1.07; VT HR = 1.05, 95%CI =0.85–1.29); or mortality (HR = 1.02, 95% CI=0.97–1.07). Conclusion After a median follow-up of 8.0 and 7.9 years in the CT and OS, respectively, the WHI cohorts provide convincing evidence that multivitamin use has little or no influence on the risk of common cancers, cardiovascular disease or total mortality in postmenopausal women. Clinical Trial Registration clinicaltrials.gov identifier: NCT00000611

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National Institutes of Health State-of-the-Science Conference Statement: Multivitamin/Mineral Supplements and Chronic Disease Prevention

Abstract: NIH consensus and state-of-the-science statements are prepared by independent panels of health professionals and public representatives on the basis of (1)

Cited by 94 publications

References 11 publications

Association of Multivitamin and Mineral Supplementation and Risk of Cardiovascular Disease

Association of Multivitamin and Mineral Supplementation and Risk of Cardiovascular Disease

Dietary Supplements and Mortality Rate in Older Women

Multivitamin Use and Risk of Cancer and Cardiovascular Disease in the Women's Health Initiative Cohorts

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