Randomized trials of vitamin E in the treatment and prevention of cardiovascular disease

Eidelman, Rachel S.; Hollar, Danielle; Herbert, Peter

doi:10.1016/j.accreview.2004.08.106

Cited by 38 publications

(44 citation statements)

References 19 publications

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“…This provides one obvious explanation for why associations between single nutrients and disease, which have been unequivocally confirmed in meta-analyses of observational cohort studies, do not necessarily translate into predictable outcomes in intervention studies with whole diets. The disparity between the impacts of single nutrients, foods and diets on health is highlighted by the potential health benefits of foods containing micronutrients, such as b-carotene and vitamin E (4,5) , and the neutral and negative outcomes from secondary prevention intervention trials with these single antioxidant micronutrients (6)(7)(8)(9) . It is also evident from the inconsistency between the established cholesterol-raising effects of dietary SFA in experimental feeding studies, and effects produced by some foods that are rich in saturated fat, such as dairy products.…”

Section: Proceedings Of the Nutrition Societymentioning

confidence: 99%

Dietary patterns and cardiovascular disease

2013

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Despite strong prospective epidemiology and mechanistic evidence for the benefits of certain micronutrients in preventing CVD, neutral and negative outcomes from secondary intervention trials have undermined the efficacy of supplemental nutrition in preventing CVD. In contrast, evidence for the positive impact of specific diets in CVD prevention, such as the Dietary Approaches to Stop Hypertension (DASH) diet, has focused attention on the potential benefits of whole diets and specific dietary patterns. These patterns have been scored on the basis of current guidelines for the prevention of CVD, to provide a quantitative evaluation of the relationship between diet and disease. Using this approach, large prospective studies have reported reductions in CVD risk ranging from 10 to 60% in groups whose diets can be variously classified as ‘Healthy’, ‘Prudent’, Mediterranean’ or ‘DASH compliant’. Evaluation of the relationship between dietary score and risk biomarkers has also been informative with respect to underlying mechanisms. However, although this analysis may appear to validate whole-diet approaches to disease prevention, it must be remembered that the classification of dietary scores is based on current understanding of diet–disease relationships, which may be incomplete or erroneous. Of particular concern is the limited number of high-quality intervention studies of whole diets, which include disease endpoints as the primary outcome. The aims of this review are to highlight the limitations of dietary guidelines based on nutrient-specific data, and the persuasive evidence for the benefits of whole dietary patterns on CVD risk. It also makes a plea for more randomised controlled trials, which are designed to support food and whole dietary-based approaches for preventing CVD.

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Section: Proceedings Of the Nutrition Societymentioning

confidence: 99%

Dietary patterns and cardiovascular disease

2013

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“…Several reviews and meta-analyses have recently concluded that, for most forms of oxidative-stress-related diseases tested so far, there is no beneficial effect of supplemental a-tocopherol or, probably, of supplemental b-carotene and ascorbic acid (Vivekananthan, 2003;Eidelman et al 2004;Shekelle et al 2004). The results of intervention studies using supplements of selenium, which is not an antioxidant itself but an essential building block of the endogenous antioxidant defence, are more positive, however (Bjelakovic et al 2004;Etminan et al 2005).…”

Section: Dietary Compounds With the Ability To Directly Scavenge Or Nmentioning

confidence: 99%

Health benefits of nuts: potential role of antioxidants

et al. 2006

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A diet rich in fruits, vegetables and minimally refined cereals is associated with lower risk for chronic degenerative diseases. Since oxidative stress is common in chronic degenerative disease, it has been assumed that dietary antioxidants may explain this protective effect. Every dietary plant contains numerous types of antioxidants with different properties. Many of these antioxidants cooperate in oxidative stress reduction in plants, and we hypothesize that many different antioxidants may also be needed for the proper protection of animal cells. To test this hypothesis, it is useful to identify dietary plants with high total antioxidant content. Several nuts are among the dietary plants with the highest content of total antioxidants. Of the tree nuts, walnuts, pecans and chestnuts have the highest contents of antioxidants. Walnuts contain more than 20 mmol antioxidants per 100 g, mostly in the walnut pellicles. Peanuts (a legume) also contribute significantly to dietary intake of antioxidants. These data are in accordance with our present extended analysis of an earlier report on nut intake and death attributed to various diseases in the Iowa Women's Health Study. We observed that the hazard ratio for total death rates showed a U-shaped association with nut/peanut butter consumption. Hazard ratio was 0·89 (CI ¼ 0·81 -0·97) and 0·81 (CI ¼ 0·75 -0·88) for nut/peanut butter intake once per week and 1-4 times per week, respectively. Death attributed to cardiovascular and coronary heart diseases showed strong and consistent reductions with increasing nut/peanut butter consumption. Further studies are needed to clarify whether antioxidants contribute to this apparent beneficial health effect of nuts. Nuts: Antioxidants: LDL oxidation: Flavonoids: FRAP: Antioxidant defence: Oxidative damageNuts are not easily defined in a manner that would be both compatible with popular usage and acceptable to botanists. For example, the groundnut or peanut is a legume, and the chufa nut, which is common in south Europe and Africa, is a tuber. Some languages such as French, even lack an umbrella word equivalent to nuts. 'Noix' in French looks like one, but just means walnuts. In this text we will not only include botanically defined nuts, but will also include data on some foods which have traditionally been defined as nuts.Nuts are highly nutritious and of prime importance for people in several regions in Asia and Africa. Most nuts contain a great deal of fat (e.g. pecan 70 %, macadamia nut 66 %, Brazil nut 65 %, walnut 60 %, almonds 55 % and peanut butter 55 %). Most have a good protein content (in the 10 -30 % range), and only a few have a very high starch content (Davidson, 1999). Recently, many nuts have also been identified as especially rich in antioxidants (Halvorsen et al. 2002;Wu et al. 2004). Nuts therefore constitute one of the most nutritionally concentrated kinds of food available. Most nuts, left in their shell, have a remarkably long shelf-life and can conveniently be stored for winter use.The aim of this paper is ...

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“…Also the meta-analysis by Eidelman et al [22] resulted in the conclusion that ''vitamin E supplementation has no statistically significant or clinically important effects on cardiovascular disease''.…”

Section: Meta-analyses Of the Intervention Studiesmentioning

confidence: 99%

Adverse effects of vitamin E by induction of drug metabolism

Brigelius‐Flohé

2007

Genes Nutr

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Observational studies with healthy persons demonstrated an inverse association of vitamin E with the risk of coronary heart disease or cancer, the outcome of large-scale clinical trials conducted to prove a benefit of vitamin E in the recurrence and/or progression of such disease, however, was disappointing. Vitamin E did not provide benefits to patients with cardiovascular diseases, cancer, diabetes or hypertension. Even harmful events and worsening of pre-existing diseases were reported, which are hard to explain. Since vitamin E is metabolized along the same routes as xenobiotics and induces drug-metabolizing enzymes in rodents, it is hypothesized that a supplementation with high dosages of vitamin E may also lead to an induction of the drug-metabolizing system in patients that depend on drug therapy. Compromising essential therapy might therefore outweigh any benefit of vitamin E in patients. It is recommended to work out at which threshold the drug-metabolizing system can be induced in humans before new trials with high dosages of vitamin E are started.

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Randomized trials of vitamin E in the treatment and prevention of cardiovascular disease

Cited by 38 publications

References 19 publications

Dietary patterns and cardiovascular disease

Dietary patterns and cardiovascular disease

Health benefits of nuts: potential role of antioxidants

Adverse effects of vitamin E by induction of drug metabolism

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