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Expert Panel: Vitamins, Supplements Useless for Most People

Denise Mann wrote . . . . . . . . .

Millions of people pop vitamins and supplements every day in hopes of staving off heart disease and cancer, but a new report finds the evidence to support that strategy is largely lacking.

While there is some research showing that a daily multivitamin may slightly reduce cancer risk, the bigger picture suggests a lack of enough evidence to say that supplements can help prevent heart disease and cancer.

There is, however, enough evidence to state that beta carotene supplements may actually increase risk of lung cancer, especially among folks who are at high risk, and may also increase the chances of dying from heart disease. What’s more, vitamin E provides no cancer or heart disease prevention benefits.

Those are the main takeaways from the new report from the U.S. Preventive Services Task Force, an independent panel of national experts that regularly make evidence-based recommendations about preventive health issues. This report updates the group’s 2014 stance on this topic.

“This is not a negative message, and it isn’t saying that there are no [cancer or heart disease prevention benefit] for vitamins and minerals,” cautioned task force vice chair Dr. Michael Barry. He’s the director of the Informed Medical Decisions Program in the Health Decision Sciences Center at Massachusetts General Hospital, in Boston.

“We called for more research with longer follow-up, as well as studies across different racial and ethnic groups, to see if there are variations,” Barry added.

The recommendations are based on a review of 84 studies on multivitamins, supplement pairs or individual supplements, and cardiovascular disease and cancer risk in healthy, non-pregnant adults, published between January 2013 and February 2022.

“For the most part, vitamin and mineral supplementation did not reduce cancer or heart disease [risk],” said Elizabeth O’Connor. She is an associate director at Kaiser Permanente Evidence-Based Practice Center in Portland, Ore. O’Connor is one of the researchers who helped analyze the studies included in the new recommendations.

Research did show a 7% reduction in cancer risk among people taking a multivitamin, compared to those taking a dummy pill or placebo. Still, the studies that led to this conclusion had limitations, including short follow-up. “Even though this finding was statistically significant, there are some lingering questions,” O’Connor said.

Importantly, the new recommendations do not apply to people with known or suspected nutritional deficiencies or special needs, such as people who are or may become pregnant and need folic acid.

The recommendations were published online in the Journal of the American Medical Association.

“Vitamin and mineral supplements are not a silver bullet for healthy Americans,” said Dr. Jenny Jia, who wrote an editorial accompanying the new study. She is an instructor of general internal medicine at Northwestern University’s Feinberg School of Medicine, in Chicago.

Instead of popping vitamins, focus on eating a balanced diet that is loaded with fruits and vegetables, exercising regularly, and getting the recommended screening tests to help prevent heart disease and cancer, she said. “Vitamins and minerals are a distraction, and offer minimal to no benefit for healthy American adults,”Jia noted.

Dr. Mark Moyad is the Jenkins/Pokempner director of preventive & alternative medicine at the University of Michigan Medical Center in Ann Arbor. He sees things differently, especially when it comes to daily multivitamins. “They may reduce cancer, and even though it’s a modest reduction, this is not a small deal,” said Moyad, who had no ties to the research.

“It’s not so much of a Wild West out there anymore when it comes to supplements,” he added. Many third-party groups now offer seals of approval for brands that are quality tested and contain what the label says they do.

“If you do take supplements, seek out ones that have a clean track record,” Moyad suggested.

The Council for Responsible Nutrition, which represents the supplements industry, took issue with the new report.

“Americans fall short in many key nutrients,” Andrea Wong, the organization’s Senior Vice President of Scientific and Regulatory Affairs, said in a statement. “In fact, the Food and Drug Administration and the 2020–2025 Dietary Guidelines for Americans identified that under-consumption of calcium, potassium, dietary fiber, and vitamin D is of public health concern for the general U.S. population because low intakes are associated with numerous health concerns.”

Wong pointed to evidence from the recent Cocoa Supplement and Multivitamin Outcomes Study (COSMOS), which she said suggests that “multivitamins help delay cognitive decline in older people.” Wong also cited data from the ongoing Physicians’ Health Study II, a “controlled trial [that] showed an 8% reduction in overall cancer risk in older male physicians who took a multivitamin.”

Source: HealthDay


Despite Hopes, Vitamin K2 Supplements Fail to Slow Calcium Buildup in Heart Valve

Laura Williamson wrote . . . . . . . . .

The progressive narrowing of the aortic heart valve in a group of older men could not be slowed during a recent clinical trial using vitamin K2 supplements, dampening hopes of finding a medical treatment for this common but serious condition.

The research, published in the American Heart Association journal Circulation, built upon earlier studies suggesting vitamin K2 supplements could slow the progression of aortic stenosis, a narrowing of the valve that controls blood flow from the heart to the rest of the body. But this randomized, double-blind, placebo-controlled trial – considered the gold standard of epidemiological studies – found vitamin K2 and vitamin D supplements did not slow the progression of calcium deposits on the aortic valves of older men once the process had begun.

“As previous animal studies, epidemiological studies and an open-label study did suggest a beneficial effect, we hoped for a positive trial,” said lead study author Dr. Axel Diederichsen, a professor in the department of cardiology at Odense University Hospital in Denmark. “Thus, we were surely disappointed.”

Aortic stenosis is the most common heart valve disease in high-income countries, according to the study, which estimates it affects about 2% to 5% of people older than 65. The number of people in the United States and Europe with aortic stenosis is expected to more than double by the year 2050, according to American Heart Association statistics that estimate 12.4% of people over 75 have the condition.

Symptoms may include chest pain, a fluttering heartbeat, trouble breathing, lightheadedness, fatigue, swollen ankles or feet and difficulty sleeping. There are no treatments when detected early, other than trying to control risk factors such as high blood pressure, high cholesterol, obesity, diabetes and gum disease. In the later stages, it is treated by replacing the heart valve. If not treated, aortic stenosis can progress and lead to heart failure and death.

“We haven’t had any medical therapies that slow the progression of stenosis,” said Dr. Brian Lindman, medical director of the Structural Heart and Valve Center and an associate professor of medicine at Vanderbilt University Medical Center in Nashville, Tennessee. “We anticipate when we see it in the earlier stages that it will eventually become severe, and you’ll have to have your valve replaced.”

Lindman, who was not involved in the research, said he was disappointed by the results because prior research suggested “this might be an effective intervention. I very much want to identify an effective medical therapy for these patients, so there’s an emotional component to it.”

In the study, 365 men with aortic stenosis from four Danish hospitals were randomly assigned to receive placebo or 720 micrograms of vitamin K2 and 25 micrograms of vitamin D for two years. All were 65 to 74 years old with aortic valve calcification scores of 300 AU or higher, a measure obtained with CT scans showing calcification had begun. The scores were measured again at the end of one year and at the end of the study. They also measured calcification levels in participants’ coronary arteries, which supply blood to the heart.

Researchers found no significant differences in valve calcification progression between the two groups, leading them to conclude the supplements were ineffective in slowing disease progression. However, there was some suggestion the group taking them experienced slower progression of calcification in their coronary arteries. Diederichsen said this needs to be explored in future studies. Researchers also said because the study only included men, the findings do not apply to women.

Research has suggested eating a diet high in vitamin K can benefit heart health. Vitamin K comes in two forms and is primarily found in leafy vegetables such as kale and spinach. Vitamin K2 is the less common form and is found in fermented foods, such as cheese. A study published last August in the Journal of the American Heart Association found eating a diet rich in vitamin K was associated with a lower risk for hospitalizations from cardiovascular disease related to plaque buildup in the arteries.

But Diederichsen said most foods contain insufficient levels of vitamin K2 to make an impact on heart health – with one exception. Natto, a traditional Japanese food made from fermented soybeans, is high in vitamin K2.

While vitamin K2 supplements showed no promise for treating aortic stenosis, Lindman remains hopeful researchers will find another way to slow the progression of the disease. “There are a number of potential drugs and pathways that still need to be tested.”

Source: American Heart Association

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What is Aortic Stenosis . . . . .