Friday, November 9, 2012

More on supplements…



            Many people believe that a daily multivitamin is harmless and may even help prevent chronic diseases, including cancer. According to Martinez, Jacobs, Baron, Marshall, and Byers (2012) about half of all adults in the U.S. take supplements. But just how helpful are multivitamins? In 2009 a study was conducted to evaluate the impact of multivitamin use on cancer risk and cardiovascular disease in women participating in the Women’s Health Initiative study. After following the patients for eight years, multivitamin use was found to have little to no influence on risk of common cancers, cardiovascular disease, or total mortality in postmenopausal women (Neuhouser et al, 2009). This and many other studies have resulted in inconclusive evidence that there is a benefit to daily supplementation for purposes other than nutritional deficiencies (Martinez et al., 2012). As a result of the lack of current scientific evidence, federal dietary guidelines and the American Cancer Society recommend a well balanced diet with plenty of fruits and vegetables (Rabin, 2012). The provider that I work with advises his patients that they can continue to take daily multivitamins if they choose, but as long as they are eating a well-balanced diet, this is not necessary.

However, a recently published study to evaluate the use of multivitamins for the prevention of cancer in men followed male physicians over the age of 50 for about eleven years and found that daily multivitamin use decreased the incidence of cancer by 8% (Gaziano et al., 2012). Interestingly multivitamin use did not impact the incidence of prostate cancer, the most common cancer in men. However, as when evaluating all types of evidence, one should ask if the results can be generalized to the population as a whole. Upon further analysis, this study was conducted on a population of well-educated male physicians who are overall less racially and ethnically diverse and had far fewer smokers than in the general population. Additionally, the study was specific to the formulation of Centrum Silver provided to the patients in the study. Thus, this study can be a building block for additional research, but the use of daily multivitamins is not an evidence-based practice at this time.

 

References

Gaziano, J. M., Sesso, H. D., Bubes, V., Smith, J. P., MacFadyen, J., Schvartz, M., … Buring, J. E. (2012). Journal of the American Medical Association, 308(18), E1-E10. doi: 10.1001/jama.2012.14641

Martinez, M. E., Jacobs, E. T., Baron, J. A., Marshall, J. R., & Byers, T. (2012). Dietary supplements and cancer prevention: Balancing potential benefits against proven harms. Journal of the National Cancer Institute, 104(10), 732-739. doi: 10.1093/jnci/djs195

Neuhouser, M. L., Wassertheil-Smoller, S., Thomson, C., Aragaki, A., Anderson, G. L., Manson, J. E., … Prentice, R. L. (2009). Mutlivitamin use and risk on cancer and cardiovascular disease in Women’s Health Initiative cohorts. Archives of Internal Medicine, 169(3), 294-304

Rabin, R. C. (2012, October 22). Curbing the enthusiasm on daily multivitamins. The New York Times. Retrieved from http://well.blogs.nytimes.com/2012/10/22/curbing-the-enthusiasm-on-daily-multivitamins/?ref=health

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