5MinuteConsult Journal Club
The Lack of Benefit of Vitamins and Supplements
JAMA. 2022;327(23):2326-2333. doi:10.1001/jama.2022.8970
The U.S. Preventive Services Task Force (USPSTF) recommends against the use of beta carotene or vitamin E supplements for the prevention of cardiovascular disease or cancer. (D recommendation)
There is insufficient evidence to assess the balance of benefits and harms of the use of multivitamin supplements for the prevention of cardiovascular disease or cancer. (I statement)
There is insufficient evidence to assess the balance of benefits and harms of the use of single- or paired-nutrient supplements (other than beta carotene and vitamin E) for the prevention of cardiovascular disease or cancer. (I statement)
Vitamins and supplements are not going to help lower patient health risks. If they live in the western world, buy food at a commercial store, and eat (reasonably) well, they will take in adequate vitamins and minerals. Even white bread is fortified with folic acid.
Eating well (high vegetable/fruit/unrefined fiber, Mediterranean diet) and exercising (30 minutes, 5 days a week) are the best ways to prevent cardiovascular disease and cancer.
How can we help patients change their behaviors, rather than take pills, to live better and longer? Typically, by one small step at a time. Smoking cessation first, then limits on alcohol (14/day for men, 7 for women), then having high fiber foods making up the majority of their intake and finally, finding an ACTIVE activity they can do each day.
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