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Multivitamins of No Benefit for Secondary CV Prevention, Cognition — Physician’s First Watch

Medical News |
December 17, 2013

Multivitamins of No Benefit for Secondary CV Prevention, Cognition

By Amy Orciari Herman

Two new studies in the Annals of Internal Medicine strengthen the argument against multivitamin use for chronic disease prevention.

In the first, some 1700 North American adults aged 50 and older who'd had a myocardial infarction at least 6 weeks earlier were randomized to either a high-dose, 28-component vitamin and mineral formulation or placebo. During roughly 4.5 years' follow-up, the incidence of the primary composite outcome — all-cause mortality, recurrent MI, stroke, revascularization, and hospitalization for angina — did not differ significantly between the groups.

In the second study, nearly 6000 U.S. male physicians aged 65 and older were randomized to a daily multivitamin or placebo. After 8.5 years' follow-up, there were no significant differences between the groups in global cognition or verbal memory.

Editorialists conclude: "We believe that the case is closed — supplementing the diet of well-nourished adults with (most) mineral or vitamin supplements has no clear benefit and might even be harmful. These vitamins should not be used for chronic disease prevention. Enough is enough."

Reader Comments (8)

Martha Fankhauser Other Healthcare Professional, Pharmacology/Pharmacy, Private consulting practice

I am so sorry that these studies get national news coverage without the critique of how the study was done and in the population that was studied (male physicians). It would be better to have data in "real" people in our population that have major medical and psychiatric disorders, poor nutrition, and minimal or no healthcare. It is very disappointing that the public is told not to take vitamins because of the studies that were recently published.

Lou Colasanti, MA Other, Epidemiology/Statistics

Just as the plural of anecdote is not data, so, too, one must guard against reading the data beyond the actual information and implications it provides. To reach general conclusions about the efficacy of anything, multivitamins included, on reducing CV risks after CVD has already manifested takes the data further than is warranted, something that is underscored by the misinforming title of this article. Moreover, to generalize to the population -at-large from a sample of physicians, a demographic group that only differs not only in terms of education -- which the abstract acknowledges might play a part in outcomes -- but also with regard to income, stress, and a host of other factors, is also of limited value.

Kelly PhDc, PMHNP, CNS, BC Other Healthcare Professional, Neurology, community mental health

The sample size was not: poor people or the mentallyl ill with fragile neurological conditions or people who eat once a day. I use vitamins usually B complex on these folks. (Not smokers, due to beta carotene increases in lung cancer, wish they had an MVI for smokers with extra C, etc.).

Sheldon Ball, MD PhD Physician, Geriatrics, Anvita Health

Some time ago in Journal Watch an editorialist in another scenario cautioned against applying results of a study to populations outside of the study group. I would think that this would suggest that for men >= 50 years of age post MI or >= 65 years of age, vitamin supplementation is of little to no benefit (individual exceptions may exist).

Jeanne Antantis Other, Other

You've just said it all with this part of the article: "well-nourished adults with (most) mineral or vitamin supplements". You apparently are not in touch with the senior population trying to figure out if they should eat and be well-nourished or pay the high price of prescription medications.

Tracy Kolenchuk Healthicine.org

This editorial and its conclusion is simply nonsense. The research studies chose people who have chronic disease, and then studied the use of specific sets of vitamins to prevent further progression of the illness.

There was no measure if any multivitamins 'prevent' chronic disease in healthy people - they only measured the progression of disease in diseased persons. Prevention has a different meaning than 'prevent the progression of' but the editors seem to not understand that distinction.

The editorial takes this further, even so far as to state that: "With respect to multivitamins, the studies published in this issue and in previous trials indicate no substantial health benefit."

But health was not measured. Only illness was measured. There is no scientific system, no journals, no research that attempts to measure healthiness, without reference to illness - yet the editorial makes the leap from failed studies of illness, to conclusions about health.
to your health, tracy

Herman Medow, Ph.DF. Other Healthcare Professional

"enough is enough"- only word missing is "Period!"- impression
is that there is no credible research evidence for benefits of
vitamins and other supplements, just more and more evidence
that these are worthless- yet another piece of worthless
"research" and the wonders of statistics massaging data, and
analyzing them with total disconnect with all other work in
this domain- The Doctors Eades pointed out long ago the
principled that when you can torture data long enough,
you will extract the conclusions you want- FDA recently
started requiring registration of all research involving
products to prevent the practice of repeated statistics-
based research, discarding unwanted results and reporting
only the desired results- might be good idea for respected
publications

Joe Alaimo, MA, DC Physician, Other, Clinic

More junk science utilizing poor quality supplements in a pharma based journal. Clear conflict of interests. Proper nutrition and supplementation is critical for overall well being.

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