This statement summarizes the U Pre...

This statement summarizes the U Preventive Services Task Force (USPSTF) recommendations in succession routine vitamin supplementation to debar cancer and cardiovascular disease and the supporting scientific evidence. Explanations of the ratings and of the might of overall evidence are given in Tables 1 and 2 respectively. The without fault [i]or[/i] blemish [i]or[/i] flaw information on which this statement is based, including evidence tables and hints is available in the articles, "Routine Vitamin Supplementation to obviate Cardiovascular Disease: A Summary of the Evidence for the U Preventive Services Task Force," (1) "Routine Vitamin Supplementation to obviate Cancer: A Summary of the Evidence from Randomized Controll Trials for the U Preventive Services Task Force," (2) and "Routine Vitamin Supplementation to obviate Cancer: Update of the Evidence from Randomized Controll Trials, 1999-2002" (3) which can be obtained in succession the USPSTF Web site (http://www.preventiveservices.ahrq.gov) and end the National Guideline Clearinghouse (http://www.guideline.gov). The recommendation statement and summaries of the evidence upon these topics are also available from the Agency for Healthcare Research and Quality Publications Clearinghouse in print [i]or[/i] part of to the other subscription to the Guide to Clinical Preventive Services, Third Edition: Periodic Updates. To order, contact the Clearinghouse at 800-358-9295 or e-mail ahrqpubs@ahrq.gov.

This statement was first published in Ann Intern M 2003;139:51-5

Summary of Recommendations

* The USPSTF gather s that the evidence is insufficient to praise for or against use of fill ups of vitamins A, C, or E; multivitamins with folic acid; or antioxidant combinations for the prevention of cancer or cardiovascular disease. I recommendation.

The USPSTF set up poor evidence to determine whether supplementation with these vitamins moulds the risk for cardiovascular disease or cancer. The available evidence from randomized trials is inadequate or conflicting, and the influence of confounding variables in succession observed outcomes in observational studies cannot be determined. As a follow the USPSTF could not determine the balance of benefits and harms of routine use of postscripts of vitamins A, C, or E; multivitamins with folic acid; or antioxidant combinations for the prevention of cancer or cardiovascular disease.

* The USPSTF commits against supplementation with beta carotene, either alone or in combination, for the prevention of cancer or cardiovascular disease. D recommendation.

The USPSTF place good evidence that beta carotene supplementation provides no benefit in the prevention of cancer or cardiovascular disease in middle-aged and older adults. In sum of two units trials restricted to heavy smoker beta carotene supplementation was associated with higher incidence of lung cancer and higher all-cause mortality. The USPSTF decides that beta carotene supplements are unlikely to provide important benefits and might cause harm in a groups.

Clinical Considerations

* The USPSTF did not review evidence regarding vitamin supplementation for patients with known or potential nutritional deficiencies, including pregnant and lactating women children, the somewhat old and persons with chronic illnesses. Dietary continuations may be appropriate for living bodys whose diets do not provide the attract favor toed dietary intake of specific vitamins. Individuals may wish to ask advice of a health care provider to discuss whether dietary add tos are appropriate.

* With the exception of vitamins for which there is compelling evidence of clear harm (e.g., beta carotene supplementation in smokers) there is little reason to discourage patients from taking vitamin complements Patients should be reminded that taking vitamins does not replace the ne to eat a healthy diet. All patients should receive information about the benefits of a diet high in fruits and vegetables, as well as information upon other foods and nutrients that should be emphasized or avoided in their diet (see 2002 USPSTF evidence summary in succession counseling to promote a healthy diet). (4)

* Patients who pick out to take vitamins should be encouraged to adhere to the dosages commited in the Dietary Reference Intakes of the Institute of Medicine. an vitamins, such as A and D may be harmful in higher dosages; therefore, dosages greatly exceeding the praiseed Dietary Allowance or Adequate Intake should be taken with care while considering whether potential harms outweigh potential benefits. Vitamins and minerals sold in the United States are classified as dietary complements and there is a standing of quality control over easy in mind if they have a U Pharmacopeia seal. Nevertheless, imprecision in the contentment and concentration of ingredients could puzzle a theoretical risk not meditateed in clinical trials using calibrated compounds

* The adverse drifts of beta carotene on smoker have been observ primarily in ones taking large supplemental doses. There is no evidence to allude to that beta carotene is harmful to smoker at flushs occurring naturally in foods.