USPSTF: Vitamin E, Beta-carotene Supplementation Not Recommended for CVD, Cancer Prevention

The US Preventive Services Task Force (USPSTF) on May 5 posted a draft recommendation statement indicating that evidence is insufficient to determine the benefits and harms of taking most vitamin, mineral, and multivitamin supplements to prevent heart disease and cancer.

However, while the benefit or harm of most supplements is unclear, the task force found specifically no benefit associated with taking vitamin E (I recommendation) and that harms outweigh benefits associated with taking beta-carotene (D recommendation). There is no evidence that either of them reduces the risk of heart disease and cancer.

“The Task Force recommends against the use of vitamin E or beta-carotene for the prevention of heart disease and cancer,” said Task Force member John Wong, MD in a Task Force statement. “The evidence shows there is no benefit to taking vitamin E and that beta-carotene can be harmful because it increases the risk of lung cancer in people already at risk, such as those who smoke, and also increases the risk of dying from heart disease or stroke.”

The Task Force draft recommendation statement is based on review of 14 180 unique citations and 351 full-text articles drawn from common medical databases for the period between January 2013 and August 2020. Surveillance continued for relevant literature through January 22, 2021.

“Because heart disease and cancer are the two leading causes of death in the US, we want to look at whether taking vitamins and minerals help [sic] prevent these important diseases,” said Chyke Doubeni, MD, MPH, a task force member and inaugural director of the Mayo Clinic Center for Health, Equity and Community Engagement Research, in the statement. “However, there is not enough evidence to know if taking vitamin, mineral and multivitamin supplements prevent these conditions, so the task force is calling for more research.”

The draft recommendation does not apply to people who are or who may become pregnant, according to the recommendation statement. For these individuals, the task force previously issued a separate statement that recommends folic acid supplements.

The Task Force states in the draft, also, that because the focus of the review on CVD and cancer, it does not address other potential benefits of supplemental vitamins and minerals on other outcomes. In addition, the studies reviewed are in predominantly healthy populations without known deficiencies and so the review does not cover therapeutic supplementation in those with medical conditions or nutritional deficits.

Authors wrote that more research is needed on the effects of vitamin D, vitamin C, and folic acid administered with other B vitamins on CVD and cancer prevention.

“The evidence base demonstrating no benefit of vitamin E on cancer and CVD is robust and does not warrant resource investment in major new de novo studies,” wrote review authors. “Given the risks identified for beta-carotene, we see no need for further research on the role of beta-carotene in CVD and cancer prevention, nor, by extension, for vitamin A.”

The public can comment on the draft recommendation on the USPSTF’s website through June 1