A report from the United States Preventive Services Task Force shows that there is no solid evidence to support any benefit for most Americans from vitamin and mineral pills, or vitamins or minerals added to foods, for the prevention of cancer or heart attacks (Annals of Internal Medicine, published online 12 November 2013). These guidelines are consistent with those from the National Institutes of Health and the Academy of Nutrition and Dietetics, and The American Heart Association. Heart attacks and cancers are the most common chronic diseases in the developed world. In 2011, heart attacks accounted for 23.7 percent of all deaths in the United States, and cancers accounted for 22.8 percent.
There is evidence that neither vitamin E nor beta-carotene prevent heart attacks or cancers, and beta-carotene (pro-vitamin A) may increase lung cancer risk in smokers. The authors did find two trials that showed a small, borderline-significant benefit from multivitamin supplements on cancer prevention in men but not in women. They found no effect on heart attacks.
How Many People Take Vitamin and Mineral Pills? North Americans spent $28.1 billion on vitamin and mineral pills in 2010. Forty-nine percent of adults used at least one dietary supplement from 2007 to 2010, and 32 percent of adults reported using a daily multivitamin-mineral supplement. Supplement takers are more likely to be women than men, and older adults rather than younger adults.
Who Needs Vitamin or Mineral Pills? The recommendations do not apply to “pregnant women, children, people who are hospitalized, have chronic illness, or have a nutritional deficiency.” Women planning pregnancy should take a daily supplement containing folic acid to help prevent neural tube defects. You may need vitamin or mineral pills if you lack access to nutritious food because of: * geography, * poverty, * inability to absorb certain nutrients, or * severe dietary restriction.
The report states that “a healthy diet may play a role in the prevention of cancer or cardiovascular disease.” Healthy people should be able to get all the vitamins and minerals they need from their food. I believe that the best ways to prevent heart attacks and cancer are lifestyle changes that include: * Eating lots of fruits, vegetables and nuts * Restricting red meat, fried foods, sugared drinks and foods with added sugars * Exercising daily * Building muscle * Avoiding overweight * Keeping vitamin D levels above 75 nmol/L * Avoiding smoking * Restricting alcohol Anyone who has systolic blood pressure greater than 120, bad LDL cholesterol above 100, or a fasting blood sugar greater than 100 should be treated with lifestyle changes and perhaps with medications. Check with your doctor.
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