Vitamin and Mineral Supplements in the Primary Prevention of Cardiovascular Disease and Cancer
Authors: Harri Hemilä
Journal: Annals of Internal Medicine (2014)

Letters6 May 2014Vitamin and Mineral Supplements in the Primary Prevention of Cardiovascular Disease and CancerHarri Hemilä, MD, PhDHarri Hemilä, MD, PhDFrom University of Helsinki, Helsinki, Finland.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L14-5009-3 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Fortmann and colleagues (1) calculated that vitamin E supplementation does not influence all-cause mortality (95% CI, −2% to 4%). This estimate was based on the pooling of the results of 5 studies. However, conclusions of study-level analyses can differ from those of corresponding individual-level analysis, a difference known as the “ecological fallacy” (2).Recently, a colleague and I analyzed heterogeneity in the effect of vitamin E on the mortality of participants in the ATBC (Alpha-Tocopherol, Beta-Carotene) study, who were male smokers aged 50 to 69 years at baseline (3). The combination of age and dietary vitamin C ...References1. Fortmann SP, Burda BU, Senger CA, Lin JS, Whitlock EP. Vitamin and mineral supplements in the primary prevention of cardiovascular disease and cancer: an updated systematic evidence review for the U.S. Preventive Services Task Force. Ann Intern Med. 2013;159:824-34. [PMID: 24217421] LinkGoogle Scholar2. Berlin JA, Santanna J, Schmid CH, Szczech LA, Feldman HI; Anti-Lymphocyte Antibody Induction Therapy Study Group. Individual patient- versus group-level data meta-regressions for the investigation of treatment effect modifiers: ecological bias rears its ugly head. Stat Med. 2002;21:371-87. [PMID: 11813224] CrossrefMedlineGoogle Scholar3. Hemilä H, Kaprio J. Modification of the effect of vitamin E supplementation on the mortality of male smokers by age and dietary vitamin C. Am J Epidemiol. 2009;169:946-53. [PMID: 19218294] CrossrefMedlineGoogle Scholar4. Packer JE, Slater TF, Willson RL. Direct observation of a free radical interaction between vitamin E and vitamin C. Nature. 1979;278:737-8. [PMID: 431730] CrossrefMedlineGoogle Scholar5. Hemilä H, Kaprio J. Vitamin E may affect the life expectancy of men, depending on dietary vitamin C intake and smoking. Age Ageing. 2011;40:215-20. [PMID: 21242192] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From University of Helsinki, Helsinki, Finland.Disclosures: None. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L14-0083. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoVitamin and Mineral Supplements in the Primary Prevention of Cardiovascular Disease and Cancer: An Updated Systematic Evidence Review for the U.S. Preventive Services Task Force Stephen P. Fortmann , Brittany U. Burda , Caitlyn A. Senger , Jennifer S. Lin , and Evelyn P. Whitlock Vitamin and Mineral Supplements in the Primary Prevention of Cardiovascular Disease and Cancer Sebastian J. Padayatty and Mark Levine Vitamin and Mineral Supplements in the Primary Prevention of Cardiovascular Disease and Cancer Yosef Dror and Felicia Stern Vitamin and Mineral Supplements in the Primary Prevention of Cardiovascular Disease and Cancer Mark J. Bolland , Andrew Grey , and Ian R. Reid Vitamin and Mineral Supplements in the Primary Prevention of Cardiovascular Disease and Cancer Stephen P. Fortmann , Evelyn P. Whitlock , and Brittany U. Burda Vitamin and Mineral Supplements in the Primary Prevention of Cardiovascular Disease and Cancer Yosef Dror and Felicia Stern Vitamin and Mineral Supplements in the Primary Prevention of Cardiovascular Disease and Cancer Mark J. Bolland , Andrew Grey , and Ian R. Reid Vitamin and Mineral Supplements in the Primary Prevention of Cardiovascular Disease and Cancer Stephen P. Fortmann , Evelyn P. Whitlock , and Brittany U. Burda Vitamin and Mineral Supplements in the Primary Prevention of Cardiovascular Disease and Cancer Sebastian J. Padayatty and Mark Levine Metrics 6 May 2014Volume 160, Issue 9Page: 655KeywordsCancer preventionCardiovascular diseasesDisclosureSurvival analysisVitamin CVitamin E ePublished: 6 May 2014 Issue Published: 6 May 2014 CopyrightCopyright © 2014 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...