Enough Is Enough
Authors: Eliseo Guallar, Saverio Stranges, Cynthia Mulrow, Lawrence J. Appel, Edgar R. Miller
Journal: Annals of Internal Medicine (2014)

Letters3 June 2014Enough Is EnoughEliseo Guallar, MD, DrPH, Saverio Stranges, MD, PhD, Cynthia Mulrow, MD, MSc, Lawrence J. Appel, MD, MPH, and Edgar R. Miller III, MD, PhDEliseo Guallar, MD, DrPHFrom Johns Hopkins University, Baltimore, Maryland; University of Warwick, Coventry, England, United Kingdom; and Annals of Internal Medicine, American College of Physicians, Philadelphia, Pennsylvania.Search for more papers by this author, Saverio Stranges, MD, PhDFrom Johns Hopkins University, Baltimore, Maryland; University of Warwick, Coventry, England, United Kingdom; and Annals of Internal Medicine, American College of Physicians, Philadelphia, Pennsylvania.Search for more papers by this author, Cynthia Mulrow, MD, MScFrom Johns Hopkins University, Baltimore, Maryland; University of Warwick, Coventry, England, United Kingdom; and Annals of Internal Medicine, American College of Physicians, Philadelphia, Pennsylvania.Search for more papers by this author, Lawrence J. Appel, MD, MPHFrom Johns Hopkins University, Baltimore, Maryland; University of Warwick, Coventry, England, United Kingdom; and Annals of Internal Medicine, American College of Physicians, Philadelphia, Pennsylvania.Search for more papers by this author, and Edgar R. Miller III, MD, PhDFrom Johns Hopkins University, Baltimore, Maryland; University of Warwick, Coventry, England, United Kingdom; and Annals of Internal Medicine, American College of Physicians, Philadelphia, Pennsylvania.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L14-5011-6 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:Dr. Frei and colleagues believe that our current knowledge based on nutritional research and dietary monitoring justifies daily use of multivitamin and mineral supplements by most persons in the United States. We disagree. In contrast to many prevention strategies, vitamin and mineral supplements are pill-based interventions that are amenable to rigorous evaluation in large-scale clinical trials with clinically relevant outcomes. The lack of efficacy and the adverse effects observed in clinical trials of antioxidant supplements, confirmed once again in a recent Cochrane review (1), should be a constant reminder of our limited ability to infer the consequences of ...References1. Bjelakovic G, Nikolova D, Gluud C. Antioxidant supplements to prevent mortality. JAMA. 2013;310:1178-9. [PMID: 24045742] CrossrefMedlineGoogle Scholar2. Gaziano JM, Sesso HD, Christen WG, Bubes V, Smith JP, MacFadyen J, et al. Multivitamins in the prevention of cancer in men: the Physicians' Health Study II randomized controlled trial. JAMA. 2012;308:1871-80. [PMID: 23162860] CrossrefMedlineGoogle Scholar3. Hercberg S, Galan P, Preziosi P, Bertrais S, Mennen L, Malvy D, et al. The SU.VI.MAX Study: a randomized, placebo-controlled trial of the health effects of antioxidant vitamins and minerals. Arch Intern Med. 2004;164:2335-42. [PMID: 15557412] CrossrefMedlineGoogle Scholar4. Evans JR, Lawrenson JG. Antioxidant vitamin and mineral supplements for preventing age-related macular degeneration. Cochrane Database Syst Rev. 2012;6:CD000253. [PMID: 22696317] MedlineGoogle Scholar5. Evans JR, Lawrenson JG. Antioxidant vitamin and mineral supplements for slowing the progression of age-related macular degeneration. Cochrane Database Syst Rev. 2012;11:CD000254. [PMID: 23152201] MedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Johns Hopkins University, Baltimore, Maryland; University of Warwick, Coventry, England, United Kingdom; and Annals of Internal Medicine, American College of Physicians, Philadelphia, Pennsylvania.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M13-2593. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoEnough Is Enough: Stop Wasting Money on Vitamin and Mineral Supplements Eliseo Guallar , Saverio Stranges , Cynthia Mulrow , Lawrence J. Appel , and Edgar R. Miller III Enough Is Enough Balz Frei , Bruce N. Ames , Jeffrey B. Blumberg , and Walter C. Willett Enough Is Enough Irvine Mason Enough Is Enough Deborah Stepp Enough Is Enough Thomas R. Friberg Enough Is Enough Jessica Fargnoli , Joyce Greenleaf , and Melissa Hafner Enough Is Enough Irvine Mason Enough Is Enough Thomas R. Friberg Enough Is Enough Jessica Fargnoli , Joyce Greenleaf , and Melissa Hafner Enough Is Enough Deborah Stepp Enough Is Enough Balz Frei , Bruce N. Ames , Jeffrey B. Blumberg , and Walter C. Willett Metrics Cited byMoringa oleifera : a review of the medicinal potential 3 June 2014Volume 160, Issue 11Page: 809-810KeywordsAntioxidant therapyBiomarkersClinical trialsDisclosureMacular degenerationNutrition ePublished: 3 June 2014 Issue Published: 3 June 2014 Copyright & PermissionsCopyright © 2014 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...