CoChat
Sign Up
Cited by 151Nutrition and Health StudiesNutritional Studies and DietAntioxidant Activity and Oxidative Stress

The DOI matches its Crossref record, with a small difference in title or year; 101 of the 101 references it cites were found in a registry or an index.

Vitamin and Mineral Supplements for the Primary Prevention of Cardiovascular Disease and Cancer: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force

Open access
O’Connor, Elizabeth A., Evans, Corinne V., Ivlev, Ilya, Rushkin, Megan C., Thomas, Rachel G., Martin, Allea, Lin, Jennifer S.·2022·JAMA
DOI 10.1001/jama.2021.15650PMC PMC13207626
Open this paper in CoChat — free accountOpen PDF

Abstract

Importance: Cardiovascular disease and cancer are the 2 leading causes of death in the US, and vitamin and mineral supplementation has been proposed to help prevent these conditions. Objective: To review the benefits and harms of vitamin and mineral supplementation in healthy adults to prevent cardiovascular disease and cancer to inform the US Preventive Services Task Force. Data Sources: MEDLINE, PubMed (publisher-supplied records only), Cochrane Library, and Embase (January 2013 to February 1, 2022); prior reviews. Study Selection: English-language randomized clinical trials (RCTs) of vitamin or mineral use among adults without cardiovascular disease or cancer and with no known vitamin or mineral deficiencies; observational cohort studies examining serious harms. Data Extraction and Synthesis: Single extraction, verified by a second reviewer. Quantitative pooling methods appropriate for rare events were used for most analyses. Main Outcomes and Measures: Mortality, cardiovascular disease events, cancer incidence, serious harms. Results: Eighty-four studies (N=739 803) were included. In pooled analyses, multivitamin use was significantly associated with a lower incidence of any cancer (odds ratio [OR], 0.93 [95% CI, 0.87-0.99]; 4 RCTs [n=48 859]; absolute risk difference [ARD] range among adequately powered trials, -0.2% to -1.2%) and lung cancer (OR, 0.75 [95% CI, 0.58-0.95]; 2 RCTs [n=36 052]; ARD, 0.2%). However, the evidence for multivitamins had important limitations. Beta carotene (with or without vitamin A) was significantly associated with an increased risk of lung cancer (OR, 1.20 [95% CI, 1.01-1.42]; 4 RCTs [n=94 830]; ARD range, -0.1% to 0.6%) and cardiovascular mortality (OR, 1.10 [95% CI, 1.02-1.19]; 5 RCTs [n=94 506] ARD range, -0.8% to 0.8%). Vitamin D use was not significantly associated with all-cause mortality (OR, 0.96 [95% CI, 0.91-1.02]; 27 RCTs [n=117 082]), cardiovascular disease (eg, composite cardiovascular disease event outcome: OR, 1.00 [95% CI, 0.95-1.05]; 7 RCTs [n=74 925]), or cancer outcomes (eg, any cancer incidence: OR, 0.98 [95% CI, 0.92-1.03]; 19 RCTs [n=86 899]). Vitamin E was not significantly associated with all-cause mortality (OR, 1.02 [95% CI, 0.97-1.07]; 9 RCTs [n=107 772]), cardiovascular disease events (OR, 0.96 [95% CI, 0.90-1.04]; 4 RCTs [n=62 136]), or cancer incidence (OR, 1.02 [95% CI, 0.98-1.08]; 5 RCTs [n=76 777]). Evidence for benefit of other supplements was equivocal, minimal, or absent. Limited evidence suggested some supplements may be associated with higher risk of serious harms (hip fracture [vitamin A], hemorrhagic stroke [vitamin E], and kidney stones [vitamin C, calcium]). Conclusions and Relevance: Vitamin and mineral supplementation was associated with little or no benefit in preventing cancer, cardiovascular disease, and death, with the exception of a small benefit for cancer incidence with multivitamin use. Beta carotene was associated with an increased risk of lung cancer and other harmful outcomes in persons at high risk of lung cancer.

Overview

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1001/jama.2021.15650

Cites

101 of 101 references verified0 citation errors · 0 not checkable

Statistics

Verification

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Citations

Cites

Research works printed but not linked: 6

  1. Murphy, 2021, Deaths: final data for 2018., Natl Vital Stat Rep, 69, 1
  2. Moon, 1997, Effect of retinol in preventing squamous cell skin cancer in moderate-risk subjects: a randomized, double-blind, controlled trial., Cancer Epidemiol Biomarkers Prev, 6, 949
  3. Agarwal, 2021, Citicoline in acute ischemic stroke: a randomized controlled trial (CAISR)., Eur Stroke J, 6, 298
  4. O’Connor, 2022, Vitamin, Mineral, and Multivitamin Supplements for the Primary Prevention of Cardiovascular Disease and Cancer: A Systematic Evidence Review for the US Preventive Services Task Force. Evidence Synthesis No. 209
  5. Kahwati, 2021, Screening for vitamin D deficiency in adults: updated evidence report and systematic review for the US Preventive Services Task Force., 1443
  6. Institute of Medicine, 2006, Dietary Reference Intakes: The Essential Guide to Nutrient Requirements

Cited by

Sorted by citations

See all 151

Related

See all

Metadata

Authors
O’Connor, E. A., Evans, C. V., Ivlev, I., Rushkin, M. C., Thomas, R. G., Martin, A., & Lin, J. S.
Affiliations
Kaiser Permanente (US)
ORCID
Venue
JAMA
Publisher
American Medical Association (AMA)
Published
2022-06-21
Volume
327
Issue
23
Pages
2334
ISSN
  • 0002-9955 (ISSN-L)
  • 0098-7484
DOI
10.1001/jama.2021.15650
PMC
PMC13207626
OpenAlex
W4283215237
Cited by
151
References
100
Citations by year
2026: 27 · 2025: 31 · 2024: 40 · 2023: 37 · 2022: 16
FWCI
6.16
Type
journal article
Language
en
Open access
Locations
  • JAMA (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (submittedVersion)
Funders
Agency for Healthcare Research and Quality (HHSA 290-2015-00007-I)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutrition and Health Studies
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
  • Health Sciences › Medicine › Biochemistry (medical) › Antioxidant Activity and Oxidative Stress
Keywords
vitamin supplementation, mineral supplementation, multivitamins, beta-carotene, vitamin A, vitamin D, cardiovascular disease prevention, cancer prevention, lung cancer, cardiovascular mortality, all-cause mortality, serious harm, healthy adults, USPSTF recommendations, primary prevention, cancer incidence, cardiovascular events, risk-benefit assessment
MeSH terms
Adult, Cardiovascular Diseases, Humans, Lung Neoplasms, Minerals, Neoplasms, Primary Prevention, United States, Vitamin A, Vitamins, beta Carotene, Dietary Supplements, Advisory Committees

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review