Quoting from
http://jama.ama-assn.org/cgi/content/abstract/297/8/842
Mortality in Randomized Trials of Antioxidant Supplements
for Primary and Secondary Prevention
Goran Bjelakovic, MD, DrMedSci; Dimitrinka Nikolova, MA;
Lise Lotte Gluud, MD, DrMedSci; Rosa G. Simonetti, MD;
Christian Gluud, MD, DrMedSci
JAMA. 2007;297:842-857.
Context: Antioxidant supplements are used for prevention
of several diseases.
Objective: To assess the effect of antioxidant supplements
on mortality in randomized primary and secondary prevention
trials.
Data Sources and Trial Selection: We searched electronic
databases and bibliographies published by October 2005.
All randomized trials involving adults comparing beta
carotene, vitamin A, vitamin C (ascorbic acid), vitamin E,
and selenium either singly or combined vs placebo or vs
no intervention were included in our analysis. Randomization,
blinding, and follow-up were considered markers of bias
in the included trials. The effect of antioxidant
supplements on all-cause mortality was analyzed with
random-effects meta-analyses and reported as relative
risk (RR) with 95% confidence intervals (CIs).
Meta-regression was used to assess the effect of covariates
across the trials.
Data Extraction: We included 68 randomized trials with
232606 participants (385 publications).
Data Synthesis: When all low- and high-bias risk trials
of antioxidant supplements were pooled together there
was no significant effect on mortality (RR, 1.02; 95% CI,
0.98-1.06). Multivariate meta-regression analyses
showed that low-bias risk trials (RR, 1.16; 95% CI,
1.05-1.29) and selenium (RR, 0.998; 95% CI, 0.997-0.9995)
were significantly associated with mortality. In 47 low-bias
trials with 180 938 participants, the antioxidant
supplements significantly increased mortality (RR, 1.05;
95% CI, 1.02-1.08). In low-bias risk trials, after exclusion
of selenium trials, beta carotene (RR, 1.07; 95% CI,
1.02-1.11), vitamin A (RR, 1.16; 95% CI, 1.10-1.24), and
vitamin E (RR, 1.04; 95% CI, 1.01-1.07), singly or combined,
significantly increased mortality. Vitamin C and selenium
had no significant effect on mortality.
Conclusions: Treatment with beta carotene, vitamin A, and
vitamin E may increase mortality. The potential roles of
vitamin C and selenium on mortality need further study.
truehawk - 02 Mar 2007 08:15 GMT
FOOD FIGHT!!!!!!!!!!!!!!!!!!!!!!!!
Study Citing Antioxidant Vitamin Risks Based on Flawed Methodology
CORVALLIS, Ore. - A study being published today on possible health
risks of antioxidant supplements is based on flawed methodology and
ignores the broad totality of evidence that comes to largely opposite
conclusions, experts said today from the Linus Pauling Institute at
Oregon State University.
The research, which was published in this week's edition of the
Journal of the American Medical Association, concluded that
antioxidant supplements such as vitamins A and E may "significantly
increase mortality," and that there was no evidence for any positive
effect of vitamin C in the reduction of mortality rates.
However, Balz Frei, professor and director of one of the world's
leading institutes that studies the possible health value of vitamins,
phytochemicals and micronutrients, said that the new study's focus on
a selected group of clinical trials disregards the results of other
more positive trials, as well as huge amounts of laboratory, animal,
and human observational and experimental data.
"This is a flawed analysis of flawed data, and it does little to help
us understand the real health effects of antioxidants, whether
beneficial or otherwise," Frei said.
"Instead of causing harm, the totality of the evidence indicates that
antioxidants from foods or supplements have many health benefits,
including reduced risk for cardiovascular disease, some types of
cancer, eye disease and neurodegenerative disease," he said. "In
addition, they are a key to an enhanced immune system and resistance
to infection."
The "meta-analysis" published in JAMA, which is a statistical analysis
of previously published data, looked at 815 antioxidant trials but
included only 68 of them in its analysis, Frei said. And two of the
studies excluded - which were published in the Journal of the National
Cancer Institute and the prominent British medical journal Lancet -
found substantial benefits and reduced mortality from intake of
antioxidant supplements.
"If these two large studies had been included, none of the reported
effects on increased mortality would have been significant, with the
exception of the effects of beta carotene," Frei said. "And the
research showing a higher incidence of lung cancer in smokers who take
supplements of beta carotene or vitamin A is old news, that's been
known for many years. Very high doses of vitamin A are known to have
multiple adverse health effects."
All the new study really demonstrates, Frei said, is a bias toward
identifying studies or research that show harm caused by antioxidants,
and selective removal of research that shows benefits.
The mean duration of the reviewed trials was 2.7 years, so the implied
conclusion is that taking antioxidant supplements can kill people in
less than three years, Frei said. It is absurd to think that vitamin
supplements could have such an effect, he said, and no biological
mechanism has been identified that would explain it. In addition, the
causes of death were not considered or were not determined in many of
the studies reviewed, and may include accidents or other causes that
have nothing to do with diet or oxidative stress.
Most trials cited in the study, Frei said, tested multiple
antioxidants and additional interventions in the treatment of disease,
including a long list of other dietary supplements and pharmaceutical
drugs. The underlying health problems or multiple types of medical,
drug and surgical treatments could all interfere with or mask the
effects that can be attributed directly to antioxidants, he said.
"These trials don't tell us anything about the usefulness of
antioxidants in the prevention of disease, or whether the supplements
had the intended effect of lowering oxidative stress in the body,"
Frei said. "It's like doing a cholesterol-lowering trial without ever
measuring serum cholesterol. How can you draw any conclusions from
such a poorly-designed study?"
About the Linus Pauling Institute: The Linus Pauling Institute at OSU
is a world leader in the study of micronutrients and their role in
promoting optimum health or preventing and treating disease. Major
areas of research include heart disease, cancer, aging and
neurodegenerative disease. Media Contact
David Stauth,
541-737-0787
Source
Balz Frei,
541-737-5078
Ghamph - 03 Mar 2007 05:54 GMT
> FOOD FIGHT!!!!!!!!!!!!!!!!!!!!!!!!
>
[quoted text clipped - 10 lines]
> Balz Frei,
> 541-737-5078
I believe in Linus Pauling and read his life story. Whenever I tell someone
that I take 13 grams of vitamin C in one serving they freak out and say "you
mean milligrams not grams" and I say "no , I mean 13,000 milligrams".
Linus Pauling was a real crusader before his life was cut short at 93.
He also took 10 to 18 grams of vitamin C per day for most of his latter
life. And no , he didn't die of osteoporosis.
Keep up the fight,
Jamffer
judy.n - 03 Mar 2007 14:12 GMT
Big problem with evidence based medicine is when they chose to exclude
studies: the Cochrane Collaborative is notorious for that: then if
your anaysis is based on poor studies the conclusion if of limited or
no value. Garbage in/garbage out. It's a real failing of trying to
make medicine more scientific through use of the "evidence": which is
often inherently corrupted through conflict of interests (drug company
funding) and suppression of data.
I appreciate the editorial.
There are other studies, one review article in NEJM stating that
everyone should take a multivitamin with at least the RDA as our diets
are often deficient.
I had recently heard from the cardiologists that they're
recommending that patients stop Vit.E, and extra folate. Vitamin A
seems to be problematic and it's in a lot of multivitamins at very
high doses.
Judy
> > FOOD FIGHT!!!!!!!!!!!!!!!!!!!!!!!!
>
[quoted text clipped - 19 lines]
> Keep up the fight,
> Jamffer