Antioxidant Vitamins and Coronary Heart Disease

Lawrence Kushi, Aaron Folsom, Ronald Prineas, Pamela Mink, Ying Wu, and Robert Bostick N Engl J Med 1996;334:1156-62

On the premise that antioxidant vitamins (e.g., A, C and E) may play a role in preventing coronary heart disease (CHD), 34,486 postmenopausal women were followed for seven years. Data analysis produced an a "striking" inverse association between vitamin E consumption from food and risk of CHD (i.e., more vitamin E = less risk of CHD). The authors concluded there was little evidence that Vitamin E consumption from supplements was inversely associated with risk of CHD. No association was observed for vitamins A and C.

Data dredging expedition. These researchers looked at vitamin A, retinol, carotenoids, vitamin E and vitamin C, from food only, from supplements only and from food and supplements. The conclusions of this study have been gleaned from 2 of the 51 statistical associations developed.

Biological plausibility... NOT!. Accepting the basic biologic theory for this result (i.e., "oxidative modification of low-density lipoprotein may promote atherosclerosis"), no rationale is offered why vitamin E in food only confers the benefit while vitamin E from supplements only or from food and supplements does not.

Is FDA increasing your risk of CHD? Accepting the results of the study, the most protective level of vitamin E intake (from food!) was found to be about 7-9 international units (IUs) per day. According to the U.S. Food and Drug Administration, the recommended daily intake of vitamin E is 30 IUs. Hmmm...

Watch out for the vitamin E clinical trial. In an accompanying editorial, two physicians from the Dartmouth Medical School state that

[This study], like the many previous epidemiologic studies of vitamin E, beta carotene and other antioxidants, gives no clear guidance to the public about the value of antioxidant supplements.

The physicians also raise the issue of the Beta-Carotene and Retinol Efficacy Trial (CARET) study of more than 18,000 persons at risk of lung cancer because of asbestos and smoking. The CARET trial was ended early when researchers realized that the vitamins used in the trial were increasing the risk of lung cancer among participants. A word to the wise--BEWARE OF RESEARCHERS BEARING VITAMINS!
Material presented on this home page constitutes opinion of the author.

Copyright © 1996 Steven J. Milloy. All rights reserved. Site developed and hosted by WestLake Solutions, Inc.