USPSTF updates recommendations on vitamin and mineral supplements

 The U.S. Preventive Services Task Force found inadequate evidence to make recommendations about most vitamins and minerals for primary disease prevention.

Sponsoring Organization: U.S. Preventive Services Task Force (USPSTF)

Background

Because more than half of U.S. adults use at least one multivitamin, mineral, or other nutrient supplement, the USPSTF updated its 2014 recommendation regarding vitamin and mineral supplementation, based on a review of more than 50 studies that have been published since 2014 (NEJM JW Gen Med Jun 1 2014 and Ann Intern Med 2014; 160:558). The recommendations apply to community-dwelling, nonpregnant adults and do not apply to children, pregnant women, or people who are chronically ill or have known nutritional deficiencies.

Recommendations

• The Task Force found no benefit and likely harm from use of β-carotene and lack of either benefit or harm from use of vitamin E, leading to a recommendation against use of either one for preventing cardiovascular disease or cancer (D recommendation).

• They found insufficient evidence to make a recommendation for or against use of multivitamins or other nutrients (except β-carotene or vitamin E) for preventing cardiovascular disease or cancer (I statement).

COMMENT

These recommendations by the USPSTF are identical to the 2014 version, despite the large number of new studies published since then. Many patients ask about multivitamins and other nutrient supplements, and many clinicians recommend supplements, based on the assumption that they can’t hurt and might help (except for the known excess risk for lung cancer with β-carotene use). In these clinical encounters, I would focus mainly on counseling against use of supplements that are proven to be harmful and then transition to a more general discussion of a healthy lifestyle.

Thomas L. Schwenk, MD, reviewing U.S. Preventive Services Task Force. JAMA 2022 Jun 21 O’Connor EA et al. JAMA 2022 Jun 21 Jia J et al. JAMA 2022 Jun 21

CITATIONS

U.S. Preventive Services Task Force. Vitamin, mineral, and multivitamin supplementation to prevent cardiovascular disease and cancer: U.S. Preventive Services Task Force recommendation statement. JAMA 2022 Jun 21; 327:2326.
[Full-text JAMA article]