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Vitamins: good or bad?

Author: Ksenia Eruslanova

Origin/Afiliation: Kseniia Eruslanova, MD, MSc. Russian clinical and research geriatric center

All of us want to have a long and healthy life. A healthy lifestyle is the most effective tool in the prevention (and sometimes treatment) of a number of cardiovascular diseases (arterial hypertension, chronic coronary syndrome (CCD)) and metabolic disorders (in particular, type 2 diabetes). But regularly exercising, eating right, and giving up bad habits can be much more difficult than just taking pills. Many, as a step towards a healthy lifestyle, choose to purchase multi- or mono-vitamins. In the summer of 2022, updated American recommendations for the prevention of cardiovascular diseases and oncology with vitamins were published in JAMA. Based on randomized clinical trials and meta-analyses, it was concluded that to date there are NO data supporting the effectiveness of taking poly- or mono-vitamins for the prevention of CCD or oncology, moreover, it has been shown that regular intake of beta-carotene (pro-vitamin A ) or vitamin E is harmful to health. Beta-carotene increases the risk of death from CCD, and in patients who smoke or work with asbestos, it increases the risk of developing lung cancer. Additional intake of vitamin E - increases mortality from all causes, the development of cardiovascular diseases and mortality from them, and does not affect cancer in any way (neither for the worse, nor for the better). RCTs and meta-analyses on multivitamins found no effect on mortality from cardiovascular diseases or oncology. Despite the documented positive effect on the prevention of oncology, the authors of therecomendations, referring to the peculiarities of the study design, do not consider these data sufficient to recommend the use of multivitamins for these purposes. Vitamin D supplementation with calcium or alone also has no effect on morbidity and mortality from cardiovascular or oncological diseases. As well as with folic acid, vitamin B12, B3 and B6. At the same time, there is evidence that folic acid increases the risk of cancer (but given that these are data on populations with elevated levels of homocysteine, it is impossible to interpolate these results for the entire population) Tenderly loved during the period of infectious diseases, vitamin C does not have any effect on cardiovascular and oncological diseases. Fashionable in recent years, selenium also did not show any protective properties.

It should be noted that if patients have a deficiency of micronutrients, it must be replenished. These recommendations refer to routine use of vitamins for prevention.

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