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According to the article, multivitamins, selenium, vitamin A, vitamin B6, vitamin C, vitamin E alone, calcium alone, folic acid and iron do not seem to have d & 39; significant effect on mortality or cardiovascular consequences. published yesterday in Annals of Internal MedicineA flawless stayA flawless stay.A flawless stay
Dietary interventions such as the Mediterranean diet also do not help reduce intake of saturated fats, altered fat intake and intake of dietary fat.
At the same time, supplementation with calcium and vitamin D could be harmful, according to the authors, as it could increase the risk of stroke.
The omega-3 and folic acid supplements were the only ones tocould reduce the risk of some cardiovascular outcomes in adults, "According to the authors. For dietary interventions, the authors indicated that a reduction in salt intake could have certain benefits.
These are the findings of a systematic review of 277 published clinical trials conducted by nearly a million people worldwide and led by Safi U. Khan, MD, of the University of West Virginia.
The other authors of the paper were affiliated with Johns Hopkins' Bloomberg School of Public Health and East Carolina University School of Medicine, Mayo Clinic, Cleveland Clinic, and Guthrie Robert Packer Hospital.
Delay any supplement, regime change in the guidelines?A flawless stay
The study was released under embargo to the press last week, accompanied by a link to the abstract, of an editorial video with an interview with the main author, the Dr. Khan, and a press release titled "Evidence suggests that most nutritional supplements and dietary interventions offer no protection against cardiovascular disease or death."A flawless stay
The press material was prepared and distributed by the American College of Physicians, a national badociation of internists.
With the newspaper, the newspaper also published an editorial titled Provide supplements to improve cardiac outcomesA flawless stayBy physicians Amitabh C. Pandey, MD, and Eric J. Topol, MD, of the Scripps Research Translational Institute of California, in response to Dr. Khan's team paper.
Ask questions about the truth of the data
Critics of the study led by Dr. Safi U. Khan focused on the variability of the data to which the document refers.
"Testing any diet or supplement in a broad population without taking into account interindividual variability seems to be the recipe for failure,"According to physicians Amitabh C. Pandey, MD, and Eric J. Topol, MD, of the Scripps Research Translational Institute in California, in an editorial responding to the journal of Dr. Khan's team.
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"Unfortunately, this study leaves us with the same fog conditions we started," Doctors Pandey and Topol wrote in their editorial.
They commented on how Mr. Khan's document had amalgamated data from people and cultures with significantly different basic regimes.
"Until these conditions are met, it would be reasonable not to change supplements or diets in all directives and recommendations," They wrote.
CRN: Study "excludes decades of nutrition research"A flawless stay
"This study is a coordinated and unequivocal attack on nutrition and its essential role in maintaining health and reducing the risk of chronic disease",Said Steve Mister, president and CEO of the Council for Responsible Nutrition, a professional group of the food supplement industry, in a statement to the press.
His statement focused on the study as well as the editorial material distributed with it. "In addition to an editorial and an accompanying video, this attack skilfully ignores decades of comprehensive and carefully researched nutrition research on the benefits of supplemental nutrients and healthy eating habits," He said.
"The study denatures not only dietary supplements, but also well-established eating habits, such as the Mediterranean diet."A flawless stay
Exclude observational studies and "ignore the role of supplements"A flawless stay
In addition, Mr. emphasized two things he called the "major limitations" of the study. The exclusion of epidemiological studies in the synthesis of researchers was the first. "Epidemiological data are essential and serve as a basis for many of the recommendations made in the Dietary Guidelines for Americans,"He said.
Secondly, he stated that the study did not take into account the proper role of dietary supplements, which he said was intended to address nutrient deficiencies.
"Consumers are turning to many of these dietary supplements not to reduce their risk of death or prevent heart disease, but to address nutrient deficiencies in their diets and to maintain health differently (eg 39; folic acid to prevent birth defects, calcium and vitamins). D to prevent falls and fractures, iron to treat anemia), "He said.
The results in omega-3 "should not be generalized to dietary supplement formulations"A flawless stay
In his article, Dr. Khan's team badociated omega-3 consumption with cardiovascular risk reduction in adults, but with little certainty, citing the publication of recent and prestigious studies on fatty acids.
They characterized the body of clinical science around long-chain omega-3 polyunsaturated fatty acids (LC-PUFA) as "contradictory". While the results of a study dubbed ASCEND, published in October 2018, Did "Not found convincing evidence of protective effects of LC-PUFA omega-3 fatty acids on overall cardiovascular benefits," A a similar study, VITAL, Showed a 19% reduction in cardiovascular outcomes in supplement participants consuming little fish, he wrote.
They also quoted A study sponsored by Amarin dubbed REDUCE-IT, Which revealed a 25% reduction in cardiovascular end points through the use of icosapent ethyl, a modified and highly purified form of EPA.
"It is not clear if the effects observed in REDUCE-IT are specific to icosapent ethyl or reflect the use of the higher dose of omega-3 LC-PUFAs. According to the recent article.
The authors added that "The results should not be generalized to dietary supplement formulations." They also perpetuated a common misunderstanding by labeling omega-3 "unregulated" supplements over drugs (the Food and Drug Administration regulates omega-3 supplements, but differently medications).
The editorial by Drs Pandey and Topol of Scripps noted that Dr. Khan's team study concluded that "With little certainty, omega-3 fatty acids …[had] a salutary effect on the heart attack. "A flawless stay
They added that "Recent randomized trials in the general population and in diabetic patients have failed to confirm any benefit in terms of cardiovascular outcomes. The results of these tests would tend to degrade at best the low degree of certainty of omega-3 fatty acid supplements in uncertainties. "A flawless stay
GOED: the benefits of omega-3s have been minimizedA flawless stay
Dr. Khan's paper clearly demonstrated the benefits of omega-3s in heart attacks and coronary heart disease, according to Harry Rice, PhD, vice president of regulatory and scientific affairs at the Global Organization for EPA & DHA Omega-3.
"Even for cardiovascular mortality, the authors reported a 7% risk reduction, which is similar to that of others, as well as the meta-badysis commissioned by GOED from a few years ago. , reportedHe told us.
"Unfortunately, the results in this publication have been minimized because they just missed the statistical significance." A flawless stay
Contrary to editorial comments by Drs Topol and Pandey, the heart health benefits of omega-3s are well established, he added.
"[The editorial’s] characterize the benefits of omega-3 as "at best uncertain" is unfortunate. One of the studies cited by these to support his opinion is VITAL and, although this study did not achieve the main result of the trial, namely a significant reduction in major cardiovascular events, omega -3 were badociated with a 28% reduction in the risk of heart attack and a 17% reduction in the risk of coronary heart disease. "A flawless stay
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