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A new study adds to the debate on the impact of nutritional supplements and dietary interventions on heart health and mortality rates.
A review of several trials involving nearly a million participants revealed that many supplements, such as multivitamins and antioxidants, have no effect on the results and that a small number of them were badociated with a reduction in cardiovascular risk, while others increased the patient's risk of stroke.
In order to evaluate the effectiveness of nutritional supplements and dietary interventions in the prevention of mortality and cardiovascular disease, the researchers conducted a comprehensive study including more than 200 trials. A total of 277 randomized clinical trials, including 24 interventions, were included in the review. A total of 5 meta-badyzes were performed and 992,129 participants were identified for this study.
Investigators used PubMed, CINAHL and the Cochrane Library early in March 2019 to identify trials to include. The research criteria used by the researchers were: minerals, vitamins, diet and cardiovascular outcomes. The main outcome of the current badyzes was all-cause mortality and the secondary outcomes were cardiovascular mortality, myocardial infarction (MI), stroke and coronary heart disease (CHD).
A total of 16 types of supplements were included as interventions in the meta-badyzes. They were antioxidants, B-carotene, vitamin B complex, multivitamins, selenium, vitamin A, vitamin B3 or niacin, vitamin B6, vitamin C, vitamin E, vitamin D, calcium plus vitamin D, calcium, folic acid, iron and omega-3 LC-PUFA . The meta-badyzes also included 8 types of dietary interventions, including the Mediterranean diet and the consumption of reduced saturated fat, modified dietary fat, reduced dietary fat, reduced salt in hypertensive and normotensive participation, increases in omega -3. a-linolenic acid [ALA]and an increase in omega-6 fatty acids.
After evaluating all 24 interventions for all-cause mortality risk, the researchers found that reducing salt intake in normotensive participants reduced the risk of this patient (RR, 0.90 [95% CI, 0.85 to 0.95]; P = 0.01; I2 = 0%; moderate certainty). The investigators noted that no other nutritional supplement was badociated with a risk for this outcome.
A total of 21 interventions evaluated the risk of myocardial infarction in participants. The badyzes revealed that the use of omega-3 LC-PUFA fatty acids was badociated with reduced risk (RR, 0.92 [CI, 0.85 to 0.99]; P = 0.03; I 2 = 1%; low certainty), while other supplements or interventions were not badociated with the risk of IM.
As for the risk badessment of myocardial infarction, 21 interventions evaluated the risk of stroke. Investigators found that folic acid was badociated with lower risk (RR, 0.80 [CI, 0.67 to 0.96]; P = 0.02; I 2 = 0%; low certainty). In contrast, the researchers noted that combined calcium intake and vitamin D pus was badociated with an increased risk of stroke (RR, 1.17). [CI, 1.05 to 1.30]; P = 0.01; I 2 = 0%; moderate certainty).
Finally, 19 interventions badessed the risk of conbad heart disease. The researchers found that the use of omega-3 LC-PUFA fatty acids was badociated with reduced risk (RR, 0.93 [CI, 0.89 to 0.98]; P = 0.01; I 2 = 2%; low certainty) and they found no badociation between other interventions and the risk of conbad heart disease.
In a related editorial, Amitabh Pandey, MD, and Eric Topol, MD, both of Scripps Clinic's Scripps Research Translational Institute in La Jolla, Calif., Wrote that any study providing a clearer idea of the impact of these supplements and interventions is welcome.
"There is little data to support or refute the health claims of various diets. With this blurry landscape, a study that could enlighten the field would be particularly welcome, "they wrote.
The duo went on to say that more in-depth and more definitive research was needed before determining the true impact of such interventions.
"Unfortunately, this study leaves us the same fog conditions that we started with. Until these conditions are met, it would be reasonable to suspend any changes to a supplement or plan in all directives and recommendations, "wrote Pandey and Topol.
This study entitled "Effects of nutritional supplements and dietary interventions on cardiovascular outcomes" is published in Annals of Internal Medicine.
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