Recent Recommendations on Vitamins and Chronic Disease Prevention

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Fletcher and Fairfield (172, 173) reviewed the use of vitamin supplements for chronic disease prevention and stated that suboptimal intake of some vitamins, at levels above those leading to classic vitamin deficiencies, can be risk factors for chronic diseases. They recommended that all adults take vitamin supplements tailored to their life situation and based on their doctor's advice. Specific responsibility was placed on the doctor to learn about their patients' use of vitamins to ensure proper supplement usage. Specific to vitamin E, recommendations for its use for reduction of prostate cancer were considered "premature." For use as a preventative against cardiovascular problems, the authors believed that the literature suggested that it might be useful in primary prevention when taken throughout long periods and that some subgroups of the population might benefit more that the general population.

Various recommendations about supplement use have been made by organizations associated with health care in the United States:

1. U.S. Preventative Services Task Force (174): Evidence is insufficient to recommend for or against the use of supplements of vitamins A, C, or E; multivitamins with folic acid; or antioxidant combinations for the prevention of cancer or cardiovascular disease.

2. American Academy of Family Physicians (175): The decision to provide special dietary intervention or nutrient supplementation must be on an individual basis using the family physician's best judgment based on evidence of benefit as well as lack of harmful effects.

3. American Heart Association (176): Vitamin or mineral substitutes are not a substitute for a balanced, nutritious diet that limits excess calories, saturated fat, trans fat, and dietary cholesterol. Scientific evidence does not suggest that consuming antioxidant vitamins can eliminate the need to reduce blood pressure, lower blood cholesterol level, or stop smoking.

4. American Cancer Society (177): Antioxidants are substances that protect the body's cells from damage caused by free radicals (byproducts of the body's normal processes). Examples of antioxidants include vitamin C, vitamin E, ^-carotene, and selenium. If you want to take in more antioxidants, health experts recommend eating a variety of fruits and vegetables, which are good sources of antioxidants. Taking large doses of antioxidant supplements is usually not recommended while undergoing chemotherapy and radiation therapy. Talk with your doctor to determine the best time to take antioxidant supplements.

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