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March 18, 2005

Vitamin E-nough But Not Too Much

By Rivka Weiser

An article in this week's Journal of the American Medical Association (JAMA) (1) adds to the mounting evidence (which ACSH has frequently pointed out) that antioxidant supplements are not the potent health-promoters that proponents claim.  The study indicates they may even increase the risk of one of the very conditions that some claim they prevent.

In the randomized placebo-controlled study, patients over the age of fifty-five with diabetes or vascular disease were given moderately high daily doses of vitamin E (400 IU) over seven years.  Those who took vitamin E had a significantly higher risk of heart failure than those taking the placebo; there was also no evidence that they had lower rates of cancer than the control group.

An accompanying editorial in JAMA crisply sums up the existing research on vitamin E and discusses its implications for individuals' attempts to prevent heart disease and cancer.  The authors state that doctors can now answer patients' inquiries about vitamin E by saying:

In nearly 68,000 patients studied to date, there is no compelling evidence that higher doses of vitamin E reduce cardiovascular risk or cancer; there are even some hints that vitamin E, in excess of normal daily intake, may slightly increase the risk of ischemic events or of heart failure.  You may hear that vitamin E is a "natural," yet effective, way to prevent heart disease or cancer, but this has proven to be a false hope.  You should not be misled into neglecting other proven methods of prevention. (2)

We could hardly have put it better ourselves.  Furthermore, when these results are viewed along with the results of many studies of other antioxidant supplements (such as vitamin C and beta-carotene) indicating that they do not have benefits and in fact my cause harm, it begins to look as if antioxidant supplements as a whole ought not to be recommended.  Instead, focusing on reducing one's risk of heart disease and cancer through proven methods, such as avoiding smoking, eating a balanced and varied diet that is high in fruits and vegetables, and exercising, is most prudent.


(1) HOPE and HOPE-TOO Trial Investigators. (2005). Effects of the long-term use of vitamin E supplementation on cardiovascular events and cancer: A randomized controlled trial. JAMA, 293, 1338-1347.
(2) Brown, BG & Crowley, J. (2005). Is there any hope for vitamin E? JAMA, 293, 1387-1390.

Rivka Weiser is a research intern at the American Council on Science and Health.

Visitor Responses

rik longenecker (March 19, 2005)

This sounds like more from the now infamous Johns Hopkins meta analysis of 19 different "studies" on vitamin E. There are about 50 years of studies on E going back to Denham Harmon in the 50's. The evidence is overwhelming that in healthy people, 400iu of mixed tocopherols very much does have a protective effect, a claim made by the FDA. There does not appear to be any additional protection afforded when taking 800iu, however. What the studies you're referencing here suggest is that in very old patients with serious health problems, E won't save them. Much ado about nothing.

Patrick (March 21, 2005)

Looks like rik couldnt be bothered to actually read the paper, or even scan the abstract. If he had, he'd have seen that this article was reporting results from a randomized, double-blind, placebo-controlled clinical trial . . . not a meta-analysis, which is subject to unique confounding factors that randomized trials are not subject to. And it shows that vitamin E has no beneficial effect with respect to cancer, and either no effect or a slightly detrimental effect on cardiovascular health.


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About the Editor:
Todd Seavey

is Director of Publications at ACSH and edits FactsAndFears.  His opinions are not necessarily ACSH's.

He can be reached at seavey [at] acsh.org.

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