Takeaway
- In a sweeping overview of meta-analyses of the effect of supplements on cardiovascular disease (CVD) risk, the authors report that most supplements do little to mitigate CVD risk.
- Vitamin D supplementation, especially combined with calcium, was linked to increased stroke risk.
Why this matters
- Major studies have found little to no benefits associated with vitamin D, fish oil, or omega 3 supplementation.
- Editorial: The title reflects the perspective: “Dispense With Supplements for Improving Heart Outcomes.”
- Editorial says it is reasonable to avoid supplement or diet modifications in guidelines/recommendations pending better evidence.
Key results
- With moderate certainty, risk ratios for CVD (95% CIs) with reduced salt were:
- All-cause mortality (normotensive patients): 0.90 (0.85-0.95).
- Cardiovascular mortality with hypertension: 0.67 (0.46-0.99).
- Of very-low–moderate certainty evidence:
- Polyunsaturated fatty acids (PUFAs), myocardial infarction: 0.92 (0.85-0.99);
- PUFAs, coronary heart disease: 0.93 (0.89-0.98);
- Folic acid, stroke: 0.80 (0.67-0.96); and
- Vitamin D plus calcium, stroke: 1.17 (1.05-1.30).
- No associations of vitamin B6, multivitamins, vitamin A, selenium, dietary intervention (e.g., low-fat diet), iron, antioxidants with any outcomes.
- Very low study heterogeneity.
Study design
- Umbrella review, evidence map, 105 meta-analyses evaluating 24 interventions (16 supplement types, 8 diets).
- Funding: No primary funding source.
Limitations
- Some poor-quality studies, evidence.
References
References
