A study in today's Journal of the
American Medical Association is the third in four months
to question the health benefits of high-dose vitamin E supplements.
In the study of nearly 4,000 patients,
researchers found that megadoses had no effect on the risk
of cardiovascular disease or cancer, but increased the risk
of heart failure.
While some doctors say vitamin E still
has potential in preventing blindness and dementia, the study's
authors say there is no reason for patients to take high doses.
Multivitamins typically contain only
30 international units of vitamin E, but many individual supplements
include 400 units or more.
"There is this belief that you can take
a miracle pill to prevent diseases like heart disease and
cancer, but it's just not true," says Eva Lonn, a leader of
the study and a professor of medicine and cardiology at McMaster
University in Ontario, Canada. "Unfortunately, we have to
pay attention to our diet and exercise and our body weight."
Encouraging results from studies in the
1990s have helped make vitamin E the most popular supplement,
taken by 22% of adults over 55, according an editorial by
E. Robert Greenberg of Dartmouth Medicine School published
in January in Annals of Internal Medicine. Nutritional
supplements had estimated sales of $19 billion in 2003.
In recent years, however, more rigorous
clinical trials have failed to show that vitamin E protects
the heart.
Because this study is the first to suggest
vitamin E may cause heart failure — a condition in which
the heart muscle doesn't pump blood as it should — Lonn
says doctors should conduct additional research to make sure
that this connection was not just a coincidence.
In her study, an extension of the Heart
Outcomes Prevention Evaluation, or HOPE, the difference in
heart failure rates among patients was small.
After seven years, 14.7% of those taking
supplements suffered heart failure, compared with 12.6% of
those who took placebos.
Researchers say the amount of vitamin
E in regular multivitamins poses little risk. A recent analysis
published in the Annals of Internal Medicine, in fact,
found that low doses might be beneficial. Some scientists
point to evidence suggesting that vitamin E may reduce the
risk of ailments such as Alzheimer's disease, age-related
macular degeneration and cataracts, says Jeffrey Blumberg,
a professor in the Friedman School of Nutrition Science and
Policy at Tufts University.
And while vitamin E may not reduce the
overall risk of cancer, researchers continue to study whether
it may prevent specific types of tumors. The National Cancer
Institute has enrolled more than 35,000 men to study whether
vitamin E and selenium, a mineral, prevent prostate cancer.
The trial's safety committee will hold
a special meeting to review the results of the new study,
says Lori Minasian, one of the scientists leading the trial.