Multivitamins May Not Prevent Disease, New Studies.12
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NEWS In the 16AJN▼ March 2014▼ Vol. 114, No. 3ajnonline.com M ore than one-third of Americans take multivi- tamin supplements, de- spite inconsistent evidence of their benefits. Two new studies do not support the use of multivitamins for the prevention of chronic disease. In one, 1,708 men and women ages 50 years and older who’d had a myocardial infarc- tion (MI) at least six weeks before were randomly as- signed to a high- dose, 28-component oral vitamin-and- mineral supplement or placebo daily. In each group, 76% of the patients com- pleted at least one year of vitamin ther- apy . However , 46% of patients in both groups discontinued the study regimen early. During a median 55 months of follow- up, the incidence of the primary composite end point—time to death from any cause, recurrent MI, stroke, coronary revascular- ization, or hospitalization for angina—was similar between the two groups: 27% in the vitamin group and 30% in the placebo group. No evidence of adverse effects from vitamin therapy was found. But the researchers caution that the high rate of nonadher- ence makes it difficult to draw firm conclusions from the find- ings. In the other study, 5,947 male physicians ages 65 years and older were randomized to a daily mul- tivitamin or placebo. Cognitive function was assessed up to four times over 12 years. After 8.5 years of follow-up, no significant diff er- ences between the two groups were found in a composite score of global cognition or in verbal memory scores. An accompanying editorial concludes that evidence from these and other trials indicate that most supplements don’t pro- tect against chronic disease or death in well-nourished adults and should be avoided.—Karen RosenbergLamas GA, et al. Ann Intern Med2013; 159(12):797-804; Grodstein F, et al. Ann In- tern Med2013;159(12):806-14; Guallar E, et al. Ann Intern Med2013;159(12):85 0-1. Multivitamins May Not Prevent Disease, New Studies Suggest No evidence that they prevent cognitive decline or cardiovascular events after myocardial infarction. P h o t o b y M i c h a e l H o l a h a n / A u g u s t a C h r o n i c l e / Z u m a p r e s s . c o m . A new guideline-development checklist for researchers. A guideline-development checklist, published in the Canadian Medical Association Journal (online December 16, 2013), provides practical steps, tools, and resources to help create high-quality health care guidelines. Few tools are available for creating guidelines, despite the many tools that exist for evaluating them. The checklist comprises 18 topics and 146 items, with links to resources and training materials to track progress and prevent developers from missing crucial steps. Both new and expert designers can use the comprehensive checklist to plan, formulate, implement, evalu- ate, and update guidelines. The checklist will be tested and updated through feedback from crowdsourcing. It can be accessed at www.guidelinedevelopment.org . NewsCAP
