Importance: According to National Health and Nutrition Examination Survey data, 52% of surveyed US adults reported using at least 1 dietary supplement in the prior 30 days and 31% reported using a multivitamin-mineral supplement. The most commonly cited reason for using supplements is for overall health and wellness and to fill nutrient gaps in the diet. Cardiovascular disease and cancer are the 2 leading causes of death and combined account for approximately half of all deaths in the US annually. Inflammation and oxidative stress have been shown to have a role in both cardiovascular disease and cancer, and dietary supplements may have anti-inflammatory and antioxidative effects.

Objective: To update its 2014 recommendation, the US Preventive Services Task Force (USPSTF) commissioned a review of the evidence on the efficacy of supplementation with single nutrients, functionally related nutrient pairs, or multivitamins for reducing the risk of cardiovascular disease, cancer, and mortality in the general adult population, as well as the harms of supplementation.

Population: Community-dwelling, nonpregnant adults.

Evidence assessment: The USPSTF concludes with moderate certainty that the harms of beta carotene supplementation (SYNTHETIC FORM) outweigh the benefits for the prevention of cardiovascular disease or cancer. The USPSTF also concludes with moderate certainty that there is no net benefit of supplementation with vitamin E (AGAIN FOR THE SYNTHETIC FORM AS WELL AS THE IOSLATED ALPHA TOCOPHEROL ONLY FORM TOO.) for the prevention of cardiovascular disease or cancer. The USPSTF concludes that the evidence is insufficient to determine the balance of benefits and harms of supplementation with multivitamins for the prevention of cardiovascular disease or cancer (MOST MULTIVITAMINS USE SYNTHETIC BETA CAROTENE AS WELL AS ISOLATED NATURAL VITAMIN E AS ALPHA TOCOPHEROL OR THE SYNTHETIC VITAMIN E FORM) Evidence is lacking and the balance of benefits and harms cannot be determined. The USPSTF concludes that the evidence is insufficient to determine the balance of benefits and harms of supplementation with single or paired nutrients (other than beta carotene and vitamin E) for the prevention of cardiovascular disease or cancer (MULTI-CAROTENOID FORMS ARE NEEDED, AND THE WHOLE FAMILY OF VITAMIN E. Evidence is lacking and the balance of benefits and harms cannot be determined.

Recommendation: The USPSTF recommends against the use of beta carotene or vitamin E supplements for the prevention of cardiovascular disease or cancer. (D recommendation) The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of the use of multivitamin supplements for the prevention of cardiovascular disease or cancer. (I statement) The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of the use of single- or paired-nutrient supplements (other than beta carotene and vitamin E) for the prevention of cardiovascular disease or cancer. (I statement).

Analysis: What this report says is that the current multi-vitamin forms and dosages, mainly synthetic and or isolated, are simply not the ones necessary to positively impact health. Plus, they are missing the needed synergistic related nutrients to enhance the health benefits of the isolated or synthetic vitamins.