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Posted at 7:00 AM ET, 11/ 5/2010

Is that right? Vitamin E boosts cardio health?

By Jennifer LaRue Huget

Nearly 13 percent of adult Americans supplement their diets with Vitamin E, a nutrient that's been thought to protect against cardiovascular disease, some cancers and even dementia.

But is taking Vitamin E supplements really such a good idea?


Maybe not, after all.

Research published last night in the BMJ (British Medical Journal) added to the growing body of evidence that Vitamin E supplementation doesn't really confer much in the way of health benefits. The new study teases out results from previous research regarding Vitamin E supplements' effect on cardiovascular health. Until that teasing-out, it had seemed that extra Vitamin E (beyond that that we typically get through our diets) didn't much affect our risk of cardiovascular disease one way or another. But on closer inspection, it turns out that taking Vitamin E, while reducing risk of ischemic stroke by about 10 percent, actually increases risk of the more-dangerous hemorrhagic stroke by 22 percent.


New findings suggest Vitamin E might not be such a great idea. (Craig Herndon - The Washington Post)

The authors find that

In this meta-analysis of randomised trials, we found that vitamin E increased the risk for haemorrhagic stroke by 22% and reduced the risk of ischaemic stroke by 10%. Using total stroke as the outcome obscures these harms and benefits.

So, they conclude

...given the relatively small reduction in risk of ischaemic stroke and the generally more severe outcome of haemorrhagic stroke, indiscriminate widespread use of vitamin E should be cautioned against.

Are you a Vitamin E devotee? Will this latest research change your view?

By Jennifer LaRue Huget  | November 5, 2010; 7:00 AM ET
Categories:  Cardiovascular Health, Dietary supplements, Nutrition and Fitness, Prevention, Vitamins  
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Comments

What E did they use to test ???? AC Grace has been making the correct E with Gamma tocopherols for a long time. A few others add mostly a mixture of Gamma and other tocopherol. This type of E is a longevity E that will ramp up your romance as well as your health.

Posted by: wpmars | November 5, 2010 10:30 AM | Report abuse

This study did not correct for dose of Vitamin E taken. It would infer the same "risk" regardless of supplementation with 50 i.u. vs. 50,000 i.u. This makes it a difficult study to apply to individual supplement decision-making. I doubt that 200 i.u. daily would show these effects, IMHO.

Posted by: Zontag | November 5, 2010 10:33 AM | Report abuse

To understand whether Vitamin E is good or bad, we need to know the baseline rates of the two kinds of strokes. If there's 100 ischemic strokes per 100,000 people and 5 hemorrhagic stroke per 100,000 people, these results will cut net strokes by about 9 people. I've looked at estimates on the web, which ischemic strokes being about 5 to 12 times more common than hemorrhagic strokes, although hemorrhagic strokes are much more likely to be fatal. On balance, I wouldn't take Vitamin E, but these data leave the issue much closer than you'd think from the column.

Posted by: gsergienko | November 5, 2010 10:11 PM | Report abuse

The blog-article would have been far more informative if dose and type(s) of vE had been reported. Meanwhile, the blog and the research article so incompletely summarized might be interpreted as pharma promotionalism.

Posted by: TeresaBinstock | November 5, 2010 10:15 PM | Report abuse

The blog-article would have been far more informative if dose and type(s) of vE had been reported. Meanwhile, the blog and the research article so incompletely summarized might be interpreted as pharma promotionalism.

Posted by: TeresaBinstock | November 5, 2010 10:16 PM | Report abuse

Reporting information such as this by the BMJ and the Washington Post is unethical. It is widely known that too much of anything that thins the blood, such as NSAIDS, fish oil, vitamin E, etc. can increase the risk of hemorrhagic stroke (bleeding stroke). This type of stroke occurs less frequently than ischemic stroke, but has a higher mortality rate. The same research could have been done with regular-strength (300 mg) aspirin which, in addition to increasing the risk of intestinal bleeding, can increase the risk of hemorrhagic stroke.

Posted by: as554629 | November 6, 2010 4:39 AM | Report abuse

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Posted by: fsafs19 | November 6, 2010 10:51 AM | Report abuse

I have only used vitamin E on my skin to help improve and replenish the skin. I also use vitamin E oils for massage and other therapy treatments. I recommend this vitamin topically for those who may be aging and need a little extra lift in the skin.

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Posted by: GeriCareFinder | November 7, 2010 1:39 AM | Report abuse

I too was upset that the Post writer didn't bother to give the dosage, but when I looked at other coverage, including a much more useful BBC article, I didn't see it either. The BBC article had a link to the scientists' abstract (something the Post was very remiss in not including). Bizarrely, the abstract also does not give dose, but does include a cryptic comment about multivitamins. It may be they thought because it was a review of 9 trials, it was too complicated to give doses. But a ballpark idea would have been grand.

From the abstract: "Markus Schürks, MD, a researcher at Brigham and Women’s Hospital in Boston, led an international team that analyzed data from the medical literature. The group reviewed nine trials published through January 2010 that included more than 118,000 study participants; 59,357 took vitamin E supplements and 59,408 took a placebo. The trials did not include people who took multivitamins."

http://www.bmj.com/content/341/bmj.c5702

I think the lesson to be drawn here is that with the researchers' emails easily available in the abstract, the Post and other news outlets are not acting any more like journalists when they don't bother to follow up and get the answer to the strangely left out dosage(s) question since they had to know that is the FIRST thing readers will want to learn. What can account for this? It seems to be either the Post blogger, Jennifer LaRue Huget, just wants to get something up immediately, to not be late, and so checking it out is not important. Or she is lazy. Either option is shameful for a journalist from a noted and generally responsible paper like the Post and an alarming subject like stroke. Ms. Huget, care to explain?

Posted by: Leila1 | November 7, 2010 7:32 AM | Report abuse

CORRECTION: The Post did include a link to the study. If I could remove my above comment, I would. However the item still should have included a line about dose since many readers will not either click on the study or read the entire thing searching for dosage information that is buried very deep in a long article.

Posted by: Leila1 | November 7, 2010 7:46 AM | Report abuse

Key bit:

Discussion of individual trials
Many large randomised controlled trials investigating the effect of vitamin E on incident major cardiovascular events were performed during the past two decades, but most did not find an overall significant effect.8 9 10 11 12 13 14 Likewise, two recent meta-analyses did not find an effect on mortality from all causes, cardiovascular death, and stroke from all causes.15 16 Our results of an overall null effect of vitamin E on total stroke agree with these earlier reports. However, the main outcome events in these previous trials—composites consisting of myocardial infarction, stroke, and death due to cardiovascular disease—may be too broad to capture the differential pathophysiology underlying ischaemic and haemorrhagic events.18 19 Subgroup analyses from previous trials support this concept by pointing towards a beneficial effect of vitamin E on incident ischaemic stroke,9 12 while suggesting a detrimental effect on incident haemorrhagic stroke.9 13 The Alpha Tocopherol, Beta Carotene Cancer Prevention trial was the first, showing that in male smokers 50 mg/day of vitamin E increased the risk of haemorrhagic stroke.12 This result was confirmed in the Physicians’ Health Study II, which randomised 14 641 male physicians from the United States to 400 IU vitamin E on alternate days or placebo.13 Results from the Women’s Health Study, which randomised 39 876 apparently healthy women to 600 IU vitamin E on alternate days or placebo, however, do not indicate increased risk of haemorrhagic stroke in women.11

Posted by: Leila1 | November 7, 2010 7:57 AM | Report abuse

Posted by: wpmars

"What E did they use to test ????"

Posted by: Zontag

"This study did not correct for dose of Vitamin E taken."

Posted by: TeresaBinstock

"The blog-article would have been far more informative if dose and type(s) of vE had been reported."

Posted by: Leila1

"I too was upset that the Post writer didn't bother to give the dosage, but when I looked at other coverage, including a much more useful BBC article, I didn't see it either."

___________________________________________

The blog/article clearly states this study was a META-ANALYSIS (http://allpsych.com/stats/unit5/21.html). That means, unlike a single experiment where this information is readily communicated (or else it wouldn't get published), this analysis was done on MANY previously conducted experiments. Therefore there is no ONE dosage or ONE type. Synthesis of MANY studies was conducted. The manner of this synthesis of the results is explained in the methodology section of the research paper.

In some circles a well-done, well-researched meta-analysis is considered to be more accurate than a single experiment because of the scope of the findings being investigated.

On the basis of this meta-analysis I am reconsidering my daily E.

Posted by: topwriter | November 7, 2010 8:34 AM | Report abuse

As several posters have hinted, the problem with meta analysis is that it lumps together studies done with different assumptions, populations and time frames and then draws conclusions. This type of analysis does increase 'sample size' but it is hard to adjust for what may be large differences in the studies being combined in the analysis.

Posted by: mgferrebee | November 7, 2010 11:25 AM | Report abuse

It appears that exogenous supplementation with mega doses of E, as promoted by entities such as Life Extension Foundation, do more harm than good. The amount of E contained in an OTC store brand multi vitamin should be of no ill effect, when you supplement with maga doses it appears at a minimum, all you are doing is enriching the manufacturers and worse hurting your health.

Posted by: thomsimonsRPh | November 7, 2010 1:21 PM | Report abuse

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