Mary Kay Vitamina C

Randomized Controlled Trial

. 2019 Jan 3;380(1):33-44.

doi: 10.1056/NEJMoa1809944. Epub 2018 Nov 10.

Vitamin D Supplements and Prevention of Cancer and Cardiovascular Disease

Nancy R Cook 1 , I-Min Lee 1 , William Christen 1 , Shari S Bassuk 1 , Samia Mora 1 , Heike Gibson 1 , David Gordon 1 , Trisha Copeland 1 , Denise D'Agostino 1 , Georgina Friedenberg 1 , Claire Ridge 1 , Vadim Bubes 1 , Edward L Giovannucci 1 , Walter C Willett 1 , Julie E Buring 1 , VITAL Research Group

Collaborators, Affiliations

  • PMID: 30415629
  • PMCID: PMC6425757
  • DOI: 10.1056/NEJMoa1809944

Free PMC article

Randomized Controlled Trial

Vitamin D Supplements and Prevention of Cancer and Cardiovascular Disease

JoAnn E Manson  et al. N Engl J Med. .

Free PMC article

Abstract

Background: It is unclear whether supplementation with vitamin D reduces the risk of cancer or cardiovascular disease, and data from randomized trials are limited.

Methods: We conducted a nationwide, randomized, placebo-controlled trial, with a two-by-two factorial design, of vitamin D3 (cholecalciferol) at a dose of 2000 IU per day and marine n-3 (also called omega-3) fatty acids at a dose of 1 g per day for the prevention of cancer and cardiovascular disease among men 50 years of age or older and women 55 years of age or older in the United States. Primary end points were invasive cancer of any type and major cardiovascular events (a composite of myocardial infarction, stroke, or death from cardiovascular causes). Secondary end points included site-specific cancers, death from cancer, and additional cardiovascular events. This article reports the results of the comparison of vitamin D with placebo.

Results: A total of 25,871 participants, including 5106 black participants, underwent randomization. Supplementation with vitamin D was not associated with a lower risk of either of the primary end points. During a median follow-up of 5.3 years, cancer was diagnosed in 1617 participants (793 in the vitamin D group and 824 in the placebo group; hazard ratio, 0.96; 95% confidence interval [CI], 0.88 to 1.06; P=0.47). A major cardiovascular event occurred in 805 participants (396 in the vitamin D group and 409 in the placebo group; hazard ratio, 0.97; 95% CI, 0.85 to 1.12; P=0.69). In the analyses of secondary end points, the hazard ratios were as follows: for death from cancer (341 deaths), 0.83 (95% CI, 0.67 to 1.02); for breast cancer, 1.02 (95% CI, 0.79 to 1.31); for prostate cancer, 0.88 (95% CI, 0.72 to 1.07); for colorectal cancer, 1.09 (95% CI, 0.73 to 1.62); for the expanded composite end point of major cardiovascular events plus coronary revascularization, 0.96 (95% CI, 0.86 to 1.08); for myocardial infarction, 0.96 (95% CI, 0.78 to 1.19); for stroke, 0.95 (95% CI, 0.76 to 1.20); and for death from cardiovascular causes, 1.11 (95% CI, 0.88 to 1.40). In the analysis of death from any cause (978 deaths), the hazard ratio was 0.99 (95% CI, 0.87 to 1.12). No excess risks of hypercalcemia or other adverse events were identified.

Conclusions: Supplementation with vitamin D did not result in a lower incidence of invasive cancer or cardiovascular events than placebo. (Funded by the National Institutes of Health and others; VITAL ClinicalTrials.gov number, NCT01169259 .).

Conflict of interest statement

Conflict of Interest Disclosures: All authors completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest.

Figures

Figure 1:
Figure 1:

Flow Diagram of Enrollment in the Vitamin D Component of the Trial.

Figure 2:
Figure 2:

Cumulative Incidence Rates of A) Total Invasive Cancer, and B) Major Cardiovascular Events, by Year of Follow-up. From Cox regression models controlling for age, sex, and omega-3 randomization group (intention-to-treat analyses).

Figure 2:
Figure 2:

Cumulative Incidence Rates of A) Total Invasive Cancer, and B) Major Cardiovascular Events, by Year of Follow-up. From Cox regression models controlling for age, sex, and omega-3 randomization group (intention-to-treat analyses).

Comment in

  • VITAL Signs for Dietary Supplementation to Prevent Cancer and Heart Disease.

    Keaney JF Jr, Rosen CJ. Keaney JF Jr, et al. N Engl J Med. 2019 Jan 3;380(1):91-93. doi: 10.1056/NEJMe1814933. Epub 2018 Nov 10. N Engl J Med. 2019. PMID: 30415594 No abstract available.

  • Vitamin D und Fischöl fallen beim Test durch.

    Diehm C. Diehm C. MMW Fortschr Med. 2019 Apr;161(6):33. doi: 10.1007/s15006-019-0349-3. MMW Fortschr Med. 2019. PMID: 30937778 Review. German. No abstract available.

  • [Vitamin D and omega-3 fatty acid supplementation does not reduce the cancer and cardiovascular risk].

    Lordick F. Lordick F. Strahlenther Onkol. 2019 Jul;195(7):693-694. doi: 10.1007/s00066-019-01455-4. Strahlenther Onkol. 2019. PMID: 31001644 German. No abstract available.

  • VITAL study: an incomplete picture?

    Infante M, Ricordi C, Baidal DA, Alejandro R, Lanzoni G, Sears B, Caprio M, Fabbri A. Infante M, et al. Eur Rev Med Pharmacol Sci. 2019 Apr;23(7):3142-3147. doi: 10.26355/eurrev_201904_17599. Eur Rev Med Pharmacol Sci. 2019. PMID: 31002167 No abstract available.

  • Cardiovascular Risk Reduction with Icosapent Ethyl.

    Chan LN. Chan LN. N Engl J Med. 2019 Apr 25;380(17):1677. doi: 10.1056/NEJMc1902165. N Engl J Med. 2019. PMID: 31018075 No abstract available.

  • Cardiovascular Risk Reduction with Icosapent Ethyl.

    Borghi C, Fogacci F, Cicero AFG. Borghi C, et al. N Engl J Med. 2019 Apr 25;380(17):1678. doi: 10.1056/NEJMc1902165. N Engl J Med. 2019. PMID: 31018076 No abstract available.

  • Re: Vitamin D Supplements and Prevention of Cancer and Cardiovascular Disease.

    Taneja SS. Taneja SS. J Urol. 2019 Aug;202(2):211-212. doi: 10.1097/01.JU.0000559602.40778.1d. Epub 2019 Jul 8. J Urol. 2019. PMID: 31063055 No abstract available.

  • Marine n-3 Fatty Acids and Vitamin D Supplementation and Primary Prevention.

    Kalra K, Treloar V. Kalra K, et al. N Engl J Med. 2019 May 9;380(19):1878. doi: 10.1056/NEJMc1902636. N Engl J Med. 2019. PMID: 31067388 No abstract available.

  • Marine n-3 Fatty Acids and Vitamin D Supplementation and Primary Prevention.

    Potvin P. Potvin P. N Engl J Med. 2019 May 9;380(19):1878. doi: 10.1056/NEJMc1902636. N Engl J Med. 2019. PMID: 31067389 No abstract available.

  • Marine n-3 Fatty Acids and Vitamin D Supplementation and Primary Prevention.

    Pilz S. Pilz S. N Engl J Med. 2019 May 9;380(19):1878-1879. doi: 10.1056/NEJMc1902636. N Engl J Med. 2019. PMID: 31067390 No abstract available.

  • Marine n-3 Fatty Acids and Vitamin D Supplementation and Primary Prevention.

    Grant WB, Boucher BJ. Grant WB, et al. N Engl J Med. 2019 May 9;380(19):1879. doi: 10.1056/NEJMc1902636. N Engl J Med. 2019. PMID: 31067391 No abstract available.

  • New Guidelines for Statistical Reporting in the Journal.

    Harrington D, D'Agostino RB Sr, Gatsonis C, Hogan JW, Hunter DJ, Normand ST, Drazen JM, Hamel MB. Harrington D, et al. N Engl J Med. 2019 Jul 18;381(3):285-286. doi: 10.1056/NEJMe1906559. N Engl J Med. 2019. PMID: 31314974 No abstract available.

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Mary Kay Vitamina C

Source: https://pubmed.ncbi.nlm.nih.gov/30415629/