Vitamin outcome evaluation

In the Heart Outcomes Prevention Evaluation 2 (HOPE-2) study, 5522 patients aged 55 or older with vascular disease or diabetes were randomized to treatment with either placebo or a combination 2, 5 mg of folic acid, 50 mg vitamin B6, and I mg vitamin B 2, for an average of five years. The primary outcome was a composite of death from cardiovascular causes, myocardial infarction, and stroke. Mean plasma homocysteine levels decreased by 2.4 jimol/L in the treatment group and increased by 0.8 jimol/L in the placebo group. The primary outcome occurred in 18.8% of patients assigned to active therapy and in 19.8% of those assigned to placebo (relative risk = 0.95 95% Cl = 0.84-1.07 P = 0.41) (68). 

Cambridge Heart Antioxidant Study DATATOR Deprenyl and Tocopherol Antioxidative Therapy of Rarkinsonism FMC, Finnish Mobile Clinic Health Examination Survey GISSI, Gruppo Italiano Studio Soprawivenza Infarto HOPE, Heart Outcome Prevention Evaluation HPFS, Health Professional Follow-up Study NHS, Nurses Health Study PPR Primary Prevention Project SPACE, Secondary Prevention with Antioxidants of Cardiovascular disease in End-stage renal disease VEAPS, Vitamin E Atherosclerosis Prevention Study VECAT Vitamin E Cataract Age-related maculopathy Trial. 

Yusuf S, Dagenais G, Pogue J, et al. Vitamin E supplementation and cardiovascular events in high-risk patients. The Heart Outcomes Prevention Evaluation Study Investigators. N Engl J Med 2000 342 154-160. 

Heart Outcomes Prevention Evaluation Study (HOPE) Investigators (2000) Vitamin E Supplementation and Cardiovascular Events in High-Risk Patients, N. Engl. J. Med. 342, 154-160. 

In addition, the results of the Heart Outcomes Prevention Evaluation (HOPE-2) study showed that combined daily administration of 2.5 mg of folic add, 50 mg of vitamin Bg and Img of vitamin B12 for five years had no ben-efidal eflects on major vascular events in a high-risk vascular disease population (Lonn et al. 2006), although fewer patients assigned to adive treatment than to placebo had a stroke (relative risk, 0.75 95 percent confidence interval, 0.59 to 0.97). Recent findings from this study show that lowering of Hey with folic add and vitamins Bg and B12 did reduce the risk of overall stroke, but not stroke severity or disability (Saposnik et al. 2009). 

Form, E., Yusuf, S., Arnold, M.J., Sheridan, P., Pogue, J., Micks, M., McQueen, M.J., Probstlield, J., Fodor, G., Held, C., Genest, J., and the Heart Outcomes Prevention Evaluation (HOPE) 2 Investigators, 2006. Homocysteine lowering with folic acid and B vitamins in vascular disease. The New England Journal of Medicine. 354 1567-1577. 

The effect of vitamin D supplementation on maternal and neonatal outcomes in pregnant women has been examined. Six trials with a total of 1023 women were included in the review. There were no significant differences in the frequency of adverse events between vitamin D and comparator groups [74 ]. No serious adverse events were reported in a systematic review of four trials evaluating the effectiveness of vitamin D supplementation in colitis [75 ]. 

Vitamin A has been evaluated as a therapy for infectious diseases largely through controlled clinical trials (Tabs. 1 and 2), and several factors must be considered in the interpretation of these studies. It is important to distinguish between the incidence versus the severity of infections as outcomes of such studies. For example, some studies have been conducted under the premise that vitamin A supplementation will prevent infection altogether, i.e. alter the inci-... 

A major concern associated with clinical trials designed to evaluate the health effects of micronutrients (as well as other dietary supplements and drugs) is that participants might take additional micronutrient supplements, which could influence trial outcomes. In the Prostate Cancer Prevention Trial (PCPT) of the drug finasteride, for example, almost half of the participants reported using a multivitamin/ mineral supplement, about one-third used single supplements of either vitamin C or E, and one in five used calcium supplements. Very little evidence is available on how individual micronutrient substances may interact with one another to influence health outcomes. For minerals, particularly, supplementation with one mineral may compromise the bioavailability of another. Also, much remains to be learned about how individual genetic susceptibilities may influence the health-related effects of micronutrient... 

VA deficiency can be prevented through direct supplementation, fortification of commonly eaten food items, or other food-based interventions that include home gardening, nutrition education, and agronomic approaches. Most evaluations have assessed the impact of direct supplementation and, occasionally, fortification on vitamin A status, xerophthalmia, survival, and other health outcomes. Data on the efficacy of dietary regimens are limited to change in vitamin A status. 

---