Meta-Analysis: High-Dosage Vitamin E Supplementation May Increase All-Cause Mortality

@article{Miller2005MetaAnalysisHV,
  title={Meta-Analysis: High-Dosage Vitamin E Supplementation May Increase All-Cause Mortality},
  author={Edgar R. Miller and Roberto Pastor-Barriuso and Darshan Dalal and Rudolph A. Riemersma and Lawrence J. Appel and Eliseo Guallar},
  journal={Annals of Internal Medicine},
  year={2005},
  volume={142},
  pages={37-46}
}
Context Does vitamin E supplementation increase mortality in adults? Contribution This meta-analysis of 19 randomized, controlled trials involving more than 135000 participants found that high-dosage vitamin E supplementation (400 IU/d for at least 1 year) increased all-cause mortality. Benefits or harms of lower-dosage supplementation were unclear. Cautions Trials that tested high dosages involved adults with chronic diseases, and these findings may not be generalizable to healthy adults. Some… 
High-dosage vitamin E supplementation and all-cause mortality.
TLDR
Although the focus of the Miller et al study may be on safety, the data ultimately challenges the advocates of high dose vitamin E to re- examine the evidence for its benefit, and it is time clinicians return to the drawing board and review both the safety and efficacy data for vitamin E supplementation to determine their practice.
Vitamin E Supplementation and Mortality in Healthy People: A Meta-Analysis of Randomised Controlled Trials
TLDR
The evidence from pooled analysis of 18 randomised controlled trials undertaken in apparently healthy people shows no effect of vitamin E supplementation at a dose of 23–800 IU/day on all-cause mortality.
Vitamin E supplementation: what's the harm in that?
TLDR
It is concluded that vitamin E supplementation is unlikely to affect mortality irrespective of the dose, and vitamin E supplements also have a high probability of being ineffective at reducing mortality.
Decision Analysis Supports the Paradigm That Indiscriminate Supplementation of Vitamin E Does More Harm than Good
TLDR
This study demonstrates that in terms of QALY, indiscriminate supplementation of high doses of vitamin E is not beneficial in preventing CVD, and selective supplementation of Vitamin E to individuals under oxidative stress requires further investigation.
How Safe is Vitamin E Supplementation?
TLDR
An overview of the earlier literature on vitamin E is provided, including a critical assessment of three meta-analyses that were neutral or negative toward vitamin E supplementation, and some guidance is offered for healthcare professionals to give to the general, healthy public and those with chronic conditions who are no doubt left puzzled about what to do regarding vitamin E supplements.
The effect of vitamin E supplementation on selected inflammatory biomarkers in adults: a systematic review and meta-analysis of randomized clinical trials
TLDR
A comprehensive meta-analysis of clinical trials revealed a beneficial effect of vitamin E supplementation, particularly in the form of α-tocopherol, on subclinical inflammation in adults, and suggested that future high-quality RCTs should be conducted to translate this anti-inflammatory effect ofitamin E to the clinical setting.
Reexamination of a Meta-Analysis of the Effect of Antioxidant Supplementation on Mortality and Health in Randomized Trials
TLDR
Results suggest that analyses of potential risks from antioxidant supplementation should be placed in the context of a benefit/risk ratio.
Influence of Vitamin E Supplementation on Glycaemic Control: A Meta-Analysis of Randomised Controlled Trials
TLDR
There is currently insufficient evidence to support a potential beneficial effect of vitamin E supplementation on improvements of HbA1c and fasting glucose and insulin concentrations in subjects with T2DM.
Supplementation with vitamin E alone is associated with reduced myocardial infarction: a meta-analysis.
TLDR
When supplemented alone, vitamin E reduces myocardial infarction in interventional trials while it appears ineffective when associated with other antioxidants.
Meta-Regression Analyses, Meta-Analyses, and Trial Sequential Analyses of the Effects of Supplementation with Beta-Carotene, Vitamin A, and Vitamin E Singly or in Different Combinations on All-Cause Mortality: Do We Have Evidence for Lack of Harm?
TLDR
Beta-carotene and vitamin E in doses higher than the RDA seem to significantly increase mortality, whereas the authors lack information on vitamin A.
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