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Vitamins for chronic disease prevention in adults: scientific review.

Abstract

CONTEXT

Although vitamin deficiency is encountered infrequently in developed countries, inadequate intake of several vitamins is associated with chronic disease.

OBJECTIVE

To review the clinically important vitamins with regard to their biological effects, food sources, deficiency syndromes, potential for toxicity, and relationship to chronic disease.

DATA SOURCES AND STUDY SELECTION

We searched MEDLINE for English-language articles about vitamins in relation to chronic diseases and their references published from 1966 through January 11, 2002.

DATA EXTRACTION

We reviewed articles jointly for the most clinically important information, emphasizing randomized trials where available.

DATA SYNTHESIS

Our review of 9 vitamins showed that elderly people, vegans, alcohol-dependent individuals, and patients with malabsorption are at higher risk of inadequate intake or absorption of several vitamins. Excessive doses of vitamin A during early pregnancy and fat-soluble vitamins taken anytime may result in adverse outcomes. Inadequate folate status is associated with neural tube defect and some cancers. Folate and vitamins B(6) and B(12) are required for homocysteine metabolism and are associated with coronary heart disease risk. Vitamin E and lycopene may decrease the risk of prostate cancer. Vitamin D is associated with decreased occurrence of fractures when taken with calcium.

CONCLUSIONS

Some groups of patients are at higher risk for vitamin deficiency and suboptimal vitamin status. Many physicians may be unaware of common food sources of vitamins or unsure which vitamins they should recommend for their patients. Vitamin excess is possible with supplementation, particularly for fat-soluble vitamins. Inadequate intake of several vitamins has been linked to chronic diseases, including coronary heart disease, cancer, and osteoporosis

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  • Authors+Show Affiliations

    ,

    Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center and Channing Laboratory, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA. kfairfie@caregroup.harvard.edu

    Source

    JAMA 287:23 2002 Jun 19 pg 3116-26

    MeSH

    Ascorbic Acid
    Avitaminosis
    Blood Coagulation
    Breast Neoplasms
    Carotenoids
    Chronic Disease
    Colorectal Neoplasms
    Coronary Disease
    Dietary Supplements
    Female
    Folic Acid
    Fractures, Bone
    Humans
    Lung Neoplasms
    Male
    Neoplasms
    Neural Tube Defects
    Prostatic Neoplasms
    Risk Factors
    Vitamin A
    Vitamin B 12
    Vitamin B 6
    Vitamin D
    Vitamin E
    Vitamin K
    Vitamins

    Pub Type(s)

    Journal Article
    Research Support, Non-U.S. Gov't
    Review

    Language

    eng

    PubMed ID

    12069675

    Citation

    Fairfield, Kathleen M., and Robert H. Fletcher. "Vitamins for Chronic Disease Prevention in Adults: Scientific Review." JAMA, vol. 287, no. 23, 2002, pp. 3116-26.
    Fairfield KM, Fletcher RH. Vitamins for chronic disease prevention in adults: scientific review. JAMA. 2002;287(23):3116-26.
    Fairfield, K. M., & Fletcher, R. H. (2002). Vitamins for chronic disease prevention in adults: scientific review. JAMA, 287(23), pp. 3116-26.
    Fairfield KM, Fletcher RH. Vitamins for Chronic Disease Prevention in Adults: Scientific Review. JAMA. 2002 Jun 19;287(23):3116-26. PubMed PMID: 12069675.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Vitamins for chronic disease prevention in adults: scientific review. AU - Fairfield,Kathleen M, AU - Fletcher,Robert H, PY - 2002/6/19/pubmed PY - 2002/6/26/medline PY - 2002/6/19/entrez SP - 3116 EP - 26 JF - JAMA JO - JAMA VL - 287 IS - 23 N2 - CONTEXT: Although vitamin deficiency is encountered infrequently in developed countries, inadequate intake of several vitamins is associated with chronic disease. OBJECTIVE: To review the clinically important vitamins with regard to their biological effects, food sources, deficiency syndromes, potential for toxicity, and relationship to chronic disease. DATA SOURCES AND STUDY SELECTION: We searched MEDLINE for English-language articles about vitamins in relation to chronic diseases and their references published from 1966 through January 11, 2002. DATA EXTRACTION: We reviewed articles jointly for the most clinically important information, emphasizing randomized trials where available. DATA SYNTHESIS: Our review of 9 vitamins showed that elderly people, vegans, alcohol-dependent individuals, and patients with malabsorption are at higher risk of inadequate intake or absorption of several vitamins. Excessive doses of vitamin A during early pregnancy and fat-soluble vitamins taken anytime may result in adverse outcomes. Inadequate folate status is associated with neural tube defect and some cancers. Folate and vitamins B(6) and B(12) are required for homocysteine metabolism and are associated with coronary heart disease risk. Vitamin E and lycopene may decrease the risk of prostate cancer. Vitamin D is associated with decreased occurrence of fractures when taken with calcium. CONCLUSIONS: Some groups of patients are at higher risk for vitamin deficiency and suboptimal vitamin status. Many physicians may be unaware of common food sources of vitamins or unsure which vitamins they should recommend for their patients. Vitamin excess is possible with supplementation, particularly for fat-soluble vitamins. Inadequate intake of several vitamins has been linked to chronic diseases, including coronary heart disease, cancer, and osteoporosis SN - 0098-7484 UR - https://www.unboundmedicine.com/medline/citation/12069675/full_citation L2 - https://jamanetwork.com/journals/jama/fullarticle/vol/287/pg/3116 DB - PRIME DP - Unbound Medicine ER -