Intakes of vitamins A, C, and e and use of multiple vitamin supplements and risk of colon cancer: A pooled analysis of prospective cohort studies

Department of Nutrition, Harvard School of Public Health, 665 Huntington Avenue, Boston, MA 02115, USA.
Cancer Causes and Control (Impact Factor: 2.74). 11/2010; 21(11):1745-57. DOI: 10.1007/s10552-010-9549-y
Source: PubMed


To evaluate the associations between intakes of vitamins A, C, and E and risk of colon cancer.
Using the primary data from 13 cohort studies, we estimated study- and sex-specific relative risks (RR) with Cox proportional hazards models and subsequently pooled RRs using a random effects model.
Among 676,141 men and women, 5,454 colon cancer cases were identified (7-20 years of follow-up across studies). Vitamin A, C, and E intakes from food only were not associated with colon cancer risk. For intakes from food and supplements (total), the pooled multivariate RRs (95% CI) were 0.88 (0.76-1.02, >4,000 vs. ≤ 1,000 μg/day) for vitamin A, 0.81 (0.71-0.92, >600 vs. ≤ 100 mg/day) for vitamin C, and 0.78 (0.66-0.92, > 200 vs. ≤ 6 mg/day) for vitamin E. Adjustment for total folate intake attenuated these associations, but the inverse associations with vitamins C and E remained significant. Multivitamin use was significantly inversely associated with colon cancer risk (RR = 0.88, 95% CI: 0.81-0.96).
Modest inverse associations with vitamin C and E intakes may be due to high correlations with folate intake, which had a similar inverse association with colon cancer. An inverse association with multivitamin use, a major source of folate and other vitamins, deserves further study.

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    • "A meta-analysis of 13 prospective European and North American cohort studies reported a decrease in risk of colon cancer among MVM supplement users compared with nonusers (relative risk [RR]: 0.88; 95% confidence interval [CI]: 0.81–0.96) [57]. MVM supplement use for 15 years was associated with a 75% reduction in colon cancer risk in the prospective Nurses’ Health Study (NHS) based on questionnaires completed by 88,756 female nurses in the United States [51]. "
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    ABSTRACT: A balanced and varied diet is the best source of essential vitamins and minerals; however, nutrient deficiencies occur, including in populations with bountiful food supplies and the means to procure nutrient-rich foods. For example, the typical American diet bears little resemblance to what experts recommend for fruit, vegetables, and whole grains, which serve as important sources of an array of vitamins and minerals. With time, deficiencies in one or more micronutrients may lead to serious health issues. A common reason people take multivitamin and mineral (MVM) supplements is to maintain or improve health, but research examining the effectiveness of MVMs in the prevention of certain chronic conditions is ongoing. In addition to the utility of MVMs for filling in relatively small but critical nutritional gaps, which may help prevent conditions such as anemia, neural tube defects, and osteoporosis, some evidence supports possible benefits of MVM supplementation with regard to cancer prevention (particularly in men) and prevention or delay of cataract, as well as some aspects of cognitive performance. Unlike some single-vitamin supplements, MVM supplements are generally well tolerated and do not appear to increase the risk of mortality, cerebrovascular disease, or heart failure. The potential benefits of MVM supplements likely outweigh any risk in the general population and may be particularly beneficial for older people.
    Nutrition Journal 07/2014; 13(1):72. DOI:10.1186/1475-2891-13-72 · 2.60 Impact Factor
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    • "Systematic and narrative reviews on the effects of MVM supplements on health have indicated that there is little convincing evidence that these DSs influence the incidence of cataracts, cardiovascular disease, diabetes [63-65], or cancers of the prostate, lungs, or breast [64,66-68]. On the other hand some studies suggest MVM supplements may improve cognitive functioning [69,70], reduce infection risk in older individuals [71], reduce colon cancer risk [72] and, when used for primary prevention, reduce the risk of all-cause mortality [73], although results are not consistent [65]. The determination of the safety of vitamins and minerals differs from that of other substances like toxins or other chemicals because a certain level of vitamins and minerals are needed for good health but above or below that level, an adverse effect may occur. "
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    • "Furthermore, among dietary factors, vitamins A, C and E have been hypothesized to reduce the risk of colon cancer because of their anti-carcinogenic properties. In this approach, vitamin A regulates nuclear receptors that suppress tumor formation, induces cell apoptosis and enhances immune function [40]. Retinoic acid (RA) has also been shown to down-regulate markers of proliferation such as hTERT and cyclins D1 and 3, markers of DNA damage such as 8-oxo Guanine and growth factors such as epidermal growth factor receptor (EGFR) and vascular endothelial growth factor (VEGF), potentially inhibiting tumor growth, angiogenesis and metastasis. "
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