Vitamins C and E Do Not Reduce Risk of Cardiac Events in Men

by | Nov 13, 2008

This week, the Journal of the American Medical Association (JAMA) reports that long-term supplementation with either vitamins C (500 mg) or E (400 IU) is ineffective at reducing major cardiovascular events, including heart attack and stroke.

The study was a ten year randomized, double-blind, placebo-controlled trial in low risk, healthy men over 50-years old.

Unfortunately, results do not get any more conclusive than this. Sorry boys, you are going to have to stick with diet and exercise for now.

It was thought that antioxidants such as vitamins C and E may reduce risk of cardiovascular disease by decreasing oxidative damage and reducing inflammation. But it appears that consuming these vitamins in supplement form is ineffective.

It is still a good idea to get enough of these antioxidants from dietary sources, however. Fruit is a good source of vitamin C. Almonds are good for vitamin E. A bonus is that a diet rich in fruits and nuts actually is associated with a lower risk of heart disease.


Also in JAMA, low-dose aspirin was shown to be ineffective at reducing the risk of cardiac events in patients with type 2 diabetes. This finding is somewhat surprising because aspirin is effective at reducing cardiac events in non-diabetic individuals, and patients with diabetes are considered to be at particularly high risk for heart disease. It was thus reasoned that aspirin should be recommended for people with diabetes. However, in this group of diabetic patients in Japan, aspirin did not the reduce risk of a cardiovascular event.

One thing to note is that this study was relatively small, only 2,539 participants. So it may have lacked statistical power to find a real benefit. If you have type 2 diabetes and are currently taking daily aspirin, I wouldn’t stop just yet.

The good news for everyone is that basic dietary and lifestyle factors are by far the largest contributors to heart disease, diabetes and cancer. You can avoid most of these problems by eating a varied diet of whole foods, maintaining a healthy weight and staying moderately active. I’d choose that over aspirin any day!

Do you take many dietary supplements?

UPDATE: The problems with vitamin C and E supplements were expanded on this week by Tara Parker-Pope at the New York Times Well Blog. It is a great read if you are interested in this topic.

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14 Responses to “Vitamins C and E Do Not Reduce Risk of Cardiac Events in Men”

  1. Steve Parker, M.D. says:

    Fortunately, there are other ways to prevent heart attack and stroke, such as not smoking, getting regular exercise, keeping blood pressure under good control, and choosing the right parents.And there’s the Mediterranean diet, which is much more hassle than popping vitamin supplements. The Mediterranean diet yields a minimum 9% reduction in cardiovascular disease – even greater reduction if adherence to the diet is good. Details of the recent Mediterranean dit meta-analysis are here:'ve already read it, Darya, but perhaps some of your readers are interested.]-Steve

  2. Anonymous says:

    I used to take an Alpha Lipoic Acid supplement, but now it just a multivitamin twice a day.I know that the FDA doesn’t regulate diet supplements like this, but wouldn’t it be a good idea if it did? Make these drug makers show proof of efficacy before going online to hawk their wares?

  3. Darya Pino says:

    steve:I absolutely agree, a Mediterranean diet (or iterations of it) is a fantastic way to cut disease risk and increase longevity. But I do not think it is that much more of a hassel to follow a Med diet than any other kind of diet. You have to eat afterall. In my experience, just a little planning early in the week makes eating healthy even easier than being unhealthy! (I cannot comment on pill popping, personally it upsets my stomach). Going out to eat is time consuming and expensive. Who can afford that in this economy?Thanks for the tip!—–anon:From what I understand, the FDA is in the process of changing their regulation on supplements. But I doubt it will end up in the same boat as regular drug regulation. Hippies do not want you taking away their St. John’s wort, even if it doesn’t do anything! But hopefully the new regulations will make it so that at least supplements contain what is written on the label and meet some basic safety standards. Right now you don’t even know what you’re getting.

  4. Anonymous says:

    So then why is supplemented Vitamin C different from dietary Vitamin C? Do the scientists provide any explanation for the ‘hows/whys’ in this?

  5. Darya Pino says:

    anon2:Right now it is just speculation, but one theory is that vitamins, minerals and other antioxidants are highly dependent on chemical context for efficacy. For example, fat soluble vitamins require some amount of oil to enter your cells. So without oil, vitamins D and E are not effective. But it could even be more complex. Maybe certain combinations of vitamins and proteins (or other molecules) in whole foods get destroyed in processing and therefore are unable to perform the same function in pill form.The beauty is the reasons don’t matter. All you need to know is that it’s better to eat delicious fruits, vegetables, grains, legumes and fish than pop pills, so go nuts!

  6. tbone says: Mediterranean pyramid promotes carb suicide! From the blogger's posts, wouldn't switching the fruits & veggie layer with breads be preferable? How do you get a daily dose of cheese? Does soy milk count?

  7. Anonymous says:

    Agreed with tbone, doesn’t the Walter Willet pyramid totally refute having that many servings of carbohydrates as a foundation of a diet? It seems like this diet is good, but it could be much better…..

  8. Anonymous says:

    It seems like it is American culture to take something apart and try to play God by putting it back together again in a more efficient way. Just a few off the top of my head….. food supplementsMcdonaldsTV dinnerssnow machinesindustrial farmsfish farmscosmetic plastic surgeryIts just never as good as the real thing, the way it existed before humans got involved. We are always looking for a shortcut, and I wonder if this tendency will forever plague us in this zero-sum world.

  9. Darya Pino says:

    tbone:Here is the Harvard healthy eating pyramid, which I agree with the most. It was developed partly by Walter Willett. What do you think?—–anon4:I agree that messing with nature is a bad idea in general. We just don’t know enough to do it right.

  10. Jed Wolpaw says:

    That’s because those are the wrong supplements. Vitamin D, Omega 3, these are the keys to long life and happiness.

  11. Darya Pino says:

    jed:That might very well be true.

  12. Anonymous says:

    My favorite supplement that I took for a while was a ‘carb blocker.’ If you took the two pills like 1/2 hour before eating a high carb meal, the chemicals in the pills would stop your body from absorbing and metabolizing the carbohydrates. Can’t remember what its called, but I got it from GNC. They also had one for fat blocking. It was probably a total hoax, but then again that is the genius of GNC- totally unregulated, they package their pills in cool looking bottles and claim a foundation of science, regardless of not really being held to any scientific standard.

  13. Darya Pino says:

    anon5:You bring up an excellent point. All those magic carb and fat blocking pills are really really scary. I do not recommend anyone touch those things.Eating vegetables is so much simpler.

  14. luccy says:

    A whole array of anti-obesity pills and medicines are available in the market that helps you to trigger off successful weight loss but the weight loss diet pill Xenical is somewhat different as it prevents around 30% of the fat you take from being absorbed in your system. This further leads to less fat accumulation and ultimately weight loss becomes a reality. For more details on Xenical, visit the website

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