NCHR Comments on USPSTF’s Recommendation Statement Regarding Vitamin Supplementation

June 1, 2021

National Center for Health Research’s Public Comments on the United States Preventive Services Task Force’s Draft Recommendation Statement Regarding Vitamin, Mineral, and Multivitamin Supplementation to Prevent Cardiovascular Disease and Cancer

We are writing to express our views on the U.S. Preventive Services Task Force’s (USPSTF) draft recommendation statement regarding vitamin, mineral, and multivitamin supplementation to prevent cardiovascular disease and cancer.

The National Center for Health Research (NCHR) is a nonprofit think tank that conducts, analyzes, and scrutinizes research on a range of health issues, with particular focus on which prevention strategies and treatments are most effective for which patients and consumers. We do not accept funding from companies that make products that are the subject of our work, so we have no conflicts of interest.

We support all 3 of USPSTF’s reissued recommendations. Due to the potential risks of supplements, particularly for those who smoke or have been exposed to asbestos, we support the “D” grade recommendation against the use of beta-carotene or vitamin E supplements for the prevention of cancer or cardiovascular disease. Further, due to insufficient evidence, we support the “I” grades for supplements other than beta-carotene or vitamin E to prevent cardiovascular disease or cancer, as well as for the use of multivitamin supplements for those diseases.

We strongly agree with the USPSTF’s assessment that there continues to be several important research gaps, despite reviewing new evidence since its 2014 recommendation. However, we urge the USPSTF to also specify the gap in data caused by the lack of information on race in the research. Only 20% of the included studies performed in the United States reported any information on participants’ race, and those that did reported 80-100% White participants. Without gathering and analyzing data on race and ethnicity, and ensuring a sufficient number of major racial/ethnic group participants, it is impossible to do subgroup analyses on the benefits and risks of these vitamin and mineral supplements for different demographic groups. This is a significant oversight, and we urge the USPSTF to identify this as a limitation of the current research.

The National Center for Health Research can be reached at or at (202) 223-4000.