Suplemen multivitamin dan mineral sekarang banyak
dikonsumsi masyarakat. Seberapa efektif untuk mencegah
kanker dan penyakit kronik? Amankah dikonsumsi? Penelitian
di bawah ini membedah 12 artikel studi efikasi dan 8 studi
keamanan.
Hasil penelitian di Cina pada masyarakat dengan status
gizi buruk, suplementasi ß-carotene, tocopherol, dan
selenium, mengurangi angka insiden kanker lambung dan
mortalitas kanker lain2 sebesar 13-21%.
Hasil penelitian di Perancis, suplementasi vitamin C,
vitamin E, ß-carotene, selenium, dan zinc mengurangi
kejadian kanker sebesar 31% untuk laki2, tapi tidak
bermakna untuk wanita.
Suplementasi multivitamin dan mineral tidak bermakna untuk
penyakit kardiovaskuler atau katarak.
Suplementasi ß-carotene, selenium, -tocopherol, retinol,
and zinc mengurangi mortalitas stroke sebesar 29%
(penelitian Linxian).
Suplementasi zinc dan anti-oksidan dapat memperlambat
progresi AMD.
Efek samping pemberian multivitamin dan mineral tidak
terbukti.
Berdasarkan bukti2 tersebut efektivitas suplementasi
kombinasi multivitamin dan mineral untuk mencegah kanker
dan penyakit kronik kurang kuat.
Abstract
The Efficacy and Safety of Multivitamin and Mineral
Supplement Use To Prevent Cancer and Chronic Disease in
Adults: A Systematic Review for a National Institutes of
Health State-of-the-Science Conference
Ann Intern Med 5 September 2006. Volume 145 Issue 5,
372-385. © 2006 American College of Physicians – American
Society of Internal Medicine
Han-Yao Huang, PhD, MPH; Benjamin Caballero, MD, PhD;
Stephanie Chang, MD; Anthony J. Alberg, PhD, MPH; Richard
D. Semba, MD, MPH; Christine R. Schneyer, MD; Renee F.
Wilson, MSc; Ting-Yuan Cheng, MSc; Jason Vassy, MPH;
Gregory Prokopowicz, MD, MPH; George J. Barnes, II, BA;
and Eric B. Bass, MD, MPH.
Background: Multivitamin and mineral supplements are the
most commonly used dietary supplements in the United
States.
Purpose: To synthesize studies on the efficacy and safety
of multivitamin/mineral supplement use in primary
prevention of cancer and chronic disease in the general
population.
Data Sources: English-language literature search of the
MEDLINE, EMBASE, and Cochrane databases through February
2006 and hand-searching of pertinent journals and
articles.
Study Selection: Randomized, controlled trials in adults
were reviewed to assess efficacy, and randomized,
controlled trials and observational studies in adults or
children were reviewed to assess safety.
Data Extraction: Paired reviewers extracted data and
independently assessed study quality.
Data Synthesis: 12 articles from 5 randomized, controlled
trials that assessed efficacy and 8 articles from 4
randomized, controlled trials and 3 case reports on
adverse effects were identified. Study quality was rated
fair for the studies on cancer, cardiovascular disease,
cataracts, or age-related macular degeneration and poor
for the studies on hypertension. In a poorly nourished
Chinese population, combined supplementation with
ß-carotene, -tocopherol, and selenium reduced the
incidence of and mortality rate from gastric cancer and
the overall mortality rate from cancer by 13% to 21%. In a
French trial, combined supplementation with vitamin C,
vitamin E, ß-carotene, selenium, and zinc reduced the rate
of cancer by 31% in men but not in women. Multivitamin and
mineral supplements had no significant effect on
cardiovascular disease or cataracts, except that combined
ß-carotene, selenium, -tocopherol, retinol, and zinc
supplementation reduced the mortality rate from stroke by
29% in the Linxian study and that a combination of 7
vitamins and minerals stabilized visual acuity loss in a
small trial. Combined zinc and antioxidants slowed the
progression of advanced age-related macular degeneration
in high-risk persons. No consistent adverse effects of
multivitamin and mineral supplements were evident.
Limitations: Only randomized, controlled trials were
considered for efficacy assessment. Special nutritional
needs, such as use of folic acid by pregnant women to
prevent birth defects, were not addressed. Findings may
not apply to use of commercial multivitamin supplements by
the general U.S. population.
Conclusions: Evidence is insufficient to prove the
presence or absence of benefits from use of multivitamin
and mineral supplements to prevent cancer and chronic
disease.
