Customize your JAMA Network experience by selecting one or more topics from the list below.
Fletcher RH, Fairfield KM. Vitamins for Chronic Disease Prevention in Adults: Clinical Applications. JAMA. 2002;287(23):3127–3129. doi:https://doi.org/10.1001/jama.287.23.3127
Author Affiliations: Department of Ambulatory Care and Prevention, Harvard Medical School/Harvard Pilgrim Health Care, and Department of Epidemiology, Harvard School of Public Health (Dr Fletcher); 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 (Dr Fairfield), Boston, Mass.
Scientific Review and Clinical Applications Section
Editor: Wendy Levinson, MD, Contributing Editor
Vitamin deficiency syndromes such as scurvy and beriberi are uncommon
in Western societies. However, suboptimal intake of some vitamins, above levels
causing classic vitamin deficiency, is a risk factor for chronic diseases
and common in the general population, especially the elderly. Suboptimal folic
acid levels, along with suboptimal levels of vitamins B6 and B12, are a risk factor for cardiovascular disease, neural tube defects,
and colon and breast cancer; low levels of vitamin D contribute to osteopenia
and fractures; and low levels of the antioxidant vitamins (vitamins A, E,
and C) may increase risk for several chronic diseases. Most people do not
consume an optimal amount of all vitamins by diet alone. Pending strong evidence
of effectiveness from randomized trials, it appears prudent for all adults
to take vitamin supplements. The evidence base for tailoring the contents
of multivitamins to specific characteristics of patients such as age, sex,
and physical activity and for testing vitamin levels to guide specific supplementation
practices is limited. Physicians should make specific efforts to learn about
their patients' use of vitamins to ensure that they are taking vitamins they
should, such as folate supplementation for women in the childbearing years,
and avoiding dangerous practices such as high doses of vitamin A during pregnancy
or massive doses of fat-soluble vitamins at any age.
Create a personal account or sign in to: