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Research Letter
July 8, 2013

The Randomized Linxian Dysplasia Nutrition Intervention Trial After 26 Years of Follow-up: No Effect of Multivitamin Supplementation on Mortality

Author Affiliations
  • 1Department of Cancer Epidemiology, Cancer Institute and Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
  • 2Nutritional Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland
  • 3Genetic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland
JAMA Intern Med. 2013;173(13):1259-1261. doi:10.1001/jamainternmed.2013.6066

Although substantial numbers of people worldwide take multivitamin supplements, including an estimated 40% or more of US adults, their effectiveness remains unclear. Recent reports from the Physicians’ Health Study (PHS) II, a randomized trial of daily multivitamins, found fewer total cancers in multivitamin recipients but no effect on overall or cause-specific mortality1,2 in a Western population that was well nourished. However, few multivitamin trials have been conducted in undernourished populations where the potential for benefit is most likely.

In 1985, we initiated the Linxian Dysplasia Nutrition Intervention Trial (NIT) to evaluate the effect of multivitamin supplements on cancer incidence and mortality in Linxian, China, a region with extremely high rates of esophageal and gastric cardia cancer and multiple vitamin and mineral deficiencies. Individuals with a previous cytological diagnosis of esophageal squamous dysplasia were randomized to receive multivitamin supplementation or placebo for 6 years.3 Results after the 6-year intervention period showed no statistically significant benefit on mortality.4 However, an additional 20 years of active follow-up after cessation of the intervention gave us the opportunity to examine the long-term effects of supplementation.

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