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Antioxidant vitamins and mineral supplements to prevent the development of age‐related macular degeneration

Age‐related macular degeneration (AMD) is a condition affecting the central area of the retina (back of the eye). The retina can deteriorate with age and some people get lesions that can lead to loss of central vision. Some studies have suggested that people who eat a diet rich in antioxidant vitamins (carotenoids, vitamins C and E) or minerals (selenium and zinc) may be less likely to get AMD. The authors identified four large, high‐quality randomised controlled trials which included 62,520 people. The trials were conducted in Australia, Finland and the USA and investigated the effects of vitamin E and beta‐carotene supplementation. These trials provide evidence that taking vitamin E and beta‐carotene supplements is unlikely to prevent the onset of AMD. There was no evidence for other antioxidant supplements and commonly marketed combinations. Although generally regarded as safe, vitamin supplements may have harmful effects and clear evidence of benefit is needed before they can be recommended.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

Antioxidant vitamins and mineral supplements to slow down the progression of age‐related macular degeneration

Age‐related macular degeneration (AMD) is a condition affecting the central area of the retina (back of the eye). The retina can deteriorate with age and some people get lesions that can lead to loss of central vision. It has been suggested that progression of the disease may be slowed down in people who eat a diet rich in antioxidant vitamins (carotenoids, vitamins C and E) or minerals (selenium and zinc). We identified 13 randomised controlled trials that included 6150 participants; five trials based in the USA, two in the UK, two trials in Austria, and one trial in each of a further four countries (Australia, China, Italy and Switzerland). The review of trials found that supplementation with antioxidants and zinc may be of modest benefit in people with AMD. This was mainly seen in one large trial that followed up participants for an average of six years. The other smaller trials with shorter follow‐up do not provide evidence of any benefit. Large well‐conducted trials in a range of populations and with different nutritional status are required. Although generally regarded as safe, vitamin supplements may have harmful effects. A systematic review of the evidence on harms of vitamin supplements is needed.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

Vitamins and minerals for female subfertility

Review question: Do supplementary oral antioxidants compared with placebo, no treatment/standard treatment or another antioxidant improve fertility outcomes for subfertile women (standard treatment includes folic acid < 1 mg).

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2013

Using medication: Dietary supplements: Can they also be harmful?

Antioxidant dietary supplements do not help prevent cancer and other life-threatening conditions. Excessive doses of the antioxidants vitamin A, vitamin E and beta-carotene can even increase the risk of dying sooner.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: November 19, 2014

Dietary supplements for treating age-related macular degeneration (AMD)

There is no evidence that dietary supplements can prevent age-related macular degeneration (AMD). But some combinations of vitamins and minerals may help delay the development of late-stage AMD.Dietary supplements contain nutrients that also occur naturally in our food, such as vitamins and minerals, but in a concentrated form and often at a higher dose. They may contain herbal substances like St. John's wort (hypericum) or garlic, or animal products such as fish oil. Dietary supplements are available in many different forms, including tablets, capsules, powder or liquids. They do not require a prescription and are also available outside of pharmacies.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: July 29, 2015

Dietary supplements for preventing postnatal depression

Postnatal depression is a common condition that affects women and may impact on their babies. Common symptoms of postnatal depression include fluctuations in mood, mood changes, suicidal ideation and preoccupation with infant well‐being ranging from over‐concern to frank delusions. There is currently not much evidence regarding interventions that might prevent or treat postnatal depression. A diet lacking in certain vitamins, minerals or other nutrients may cause postnatal depression in some women. Correcting this deficiency with dietary supplements might therefore prevent postnatal depression. Examples of possible dietary supplements aimed at preventing postnatal depression include omega‐3 fatty acids, iron, folate, s‐adenosyl‐L‐methionine, vitamin B12 (cobalamin), B6 (pyridoxine), B2 (riboflavin), vitamin D and calcium.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2013

One, two or three times a week iron supplements for improving health and development among children under 12 years of age

Approximately 600 million preschool and school‐age children are anaemic worldwide. It is estimated that half of these cases are due to a lack of iron. Iron deficiency anaemia during childhood may slow down growth, reduce motor and brain development, and increase illness and death. If anaemia is not treated promptly, these problems may persist later in life. Taking supplements containing iron (sometimes combined with folic acid and other vitamins and minerals) on a daily basis has shown to improve children's health but its use has been limited because supplements may produce side effects such as nausea, constipation or staining of the teeth. It has been suggested that giving iron one, two or three times a week (known as 'intermittent' supplementation) may reduce these side effects and be easier to remember, and thus encourage children to continue taking the iron supplements.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

Prostate Cancer, Nutrition, and Dietary Supplements (PDQ®): Patient Version

Expert-reviewed information summary about the use of nutrition and dietary supplements for reducing the risk of developing prostate cancer or for treating prostate cancer.

PDQ Cancer Information Summaries [Internet] - National Cancer Institute (US).

Version: June 9, 2017

Antioxidant drugs for preventing lung cancer in healthy people

Lung cancer is among the leading causes of cancer death all over the world and its prevention has become a public health priority. It has been suggested that vitamin supplements may prevent lung cancer. In this new updated version of a previous review five additional studies have been added to the four previous ones. Updated analysis of the data shows that taking supplements of vitamins or minerals, either alone or combined, does not result in a reduction in either lung cancer incidence or lung cancer mortality, neither on males nor females. So current evidence does not support recommending the use of supplements of vitamins A, C and E or selenium, either alone or combined, for the prevention of lung cancer in healthy people. Indeed, in smokers and people exposed to asbestos the use of beta‐carotene supplements should be avoided because it may be associated with a small increase in lung cancer incidence and mortality.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

Intermittent regimens of iron supplementation during pregnancy

Anaemia is a frequent condition during pregnancy, particularly among women from low‐ and middle‐income countries who have insufficient iron intake to meet increased iron needs. Traditionally, pregnancy anaemia has been prevented with the provision of daily iron supplements, however, it has recently been proposed that if women take supplements less often, such as once or twice weekly rather than daily, this might reduce side effects and increase acceptance and adherence to supplementation. In this review we assess the benefits and harms of intermittent (i.e. two or three times a week on non‐consecutive days) oral supplementation with iron or iron + folic acid or iron + vitamins and minerals for pregnant women.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

Vitamin D supplementation for women during pregnancy

Vitamin D is produced by the human body from exposure to sunlight and can also be consumed from foods such as fish‐liver oils, fatty fish, mushrooms, egg yolks, and liver. Vitamin D has many functions in the body; it helps maintain bone integrity and calcium homeostasis.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2016

Iron supplements taken one, two or three times a week for preventing anaemia and its consequences in menstruating women

Approximately one out of three non‐pregnant women of reproductive age are anaemic worldwide. Although causes of anaemia are multiple, it very often results from sustained iron deficiency. Being anaemic makes women more likely to suffer infections and to have a diminished physical and work performance. If they become pregnant, they may also have a greater risk of having low birth weight babies and other complications during delivery.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

Folic acid supplements before conception and in early pregnancy (up to 12 weeks) for the prevention of birth defects

Folic acid is a synthetic form of folate used in supplements and fortified staple foods (like wheat and maize flour) to reduce the occurrence of neural tube defects (NTDs). These include spina bifida (or cleft spine), where there is an opening in one or more of the bones (vertebrae) of the spinal column, and anencephaly where the head (cephalic) end of the neural tube fails to close. Supplementation with folic acid is internationally recommended to women from the moment they are trying to conceive until 12 weeks of pregnancy. Another option recommended by the World Health Organization (WHO) is that women of reproductive age take intermittent (weekly) iron and folic acid supplements, especially in populations where the prevalence of anaemia is above 20%. Supplementation may also reduce other birth defects such as cleft lip, with or without cleft palate, and congenital cardiovascular defects. Recently, 5‐methyl‐tetrahydrofolate (5‐MTHF) has been proposed as an alternative to folic acid supplementation. This is because most dietary folate and folic acid are metabolised to 5‐MTHF. Some women have gene characteristics which reduce folate concentration in blood.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2016

Nutritional supplements for people being treated for active tuberculosis

Cochrane researchers conducted a review of the effects of nutritional supplements for people being treated for tuberculosis. After searching for relevant studies up to 4 February 2016, they included 35 relevant studies with 8283 participants. Their findings are summarized below.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2016

Nutritional supplementation for older people after hip fracture

Older people with hip fractures are often malnourished at the time of their fracture and many have poor food intake while in hospital. Malnutrition may hinder recovery after hip fracture. We reviewed the effects of nutritional interventions in older people recovering from hip fracture.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2016

Irritable bowel syndrome: What helps – and what doesn’t

There are a lot of treatments for the relief of irritable bowel syndrome (IBS) – but there is a lack of good-quality research on them. Because the causes of IBS are not clear, it is difficult to find suitable treatments. But research has suggested that at least some medications and treatments may help.The main symptoms of irritable bowel syndrome are abdominal pain, constipation and diarrhea. Most people only have mild symptoms that they can cope with fairly well without having treatment. Over time they learn to understand their body's signals. But some people have such severe symptoms that their everyday lives are greatly affected and it becomes very distressing. If that is the case, various treatment options can be considered.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: October 20, 2016

Preventing osteoporosis

As people get older, it is normal for their bones to become weaker and their risk of fractures to increase somewhat. But in osteoporosis bones become less dense earlier and faster. Measures to prevent osteoporosis from developing can be particularly important for women and people with specific risk factors.Osteoporosis does not cause any symptoms at first. The first sign of osteoporosis is often a bone fracture – and by that point quite a lot of bone tissue has usually already broken down. Some people are at a greater risk of having brittle bones, including older post-menopausal women, men over the age of 65, and people who have a family history of osteoporosis or are overweight. Lack of exercise, smoking and the use of some medications play a role too.Not all risk factors can be influenced. But there are some things that you can do to help strengthen your bones:make sure that you get enough calcium and vitamin D,stay physically active – this will help prevent breakdown of bone tissue,do not smoke.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: April 9, 2014

Iodine supplementation for women before, during or after pregnancy

It is estimated that over 1.8 billion people worldwide do not get enough iodine in their diet, putting them at risk of iodine deficiency. Iodine is an essential nutrient needed in small amounts for the body to make thyroid hormones. The World Health Organization (WHO) recommends that iodine is added to salt to prevent problems caused by lack of iodine. Women who are pregnant or breastfeeding need extra iodine, which puts them at greater risk of deficiency. The breast milk contains iodine for the infant.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2017

Osteoporosis: Overview

Having weak bones that easily break is a sign of osteoporosis. It is normal for your bones to become less dense as you grow older, but osteoporosis speeds up this process. Osteoporosis can be a problem for older people because they also have a greater risk of falling.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: April 9, 2014

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