Medicine in the News

Dietary Supplements are Unlikely to Do Much for Your Heart

Save Your Money and Don’t Buy Tons of Dietary Supplements

Medicine in the News

dietary supplements polypharmacy
Image: © Voyagerix

Diagnosis Life keeps you in the know with the latest in health and wellness. Here are three of the hottest medical stories making the rounds, in simple terms.

  1. Those dietary supplements may not be doing much for your heart.

    Diagnosis Life summary:
    I’ve said it before, I’ll say it again — dietary supplements are a money-making industry. There is rarely enough data to show that any given supplement has clinical benefit and is worth the price tag. A meta-analysis in the Annals of Internal Medicine (DOI:10.7326/M19-0341) looked at 277 randomized controlled trials of 24 dietary supplements in nearly 1 million adults. All in all, the results were not all that impressive. Dietary supplements like multivitamins or vitamins A, C, D, and E had no effect on cardiovascular outcomes. Findings were notable in that omega-3 fatty acids were associated with reduced heart risk. Folic acid was protective against stroke, but calcium plus vitamin D supplements actually increased the risk of stroke. The researchers of the study warned about the “suboptimal quality of the evidence”, but it may be reasonable to say that you may be better off leaving those dietary supplements on the shelf.

  2. Babies treated with acid-suppressing medications may be at higher risk for fractures when they get older.

    Diagnosis Life summary:
    Acid reflux can be a problem for infants. In order to assure they are able to maintain proper nutrition, they may need to take acid-suppressing medications like H2 blockers and proton pump inhibitors (PPI) for their symptoms. A study in Pediatrics (DOI:10.1542/peds.2018-2625) looked at more than 851,000 children — approximately 72,000 treated with H2 blockers, 8,000 treated with PPI, and 18,000 treated with both an H2 blocker and PPI in their first year of life. The rest were considered to be controls. Children were more likely to have a fracture by 4 years old if they were on PPI therapy or combined treatment with both an H2 blocker and PPI. With that in mind, empiric treatment with a PPI should be avoided unless a child has failed treatment with an H2 blocker alone.

  3. A simple lab test may let you know if you need antibiotics when your COPD flares up.

    Diagnosis Life summary:
    Flare-ups of COPD can be common. The standard of care for “bad” cases has been to treat with antibiotics, even if there has not been a confirmed infection. That “better-safe-than-sorry” approach is now being questioned by a study in the New England Journal of Medicine (DOI:10.1056/NEJMoa1803185). The researchers looked at a lab test that can be performed right in the office setting. C-reactive protein (CRP) is a marker of inflammation. Looking at 650 adults who had COPD flare-ups, it was found that antibiotics were unlikely to be beneficial for CRP levels < 20 mg/L, possibly beneficial for CRP of 20–40 mg/L, and likely beneficial for CRP > 40 mg/L. If we can treat less often with antibiotics and still maintain good clinical outcomes, that’s what we should do. After all, antibiotic resistance is emerging as a serious worldwide threat.

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