CRN Challenges Task Force Recs

WASHINGTONOn Dec. 9, the Council for Responsible Nutrition (CRN) submitted comments on the U.S. Preventive Services Task Force (USPSTF) Draft Recommendation Statement on Vitamin, Mineral, and Multivitamin Supplements for the Primary Prevention of Cardiovascular Disease and Cancer. USPSTF released the document on Nov. 12, 2013 and accepted comments through Dec. 9.

In the recommendation, the task force found, "The current evidence is insufficient to assess the balance of benefits and harms of the use of multivitamins for the prevention of cardiovascular disease or cancer." The USPSTF also concluded the current evidence is "insufficient" to assess the balance and harms of single- and paired-nutrient supplements for cancer and cardiovascular disease (CVD); it also recommended against using beta-carotene and vitamin E for prevention of the aforementioned conditions.

In its draft comments, CRN reminded the task force that its recommendation has vast implications, noting, "Given that the USPSTFs recommendations are highly influential, it is important that the task forces final recommendation is clearly communicated to stakeholders to ensure the accuracy of the reports meaning when transferred to the public by secondary sources." CRN cited multiple misinterpretations of previous draft recommendations, including in Time and Newsweek.

The document indicates there are few randomized controlled trials (RCTs) on vitamin combinations that can be generalized to the U.S. population; consequently, it notes the limited evidence prohibits the task force from drawing meaningful conclusions.

However, CRN reiterated the difference between no firm conclusion based on existing evidence" and the available evidence demonstrates a lack of benefit" are huge. "In this case, the absence of an adequate number of robust RCTs of multivitamin supplements that prove multivitamins prevent cardiovascular disease and cancer, based on standards used to establish the efficacy of drugs, should lead to a call for more research and a new research paradigm, not a conclusion of no benefit," CRN said.

As a result, CRN recommended the USPSTF "underscore that the inability to draw firm conclusions based on the limited nature of the existing evidence is not equivalent to a conclusion that existing evidence demonstrates a lack of benefit," and highlight the limited scope of the report.