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Research Studies is a monthly compilation of research articles funded by AHRQ or authored by AHRQ researchers and recently published in journals or newsletters.
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1 to 25 of 28 Research Studies DisplayedTracer H, Justus M
Vitamin, mineral, and multivitamin supplementation to prevent cardiovascular disease and cancer.
This Putting Prevention into Practice case study is used to increase understanding of the USPSTF final recommendation on vitamin, mineral, and multivitamin supplementation to prevent cardiovascular disease and cancer. A case study was presented using a 53-year-old-patient with no significant history presenting for a wellness visit. The patient’s 10-year cardiovascular risk and BMI are described. Three multiple-choice questions are presented regarding harms and benefits, and recommendations not to use supplementation to prevent cardiovascular disease and cancer.
AHRQ-authored.
Citation: Tracer H, Justus M .
Vitamin, mineral, and multivitamin supplementation to prevent cardiovascular disease and cancer.
Am Fam Physician 2022 Nov;106(5):565-66..
Keywords: U.S. Preventive Services Task Force (USPSTF), Cardiovascular Conditions, Cancer, Vitamins and Supplements, Prevention, Evidence-Based Practice, Guidelines
O'Connor EA, Evans CV, Ivlev I
Vitamin and mineral supplements for the primary prevention of cardiovascular disease and cancer: updated evidence report and systematic review for the US Preventive Services Task Force.
This evidence report and systematic review updated the 2013 USPSTF final recommendation to assess benefits and harms of using vitamin and mineral supplements for the primary prevention of cardiovascular disease and cancer. After an extensive literature review, 84 studies were included. While multivitamin use was significantly associated with a lower incidence of any cancer and lung cancer, the evidence had serious limitations. Beta carotene was significantly associated with an increased risk of lung cancer and cardiovascular mortality. Vitamins D and E were not significantly associated with all-cause mortality, cardiovascular disease events, or cancer incidence. Evidence for the benefit of other supplements was equivocal, minimal, or absent. There was limited evidence that suggested some supplements may be associated with higher risk of serious harms (hip fracture [vitamin A], hemorrhagic stroke [vitamin E], and kidney stones [vitamin C, calcium]).
AHRQ-funded; 290201500007I.
Citation: O'Connor EA, Evans CV, Ivlev I .
Vitamin and mineral supplements for the primary prevention of cardiovascular disease and cancer: updated evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2022 Jun 21;327(23):2334-47. doi: 10.1001/jama.2021.15650..
Keywords: U.S. Preventive Services Task Force (USPSTF), Vitamins and Supplements, Cardiovascular Conditions, Cancer, Prevention, Evidence-Based Practice
Tracer H, West R
Screening for vitamin D deficiency in adults.
This case study in the “Putting Prevention into Practice: An Evidence Based Approach” series focuses on screening for vitamin D deficiency in adults. It includes a case study, questions, and answers.
AHRQ-authored.
Citation: Tracer H, West R .
Screening for vitamin D deficiency in adults.
Am Fam Physician 2021 Nov 1;104(5):515-16..
Keywords: U.S. Preventive Services Task Force (USPSTF), Vitamins and Supplements, Screening, Prevention, Guidelines, Evidence-Based Practice, Case Study
Shah SC, Zhu X, Dai Q
Magnesium intake is associated with a reduced risk of incident liver cancer, based on an analysis of the NIH-American Association of Retired Persons (NIH-AARP) Diet and Health Study prospective cohort.
Liver cancer incidence and mortality are escalating globally. Magnesium intake has been studied extensively in nonmalignant liver pathology, but the association between dietary intake of magnesium and primary liver malignancy has not been previously evaluated. In this study, investigators aimed to determine the association between total magnesium intake and primary liver cancer risk. The investigators concluded that based on their prospective cohort analysis, magnesium intake was associated with a lower risk of primary liver cancer, which was more pronounced among moderate and heavy alcohol users.
AHRQ-funded; HS026395.
Citation: Shah SC, Zhu X, Dai Q .
Magnesium intake is associated with a reduced risk of incident liver cancer, based on an analysis of the NIH-American Association of Retired Persons (NIH-AARP) Diet and Health Study prospective cohort.
Am J Clin Nutr 2021 Mar 11;113(3):630-38. doi: 10.1093/ajcn/nqaa326..
Keywords: Cancer, Risk, Digestive Disease and Health, Vitamins and Supplements, Prevention
Shah SC, Dai Zhu, X
Associations between calcium and magnesium intake and the risk of incident gastric cancer: a prospective cohort analysis of the National Institutes of Health-American Association of Retired Persons (NIH-AARP) Diet and Health Study.
Gastric cancer remains a leading cause of cancer-related mortality. Identifying dietary and other modifiable disease determinants has important implications for risk attenuation in susceptible individuals. The primary aim of the investigators was to estimate the association between dietary and supplemental intakes of calcium and magnesium and the risk of incident gastric cancer. They conducted a prospective cohort analysis of the National Institutes of Health-American Association of Retired Persons Diet and Health Study.
AHRQ-funded; HS026395.
Citation: Shah SC, Dai Zhu, X .
Associations between calcium and magnesium intake and the risk of incident gastric cancer: a prospective cohort analysis of the National Institutes of Health-American Association of Retired Persons (NIH-AARP) Diet and Health Study.
Int J Cancer 2020 Jun 1;146(11):2999-3010. doi: 10.1002/ijc.32659..
Keywords: Cancer, Digestive Disease and Health, Vitamins and Supplements, Risk, Prevention, Nutrition, Patient-Centered Outcomes Research, Evidence-Based Practice
Shah SC, Dai Q, Zhu X
Associations between calcium and magnesium intake and the risk of incident oesophageal cancer: an analysis of the NIH-AARP Diet and Health Study prospective cohort.
Risk reduction through dietary modifications is an adjunct strategy for prevention of oesophageal cancer, a leading cause of cancer-related mortality and morbidity worldwide. In this study, the investigators aimed to estimate the association between calcium and magnesium intakes and incident oesophageal cancer (OC) by conducting a retrospective analysis of the NIH-AARP Diet and Health Study prospective cohort.
AHRQ-funded; HS026395.
Citation: Shah SC, Dai Q, Zhu X .
Associations between calcium and magnesium intake and the risk of incident oesophageal cancer: an analysis of the NIH-AARP Diet and Health Study prospective cohort.
Br J Cancer 2020 Jun;122(12):1857-64. doi: 10.1038/s41416-020-0818-6..
Keywords: Cancer, Vitamins and Supplements, Risk
Fink HA, Linskens EJ, MacDonald R
Benefits and harms of prescription drugs and supplements for treatment of clinical Alzheimer-type dementia
This is a systematic review and meta-analysis of the benefits and harms of prescription drugs and supplements for treatment of clinical Alzheimer-type dementia (CATD). Studies with low or medium risk of bias (ROB) were analyzed and rated. The analysis concluded there was a slight reduction in short-term cognitive decline with cholinesterase inhibitors and memantime, and cholinesterase inhibitors slightly reduced reported functional decline. There was mostly insufficient evidence on drug treatment of behavioral and psychological symptoms of dementia and on supplements for all outcomes.
AHRQ-funded; 290201500008I.
Citation: Fink HA, Linskens EJ, MacDonald R .
Benefits and harms of prescription drugs and supplements for treatment of clinical Alzheimer-type dementia
Ann Intern Med 2020 May 19;172(10):656-68. doi: 10.7326/m19-3887..
Keywords: Elderly, Dementia, Neurological Disorders, Medication, Vitamins and Supplements, Patient-Centered Outcomes Research, Evidence-Based Practice, Adverse Drug Events (ADE), Adverse Events, Outcomes, Treatments
Cheng TL, Mistry KB, Wang G
Folate nutrition status in mothers of the Boston birth cohort, sample of a US urban low-income population.
Researchers examined maternal folic acid supplementation and plasma folate concentrations in the Boston Birth Cohort, a predominantly urban, low-income, minority population. Their findings indicated that fewer than 5 percent of mothers in the Boston Birth Cohort started folic acid supplements before pregnancy, and approximately one third of mothers had either too low or too high plasma folate levels.
AHRQ-authored.
Citation: Cheng TL, Mistry KB, Wang G .
Folate nutrition status in mothers of the Boston birth cohort, sample of a US urban low-income population.
Am J Public Health 2018 Jun;108(6):799-807. doi: 10.2105/ajph.2018.304355.
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Keywords: Nutrition, Pregnancy, Low-Income, Urban Health, Vitamins and Supplements
Rizvi RF, Adam TJ, Lindemann EA
Comparing existing resources to represent dietary supplements.
Dietary supplements (DS) are widely consumed despite limited knowledge around their safety/efficacy and any well-established regulatory policies. In this pilot study, five DS resources were evaluated and compared both quantitatively and qualitatively. The authors found fragmented and inconsistent distribution of DS representation in terms of essential data elements across five resources.
AHRQ-funded; HS022085.
Citation: Rizvi RF, Adam TJ, Lindemann EA .
Comparing existing resources to represent dietary supplements.
AMIA Jt Summits Transl Sci Proc 2018 May 18;2017:207-16..
Keywords: Comparative Effectiveness, Nutrition, Patient Safety, Vitamins and Supplements
Spatz ES, Wang Y, Beckman AL
Traditional Chinese medicine for acute myocardial infarction in western medicine hospitals in China.
This study examined the use of traditional Chinese medicine (TCM) in patients admitted for acute myocardial infarction (AMI) in China during the first 24 hours of hospitalization. The data came from the China Patient-centered Evaluative Assessment of Cardiac Events Retrospective Study of Acute Myocardial Infarction. A chart review was done of randomly sampled patients in 2001, 2006 and 2011 in 162 Western medicine hospitals across China. Nearly all (99%) hospitals used some form of TCM, with Salvia miltiorrhiza being the most commonly prescribed. This TCM treatment (and others) was used intravenously and use has increased over the span of the study, despite lack of evidence of benefit or harm.
AHRQ-funded; HS023000.
Citation: Spatz ES, Wang Y, Beckman AL .
Traditional Chinese medicine for acute myocardial infarction in western medicine hospitals in China.
Circ Cardiovasc Qual Outcomes 2018 Mar;11(3):e004190. doi: 10.1161/circoutcomes.117.004190..
Keywords: Adverse Events, Cardiovascular Conditions, Complementary and Alternative Medicine, Heart Disease and Health, Hospitals, Mortality, Outcomes, Patient-Centered Outcomes Research, Patient Safety, Practice Patterns, Risk, Vitamins and Supplements
Butler M, Nelson VA, Davila H
Over-the-counter supplement interventions to prevent cognitive decline, mild cognitive impairment, and clinical Alzheimer-type dementia: a systematic review.
This review summarizes the evidence on efficacy and harms of over-the-counter (OTC) supplements to prevent or delay cognitive decline, mild cognitive impairment (MCI), or clinical Alzheimer-type dementia in adults with normal cognition or MCI but no dementia diagnosis. It concluded that evidence is insufficient to recommend any OTC supplement for cognitive protection in adults with normal cognition or MCI.
AHRQ-funded; 290201500008I.
Citation: Butler M, Nelson VA, Davila H .
Over-the-counter supplement interventions to prevent cognitive decline, mild cognitive impairment, and clinical Alzheimer-type dementia: a systematic review.
Ann Intern Med 2018 Jan 2;168(1):52-62. doi: 10.7326/m17-1530.
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Keywords: Comparative Effectiveness, Dementia, Patient-Centered Outcomes Research, Prevention, Vitamins and Supplements
Chilukuri N, Cheng TL, Psoter KJ
Effectiveness of a pediatric primary care intervention to increase maternal folate use: results from a cluster randomized controlled trial.
This study assessed the impact of provision of folate vitamins and a preconception health intervention on folate use among a group of mostly African-American and low-income mothers bringing infants to pediatric primary care. It found that among all participants, daily vitamin intake increased from baseline to 6-month follow-up (33.8 percent vs 42.6 percent).
AHRQ-authored.
Citation: Chilukuri N, Cheng TL, Psoter KJ .
Effectiveness of a pediatric primary care intervention to increase maternal folate use: results from a cluster randomized controlled trial.
J Pediatr 2018 Jan;192:247-52.e1. doi: 10.1016/j.jpeds.2017.09.020.
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Keywords: Maternal Care, Patient Adherence/Compliance, Social Determinants of Health, Primary Care, Vitamins and Supplements
Fan Y, Adam TJ, McEwan R
Detecting signals of interactions between warfarin and dietary supplements in electronic health records.
This study detected signals of interactions between warfarin and seven dietary supplements, viz., alfalfa, garlic, ginger, ginkgo, ginseng, St. John's Wort, and Vitamin E by analyzing structured clinical data and unstructured clinical notes from the University of Minnesota Clinical Data Repository. There was a statistically significant association of warfarin concurrently used with supplements which can potentially increase the risk of adverse events, such as gastrointestinal bleeding.
AHRQ-funded; HS022085.
Citation: Fan Y, Adam TJ, McEwan R .
Detecting signals of interactions between warfarin and dietary supplements in electronic health records.
Stud Health Technol Inform 2017;245:370-74.
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Keywords: Adverse Drug Events (ADE), Blood Thinners, Electronic Health Records (EHRs), Medication, Vitamins and Supplements
Kemper AR, Fan T, Grossman DC
Gaps in evidence regarding iron deficiency anemia in pregnant women and young children: summary of US Preventive Services Task Force recommendations.
The USPSTF found insufficient evidence to recommend routine iron supplementation for pregnant women or routine screening for iron deficiency anemia in pregnant women or young children. The USPSTF identified a critical evidence gap that is related to whether changing hematologic indexes in otherwise asymptomatic pregnant women or in infants within populations who are reflective of the United States leads to an improvement in maternal or child health outcomes.
AHRQ-authored.
Citation: Kemper AR, Fan T, Grossman DC .
Gaps in evidence regarding iron deficiency anemia in pregnant women and young children: summary of US Preventive Services Task Force recommendations.
Am J Clin Nutr 2017 Dec;106(Suppl 6):1555s-58s. doi: 10.3945/ajcn.117.155788.
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Keywords: Children/Adolescents, Evidence-Based Practice, Pregnancy, U.S. Preventive Services Task Force (USPSTF), Vitamins and Supplements
Balk EM, Lichtenstein AH
Omega-3 fatty acids and cardiovascular disease: summary of the 2016 Agency of Healthcare Research and Quality evidence review.
The authors summarize the 2016 update of the 2004 Agency of Healthcare Research and Quality's evidence review of omega-3 fatty acids and cardiovascular disease (CVD). The overall findings for the effects of marine oil supplements on intermediate CVD outcomes remain largely unchanged. The strongest effect of marine oils is on triglyceride concentrations.
AHRQ-funded; 290201500002I.
Citation: Balk EM, Lichtenstein AH .
Omega-3 fatty acids and cardiovascular disease: summary of the 2016 Agency of Healthcare Research and Quality evidence review.
Nutrients 2017 Aug 11;9(8). doi: 10.3390/nu9080865.
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Keywords: Cardiovascular Conditions, Comparative Effectiveness, Evidence-Based Practice, Patient-Centered Outcomes Research, Vitamins and Supplements
Koronkowski MJ, Semla TP, Schmader KE
Recent literature update on medication risk in older adults, 2015-2016.
Medications can pose considerable risk in older adults. This article intended to provide a narrative review of key publications in medication safety for clinicians and researchers committed to improving medication safety in older adults. It annotates four articles addressing this concern from 2016.
AHRQ-funded; HS023779.
Citation: Koronkowski MJ, Semla TP, Schmader KE .
Recent literature update on medication risk in older adults, 2015-2016.
J Am Geriatr Soc 2017 Jul;65(7):1401-05. doi: 10.1111/jgs.14887.
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Keywords: Elderly, Medication, Risk, Adverse Drug Events (ADE), Vitamins and Supplements
Sathe N, Andrews JC, McPheeters ML
Nutritional and dietary interventions for autism spectrum disorder: a systematic review.
The objective of this study was to evaluate the effectiveness and safety of dietary interventions or nutritional supplements in autism spectrum disorder (ASD). Since the studies reviewed were small and short-term, and there were few fully categorized populations or concomitant interventions, the researchers concluded that there is little evidence to support the use of nutritional supplements or dietary therapies for children with ASD.
AHRQ-funded; 290201500003I.
Citation: Sathe N, Andrews JC, McPheeters ML .
Nutritional and dietary interventions for autism spectrum disorder: a systematic review.
Pediatrics 2017 Jun;139(6):e20170346. doi: 10.1542/peds.2017-0346.
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Keywords: Evidence-Based Practice, Nutrition, Vitamins and Supplements, Autism
Viswanathan M, Treiman KA, Kish-Doto J
Folic acid supplementation for the prevention of neural tube defects: an updated evidence report and systematic review for the US Preventive Services Task Force.
This report reviewed the evidence on folic acid supplementation for preventing neural tube defects to inform the US Preventive Services Task Force for an updated Recommendation Statement. In studies conducted before the initiation of food fortification in the United States in 1998, folic acid supplementation provided protection against neural tube defects. Newer postfortification studies have not demonstrated a protective association but have the potential for misclassification and recall bias.
AHRQ-funded; 290201200015I.
Citation: Viswanathan M, Treiman KA, Kish-Doto J .
Folic acid supplementation for the prevention of neural tube defects: an updated evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2017 Jan 10;317(2):190-203. doi: 10.1001/jama.2016.19193.
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Keywords: U.S. Preventive Services Task Force (USPSTF), Pregnancy, Prevention, Evidence-Based Practice, Vitamins and Supplements
Lee S, Teschemaker AR, Daniel M
Calcium and vitamin D use among older adults in U.S.: results from national survey.
The investigators conducted this study to describe a 10-year trend of calcium and vitamin D use from 2000 to 2009 and to evaluate age, gender, and racial disparities using national level health data. They found variability in the access to the medications, despite the observed increases associated with calcium and vitamin D supplements.
AHRQ-funded; HS011673.
Citation: Lee S, Teschemaker AR, Daniel M .
Calcium and vitamin D use among older adults in U.S.: results from national survey.
J Nutr Health Aging 2016 Mar;20(3):300-5. doi: 10.1007/s12603-015-0614-9.
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Keywords: Disparities, Racial and Ethnic Minorities, Sex Factors, Vitamins and Supplements
Fan T, Blitz J
Screening for iron deficiency anemia and iron supplementation in pregnant women to improve maternal health and birth outcomes.
This case study quiz involves a 28-year-old woman presents for a routine antepartum visit. She is 33 weeks pregnant and also has a four-year-old son. She has no particular problems, and the findings from your examination are unremarkable. She asks if her blood iron level should be tested. Based on the recommendations of the U.S. Preventive Services Task Force, the quiz asks 3 questions involving screening and treatment.
AHRQ-authored.
Citation: Fan T, Blitz J .
Screening for iron deficiency anemia and iron supplementation in pregnant women to improve maternal health and birth outcomes.
Am Fam Physician 2016 Jan 15;93(2):137-8..
Keywords: Vitamins and Supplements, Pregnancy, Case Study, U.S. Preventive Services Task Force (USPSTF)
Zhang R, Manohar N, Arsoniadis E
Evaluating term coverage of herbal and dietary supplements in electronic health records.
Some supplements can interact with prescription medications, potentially leading to clinically important and potentially preventable adverse reactions. Clinical notes and corresponding medication lists from an integrated healthcare system were extracted and compared with online databases. The authors found that, overall, about 40% of listed medications are supplements, most of which are included in medication lists as nutritional or miscellaneous products. They found gaps between supplement and standard medication terminologies and identified supplements which were not mentioned in the medication lists.
AHRQ-funded; HS022085.
Citation: Zhang R, Manohar N, Arsoniadis E .
Evaluating term coverage of herbal and dietary supplements in electronic health records.
AMIA Annu Symp Proc 2015 Nov 5;2015:1361-70.
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Keywords: Adverse Drug Events (ADE), Data, Electronic Health Records (EHRs), Medication, Vitamins and Supplements
Singh JA, Bharat A, Edwards NL
An internet survey of common treatments used by patients with gout including cherry extract and juice and other dietary supplements.
The researchers aimed to assess the prevalent use of cherry extract/products and other supplements by gout patients and the characteristics of these patients. They found that almost 50 percent of gout patients used cherry extract, juice or other supplements. Twenty-seven percent of men and 18 percent of women reported using other food items/natural supplements.
AHRQ-funded; HS021110.
Citation: Singh JA, Bharat A, Edwards NL .
An internet survey of common treatments used by patients with gout including cherry extract and juice and other dietary supplements.
J Clin Rheumatol 2015 Jun;21(4):225-6. doi: 10.1097/rhu.0000000000000246..
Keywords: Vitamins and Supplements, Comparative Effectiveness, Centers for Education and Research on Therapeutics (CERTs)
Wang JW, Hogan PG, Hunstad DA
Vitamin D sufficiency and Staphylococcus aureus infection in children.
Vitamin D sufficiency may be one of a myriad of host and environmental factors that can be directly impacted to reduce the frequency of S. aureus skin and soft tissue infection. The researchers found that children with vitamin D deficiency or insufficiency [25-hydroxyvitamin D <30 ng/mL] were more likely to present with recurrent, rather than primary, S. aureus skin or soft tissue infection.
AHRQ-funded; HS021736.
Citation: Wang JW, Hogan PG, Hunstad DA .
Vitamin D sufficiency and Staphylococcus aureus infection in children.
Pediatr Infect Dis J 2015 May;34(5):544-5. doi: 10.1097/inf.0000000000000667..
Keywords: Vitamins and Supplements, Children/Adolescents
Cantor AG, Bougatsos C, Blazina I
Routine iron supplementation and screening for iron deficiency anemia in pregnancy: a systematic review for the U.S. Preventive Services Task Force.
This study reviews screening and supplementation for iron deficiency anemia in pregnancy. Prevalence in the U.S. rises to 28.4 percent in the final trimester from 5 percent in early pregnancy. There is inconclusive evidence that prenatal iron supplementation improves maternal or infant health outcomes, but supplementation may improve maternal hematological indices.
AHRQ-funded; 290201200015I
Citation: Cantor AG, Bougatsos C, Blazina I .
Routine iron supplementation and screening for iron deficiency anemia in pregnancy: a systematic review for the U.S. Preventive Services Task Force.
Ann Intern Med. 2015 Apr 21;162(8):566-76. doi: 10.7326/m14-2932..
Keywords: U.S. Preventive Services Task Force (USPSTF), Pregnancy, Vitamins and Supplements, Screening
McDonagh MS, Blazina I, Dana T
Screening and routine supplementation for iron deficiency anemia: a systematic review.
The goal of this study was to review the evidence regarding the benefits and harms of screening and routine supplementation for IDA for the US Preventive Services Task Force. It found that no studies assessed the benefits or harms of screening or the association between improvement in impaired iron status and clinical outcomes.
AHRQ-funded; 290201200015I.
Citation: McDonagh MS, Blazina I, Dana T .
Screening and routine supplementation for iron deficiency anemia: a systematic review.
Pediatrics 2015 Apr;135(4):723-33. doi: 10.1542/peds.2014-3979..
Keywords: U.S. Preventive Services Task Force (USPSTF), Children/Adolescents, Screening, Vitamins and Supplements
