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Beta carotene, Vit E ineffective in COPD |
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Clinical Question: Do Vitamin E or beta carotene supplements improve symptoms in patients with COPD? Bottom Line: Beta−carotene and vitamin E supplements provide no benefit in symptoms of COPD, BUT, a diet rich in these nutrients is associated with a lower risk of developing COPD. This should make us stop thinking about single dietary components as a preventive and look at the 'total package'. These lessons probably carry over to heart disease prevention and other conditions. Reference: Rautalahati M, Virtamo J, Haukka J, et al. The effect of alpha−tocopherol and beta−carotene supplementation on COPD symptoms. Am J Resp CC Med 1997;156:1447−1452. Study Design: Randomized controlled trial (double−blinded) Synopsis: This is a spin−off of a clinical trial of Vitamin E or beta−carotene to prevent cancer among 29,133 male smokers. While the main results were disheartening (beta−carotene was associated with an INCREASED cancer risk), the investigators are looking for other potential benefits. They initially assessed dietary intake of beta−carotene and Vitamin E. They randomly assigned the subjects to receive vitamin E or beta−carotene in a factorial design (vitamin E plus beta−carotene placebo, vitamin E placebo plus beta−carotene, vitamin E plus beta−carotene, or placebo plus placebo). They evaluated respiratory symptoms at baseline and throughout the study. They also studied the baseline prevalence of COPD in relation to dietary intake of beta−carotene and vitamin E. Interestingly, a diet rich in vitamin E or beta−carotene was associated with a lower risk of chronic bronchitis (OR 0.87 and 0.78 respectively) and dyspnea (OR 0.77 and 0.67 respectively). These also correlated with high serum levels of these nutrients. When he subjects were supplemented with vitamin E or beta−carotene (or both), there was no beneficial effect on respiratory symptoms!
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