Meyers et al1 recently reviewed the safety of antioxidant vitamins and asserted that the antioxidants are safe. Recent clinical studies, however, suggest that a more circumspect approach regarding their administration is warranted, especially since supplementation usage may be as high as 40% in the US population.1
The Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study, a randomized, 2×2 factorial trial of antioxidants in 29 133 Finnish middle-aged male smokers that was designed to test the efficacy of α-tocopherol (50 mg/d) and β-carotene (20 mg/d) in the prevention of lung cancer, demonstrated an apparent excess of deaths from lung cancer and ischemic heart disease in those treated with β-carotene.2 In addition, there was a possible increased risk of hemorrhagic stroke in the α-tocopherol— treated group when compared with the placebo-treated group.
The Beta-Carotene and Retinol Efficacy Trial, a multicenter, randomized, double-blind, placebo-controlled primary prevention trial involving 18314 smokers, former smokers, and