A systematic review and meta-analysis of randomized controlled intervention trials of micronutrients on cardiovascular disease (CVD) and clinical events concluded that some but not all micronutrients may be beneficial. The analysis identified a total of 884 randomized controlled intervention trials evaluating 27 types of micronutrients among 883,627 participants (4,895,544 person-years). There was moderate- to high-quality evidence of benefit for micronutrients with important pleiotropic effects in addition to antioxidant capacity. Specifically, n-3 fatty acid supplementation decreased CVD mortality (relative risk [RR]: 0.93), myocardial infarction (RR: 0.85), and coronary heart disease events (RR: 0.86). Folic acid supplementation decreased stroke risk (RR: 0.84). Coenzyme Q10 supplementation decreased all-cause mortality (RR: 0.68). Vitamin C, D, E, and selenium showed no effect on risk of CVD or type 2 diabetes. β-carotene supplementation even increased all-cause (RR: 1.10) and CVD mortality (RR: 1.12), and stroke risk (RR: 1.09). The findings open interesting perspectives for CVD prevention and highlight the importance of micronutrient diversity and the balance of benefits and risks. Source: https://www.jacc.org/