Vitamin E supplements should not be recommended to people with coronary heart disease but such patients should be advised to eat more oily fish, according to Ms Lee Hooper (dietitian, Princess Royal hospital, Telford) and colleagues.
In a letter to the Lancet (1999;354:1557), Ms Hooper reports the results of a meta-analysis of vitamin E and fish oils trials in people with coronary heart disease. A substantial survival benefit from vitamin E was found to be unlikely and the supplement may even be "modestly harmful". In contrast, fish oil supplements, or an increased dietary intake of oily fish, had a significant protective effect.