On 2017 Jan 23, Harri Hemila commented:

Vitamin E may increase and decrease all-cause mortality in subgroups of males

Galli F, 2017 claimed that supplementation with vitamin E may have no effect on all-cause mortality even at supra-nutritional doses. They did not consider the strong evidence from the ATBC Study, which indicates that the effects of vitamin E on all-cause mortality appear to be heterogeneous.

The ATBC Study investigated 29 133 male smokers, and Hemilä H, 2009 showed that the effect of vitamin E on all-cause mortality was simultaneously modified by age and dietary vitamin C intake with P = 0.0005 for the test of heterogeneity. Vitamin E had no influence on mortality in males who had a low dietary intake of vitamin C. However, among males who had a high intake of vitamin C, supplementation with vitamin E increased mortality by 19% among those who were 50-62 years at the baseline of the trial, whereas it decreased mortality by 41% among those who were 66 years and older. The decrease in mortality amongst the oldest participants suggested that vitamin E might increase life span, and indeed, men that were administered vitamin E lived for half a year longer at the upper end of the follow-up age range, see Hemilä H, 2011.

Galli F, 2017 further also claimed that vitamin E intake is unlikely to affect mortality regardless of dose, and they referred to the Bayesian meta-analysis on vitamin E by Berry D, 2009. However, Galli et al. overlooked that the Bayesian meta-analysis was based on between-trial analysis, whereas the evidence for heterogeneity in vitamin E effect in the ATBC Study was based on individual participant level analysis, a much more reliable analysis Hemilä H, 2009. Between-study analysis may suffer from ecological fallacy. Galli et al. also disregarded other detailed criticisms of the Berry et al. meta-analysis on vitamin E by Greenland S, 2009 and Miller ER 3rd, 2009.

Galli F, 2017 concluded that since an indiscriminate vitamin E supplementation is not supported by the available evidence, future efforts are necessary to establish biomarkers and selection criteria to predict who is likely to benefit from vitamin E supplementation. However, the ATBC Study analyses indicate that age and responses to life style questionnaires may characterize people who benefit of vitamin E administration. It seems illogical therefore that the variables already identified in the ATBC Study analyses were not considered in the review by Galli et al.

On 2017 Jan 23, Harri Hemila commented:

Vitamin E may increase and decrease all-cause mortality in subgroups of males

Galli F, 2017 claimed that supplementation with vitamin E may have no effect on all-cause mortality even at supra-nutritional doses. They did not consider the strong evidence from the ATBC Study, which indicates that the effects of vitamin E on all-cause mortality appear to be heterogeneous.

The ATBC Study investigated 29 133 male smokers, and Hemilä H, 2009 showed that the effect of vitamin E on all-cause mortality was simultaneously modified by age and dietary vitamin C intake with P = 0.0005 for the test of heterogeneity. Vitamin E had no influence on mortality in males who had a low dietary intake of vitamin C. However, among males who had a high intake of vitamin C, supplementation with vitamin E increased mortality by 19% among those who were 50-62 years at the baseline of the trial, whereas it decreased mortality by 41% among those who were 66 years and older. The decrease in mortality amongst the oldest participants suggested that vitamin E might increase life span, and indeed, men that were administered vitamin E lived for half a year longer at the upper end of the follow-up age range, see Hemilä H, 2011.

Galli F, 2017 further also claimed that vitamin E intake is unlikely to affect mortality regardless of dose, and they referred to the Bayesian meta-analysis on vitamin E by Berry D, 2009. However, Galli et al. overlooked that the Bayesian meta-analysis was based on between-trial analysis, whereas the evidence for heterogeneity in vitamin E effect in the ATBC Study was based on individual participant level analysis, a much more reliable analysis Hemilä H, 2009. Between-study analysis may suffer from ecological fallacy. Galli et al. also disregarded other detailed criticisms of the Berry et al. meta-analysis on vitamin E by Greenland S, 2009 and Miller ER 3rd, 2009.

Galli F, 2017 concluded that since an indiscriminate vitamin E supplementation is not supported by the available evidence, future efforts are necessary to establish biomarkers and selection criteria to predict who is likely to benefit from vitamin E supplementation. However, the ATBC Study analyses indicate that age and responses to life style questionnaires may characterize people who benefit of vitamin E administration. It seems illogical therefore that the variables already identified in the ATBC Study analyses were not considered in the review by Galli et al.