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Continuing Medical Education

After evaluating an article designated for Continuing Medical Education (CME) in the American Journal of Clinical Nutrition (AJCN), participants in the American Society for Nutrition (ASN) CME program should be able to show that their knowledge of clinical nutrition has increased. Participants should also be able to evaluate whether the clinical information provided in the CME-designated article is relevant to the provision of patient care.

Accreditation and credits

The ASN is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The ASN designates each CME program for 1 hour of category 1 credit toward the American Medical Association (AMA) Physician’s Recognition Award. Each physician should claim only those hours of credit that he or she actually spent on the education program.

Instructions

Each issue of the AJCN will usually include at least 2 articles designated for CME credit. After reading the CME-designated article, select the best answer to each exam question listed below and complete the evaluation. To receive CME credit, you should return the exam and evaluation pages along with the CME Participant Response Form by September 30, 2007. Please fax the pages to the ASN at 301-634-7351 or mail them to the following address: American Society for Nutrition, CME Program, 9650 Rockville Pike, Bethesda, MD 20814. Note that all responses must be prepaid. Answers to the questions will be mailed to all participants, and certificates of credit will be sent to participants who successfully complete each exam. Please be sure to make a photocopy of the exam for your records before submitting it to the ASN.

Article: Bleys J, Miller ER III, Pastor-Barriuso R, Appel LJ, Guallar E. Vitamin-mineral supplementation and the progression of atherosclerosis: a meta-analysis of randomized controlled trials. Am J Clin Nutr 2006;84:880–7.

One hour of category 1 credit will be issued for successful completion of this entire exam.

CME exam

1. Which statement below reflects areas of controversy regarding antioxidants and multivitamins in preventing the progression of atherosclerosis?

1. Conclusive data support the preventive effects of vitamin E, but not of vitamin B-12, on the progression of atherosclerosis.
   
2. Antioxidants generally prevent clinical atherosclerosis.
   
3. Folic acid is known to prevent the progression of atherosclerosis through homocysteine lowering.
   
4. All of the above are correct.
   
5. None of the above are correct.
   

2. Which method below has provided conclusive evidence that antioxidants such as vitamins E and C, ß-carotene, and selenium can diminish the clinical progression of atherosclerosis?

1. In vitro studies
   
2. Clinical trials showing protection against cardiovascular endpoints or mortality
   
3. Cross-sectional epidemiologic studies of supplement users compared with nonusers
   
4. Imaging measurements of atherosclerosis progression
   
5. None of the above
   

3. Why would a combination of supplemental vitamin B-12, folate, and vitamin B-6 be presumed to reduce the progression of atherosclerosis?

1. All vitamins contribute to the lowering of homocysteine, a compound shown to be elevated in clinical cardiovascular disease.
   
2. Folate in high doses reduces the incidence of cardiovascular events.
   
3. Vitamin B-12 deficiency is more common in patients who have experienced cardiovascular events.
   
4. All of the above.
   

4. On the basis of the cited study, which guideline below is available to the practitioner?

1. Conclusive evidence exists that ß-carotene and vitamin E supplementation decreases the likelihood of recurrence of a myocardial infarction.
   
2. Amultivitamin containing folate, vitamin B-6, and vitamin B-12 will reduce the likelihood of recurrence of a myocardial infarction.
   
3. Supplemental use of an antioxidant such as vitamin E together with a homocysteine-lowering agent, such as folic acid, will reduce the likelihood of recurrence of a myocardial infarction.
   
4. No conclusive data support the potential benefits of supplemental antioxidant or homocysteine-lowering agents in preventing the recurrence of a myocardial infarction.
   

CME exam evaluation

1. Were the CME program objectives successfully met?

1. Yes
   
2. No
   
3. Partially (please explain)
   

2. Did you find this article and its CME questions relevant to your practice?

1. Yes
   
2. No
   
3. Partially (please explain)
   

3. Will completion of this CME exam affect the way that you treat your patients?

1. Yes (please explain)
   
2. No
   

4. Was the information presented in this article objective, balanced, and free of commercial bias?

1. Yes
   
2. No
   

Comments

Related articles in AJCN:

Vitamin-mineral supplementation and the progression of atherosclerosis: a meta-analysis of randomized controlled trials

Joachim Bleys, Edgar R Miller, III, Roberto Pastor-Barriuso, Lawrence J Appel, and Eliseo Guallar
AJCN 2006 84: 880-887. [Abstract] [Full Text]  

This Article Full Text (PDF) Purchase Article View Shopping Cart Alert me when this article is cited Alert me if a correction is posted Services Related articles in AJCN Similar articles in this journal Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Search for Related Content