Höchstmengen für Vitamine und Mineralstoffe in Nahrungsergänzungsmitteln

Dietary supplement intake in women with breast cancer before and after diagnosis: results from the SUCCESS C trial

BACKGROUND

There is little evidence that dietary supplements are beneficial for patients with breast cancer; therefore, they are usually not recommended by treatment guidelines. The aim of the present analysis was to assess the prevalence of dietary supplement (DS) intake among women before and after a breast cancer diagnosis.

METHODS

Participants in the SUCCESS C lifestyle intervention study, a randomized controlled trial in women with newly diagnosed intermediate- to high-risk breast cancer, completed two questionnaires on dietary supplement intake 24 months (QS1) and 48 months (QS2) after beginning the lifestyle intervention. The study was registered on 12.17.2008 under the EU Clinical Trials Register https://www.clinicaltrialsregister.eu/ , trial registration number: 2008-005453-38. The questionnaires collected data on DS intake during the 5-year period prediagnosis (QS1) and in the period postdiagnosis (QS2). Multivariate logistic regression models were fitted to examine differences in DS intake between the two intervention groups. The groups were then pooled to examine differences in DS use between the prediagnostic and postdiagnostic period.

RESULTS

A total of 320 questionnaires from 58.5% of intervention group completers and 416 questionnaires from 46.6% of low-level intervention group completers were included in the analysis. Overall, 20.2% of all respondents reported taking DS prior to their diagnosis. After a cancer diagnosis, the percentage of women taking DS significantly increased to 56.4% (p for time effect < 0.0001). No differences in DS intake between the intervention groups were observed. Single or combined preparations of vitamins and minerals/trace elements were the most frequently reported supplements. Notably, a 9-fold increase in vitamin D intake was reported postdiagnosis, where the proportion of women increased from 3.8 to 34.5%.

CONCLUSION

A 3-fold increase in the reported intake of dietary supplements was seen in women after a breast cancer diagnosis. These observations underscore the need to incorporate patient education surrounding the use of dietary supplements in a treatment care plan, particularly addressing the negligible benefits as well as the potential risks and treatment interactions.

Long-term dietary exposure to copper in the population in Germany – Results from the BfR MEAL study

The German Total Diet Study (BfR MEAL Study) measured copper in 356 foods. In 105 of these foods copper was determined separately for conventionally and organically pooled samples. Mammalian liver, nuts, oilseeds, cocoa powder and chia seeds contained the highest copper levels. Organically produced foods tended to have higher levels compared to conventionally produced foods. Children's copper exposure was between 0.04 mg/kg body weight per day (mg/kg bw/day) and 0.07 mg/kg bw/day (median). High exposure (95th percentile) ranged between 0.07 mg/kg bw/day and 0.11 mg/kg bw/day. Adult's exposure ranged between 0.02 mg/kg bw/day (median) and 0.04 mg/kg bw/day (95th percentile). Grains and grain-based products were main contributors for all age groups. Copper intake was about 10% higher in a scenario where consumers select the organically produced variants. Children's median and high exposure was above the acceptable daily intake (ADI) of 0.07 mg/kg bw/day set by the European Food Safety Authority (EFSA). However, according to EFSA's evaluation this is not of concern due to higher requirement related to growth. For adults, frequent consumers of mammalian liver exceeded the ADI in median and 95th percentile. Intake of copper-containing dietary supplements may also lead to exceedance of the ADI in all age groups.

Short-term zinc supplementation of zinc-deficient seniors counteracts CREMα - mediated IL-2 suppression

Background

Aging is accompanied by a dramatic decline in the interleukin (IL)-2 production capacity of human immune cells, thus making seniors more susceptible to a variety of age-related diseases. A common cause of impaired cytokine production in advanced age is a deficiency of the essential micronutrient zinc. Nevertheless, the molecular mechanisms underlying a zinc deficiency-induced decrease in IL-2 production have not yet been satisfactorily elucidated. Recent animal and in vitro data suggested that the transcription factor cAMP-responsive element modulator (CREM) \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\alpha$$\end{document}α plays a critical role in T cells´ disturbed IL-2 production in suboptimal zinc conditions. However, its role in the human aging process and the possibility of influencing this detrimental process by short-term zinc supplementation have not yet been evaluated.

Results

Comparing peripheral lymphocytes of 23 young and 31 elderly subjects with either high, intermediate, or deficient zinc status, we observed zinc-dependent regulation of the IL-2 production mediated by the transcription factor CREM \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\alpha$$\end{document}α. For the first time in humans, we report a mutual relationship between low zinc levels, high CREM \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\alpha$$\end{document}α expression, subsequent impaired IL-2 production, and vice versa. Remarkably, an average of only 6 days of in vivo zinc supplementation to zinc-deficient seniors was sufficient to rapidly improve zinc status, reverse CREM \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\alpha$$\end{document}α overexpression, and counteract subsequent low IL-2 production rates.

Conclusions

Our ex vivo and in vivo data identify zinc deficiency-mediated CREM \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\alpha$$\end{document}α overexpression as a key cellular mechanism underlying impaired IL-2 production in the elderly and point toward the use of zinc as a rapidly immune-enhancing add-on nutraceutical in geriatric therapy.

Graphical abstract

During the aging process, there is a progressive decrease in zinc status, which in turn leads to overexpression of the transcription factor CREM\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\mathrm{\alpha }$$\end{document}α in peripheral lymphocytes. CREMα is a negative regulator of the IL-2 gene, the overexpression of which dramatically limits adequate IL-2 production. This deleterious mechanism can be counteracted by short-term oral zinc administration, which can adjust IL-2 production in old, zinc-deficient individuals to a level similar to that of young adults.

Vitamin Substitution Beyond Childhood—Requirements and Risks

BACKGROUND

Vitamins are vitally important, but they are not always adequately supplied with the diet. In this review, we present the advantages and disadvantages of vitamin supplementation and the indications for it in various life situations.

METHODS

This review is based on pertinent publications retrieved by a selective search of the literature.

RESULTS

The German National Nutrition Survey II (Nationale Verzehrsstudie II) showed that most people in Germany consume adequate amounts of vitamins in their diet, with the exception of vitamin D and folate. Supplements are often taken by adults who already consume a balanced diet. Depending on the vitamin, 3-13% of survey respondents took vitamin supplements; the ones most often taken were vitamins C and E. No convincing evidence has yet demonstrated a health benefit from vitamin supplementation in addition to a balanced diet for the primary prevention of nutrition-associated diseases. Vitamin supplementation is indicated in certain specific life situations, e.g., pregnancy, but otherwise unnecessary, unless a deficiency has been diagnosed or the individual is at elevated risk.

CONCLUSION

Vitamin supplementation is recommended for certain population groups: folic acid for pregnant women, vitamin B12 for vegans and persons with resorption disorders, vitamin D for persons with insufficient endogenous synthesis. In all other cases, it should first be tested whether the individual might be substantially helped by dietary changes alone. In general, the potential adverse effects of vitamin supplementation need to be considered, and its benefits weighed against its risks.

Use of vitamin and mineral supplements among adolescents living in Germany-Results from EsKiMo II

Dietary supplements may contribute to nutrient intake; however, actual data on dietary supplement use among adolescents living in Germany are rare. The aim of this analysis was to describe the current use of dietary supplements, its determinants, and reasons of use. Changes in supplement use over time were evaluated by comparing the results with those from EsKiMo I (2006). Data from the Eating Study as a KiGGS Module EsKiMo II (2015-2017) were used to analyze supplement intake according to sociodemographic, health characteristics, and physical exercise behavior of 12-17-year-olds (n = 1356). Supplement use during the past four weeks was assessed by a standardized computer assisted personal interview. Multivariable logistic regression was used to identify the association between supplement use and its determinants. Between 2015-2017, 16.4% (95%-CI: 13.0-19.7%) of the adolescents used dietary supplements, and its use decreased with lower levels of physical exercise and overweight. Most supplement users used only one supplement, often containing both vitamins and minerals. The most frequently supplemented nutrients were vitamin C and magnesium. The main reported reason to use supplements was 'to improve health'. Prevalence of supplement use was slightly lower in 2015-2017 than in 2006 (18.5%; 95%-CI: 15.8-21.2%). The results underline the importance of including nutrient intake through dietary supplements in nutrition surveys.