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Behrendt I, Eichner G, Fasshauer M. Association of Antioxidants Use with All-Cause and Cause-Specific Mortality: A Prospective Study of the UK Biobank. Antioxidants (Basel) 2020; 9:E1287. [PMID: 33339307 PMCID: PMC7766648 DOI: 10.3390/antiox9121287] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 12/07/2020] [Accepted: 12/14/2020] [Indexed: 11/22/2022] Open
Abstract
Prospective studies and randomized controlled trials elucidating the impact of antioxidants supplementation on mortality risk are inconclusive. The present analysis determined association between regular antioxidants use and all-cause (primary objective), as well as cause-specific, mortality in 345,626 participants of the UK Biobank cohort using Cox proportional hazard models. All models were adjusted for confounders and multiple testing. Antioxidants users were defined as participants who indicated to regularly use at least one of the following: multivitamins, vitamin C, vitamin E, selenium, and zinc. Median age of antioxidants users (n = 101,159) and non-users (n = 244,467) at baseline was 57 years. During 3.9 million person-years and a median follow-up of 11.5 years, 19,491 deaths occurred. Antioxidants use was not significantly associated with all-cause, cancer, and non-cancer mortality including several cancer and non-cancer subtypes. Interestingly, mortality risk from respiratory disease was significantly 21% lower among antioxidants users as compared to non-users (hazard ratio: 0.79; 95% confidence interval: 0.67, 0.92). In conclusion, the present study findings do not support recommendations for antioxidants supplementation to prevent all-cause, cancer, or non-cancer mortality on a population level. The significant inverse association between antioxidants use and respiratory disease mortality needs further study.
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Affiliation(s)
- Inken Behrendt
- Institute of Nutritional Science, Justus-Liebig University of Giessen, 35390 Giessen, Germany;
| | - Gerrit Eichner
- Mathematical Institute, Justus-Liebig University of Giessen, 35392 Giessen, Germany;
| | - Mathias Fasshauer
- Institute of Nutritional Science, Justus-Liebig University of Giessen, 35390 Giessen, Germany;
- Department of Internal Medicine (Endocrinology, Nephrology, and Rheumatology), University of Leipzig, 04103 Leipzig, Germany
- Leipzig University Medical Center, IFB AdiposityDiseases, 04103 Leipzig, Germany
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2
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Das A, Hsu MSH, Rangan A, Hirani V. Dietary or supplemental intake of antioxidants and the risk of mortality in older people: A systematic review. Nutr Diet 2020; 78:24-40. [DOI: 10.1111/1747-0080.12611] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2019] [Revised: 02/06/2020] [Accepted: 02/09/2020] [Indexed: 12/26/2022]
Affiliation(s)
- Arpita Das
- School of Life and Environmental Science, Charles Perkins Centre The University of Sydney Sydney New South Wales Australia
| | - Michelle S. H. Hsu
- South Eastern Sydney Local Health District (SESLHD) Caringbah New South Wales Australia
| | - Anna Rangan
- School of Life and Environmental Science, Charles Perkins Centre The University of Sydney Sydney New South Wales Australia
| | - Vasant Hirani
- School of Life and Environmental Science, Charles Perkins Centre The University of Sydney Sydney New South Wales Australia
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Different Socio-Demographic and Lifestyle Factors Can Determine the Dietary Supplement Use in Children and Adolescents in Central-Eastern Poland. Nutrients 2019; 11:nu11030658. [PMID: 30889923 PMCID: PMC6470763 DOI: 10.3390/nu11030658] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Revised: 03/12/2019] [Accepted: 03/13/2019] [Indexed: 12/31/2022] Open
Abstract
Vitamin/mineral supplement (VMS) use has become increasingly popular in children and adolescents; however, different predictors may be associated with their usage. Therefore, the aim of this study was to compare determinants of VMS use in 1578 children and adolescents. Data was collected among parents of children (≤12 years old) and among adolescents (>12 years old) who attended public schools by a self-administered questionnaire. Multivariate-adjusted logistic regression models were used to estimate odds ratios (ORs) and 95% confidence intervals (95% CIs) for determining the predictors of VMS use. In children, the following determinants of VMS use were indicated: socioeconomic status (average vs. very good/good; OR: 1.69, 95% CI: 1.16–2.48), physical activity (1–5 vs. <1 h/week; OR: 1.44, 95% CI: 1.02–2.04), BMI (≥25 vs. 18.5–24.9 kg/m2; OR: 0.67, 95% CI: 0.46–0.98), and presence of chronic diseases (yes vs. no; OR: 2.32, 95% CI: 1.46–3.69). In adolescents, gender (male vs. female; OR: 0.56, 95% CI: 0.37–0.87), residential area (rural vs. urban; OR: 0.63, 95% CI: 0.40–0.99), BMI (<18.5 vs. 18.5–24.9 kg/m2; OR: 0.35, 95% CI: 0.17–0.73), and health status (average/poor vs. at least good; OR: 1.96, 95% CI: 1.13–3.39) were factors of VMS use. In both groups, the mother’s higher educational level, fortified food consumption and diet modification towards better food choices were predictors of VMS use. In conclusion, most of the predictors of VMS use were different in children and adolescents.
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Turck D, Bresson JL, Burlingame B, Dean T, Fairweather-Tait S, Heinonen M, Hirsch-Ernst KI, Mangelsdorf I, McArdle HJ, Naska A, Nowicka G, Pentieva K, Sanz Y, Siani A, Sjödin A, Stern M, Tomé D, Van Loveren H, Vinceti M, Willatts P, Lamberg-Allardt C, Przyrembel H, Tetens I, Dumas C, Fabiani L, Forss AC, Ioannidou S, Neuhäuser-Berthold M. Dietary Reference Values for riboflavin. EFSA J 2017; 15:e04919. [PMID: 32625611 PMCID: PMC7010026 DOI: 10.2903/j.efsa.2017.4919] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Following a request from the European Commission, the EFSA Panel on Dietetic Products, Nutrition and Allergies (NDA) derives dietary reference values (DRVs) for riboflavin. The Panel considers that the inflection point in the urinary riboflavin excretion curve in relation to riboflavin intake reflects body saturation and can be used as a biomarker of adequate riboflavin status. The Panel also considers that erythrocyte glutathione reductase activation coefficient is a useful biomarker, but has limitations. For adults, the Panel considers that average requirements (ARs) and population reference intakes (PRIs) can be determined from the weighted mean of riboflavin intake associated with the inflection point in the urinary riboflavin excretion curve reported in four intervention studies. PRIs are derived for adults and children assuming a coefficient of variation of 10%, in the absence of information on the variability in the requirement and to account for the potential effect of physical activity and the methylenetetrahydrofolate reductase 677TT genotype. For adults, the AR and PRI are set at 1.3 and 1.6 mg/day. For infants aged 7-11 months, an adequate intake of 0.4 mg/day is set by upward extrapolation from the riboflavin intake of exclusively breastfed infants aged 0-6 months. For children, ARs are derived by downward extrapolation from the adult AR, applying allometric scaling and growth factors and considering differences in reference body weight. For children of both sexes aged 1-17 years, ARs range between 0.5 and 1.4 mg/day, and PRIs between 0.6 and 1.6 mg/day. For pregnant or lactating women, additional requirements are considered, to account for fetal uptake and riboflavin accretion in the placenta during pregnancy or the losses through breast milk, and PRIs of 1.9 and 2.0 mg/day, respectively, are derived.
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Kuczmarski MF, Beydoun MA, Shupe ES, Pohlig RT, Zonderman AB, Evans MK. Use of Dietary Supplements Improved Diet Quality But Not Cardiovascular and Nutritional Biomarkers in Socioeconomically Diverse African American and White Adults. J Nutr Gerontol Geriatr 2017; 36:92-110. [PMID: 28339339 PMCID: PMC5629122 DOI: 10.1080/21551197.2017.1299659] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Knowledge of the contribution of supplements to overall nutritional health is limited. The research objectives were to describe motivations for use of dietary supplements by African Americans and Whites examined in the Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) study and to determine if supplements provided beneficial effects to micronutrient diet quality and nutritional and cardiovascular biomarkers. The majority of the HANDLS study population were smokers, overweight or obese, and self-reported their health as poor to good. The top two reasons for their supplement use were to supplement the diet and to improve overall health. Micronutrient intake was calculated from two 24-hour recalls and a supplement questionnaire. Diet quality was assessed by the Mean Adequacy Ratio (MAR) [Maximum score = 100] derived from the Nutrient Adequacy Ratio (NAR) for 17 micronutrients. The MAR score for nonusers was 73.12, for supplement users based on diet alone was 74.89, and for food and supplements was 86.61. Dietary supplements significantly increased each NAR score and MAR score. However, there were no significant differences between the population proportions with inadequate or excessive blood levels for any biomarkers examined. Nutrition education programs and intervention strategies addressing dietary supplement intake might lead to healthier food choices and may improve the health of this population.
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Affiliation(s)
| | - May A. Beydoun
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, National Institutes of Health, Baltimore, Maryland, USA
| | - Emily Stave Shupe
- Department of Behavioral Health and Nutrition, University of Delaware, Newark, Delaware, USA
| | - Ryan T. Pohlig
- Department of Behavioral Health and Nutrition, University of Delaware, Newark, Delaware, USA
| | - Alan B. Zonderman
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, National Institutes of Health, Baltimore, Maryland, USA
| | - Michele K. Evans
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, National Institutes of Health, Baltimore, Maryland, USA
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Paganini-Hill A, Kawas CH, Corrada MM. Antioxidant vitamin intake and mortality: the Leisure World Cohort Study. Am J Epidemiol 2015; 181:120-6. [PMID: 25550360 PMCID: PMC4351350 DOI: 10.1093/aje/kwu294] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2014] [Accepted: 09/22/2014] [Indexed: 12/14/2022] Open
Abstract
To assess the relationship between antioxidant vitamin intake and all-cause mortality in older adults, we examined these associations using data from the Leisure World Cohort Study, a prospective study of residents of the Leisure World retirement community in Laguna Hills, California. In the early 1980s, participants (who were aged 44-101 years) completed a postal survey, which included details on use of vitamin supplements and dietary intake of foods containing vitamins A and C. Age-adjusted and multivariate-adjusted (for factors related to mortality in this cohort—smoking, alcohol intake, caffeine consumption, exercise, body mass index, and histories of hypertension, angina, heart attack, stroke, diabetes, rheumatoid arthritis, and cancer) hazard ratios for death were calculated using Cox regression for 8,640 women and 4,983 men (median age at entry, 74 years). During follow-up (1981-2013), 13,104 participants died (median age at death, 88 years). Neither dietary nor supplemental intake of vitamin A or vitamin C nor supplemental intake of vitamin E was significantly associated with mortality after multivariate adjustment. A compendium that summarizes previous findings of cohort studies evaluating vitamin intake and mortality is provided. Attenuation in the observed associations between mortality and antioxidant vitamin use after adjustment for confounders in our study and in previous studies suggests that such consumption identifies persons with other mortality-associated lifestyle and health risk factors.
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Affiliation(s)
- Annlia Paganini-Hill
- Correspondence to Dr. Annlia Paganini-Hill, Clinic for Aging Research and Education, University of California, Irvine, 24361 El Toro Road #150, Laguna Woods, CA 92637 (e-mail: )
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Sherman H, Forsberg C, Karp A, Törnkvist L. The 75-year-old persons' self-reported health conditions: a knowledge base in the field of preventive home visits. J Clin Nurs 2012; 21:3170-82. [DOI: 10.1111/j.1365-2702.2012.04314.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- Helena Sherman
- Centre for Family Medicine (CeFAM), Karolinska Institutet; Huddinge; Sweden
| | - Christina Forsberg
- Division of Nursing, Department of Neurobiology, Care Science and Society (NVS); Karolinska Institutet; Huddinge; Sweden
| | - Anita Karp
- Aging Research Centre (ARC); Stockholm; Sweden
| | - Lena Törnkvist
- Centre for Family Medicine (CeFAM), Karolinska Institutet; Huddinge; Sweden
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8
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Sahmoun AE, Schwartz GG. Smoking and Supplement Use Among Men in a Rural Population. J Diet Suppl 2009; 6:280-9. [DOI: 10.1080/19390210903149493] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Pocobelli G, Peters U, Kristal AR, White E. Use of supplements of multivitamins, vitamin C, and vitamin E in relation to mortality. Am J Epidemiol 2009; 170:472-83. [PMID: 19596711 DOI: 10.1093/aje/kwp167] [Citation(s) in RCA: 60] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
In this cohort study, the authors evaluated how supplemental use of multivitamins, vitamin C, and vitamin E over a 10-year period was related to 5-year total mortality, cancer mortality, and cardiovascular disease (CVD) mortality. Participants (n = 77,719) were Washington State residents aged 50-76 years who completed a mailed self-administered questionnaire in 2000-2002. Adjusted hazard ratios and 95% confidence intervals were computed using Cox regression. Multivitamin use was not related to total mortality. However, vitamin C and vitamin E use were associated with small decreases in risk. In cause-specific analyses, use of multivitamins and use of vitamin E were associated with decreased risks of CVD mortality. The hazard ratio comparing persons who had a 10-year average frequency of multivitamin use of 6-7 days per week with nonusers was 0.84 (95% confidence interval: 0.70, 0.99); and the hazard ratio comparing persons who had a 10-year average daily dose of vitamin E greater than 215 mg with nonusers was 0.72 (95% confidence interval: 0.59, 0.88). In contrast, vitamin C use was not associated with CVD mortality. Multivitamin and vitamin E use were not associated with cancer mortality. Some of the associations we observed were small and may have been due to unmeasured healthy behaviors that were more common in supplement users.
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Affiliation(s)
- Gaia Pocobelli
- Department of Epidemiology, University of Washington, Seattle, USA.
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Sobesky J. [Stroke prevention outside the pharmacy : risk factors and lifestyle]. DER NERVENARZT 2008; 79:1156-1163. [PMID: 18806982 DOI: 10.1007/s00115-008-2528-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Advice on modifiable risk and lifestyle factors for stroke prevention should be an established component of medical consultation. It is most important to explain that alterations to the lifestyle can be highly efficient with respect to the individual risk profile. The following review describes the importance of lifestyle factors such as nutrition, smoking, alcohol consumption, psychiatric condition, sport, dental hygiene and sleep disturbances for the risk of stroke using current data. It provides evidence that lifestyle modifications are highly effective with respect to stroke prevention. Corresponding recommendations and preventive strategies are presented.
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Affiliation(s)
- J Sobesky
- Klinik und Poliklinik für Neurologie, Universitätsklinik Köln, Kerpenerstrasse 62, 50924, Köln, Deutschland.
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