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Hauner D, Mang A, Donik L, Schederecker F, Meyer D, Rack B, Janni W, Hauner H. Dietary supplement intake in women with breast cancer before and after diagnosis: results from the SUCCESS C trial. BMC Cancer 2024; 24:591. [PMID: 38750410 PMCID: PMC11094984 DOI: 10.1186/s12885-024-12341-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Accepted: 05/06/2024] [Indexed: 05/19/2024] Open
Abstract
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.
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Affiliation(s)
- Dagmar Hauner
- Institute of Nutritional Medicine, Else Kröner Fresenius Center for Nutritional Medicine, TUM School of Medicine and Health, Technical University of Munich, Munich, Germany
| | - Anna Mang
- Institute of Nutritional Medicine, Else Kröner Fresenius Center for Nutritional Medicine, TUM School of Medicine and Health, Technical University of Munich, Munich, Germany
| | - Lara Donik
- Institute of Nutritional Medicine, Else Kröner Fresenius Center for Nutritional Medicine, TUM School of Medicine and Health, Technical University of Munich, Munich, Germany
| | - Florian Schederecker
- Institute of Nutritional Medicine, Else Kröner Fresenius Center for Nutritional Medicine, TUM School of Medicine and Health, Technical University of Munich, Munich, Germany
- Chair of Epidemiology, TUM School of Medicine and Health, Technical University of Munich, Munich, Germany
| | - Dorothy Meyer
- Institute of Nutritional Medicine, Else Kröner Fresenius Center for Nutritional Medicine, TUM School of Medicine and Health, Technical University of Munich, Munich, Germany
| | - Brigitte Rack
- Department of Gynecology and Obstetrics, University Hospital Ulm, Ulm, Germany
| | - Wolfgang Janni
- Department of Gynecology and Obstetrics, University Hospital Ulm, Ulm, Germany
| | - Hans Hauner
- Institute of Nutritional Medicine, Else Kröner Fresenius Center for Nutritional Medicine, TUM School of Medicine and Health, Technical University of Munich, Munich, Germany.
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El Toum Y, Costa T, El Toum E, Haddad T, Salameh P, El Karak F, Ghosn M, Nasr F, Chahine G, Kattan J, Kourie HR. Supplement use and its impact on daily life of cancer patients: a cross-sectional study. Support Care Cancer 2024; 32:172. [PMID: 38379082 DOI: 10.1007/s00520-024-08380-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Accepted: 02/12/2024] [Indexed: 02/22/2024]
Abstract
PURPOSE This cross-sectional study aimed to investigate the prevalence and characteristics of supplement usage among cancer patients and explore its potential associations with anxiety, excessive daytime sleepiness, and overall quality of life. METHODS Cancer patients receiving specific care at Hôtel Dieu de France University Hospital, Beirut, were enrolled between April and June 2023. In face-to-face interviews, participants were asked to complete a questionnaire consisting of sociodemographic information, supplement usage details, and cancer-related variables. Three validated surveys (Epworth Sleepiness Scale, GAD-7, and EORTC-QLQ-C15-PAL) were employed to assess excessive daytime sleepiness, anxiety, and overall quality of life. Statistical analyses, including chi-square tests, t-tests, and multiple regression models, were conducted to examine associations between supplement use and other variables. RESULTS A total of 202 participants were interviewed. Fifty-two percent reported regular use of supplements following their cancer diagnosis, with vitamin D being the most commonly used supplement. Using multivariate logistic regression, supplement use was associated with being female, having lower educational levels, having a longer duration since cancer diagnosis, and having a poor overall quality of life. The multivariate logistic regression showed no significant correlation between supplement use and excessive daytime sleepiness and anxiety. CONCLUSION This study highlights a high prevalence of supplement usage among cancer patients in Lebanon, indicating a rising interest in alternative therapies aimed at enhancing quality of life. Larger prospective studies are needed to assess the relation between supplement intake and excessive daytime sleepiness and anxiety and establish clear guidelines pertaining to supplement use in cancer patients.
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Affiliation(s)
- Youssef El Toum
- Faculty of Medicine, Saint Joseph University of Beirut, Beirut, Lebanon.
| | - Tarek Costa
- Faculty of Medicine, Saint Joseph University of Beirut, Beirut, Lebanon
| | - Elissa El Toum
- Faculty of Medical Sciences, Lebanese University, Hadat, Lebanon
| | - Tina Haddad
- Faculty of Medicine, Saint Joseph University of Beirut, Beirut, Lebanon
| | - Pascale Salameh
- Faculty of Medical Sciences, Lebanese University, Hadat, Lebanon
| | - Fady El Karak
- Hematology-Oncology Department, Faculty of Medicine, Saint Joseph University of Beirut, Beirut, Lebanon
| | - Marwan Ghosn
- Hematology-Oncology Department, Faculty of Medicine, Saint Joseph University of Beirut, Beirut, Lebanon
| | - Fady Nasr
- Hematology-Oncology Department, Faculty of Medicine, Saint Joseph University of Beirut, Beirut, Lebanon
| | - Georges Chahine
- Hematology-Oncology Department, Faculty of Medicine, Saint Joseph University of Beirut, Beirut, Lebanon
| | - Joseph Kattan
- Hematology-Oncology Department, Faculty of Medicine, Saint Joseph University of Beirut, Beirut, Lebanon
| | - Hampig Raphael Kourie
- Hematology-Oncology Department, Faculty of Medicine, Saint Joseph University of Beirut, Beirut, Lebanon
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Papatesta EM, Kanellou A, Peppa E, Trichopoulou A. Is Dietary (Food) Supplement Intake Reported in European National Nutrition Surveys? Nutrients 2023; 15:5090. [PMID: 38140349 PMCID: PMC10871081 DOI: 10.3390/nu15245090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 12/06/2023] [Accepted: 12/08/2023] [Indexed: 12/24/2023] Open
Abstract
Dietary (food) supplements (DSs) have seen a sharp increase in use and popularity in recent years. Information on DS consumption is vital for national nutrition monitoring. The objective of this study was to investigate whether DS intake was reported in the National Nutrition Surveys (NNSs) in all European countries. NNSs reporting DS use were retrieved via literature review (i.e., PubMed, Google Scholar, Scopus), scientific and organizational publications (EFSA), or open-published government and other official reports. Included were the European NNSs referring to adults, published in English, French, or German, post-2000. Out of the 53 European countries, 30 recorded DS intake. Among them, related findings on the percentage of DS intake were published in 21 cases, 5 of them written in the local language. DS use varied by nation, with Finland and Denmark having the greatest (over 50%) and Italy having the lowest percentage (5%). In terms of comprehensive reported data on DS consumption in Europe and the investigation of the contribution of DSs to total nutrient intake, there is a need for improvement. Common DS categories should be defined upon agreement among the involved scientific parties to allow for comparable data and estimations between surveys.
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Affiliation(s)
- Eleni Maria Papatesta
- Center for Public Health Research and Education, Academy of Athens, Alexandroupoleos 23, 11528 Athens, Greece; (E.M.P.); (A.K.); (E.P.)
| | - Anastasia Kanellou
- Center for Public Health Research and Education, Academy of Athens, Alexandroupoleos 23, 11528 Athens, Greece; (E.M.P.); (A.K.); (E.P.)
- Department of Food Science and Technology, University of West Attica (UniWA), 28 Agiou Spyridonos Str., 12243 Egaleo-Athens, Greece
| | - Eleni Peppa
- Center for Public Health Research and Education, Academy of Athens, Alexandroupoleos 23, 11528 Athens, Greece; (E.M.P.); (A.K.); (E.P.)
| | - Antonia Trichopoulou
- Center for Public Health Research and Education, Academy of Athens, Alexandroupoleos 23, 11528 Athens, Greece; (E.M.P.); (A.K.); (E.P.)
- School of Medicine, National and Kapodistrian University of Athens, 75 Mikras Asias Str., 11527 Athens, Greece
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Sanne I, Bjørke-Monsen AL. Dietary behaviors and attitudes among Norwegian medical students. BMC MEDICAL EDUCATION 2023; 23:220. [PMID: 37024871 PMCID: PMC10080805 DOI: 10.1186/s12909-023-04194-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 03/24/2023] [Indexed: 06/19/2023]
Abstract
BACKGROUND Dietary patterns and beliefs are influenced by socioeconomic status, cultural influences, as well as medical advice, social media and marketing. Medical doctors are expected to provide correct, updated and non-biased nutritional advice to their patients, but their own dietary behaviors and attitudes may influence nutritional counselling. METHODS We have investigated dietary habits and food attitudes among medical students by using an anonymous survey distributed to all students at the Medical Faculty, University of Bergen, Norway. The survey included a 36-item questionnaire covering information about demographics, former and current diet, use of nutritional supplements, tobacco and alcohol, in addition to food attitudes and nutritional knowledge. Descriptive statistics were calculated for each survey item. RESULTS Of the 880 students, 394 responded to the survey. Although 90% of the students were omnivores, the majority had a negative attitude towards meat, and considered fish to be healthier than meat. Significantly more women than men reported use of a special diet and excluded meat from their diet, even if they were omnivores. The most frequently used supplement was cod liver oil or omega 3 fatty acids. CONCLUSION The medical students' diet and food attitudes not only reflect current health recommendations, but also popular beliefs and marketing in Norway. Curriculum planners should make the students capable of recognizing the influence of social media, marketing and medicine-food industry interactions, to ensure relevant nutrition knowledge for future doctors.
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Affiliation(s)
- Ingebjørg Sanne
- Department of Hematology and Oncology, Stavanger University Hospital, Stavanger, Norway
| | - Anne-Lise Bjørke-Monsen
- Laboratory of Medical Biochemistry, Innlandet Hospital Trust, Lillehammer, Norway.
- Laboratory of Medical Biochemistry, Førde Central Hospital, Førde, Norway.
- Department of Medical Biochemistry and Pharmacology, Haukeland University Hospital, Bergen, 5021, Norway.
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Assies JM, Sältz MD, Peters F, Behrendt CA, Jagodzinski A, Petersen EL, Schäfer I, Twerenbold R, Blankenberg S, Rimmele DL, Thomalla G, Makarova N, Zyriax BC. Cross-Sectional Association of Dietary Patterns and Supplement Intake with Presence and Gray-Scale Median of Carotid Plaques-A Comparison between Women and Men in the Population-Based Hamburg City Health Study. Nutrients 2023; 15:1468. [PMID: 36986198 PMCID: PMC10054689 DOI: 10.3390/nu15061468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 03/15/2023] [Accepted: 03/16/2023] [Indexed: 03/30/2023] Open
Abstract
This population-based cross-sectional cohort study investigated the association of the Mediterranean and DASH (Dietary Approach to Stop Hypertension) diet as well as supplement intake with gray-scale median (GSM) and the presence of carotid plaques comparing women and men. Low GSM is associated with plaque vulnerability. Ten thousand participants of the Hamburg City Health Study aged 45-74 underwent carotid ultrasound examination. We analyzed plaque presence in all participants plus GSM in those having plaques (n = 2163). Dietary patterns and supplement intake were assessed via a food frequency questionnaire. Multiple linear and logistic regression models were used to assess associations between dietary patterns, supplement intake and GSM plus plaque presence. Linear regressions showed an association between higher GSM and folate intake only in men (+9.12, 95% CI (1.37, 16.86), p = 0.021). High compared to intermediate adherence to the DASH diet was associated with higher odds for carotid plaques (OR = 1.18, 95% CI (1.02, 1.36), p = 0.027, adjusted). Odds for plaque presence were higher for men, older age, low education, hypertension, hyperlipidemia and smoking. In this study, the intake of most supplements, as well as DASH or Mediterranean diet, was not significantly associated with GSM for women or men. Future research is needed to clarify the influence, especially of the folate intake and DASH diet, on the presence and vulnerability of plaques.
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Affiliation(s)
- Julia Maria Assies
- Midwifery Science—Health Care Research and Prevention, Research Group Preventive Medicine and Nutrition, Institute for Health Service Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf, Martinistraße 52, W26, 20246 Hamburg, Germany; (J.M.A.); (M.D.S.); (B.-C.Z.)
| | - Martje Dorothea Sältz
- Midwifery Science—Health Care Research and Prevention, Research Group Preventive Medicine and Nutrition, Institute for Health Service Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf, Martinistraße 52, W26, 20246 Hamburg, Germany; (J.M.A.); (M.D.S.); (B.-C.Z.)
| | | | | | | | - Elina Larissa Petersen
- Population Health Research Department, University Heart and Vascular Center, 20246 Hamburg, Germany
- Department of Cardiology, University Heart and Vascular Center, 20246 Hamburg, Germany
| | - Ines Schäfer
- Population Health Research Department, University Heart and Vascular Center, 20246 Hamburg, Germany
- Department of Cardiology, University Heart and Vascular Center, 20246 Hamburg, Germany
| | - Raphael Twerenbold
- Population Health Research Department, University Heart and Vascular Center, 20246 Hamburg, Germany
- Department of Cardiology, University Heart and Vascular Center, 20246 Hamburg, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Luebeck, 20246 Hamburg, Germany
| | - Stefan Blankenberg
- Population Health Research Department, University Heart and Vascular Center, 20246 Hamburg, Germany
- Department of Cardiology, University Heart and Vascular Center, 20246 Hamburg, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Luebeck, 20246 Hamburg, Germany
| | - David Leander Rimmele
- Department of Neurology, University Medical Centre Hamburg-Eppendorf, Martinistraße 52, 20246 Hamburg, Germany
| | - Götz Thomalla
- Department of Neurology, University Medical Centre Hamburg-Eppendorf, Martinistraße 52, 20246 Hamburg, Germany
| | - Nataliya Makarova
- Midwifery Science—Health Care Research and Prevention, Research Group Preventive Medicine and Nutrition, Institute for Health Service Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf, Martinistraße 52, W26, 20246 Hamburg, Germany; (J.M.A.); (M.D.S.); (B.-C.Z.)
- German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Luebeck, 20246 Hamburg, Germany
| | - Birgit-Christiane Zyriax
- Midwifery Science—Health Care Research and Prevention, Research Group Preventive Medicine and Nutrition, Institute for Health Service Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf, Martinistraße 52, W26, 20246 Hamburg, Germany; (J.M.A.); (M.D.S.); (B.-C.Z.)
- German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Luebeck, 20246 Hamburg, Germany
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Contribution of base diet, voluntary fortified foods and supplements to micronutrient intakes in the UK. J Nutr Sci 2022; 11:e51. [PMID: 35836696 PMCID: PMC9241063 DOI: 10.1017/jns.2022.47] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 05/27/2022] [Indexed: 11/17/2022] Open
Abstract
The objective of the present study was to evaluate the contribution of voluntary fortified foods and supplements to reducing micronutrient shortfalls in the UK population. A secondary analysis of the UK National Diet and Nutrition Survey was conducted (2012/13–2013/14, N 2546, 1·5–95 years). Micronutrient intakes were derived from food consumption intake data and food composition data and calculated as the proportion below or above the Dietary Reference Values for males and females of different age groups, for those on a base diet only, users of fortified foods but no supplements and users of fortified foods and supplements. Of the population consuming a base diet only, 21–45 % and 5–29 % fell below the Estimated Average Requirement (EAR) for minerals and vitamins, respectively. About 3–13 % fewer consumers of fortified foods fell below the EAR for vitamins and minerals. Supplements barely reduced the prevalence of intakes below the EAR. Among supplement non-users and users, 99 and 96 % failed to meet the reference intakes for vitamin D. More women than men were at risk of inadequacies of micronutrient intakes. The prevalence of inadequacies declined with increasing age. Voluntary fortified foods but not supplements made a meaningful contribution to intakes of vitamin and minerals, without risk of unacceptably high intakes. These insights may help the UK to define approaches to address micronutrients of concern in vulnerable groups.
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Sundgot-Borgen C, Mathisen TF, Torstveit MK, Sundgot-Borgen J. Explanations for use of dietary- and muscle enhancing dietary supplements among university students: a national cross-sectional study. BMC Nutr 2022; 8:17. [PMID: 35209960 PMCID: PMC8867755 DOI: 10.1186/s40795-022-00510-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 02/14/2022] [Indexed: 11/18/2022] Open
Abstract
Background Use of dietary supplements (DS) and muscle enhancing dietary supplements (MEDS) is frequent among students despite the lack of evidence of effects and health risks related to consumption. We need to increase our understanding of students’ motivation, examine potential gender differences, and explore explanatory factors, to address preventive measures related to use. Therefore, this study aimed to explore the frequency of, and the reasons for, DS use among university students, as well as explanatory factors for use of MEDS. Method Male and female students from nine Norwegian universities participated in this cross-sectional study. Participants responded to questions about demographics, DS and MEDS use, internalization of body ideals, physical activity- and exercise level, motives for exercise, and exercise context. Independent t-test, Chi-square test, Pearson’s correlation, and logistic regression were used to investigate between group differences, associations, and explanatory factors for use, respectively. P-values ≤ 0.05 were defined as significant. Results A total of 1001 males (34%) and females, with a mean(sd) age of 24.21(4.76) years, participated. The frequency of DS use was 42% and 40% (p = .414) in males and females, respectively, in which more males than females used DS to improve physical or mental performance (p = < .001), increase muscle mass (p = < .001) and weight for health (p = .014), and improve appearance (p = < .001). In males and females, respectively, 25% and 10% used MEDS (p = < .001). In males, being a fitness center member (OR:3.80), exercising to improve muscle mass (OR:1.96), and a higher physical activity level (OR:1.09) positively explained MEDS use, while exercising to increase endurance (OR:0.49) and being an exercise science student (OR:0.47) negatively explained MEDS use. In females, internalizing the athletic body ideal (OR:1.78) and exercising to improve muscle mass (OR:1.74) positively explained MEDS use. Conclusions Our main findings indicate that a surprisingly high percentage of male and female Norwegian students use DS and MEDS, and that reasons for use, and variables explaining the variability in frequency of use, differ between genders. Longitudinal studies to investigate direction of associations are needed in future research. Supplementary Information The online version contains supplementary material available at 10.1186/s40795-022-00510-1.
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Affiliation(s)
- Christine Sundgot-Borgen
- Department of Sports Medicine, Norwegian School of Sport Sciences, Sognsveien 220, N-0806, Oslo, Norway. .,Regional Department for Eating Disorders, Division of Mental Health and Addiction, Oslo University Hospital, Postbox 4956, Nydalen, 0424, Oslo, Norway.
| | | | | | - Jorunn Sundgot-Borgen
- Department of Sports Medicine, Norwegian School of Sport Sciences, Sognsveien 220, N-0806, Oslo, Norway
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Is the Magnesium Content in Food Supplements Consistent with the Manufacturers' Declarations? Nutrients 2021; 13:nu13103416. [PMID: 34684417 PMCID: PMC8538386 DOI: 10.3390/nu13103416] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Revised: 09/24/2021] [Accepted: 09/25/2021] [Indexed: 11/16/2022] Open
Abstract
Food supplements (FS) are gaining more and more popularity because they are a quick way to compensate for deficiencies in the diet. Due to their affordable price and easy-to-take form, they are eaten by all age groups and by healthy and sick people. There are many categories of this type of preparations on the market, and FS with magnesium (Mg) are some of the most commonly used. Therefore, the aim of the study was to determine the Mg content in FS and to compare the estimated value with that declared by the manufacturer. The study included 116 FS containing Mg. In order to determine the Mg content, the atomic absorption spectrometry (AAS) method was used. The tested FS were divided in terms of the declared content, pharmaceutical form, chemical form of Mg, composition complexity, and price. It was shown that in the case of 58.7% of the samples, the Mg content was different than the permissible tolerance limits set by the Polish chief sanitary inspectorate, which range from -20% to +45%. It has been estimated that as a result of the differences in the content, the patient may take up to 304% more Mg per day or 98% less than it is stated in the declaration. The above results indicate that the quality and safety of FS should be more closely monitored.
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Keshavarz P, Shafiee M, Islam N, Whiting SJ, Vatanparast H. Prevalence of vitamin-mineral supplement use and associated factors among Canadians: results from the 2015 Canadian Community Health Survey. Appl Physiol Nutr Metab 2021; 46:1370-1377. [PMID: 34087082 DOI: 10.1139/apnm-2021-0090] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Vitamin/mineral supplements are used for improving micronutrient intake and preventing deficiencies, particularly for shortfall nutrients. We assessed the prevalence of vitamin/mineral supplement use and associated factors among a representative sample of Canadians aged ≥1 y. We used nationally representative data from the 2015 Canadian Community Health Survey (CCHS)-Nutrition. The prevalence of vitamin/mineral supplement use containing shortfall nutrients (Vitamins: A, C, D, B6, B12 and folate; Minerals: calcium, magnesium, and zinc) was examined in this study. Logistic regression models were performed to determine factors associated with vitamin/mineral supplement use among Canadian children (1-18 years) and adults (>19 years). The overall prevalence of vitamin/mineral supplement use was 38% among men and 53% among women. Males aged 14-18 years had the lowest prevalence (26.5%; 95% CI = 21.9-31.0) and females aged ≥71 years had the highest prevalence (67.8%; 95% CI = 64.1-71.5) of vitamin/mineral supplement use. Female gender, older age, higher education level, higher income, living in urban areas, having chronic conditions, having a normal body mass index (BMI), and being non-smoker were independent positive predictors of vitamin/mineral supplement use among adults. Independent positive predictors of vitamin/mineral supplement use among Canadian children included younger age, having a normal BMI, and being food secure. Novelty bullets • The overall prevalence of vitamin/mineral supplement use among Canadian men and women was 38% and 53%, respectively. • Sociodemographic and lifestyle variables were associated with vitamin/mineral supplement use, especially among Canadian adults.
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Affiliation(s)
| | | | - Naorin Islam
- University of Saskatchewan, 7235, Saskatoon, Saskatchewan, Canada;
| | - Susan J Whiting
- University of Saskatchewan, College of Pharmacy and Nutrition, 107 Wiggins Road, Saskatoon, Saskatchewan, Canada, S7N 5E5;
| | - Hassan Vatanparast
- University of Saskatchewan, 7235, Saskatoon, Canada, S7N 5A2.,University of Saskatchewan, 7235, Saskatoon, Canada, S7N 5A2;
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Tank M, Franz K, Cereda E, Norman K. Dietary supplement use in ambulatory cancer patients: a survey on prevalence, motivation and attitudes. J Cancer Res Clin Oncol 2021; 147:1917-1925. [PMID: 33825025 PMCID: PMC8164602 DOI: 10.1007/s00432-021-03594-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 03/10/2021] [Indexed: 12/31/2022]
Abstract
PURPOSE Patients with cancer often believe dietary supplements (DS) such as micronutrients and botanical products to be health supporting and non-toxic despite growing concerns regarding potential pharmacological interactions. Studies on the prevalence of DS use among patients with cancer are heterogeneous and mainly conducted at university-based cancer centers. This survey focused on a particular cancer patient group treated in an ambulatory setting without regular access to professional nutritional counselling. METHODS Patients with a history of cancer or hematological malignancy were included in this survey. A self-reported questionnaire was used to evaluate the different aspects of DS use, changes in dietary habits and patients' demographic characteristics. RESULTS Almost every second patient reported using DS (47.2%). Women (56.3%), patients with an academic degree (56.0%) and non-smokers (84.8%) were more inclined to use DS. Along with magnesium (16.6%), calcium (14.3%), multivitamins (12.0%) and vitamin C (9.4%), use of herbal supplements (12.6%) was common. Women (84.8% vs. 74.9% of men, p = < 0.001) and patients younger than 65 years (84.4% vs. 77.2% of patients > 65 y, p = 0.002) sought dietary advice more often. Support of the immune system was the main reason for DS use (26.4%) and a relevant number of patients (49.6%) reported to have changed their dietary habits following cancer diagnosis. CONCLUSION DS use is common among patients with cancer treated in an ambulatory setting. This finding should encourage oncologists to implement detailed questioning about DS use and dietary habits to prevent potential interactions and offer substantial advice.
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Affiliation(s)
- Maja Tank
- Medizinisches Versorgungszentrum Tempelhof Oncology, Berlin, Germany.,Department of Geriatrics, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Reinickendorfer Str. 61, 13347, Berlin, Germany
| | - Kristina Franz
- Department of Geriatrics, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Reinickendorfer Str. 61, 13347, Berlin, Germany.,Institute of Nutritional Science, University of Potsdam, Potsdam, Germany
| | - Emanuele Cereda
- Clinical Nutrition and Dietetics Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Kristina Norman
- Department of Geriatrics, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Reinickendorfer Str. 61, 13347, Berlin, Germany. .,Institute of Nutritional Science, University of Potsdam, Potsdam, Germany. .,Department of Nutrition and Gerontology, German Institute of Human Nutrition Potsdam-Rehbrücke, Nuthetal, Germany.
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Nutraceutical Use among Patients with Chronic Disease Attending Outpatient Clinics in a Tertiary Hospital. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2020; 2020:9814815. [PMID: 33224262 PMCID: PMC7673927 DOI: 10.1155/2020/9814815] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 10/23/2020] [Accepted: 10/27/2020] [Indexed: 11/17/2022]
Abstract
Food-drug interphase products, referring to nutraceuticals in this study, are a category of health products containing a combination of food ingredients with active substances for oral consumption. Many of these products are marketed as an alternative to prescription medicine to treat various ailments despite the lack of scientific evidence, influencing patients with chronic diseases to consume nutraceutical products. This study aimed to determine the prevalence and factors associated with knowledge, attitude, and practice of nutraceutical use among patients with chronic disease attending to the outpatient clinic. This is a cross-sectional study involving patients with chronic disease at the outpatient specialist clinic. Samples were recruited from the outpatient clinic using convenience sampling. Data was collected using a self-administered questionnaire, which was self-constructed and validated. We found that the use of nutraceuticals was prevalent among 17.9% of respondents. More than half (60.9%) of the respondents have poor knowledge of nutraceutical and 53.1% of respondents have a positive attitude towards nutraceutical. Gender and morbidities were the factors associated with the practice of nutraceutical usage. Female patients are more likely to have increased use of nutraceutical than male patients and patients with multiple morbidities have higher odds of using nutraceutical than patients with single morbidities. There is a high number of patients who consume nutraceutical products and public knowledge of nutraceutical needs to be improved further. The government should develop appropriate regulation and monitoring of nutraceutical products.
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Lim JC, Caballero Arredondo M, Braakhuis AJ, Donaldson PJ. Vitamin C and the Lens: New Insights into Delaying the Onset of Cataract. Nutrients 2020; 12:E3142. [PMID: 33066702 PMCID: PMC7602486 DOI: 10.3390/nu12103142] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 10/06/2020] [Accepted: 10/09/2020] [Indexed: 12/18/2022] Open
Abstract
Cataracts or clouding of the lens is the leading cause of blindness in the world. Age and diabetes are major risk factors, and with an increasing aging and diabetic population, the burden of cataracts will grow. Cataract surgery is an effective way to restore vision; however, alternatives to cataract surgery are required to reduce the looming cataract epidemic. Since it is well established that oxidative damage plays a major role in the etiology of cataracts, antioxidants have been promoted as therapies to delay and/or prevent cataracts. However, many antioxidant interventions including vitamin C have produced mixed results as anti-cataract therapies. Progress has been made towards our understanding of lens physiology and the mechanisms involved in the delivery and uptake of antioxidants to the lens which may guide future studies aimed at addressing some of the inconsistencies seen in previous animal and human studies. Of interest is the potential for vitamin C based supplements in delaying the onset of cataracts post vitrectomy which occurs in up to 80% of patients within two years. These targeted approaches are required to reduce the burden of cataract on hospitals and improve the quality of life of our aging and diabetic population.
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Affiliation(s)
- Julie C Lim
- Department of Physiology, New Zealand National Eye Centre, Faculty of Medical and Health Sciences, The University of Auckland, Auckland 1142, New Zealand;
| | - Mariana Caballero Arredondo
- Discipline of Nutrition, Faculty of Medical and Health Sciences, The University of Auckland, Auckland 1142, New Zealand; (M.C.A.); (A.J.B.)
| | - Andrea J. Braakhuis
- Discipline of Nutrition, Faculty of Medical and Health Sciences, The University of Auckland, Auckland 1142, New Zealand; (M.C.A.); (A.J.B.)
| | - Paul J. Donaldson
- Department of Physiology, New Zealand National Eye Centre, Faculty of Medical and Health Sciences, The University of Auckland, Auckland 1142, New Zealand;
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Costa JG, Vidovic B, Saraiva N, do Céu Costa M, Del Favero G, Marko D, Oliveira NG, Fernandes AS. Contaminants: a dark side of food supplements? Free Radic Res 2019; 53:1113-1135. [PMID: 31500469 DOI: 10.1080/10715762.2019.1636045] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Food supplements (FS) are often consumed as one of the strategies to fight ageing-associated pathologies, especially in the case of oxidative stress-related diseases. Despite the popularity of FS, some concerns about their quality and safety have been raised, especially regarding the presence of contaminants. This paper reviews and discusses the occurrence of contaminants in marketed samples of FS in the last two decades, considering both scientific literature and notifications registered on RASFF portal. The most relevant classes of contaminants were included namely metals, toxins, pesticides, dioxins and PCBs, as well as pharmacologically active ingredients. Variable amounts of contaminants were reported in a significant number of commercially available FS. Although the presence of contaminants does not necessarily mean that their levels exceed the regulatory limits or that the FS intake constitutes a risk to human health, it alerts for the need to further monitor FS safety. The evaluation of the risk associated to the consumption of FS, especially in the elderly population, is particularly challenging due to the frequent exposure to multiple toxicants and to different exposure sources, as well as due to possible pre-existing diseases and respective therapeutics. Therefore, improved quality control procedures and monitoring programs should be pursued in order to avoid undesirable products and assure the safety of FS.
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Affiliation(s)
- João Guilherme Costa
- CBIOS, Universidade Lusófona Research Center for Biosciences & Health Technologies, Lisboa, Portugal
| | - Bojana Vidovic
- Department of Bromatology, Faculty of Pharmacy, University of Belgrade, Belgrade, Serbia
| | - Nuno Saraiva
- CBIOS, Universidade Lusófona Research Center for Biosciences & Health Technologies, Lisboa, Portugal
| | - Maria do Céu Costa
- CBIOS, Universidade Lusófona Research Center for Biosciences & Health Technologies, Lisboa, Portugal.,ASAE/ONRE, National Observatory for Emerging Risks, Lisboa, Portugal
| | - Giorgia Del Favero
- Department of Food Chemistry and Toxicology, Faculty of Chemistry, University of Vienna, Vienna, Austria
| | - Doris Marko
- Department of Food Chemistry and Toxicology, Faculty of Chemistry, University of Vienna, Vienna, Austria
| | - Nuno G Oliveira
- Research Institute for Medicines (iMed.ULisboa), Faculty of Pharmacy, Universidade de Lisboa, Lisboa, Portugal
| | - Ana Sofia Fernandes
- CBIOS, Universidade Lusófona Research Center for Biosciences & Health Technologies, Lisboa, Portugal.,ASAE/ONRE, National Observatory for Emerging Risks, Lisboa, Portugal
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Gong W, Liu A, Yao Y, Ma Y, Ding C, Song C, Yuan F, Zhang Y, Feng G, Chen Z, Ding G. Nutrient Supplement Use among the Chinese Population: A Cross-Sectional Study of the 2010⁻2012 China Nutrition and Health Surveillance. Nutrients 2018; 10:E1733. [PMID: 30424493 PMCID: PMC6266204 DOI: 10.3390/nu10111733] [Citation(s) in RCA: 57] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Revised: 10/15/2018] [Accepted: 10/17/2018] [Indexed: 12/19/2022] Open
Abstract
Nutrient supplements play a key role in managing malnutrition/chronic diseases and are commonly used in the world, but few studies described the prevalence of nutrient supplement use at the national level in China. To our knowledge, this study provides the first detailed investigation of nutrient supplement use in a nationally representative sample of the Chinese population. This study aimed to describe the prevalence of the nutrient supplement use among the Chinese population aged 6 years or older in 2010⁻2012. A stratified multistage cluster sampling method was conducted to recruit participants from 150 surveillance sites. The demographic characteristics and information about nutrient supplement use were collected through an interview-administrative questionnaire. A total of 74,501 children and adults (excluding the pregnant women) were included in the study (mean age, 35.7 years; male, 47.0%, female, 53.5%). Only 0.71% of the participants reported using nutrient supplements in the previous month. Participants aged 6⁻11 years and 60 years and above, female, living in large urban, with higher education level and higher family incomes were more likely to use nutrient supplements than their counterparts (p < 0.05). The prevalence of nutrient supplement use increased with age in Chinese adults. The highest usage among the nutrient supplements was multi-vitamins and minerals with 0.37%. More females used single vitamin, multi-mineral, multi-vitamins and minerals than males (p < 0.05). The nutrient supplement use proportion was highest amongst the participants with a health problem, and the participants who had no idea about their health conditions were the least likely to use the nutrient supplements (p < 0.05). The prevalence of nutrient supplement use was low among the Chinese population in 2010⁻2012. Further research is required to understand the social cognition, usage reasons, dosage and consumption motivation of NS, and the relationships with health effects, to ensure that the nutrient supplements can be appropriately promoted in China.
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Affiliation(s)
- Weiyan Gong
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 10000, China.
| | - Ailing Liu
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 10000, China.
| | - Yecheng Yao
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 10000, China.
| | - Yanning Ma
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 10000, China.
| | - Caicui Ding
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 10000, China.
| | - Chao Song
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 10000, China.
| | - Fan Yuan
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 10000, China.
| | - Yan Zhang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 10000, China.
| | - Ganyu Feng
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 10000, China.
| | - Zheng Chen
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 10000, China.
| | - Gangqiang Ding
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 10000, China.
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Awareness and Attitude Toward Use of Dietary Supplements and the Perceived Outcomes Among Saudi Adult Male Members of Fitness Centers in Saudi Arabia. Int J Sport Nutr Exerc Metab 2018; 28:509-514. [DOI: 10.1123/ijsnem.2017-0246] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Dietary supplements are believed to enhance athletic performance and/or prevent/reverse pathological states. Despite the increasing use of dietary supplements in Saudi Arabia, systematic studies in this field are lacking. This study aims to assess the relation between demographic and social characteristics and dietary supplement use among adult males in Saudi Arabia. Demographic and dietary supplements data from fitness club participants were collected through a questionnaire, and the Pearson chi-square test was used to determine associations. A total of 448 apparently healthy adult males above 20 years of age, who were registered at fitness centers located in Saudi Arabia, participated in the study. The majority (275 [62%]) of the study participants were younger (20–30 years), of normal weight (189 [43%]), without health problems (332 [79%]), and obtained an undergraduate degree or higher (336 [77%]). The majority (58%) took supplements under the supervision of a professional and the rest depended on Internet (22%), friends (12%), or books (4%) for choosing supplement types. The main motives of the participants for visiting the fitness center were: weight loss (N = 149 [35%]), keeping fit (N = 101 [24%]), and muscle building (N = 151 [35%]). One hundred and fifty-five participants (44%) were taking supplements on a daily basis with 34 (10%) having taken it for a prolonged duration (>1 year). The most commonly used supplements were proteins (29%) and multivitamins (21%). Supplement use was not associated with the participants’ family income or level of education but was positively associated with younger age (<31 years), χ2(2, N = 443) = 4.96, p = .03.
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Sivertsen K, Lukic M, Kristoffersen AE. Gender specific association between the use of complementary and alternative medicine (CAM) and alcohol consumption and injuries caused by drinking in the sixth Tromsø study. BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE 2018; 18:239. [PMID: 30103714 PMCID: PMC6090777 DOI: 10.1186/s12906-018-2301-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Accepted: 07/31/2018] [Indexed: 12/13/2022]
Abstract
BACKGROUND Alcohol is consumed almost worldwide and is the most widely used recreational drug in the world. Harmful use of alcohol is known to cause a large disease-, social- and economic burden on society. Only a few studies have examined the relationship between CAM use and alcohol consumption. To our knowledge there has been no such research in Norway. The aim of this study is to describe and compare alcohol consumption and injuries related to alcohol across gender and different CAM approaches. METHODS The data used in this study is based on questionnaire data gathered from the sixth Tromsø Study conducted between 2007 and 2008. Information on CAM use and alcohol consumption was available for 6819 women and 5994 men, 64.8% of the invited individuals. Pearson chi-square tests and independent sample t-tests were used to describe the basic characteristics of the participants and to calculate the differences between men and women regarding these variables. Binary logistic regression analyses were used to investigate the associations between the different CAM approaches and alcohol consumptions and injuries caused by drinking. RESULTS Women who drank alcohol more than once a month were more likely to have applied herbal or "natural" medicine and self-treatment techniques (meditation, yoga, qi gong or tai-chi), compared to those who never drank, and those who only drank monthly or less. For women, an association was also found between having experienced injuries caused by drinking and use of self-treatment techniques and visit to a CAM practitioner. No association was found between amount of alcohol consumed and use of CAM approaches. For men, an association was found between injuries caused by drinking and use of herbal or "natural" medicine. CONCLUSION The findings from this cross-sectional study suggests that women who drink frequently are more likely to use "natural" medicine and self-treatment techniques. Both men and women who had experienced injuries because of their drinking were more likely to have used CAM approaches.
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Affiliation(s)
- Kristina Sivertsen
- Department for drugs – and addiction treatment and A-larm Norway, Hospital of Southern Norway, Kristiansand, Norway
| | - Marko Lukic
- Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Agnete E. Kristoffersen
- National Research Center in Complementary and Alternative Medicine (NAFKAM), Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
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Vitamin D supplement use and associated demographic, dietary and lifestyle factors in 8024 South Asians aged 40-69 years: analysis of the UK Biobank cohort. Public Health Nutr 2018; 21:2678-2688. [PMID: 29936916 DOI: 10.1017/s1368980018001404] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Vitamin D deficiency (serum 25-hydroxyvitamin D<25nmol/L) is extremely common in western-dwelling South Asians but evidence regarding vitamin D supplement usage in this group is very limited. This work identifies demographic, dietary and lifestyle predictors associated with vitamin D supplement use. DESIGN Cross-sectional analysis of baseline vitamin D supplement use data. SETTING UK Biobank cohort. SUBJECTS In total, n 8024 South Asians (Bangladeshi, Indian, Pakistani), aged 40-69 years. RESULTS Twenty-three % of men and 39% of women (P<0.001) [22% of Bangladeshis, 32% of Indians, 25% of Pakistanis (P<0.001)] took a vitamin D containing supplement. Median vitamin D intakes from diet were low at 1.0-3.0 micrograms per day, being highest in Bangladeshis and lowest in Indians (P<0.001). Logistic regression modelling showed that females had a higher odds of vitamin D supplement use than males (odds ratio (OR) = 2.02; 95% confidence interval (CI) 1.79 to 2.28). A lower supplement usage was seen in younger persons (40-60 years) (OR=0.75; 95% CI 0.65 to 0.86 reference= >60 years), and those living outside of Greater London (OR=0.53 to 0.77), with borderline trends for a lower body mass index, higher oily fish intake and higher household income associated with increased odds of vitamin D supplement use. CONCLUSIONS Vitamin D supplements were not used by most South Asians and intakes from diet alone are likely to be insufficient to maintain adequate vitamin D status. Public health strategies are now urgently required to promote the use of vitamin D supplements in these specific UK South Asian subgroups.
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19
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Which Types of Dietary Supplements Are Used in Korea? Data from the 2015 Korea National Health and Nutrition Examination Survey. ACTA ACUST UNITED AC 2018. [DOI: 10.15384/kjhp.2018.18.3.107] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Anders S, Schroeter C. The impact of nutritional supplement intake on diet behavior and obesity outcomes. PLoS One 2017; 12:e0185258. [PMID: 28991921 PMCID: PMC5633155 DOI: 10.1371/journal.pone.0185258] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Accepted: 09/08/2017] [Indexed: 12/21/2022] Open
Abstract
After decades-old efforts to nudge consumers towards healthier lifestyles through dietary guidelines, diet-related diseases are on the rise. In addition, a growing share of U.S. consumers proactively chooses nutritional supplements as an alternative preventative way of maintaining good health, a $25.5 billion industry in the United States. This paper investigates possible linkages between the economics of consumer supplement choices and the relationship to important dietary and health outcomes. We use National Health and Nutrition Examination Survey (NHANES) data to estimate the impact of nutritional supplements intake on respondent's body weight outcomes, controlling for diet quality.: The focus of this article is to determine whether nutritional supplements takers differ from non-takers with regard to their health outcomes when controlling for differences in diet quality, based on individual Healthy Eating Index (HEI-2010) score. The analysis applies treatment effects estimators that account for the selection bias and endogeneity of self-reported behavior and diet-health outcomes. The analysis demonstrates a negative association between supplement intake and BMI but no significant effect on an individual's diet quality. Our findings suggest that individuals proactively invest into their health by taking nutritional supplements instead of improving diet quality through more nutritious food choices. Our results provide important contributions to the literature on a key food policy issue. Knowledge of the determinants of supplement demand in the context of strong diet-health trends should also be helpful to stakeholders in the U.S. produce sector in their competition over consumer market share.
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Affiliation(s)
- Sven Anders
- Department of Resource Economics and Environmental Sociology, University of Alberta, Edmonton, Canada
| | - Christiane Schroeter
- Agribusiness Department, California Polytechnic State University, San Luis Obispo, California, United States of America
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Characterisation of vitamin and mineral supplement users differentiated according to their motives for using supplements: results of the German National Nutrition Monitoring (NEMONIT). Public Health Nutr 2017. [PMID: 28629485 DOI: 10.1017/s1368980017001021] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVE To characterise German vitamin and mineral supplement users differentiated by their motives for supplement use. DESIGN Data were obtained from the German National Nutrition Monitoring (2010/11) via two 24 h dietary recalls and a telephone interview. Motive-based subgroups of supplement users were identified by factor and cluster analysis. Sociodemographic, lifestyle, health and dietary characteristics and supplement use were examined. Differences were analysed using χ 2 tests, logistic and linear regression models. SETTING Germany, nationwide. SUBJECTS Individuals (n 1589) aged 18-80 years. RESULTS Three motive-based subgroups were identified: a 'Prevention' subgroup (n 324), characterised by the motive to prevent nutrient deficiencies; a 'Prevention and additional benefits' subgroup (n 166), characterised by motives to prevent health problems and improve well-being and performance; and a 'Treatment' subgroup (n 136), characterised by motives to treat nutrient deficiencies or diseases. Members of the two prevention subgroups had a higher Healthy Eating Index score and tended to be more physically active than non-users. Those in the 'Prevention and additional benefits' subgroup supplemented with a greater number of micronutrients. Members of the 'Treatment' subgroup tended to be older and have a lower self-reported health status than non-users, and supplemented with a smaller number of micronutrients. CONCLUSIONS The majority of supplement users take supplements for preventive purposes and they are more health conscious than non-users of supplements due to their concerns about developing health problems. Those supplementing for treatment purposes may have underlying health indications and may be more likely to benefit from supplementation than those supplementing for preventive purposes.
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Schwingshackl L, Boeing H, Stelmach-Mardas M, Gottschald M, Dietrich S, Hoffmann G, Chaimani A. Dietary Supplements and Risk of Cause-Specific Death, Cardiovascular Disease, and Cancer: A Systematic Review and Meta-Analysis of Primary Prevention Trials. Adv Nutr 2017; 8:27-39. [PMID: 28096125 PMCID: PMC5227980 DOI: 10.3945/an.116.013516] [Citation(s) in RCA: 114] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Our aim was to assess the efficacy of dietary supplements in the primary prevention of cause-specific death, cardiovascular disease (CVD), and cancer by using meta-analytical approaches. Electronic and hand searches were performed until August 2016. Inclusion criteria were as follows: 1) minimum intervention period of 12 mo; 2) primary prevention trials; 3) mean age ≥18 y; 4) interventions included vitamins, fatty acids, minerals, supplements containing combinations of vitamins and minerals, protein, fiber, prebiotics, and probiotics; and 5) primary outcome of all-cause mortality and secondary outcomes of mortality or incidence from CVD or cancer. Pooled effects across studies were estimated by using random-effects meta-analysis. Overall, 49 trials (69 reports) including 287,304 participants met the inclusion criteria. Thirty-two trials were judged as low risk-, 15 trials as moderate risk-, and 2 trials as high risk-of-bias studies. Supplements containing vitamin E (RR: 0.88; 95% CI: 0.80, 0.96) significantly reduced cardiovascular mortality risk, whereas supplements with folic acid reduced the risk of CVD (RR: 0.81; 95% CI: 0.70, 0.94). Vitamins D, C, and K; selenium; zinc; magnesium; and eicosapentaenoic acid showed no significant risk reduction for any of the outcomes. On the contrary, vitamin A was linked to an increased cancer risk (RR: 1.16; 95% CI: 1.00, 1.35). Supplements with β-carotene showed no significant effect; however, in the subgroup with β-carotene given singly, an increased risk of all-cause mortality by 6% (RR: 1.06; 95% CI: 1.02, 1.10) was observed. Taken together, we found insufficient evidence to support the use of dietary supplements in the primary prevention of cause-specific death, incidence of CVD, and incidence of cancer. The application of some supplements generated small beneficial effects; however, the heterogeneous types and doses of supplements limit the generalizability to the overall population.
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Affiliation(s)
- Lukas Schwingshackl
- Department of Epidemiology, German Institute of Human Nutrition, Nuthetal, Germany;
| | - Heiner Boeing
- Department of Epidemiology, German Institute of Human Nutrition, Nuthetal, Germany
| | - Marta Stelmach-Mardas
- Department of Epidemiology, German Institute of Human Nutrition, Nuthetal, Germany
- Department of Pediatric Gastroenterology and Metabolic Diseases, Poznan University of Medical Sciences, Poznan, Poland
| | - Marion Gottschald
- Department of Epidemiology, German Institute of Human Nutrition, Nuthetal, Germany
| | - Stefan Dietrich
- Department of Epidemiology, German Institute of Human Nutrition, Nuthetal, Germany
| | - Georg Hoffmann
- Department of Nutritional Sciences, Faculty of Life Sciences, University of Vienna, Vienna, Austria; and
| | - Anna Chaimani
- Department of Hygiene and Epidemiology, School of Medicine, University of Ioannina, Ioannina, Greece
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Marques-Vidal P, Vollenweider P, Waeber G. Trends in vitamin, mineral and dietary supplement use in Switzerland. The CoLaus study. Eur J Clin Nutr 2016; 71:122-127. [DOI: 10.1038/ejcn.2016.137] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2015] [Revised: 06/03/2016] [Accepted: 07/04/2016] [Indexed: 12/20/2022]
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Rautiainen S, Manson JE, Lichtenstein AH, Sesso HD. Dietary supplements and disease prevention - a global overview. Nat Rev Endocrinol 2016; 12:407-20. [PMID: 27150288 DOI: 10.1038/nrendo.2016.54] [Citation(s) in RCA: 122] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Dietary supplements are widely used and offer the potential to improve health if appropriately targeted to those in need. Inadequate nutrition and micronutrient deficiencies are prevalent conditions that adversely affect global health. Although improvements in diet quality are essential to address these issues, dietary supplements and/or food fortification could help meet requirements for individuals at risk of deficiencies. For example, supplementation with vitamin A and iron in developing countries, where women of reproductive age, infants and children often have deficiencies; with folic acid among women of reproductive age and during pregnancy; with vitamin D among infants and children; and with calcium and vitamin D to ensure bone health among adults aged ≥65 years. Intense debate surrounds the benefits of individual high-dose micronutrient supplementation among well-nourished individuals because the alleged beneficial effects on chronic diseases are not consistently supported. Daily low-dose multivitamin supplementation has been linked to reductions in the incidence of cancer and cataracts, especially among men. Baseline nutrition is an important consideration in supplementation that is likely to modify its effects. Here, we provide a detailed summary of dietary supplements and health outcomes in both developing and developed countries to help guide decisions about dietary supplement recommendations.
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Affiliation(s)
- Susanne Rautiainen
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02215, USA
- Institute of Environmental Medicine, Karolinska Institutet, 171 77 Stockholm, Sweden
| | - JoAnn E Manson
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02215, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts 02215, USA
| | - Alice H Lichtenstein
- Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, Massachusetts 02111, USA
| | - Howard D Sesso
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02215, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts 02215, USA
- Division of Aging, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02215, USA
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Consumption and reasons for use of dietary supplements in an Australian university population. Nutrition 2016; 32:524-30. [DOI: 10.1016/j.nut.2015.10.022] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2015] [Revised: 09/17/2015] [Accepted: 10/31/2015] [Indexed: 12/31/2022]
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Angelo G, Drake VJ, Frei B. Efficacy of Multivitamin/mineral Supplementation to Reduce Chronic Disease Risk: A Critical Review of the Evidence from Observational Studies and Randomized Controlled Trials. Crit Rev Food Sci Nutr 2016; 55:1968-91. [PMID: 24941429 DOI: 10.1080/10408398.2014.912199] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
We reviewed recent scientific evidence regarding the effects of multivitamin/mineral (MVM) supplements on risk of chronic diseases, including cancer, cardiovascular disease, and age-related eye diseases. Data from randomized controlled trials (RCTs) and observational, prospective cohort studies were examined. The majority of scientific studies investigating the use of MVM supplements in chronic disease risk reduction reported no significant effect. However, the largest and longest RCT of MVM supplements conducted to date, the Physicians' Health Study II (PHS II), found a modest and significant reduction in total and epithelial cancer incidence in male physicians, consistent with the Supplémentation en Vitamines et Minéraux Antioxydants (SU.VI.MAX) trial. In addition, PHS II found a modest and significant reduction in the incidence of nuclear cataract, in agreement with several other RCTs and observational, prospective cohort studies. The effects of MVM use on other subtypes of cataract and age-related macular degeneration remain unclear. Neither RCTs nor prospective cohort studies are without their limitations. The placebo-controlled trial design of RCTs may be inadequate for nutrient interventions, and residual confounding, measurement error, and the possibility of reverse causality are inherent to any observational study. National surveys show that micronutrient inadequacies are widespread in the US and that dietary supplements, of which MVMs are the most common type, help fulfill micronutrient requirements in adults and children.
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Affiliation(s)
- Giana Angelo
- a Linus Pauling Institute, Oregon State University , Corvallis , Oregon , USA
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27
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Gemmill R, Agar C, Freeman SL, Hollands T. Factors affecting owners’ choice of nutritional supplements for use in dressage and eventing horses. Vet Rec Open 2016. [DOI: 10.1136/vetreco-2015-000155] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- R. Gemmill
- School of Veterinary Medicine and ScienceUniversity of NottinghamLoughboroughLeicestershireUK
- Elizabeth Smith Veterinary PracticeBedfordshireUK
| | - C. Agar
- School of Veterinary Medicine and ScienceUniversity of NottinghamLoughboroughLeicestershireUK
- Cockburn Veterinary GroupCoalvilleLeicestershireUK
| | - S. L. Freeman
- School of Veterinary Medicine and ScienceUniversity of NottinghamLoughboroughLeicestershireUK
| | - T. Hollands
- School of Veterinary MedicineUniversity of SurreyGuildfordUK
- Dodson and Horrell LtdKetteringNorthamptonshireUK
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White DJ, Cox KHM, Peters R, Pipingas A, Scholey AB. Effects of Four-Week Supplementation with a Multi-Vitamin/Mineral Preparation on Mood and Blood Biomarkers in Young Adults: A Randomised, Double-Blind, Placebo-Controlled Trial. Nutrients 2015; 7:9005-17. [PMID: 26529011 PMCID: PMC4663579 DOI: 10.3390/nu7115451] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2015] [Revised: 10/22/2015] [Accepted: 10/26/2015] [Indexed: 11/16/2022] Open
Abstract
This study explored the effects of four-week multi-vitamin and mineral (MVM) supplementation on mood and neurocognitive function in healthy, young adults. Fifty-eight healthy adults, 18–40 years of age (M = 25.82 years, SD = 4.87) participated in this randomised, double-blind, placebo-controlled trial, in which mood and blood biomarkers were assessed at baseline and after four weeks of supplementation. Compared to placebo, MVM supplementation was associated with significantly lowered homocysteine and increased blood B-vitamin levels (p < 0.01). MVM treatment was also associated with significantly improved mood, as measured by reduced scores on the “depression-dejection” subscale of the Profile of Mood States (p = 0.018). These findings suggest that the four weeks of MVM supplementation may have beneficial effects on mood, underpinned by elevated B-vitamins and lowered homocysteine in healthy young adults.
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Affiliation(s)
- David J White
- Centre for Human Psychopharmacology, Swinburne University of Technology, Hawthorn, VIC 3122, Australia.
| | - Katherine H M Cox
- Centre for Human Psychopharmacology, Swinburne University of Technology, Hawthorn, VIC 3122, Australia.
| | - Riccarda Peters
- Centre for Human Psychopharmacology, Swinburne University of Technology, Hawthorn, VIC 3122, Australia.
| | - Andrew Pipingas
- Centre for Human Psychopharmacology, Swinburne University of Technology, Hawthorn, VIC 3122, Australia.
| | - Andrew B Scholey
- Centre for Human Psychopharmacology, Swinburne University of Technology, Hawthorn, VIC 3122, Australia.
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29
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Yong PW, Tan LB, Loh YH. Consumption of dietary health supplements among hospitalized patients at an acute tertiary Hospital. PHARMANUTRITION 2014. [DOI: 10.1016/j.phanu.2014.07.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Hutchinson J, Burley VJ, Greenwood DC, Cade JE. General supplement use, subsequent use and cancer risk in the UK Women's Cohort Study. Eur J Clin Nutr 2014; 68:1095-100. [PMID: 24801368 DOI: 10.1038/ejcn.2014.85] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2013] [Revised: 02/02/2014] [Accepted: 03/24/2014] [Indexed: 01/12/2023]
Abstract
BACKGROUND/OBJECTIVES To determine whether general dietary supplement use is associated with cancer risk in UK women and to estimate risks related to use at one and two recording points. SUBJECTS/METHODS Cox's proportional hazard regression models were used to estimate cancer risks for 32 665 middle-aged women in the UK Women's Cohort Study relating to any current supplement use recorded in a baseline questionnaire. During a median follow-up of 15 years, there were 3936 registered cancer incidences, including 1344 breast, 429 smoking-related and 362 colorectal cancers. Cancer risks for 12 948 of these women, who also completed questionnaires on average 4.4 years later, were estimated in relation to any supplement use at both time points (1527 cancers, including 561 breast, 131 smoking-related and 141 colorectal cancers). Adjustments were made for baseline confounders. RESULTS Total smoking-related cancers were associated with baseline supplement use (hazard ratio (HR)=1.41, 95% confidence interval (CI): 1.10, 1.81) compared with non-use, but not associated with use at both recording points (HR=1.29; 95% CI: 0.78, 2.13) compared with use at neither. There was no evidence of the associations between total, colorectal or breast cancers and baseline supplement use, or use at both recording points. In sub-analyses, no significant associations with breast cancer were found for premenopausal or postmenopausal baseline users, or similarly for use at both points (HR=1.35, 95% CI: 0.91, 2.01; and HR=0.93, 95% CI: 0.68, 1.26, respectively). CONCLUSIONS There was evidence that general supplement use was associated with increased smoking-related cancer risk, but there was no evidence of associations with total, colorectal and breast cancers.
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Affiliation(s)
- J Hutchinson
- Nutritional Epidemiology Group, School of Food Science & Nutrition, University of Leeds, Willow Terrace Road, Leeds, UK
| | - V J Burley
- Nutritional Epidemiology Group, School of Food Science & Nutrition, University of Leeds, Willow Terrace Road, Leeds, UK
| | - D C Greenwood
- Division of Biostatistics, University of Leeds, Leeds, UK
| | - J E Cade
- Nutritional Epidemiology Group, School of Food Science & Nutrition, University of Leeds, Willow Terrace Road, Leeds, UK
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31
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Prasad K, Ziegenfuss JY, Cha SS, Sood A, Tilburt JC. Characteristics of exclusive users of mind-body medicine vs. other alternative medicine approaches in the United States. Explore (NY) 2014; 9:219-25. [PMID: 23906100 DOI: 10.1016/j.explore.2013.04.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2012] [Indexed: 10/26/2022]
Abstract
CONTEXT Persons using one group of complementary and alternative medicine (CAM) may differ in important ways from users of other CAM therapies. OBJECTIVES The aim of this study was to characterize the United States (US) adult population using exclusively mind-body medicine (MBM) and to determine if their characteristics differed from those using exclusively non-vitamin natural products. DESIGN/SETTING Using the 2007 National Health Interview Survey (NHIS) and its periodic supplement on CAM use, descriptive characteristics of exclusive MBM users, as well as those using exclusively non-vitamin natural products were identified. PATIENTS A total of 75,764 persons completing the 2007 NHIS with adults aged 18 years and older. MAIN OUTCOME MEASURES Characteristics of MBM users, prevalence of MBM use, and characteristics of exclusive MBM users compared to exclusive non-vitamin natural product users. RESULTS Among CAM users (N = 83,013,655), 21.8% of the adult population (age 18 or older) reported using exclusive MBM therapy. In multivariate models, exclusive MBM use was associated with female gender, higher educational attainment, younger age, residing in Northeast US, being Asian or black race, and a current smoker compared to those using exclusive non-vitamin natural products. Using bivariate comparisons, individuals that exclusively used MBM were more likely to be white females (60.5%), in a younger age category (18-39 years), educated beyond high school (68.3%), and more likely from the Southern US (32.4%). A greater level of depression in MBM users was noted compared to non-vitamin natural product users (6.6%).
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Affiliation(s)
- Kavita Prasad
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USA
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Lentjes MAH, Welch AA, Luben RN, Khaw KT. Differences in dietary supplement use and secular and seasonal trends assessed using three different instruments in the EPIC-Norfolk population study. J Diet Suppl 2014; 10:142-51. [PMID: 23725527 DOI: 10.3109/19390211.2013.790336] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE Supplement use has increased over time and measurements of supplement use are dependent on instruments chosen. Therefore, we investigated three different questionnaires to measure supplement use and whether these results were associated with age, year of recruitment (secular trend, 1993-1998), and seasonal trends. DESIGN The questionnaires were self-administered within a median time interval of 54 days and included a Health and Lifestyle Questionnaire (1-year recall), a Food Frequency Questionnaire (1-year recall), and a 7-day diet diary. SETTING Men and women, aged 40-79 years from the general population living in Norfolk (East Anglia, UK), recruited between 1993 and 1998 in the European Prospective Investigation into Cancer Study (EPIC-Norfolk). RESULTS The prevalence of supplement use estimated with different instruments ranged from 31.7% to 39.0% for men and 45.0% to 54.3% for women. Agreement was substantial with kappa-statistics between 0.72 and 0.81. Participants' age (men only) and recruitment year were independently associated with supplement use; season showed inconsistent results. CONCLUSIONS The diary provides a good agreement as measured by the kappa-statistic, compared to more long-term measures of supplement use classification. The secular and seasonal trends in supplement use and type of assessment instrument need to be taken into account in studies on health and supplement use.
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Affiliation(s)
- Marleen A H Lentjes
- Department of Public Health & Primary Care, EPIC-Norfolk Study, Strangeways Research Laboratories, University of Cambridge, Worts Causeway, Cambridge, United Kingdom.
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Boucher BA, Cotterchio M, Anderson LN, Kreiger N, Kirsh VA, Thompson LU. Use of isoflavone supplements is associated with reduced postmenopausal breast cancer risk. Int J Cancer 2012; 132:1439-50. [DOI: 10.1002/ijc.27769] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2012] [Accepted: 07/23/2012] [Indexed: 11/11/2022]
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Briancon S, Boini S, Bertrais S, Guillemin F, Galan P, Hercberg S. Long-term antioxidant supplementation has no effect on health-related quality of life: The randomized, double-blind, placebo-controlled, primary prevention SU.VI.MAX trial. Int J Epidemiol 2011; 40:1605-16. [DOI: 10.1093/ije/dyr161] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
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35
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Verkaik-Kloosterman J, Dodd KW, Dekkers ALM, van 't Veer P, Ocké MC. A three-part, mixed-effects model to estimate the habitual total vitamin D intake distribution from food and dietary supplements in Dutch young children. J Nutr 2011; 141:2055-63. [PMID: 21956963 DOI: 10.3945/jn.111.142398] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Statistical modeling of habitual micronutrient intake from food and dietary supplements using short-term measurements is hampered by heterogeneous variances and multimodality. Summing short-term intakes from food and dietary supplements prior to simple correction for within-person variation (first add then shrink) may produce estimates of habitual total micronutrient intake so badly biased as to be smaller than estimates of habitual intake from food sources only. A 3-part model using a first shrink then add approach is proposed to estimate the habitual micronutrient intake from food among nonsupplement users, food among supplement users, and supplements. The population distribution of habitual total micronutrient intake is estimated by combining these 3 habitual intake distributions, accounting for possible interdependence between Eq. 2 and 3. The new model is an extension of a model developed by the USA National Cancer Institute. Habitual total vitamin D intake among young children was estimated using the proposed model and data from the Dutch food consumption survey (n = 1279). The model always produced habitual total intakes similar to or higher than habitual intakes from food sources only and also preserved the multimodal shape of the observed total vitamin D intake distribution. This proposed method incorporates several sources of covariate information that should provide more precise estimates of the habitual total intake distribution and the proportion of the population with intakes below/above cutpoint values. The proposed methodology could be useful for other complex situations, e.g. where high concentrations of micronutrients appear in episodically consumed foods.
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36
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Hara A, Sasazuki S, Inoue M, Shimazu T, Iwasaki M, Sawada N, Yamaji T, Ishihara J, Iso H, Tsugane S. Use of vitamin supplements and risk of total cancer and cardiovascular disease among the Japanese general population: a population-based survey. BMC Public Health 2011; 11:540. [PMID: 21740538 PMCID: PMC3146872 DOI: 10.1186/1471-2458-11-540] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2010] [Accepted: 07/08/2011] [Indexed: 12/14/2022] Open
Abstract
Background Despite the popular use of vitamin supplements and several prospective cohort studies investigating their effect on cancer incidence and cardiovascular disease (CVD), scientific data supporting their benefits remain controversial. Inconsistent results may be partly explained by the fact that use of supplements is an inconsistent behavior in individuals. We examined whether vitamin supplement use patterns affect cancer and CVD risk in a population-based cohort study in Japan. Methods A total of 28,903 men and 33,726 women in the Japan Public Health Center-based Prospective Study cohort, who answered questions about vitamin supplement use in the first survey from 1990-1994 and the second survey from 1995-1998, were categorized into four groups (never use, past use, recent use, and consistent use) and followed to the end of 2006 for cancer and 2005 for CVD. Sex-specific hazard ratios (HRs) and 95% confidence intervals (95% CIs) were used to describe the relative risks of cancer and CVD associated with vitamin supplement use. Results During follow-up, 4501 cancer and 1858 CVD cases were identified. Multivariate adjusted analysis revealed no association of any pattern of vitamin supplement use with the risk of cancer and CVD in men. In women, consistent use was associated with lower risk of CVD (HR 0.60, 95% CI 0.41-0.89), whereas past (HR 1.17, 95% CI 1.02-1.33) and recent use (HR 1.24, 95% CI 1.01-1.52) were associated with higher risk of cancer. Conclusions To our knowledge, this is the first prospective cohort study to examine simultaneously the associations between vitamin supplement use patterns and risk of cancer and CVD. This prospective cohort study demonstrated that vitamin supplement use has little effect on the risk of cancer or CVD in men. In women, however, consistent vitamin supplement use might reduce the risk of CVD. Elevated risk of cancer associated with past and recent use of vitamin supplements in women may be partly explained by preexisting diseases or unhealthy background, but we could not totally control for this in our study.
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Affiliation(s)
- Azusa Hara
- Epidemiology and Prevention Division, Research Center for Cancer Prevention and Screening, National Cancer Center, Chuo-ku, Tokyo 104-0045, Japan.
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