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. 2019 May 7;170(9):604-613.
doi: 10.7326/M18-2478. Epub 2019 Apr 9.

Association Among Dietary Supplement Use, Nutrient Intake, and Mortality Among U.S. Adults: A Cohort Study

Fan Chen  1 , Mengxi Du  2 , Jeffrey B Blumberg  2 , Kenneth Kwan Ho Chui  3 , Mengyuan Ruan  4 , Gail Rogers  5 , Zhilei Shan  6 , Luxian Zeng  2 , Fang Fang Zhang  2
Affiliations

Association Among Dietary Supplement Use, Nutrient Intake, and Mortality Among U.S. Adults: A Cohort Study

Fan Chen et al. Ann Intern Med. .

Abstract

Background: The health benefits and risks of dietary supplement use are controversial.

Objective: To evaluate the association among dietary supplement use, levels of nutrient intake from foods and supplements, and mortality among U.S. adults.

Design: Prospective cohort study.

Setting: NHANES (National Health and Nutrition Examination Survey) data from 1999 to 2010, linked to National Death Index mortality data.

Participants: 30 899 U.S. adults aged 20 years or older who answered questions on dietary supplement use.

Measurements: Dietary supplement use in the previous 30 days and nutrient intake from foods and supplements. Outcomes included mortality from all causes, cardiovascular disease (CVD), and cancer.

Results: During a median follow-up of 6.1 years, 3613 deaths occurred, including 945 CVD deaths and 805 cancer deaths. Ever-use of dietary supplements was not associated with mortality outcomes. Adequate intake (at or above the Estimated Average Requirement or the Adequate Intake level) of vitamin A, vitamin K, magnesium, zinc, and copper was associated with reduced all-cause or CVD mortality, but the associations were restricted to nutrient intake from foods. Excess intake of calcium was associated with increased risk for cancer death (above vs. at or below the Tolerable Upper Intake Level: multivariable-adjusted rate ratio, 1.62 [95% CI, 1.07 to 2.45]; multivariable-adjusted rate difference, 1.7 [CI, -0.1 to 3.5] deaths per 1000 person-years), and the association seemed to be related to calcium intake from supplements (≥1000 mg/d vs. no use: multivariable-adjusted rate ratio, 1.53 [CI, 1.04 to 2.25]; multivariable-adjusted rate difference, 1.5 [CI, -0.1 to 3.1] deaths per 1000 person-years) rather than foods.

Limitations: Results from observational data may be affected by residual confounding. Reporting of dietary supplement use is subject to recall bias.

Conclusion: Use of dietary supplements is not associated with mortality benefits among U.S. adults.

Primary funding source: National Institutes of Health.

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Conflict of interest statement

Conflict of Interest (COI) Statement: None of the authors has conflicts of interest to report.

References

    1. Kantor ED, Rehm CD, Du M, White E, Giovannucci EL. Trends in Dietary Supplement Use Among US Adults From 1999–2012. JAMA. 2016;316(14):1464–74. - PMC - PubMed
    1. Bjelakovic G, Nikolova D, Gluud LL, Simonetti RG, Gluud C. Mortality in randomized trials of antioxidant supplements for primary and secondary prevention: systematic review and meta-analysis. JAMA. 2007;297(8):842–57. - PubMed
    1. Schwingshackl L, Boeing H, Stelmach-Mardas M, Gottschald M, Dietrich S, Hoffmann G, et al. 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(1):27–39. - PMC - PubMed
    1. Alpha-Tocopherol BCCPSG. The effect of vitamin E and beta carotene on the incidence of lung cancer and other cancers in male smokers. N Engl J Med. 1994;330(15):1029–35. - PubMed
    1. Omenn GS, Goodman GE, Thornquist MD, Balmes J, Cullen MR, Glass A, et al. Effects of a combination of beta carotene and vitamin A on lung cancer and cardiovascular disease. N Engl J Med. 1996;334(18):1150–5. - PubMed

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