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Mortality and dietary supplements

Sep 16, 2020
Categories:  Scientific publication
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Author:  Vita Forest

Whether the use of a dietary supplement is associated with health benefits or risks is relevant and controversial. In general, the research evidence suggests no benefit or harm. But there are several randomized controlled trials that report adverse outcomes associated with the use of dietary supplements, especially at high doses [1,2].

For example, one research showed that carotene supplements (20 or 30 mg / day) increase the risk of developing lung cancer in smokers [3,4]. The research on the cancer prevention with selenium and vitamin E reported that additional consumption of vitamin E (400 IU / day) increases the risk of prostate cancer in men [5]. The CPS-II nutrition group (Cancer Prevention Study II) found that supplemental calcium doses (≥1000 mg / day) were correlated with an increased risk of death in men. However, lower doses (<1000 mg / day) or dietary calcium intake were not associated with increased mortality [6]. Therefore, both the dose of the supplement and the source of the nutrients (food against dietary supplements) can play a crucial role in determining the benefits or risks of its consumption.

In the research used as the basis for this article, the authors used a representative sample of US adults and evaluated the relation between dietary supplement use and all-cause mortality, cardiovascular disease (CVD), and cancer. In addition, the authors evaluated whether moderate or excessive nutrient intake was associated with mortality, and whether the addictions for nutrient intake were different from food and dietary supplements.

The researchers found that dietary supplement use was not associated with an increase in mortality in a nationally representative sample of US adults.

The evidence suggests that adequate nutritional intake from food has been correlated with reduced mortality, while excessive intake of dietary supplements can be harmful to the body. The results indicate that the supplement itself does not have direct health benefits. The obvious relation between supplement use and reduced mortality can be explained by higher socioeconomic status and healthy lifestyle factors that are known to reduce mortality.

These results and those of other researchers [7,8] show that people who use dietary supplements have a higher level of education and income, as well as a healthier lifestyle in general (for example, better diet, higher levels of physical activity, no smoking or drinking alcohol, and a healthy weight) than non-users.

The long-term multivitamin use was not associated with a reduction in stroke incidence or mortality among women in the Nursing Health Study [9]. Similarly, a systematic review of cohort studies and interventional trials does not confirm the benefits of using supplements for primary prevention of cardiovascular disease or cancer [10,11].

There was also evidence that excessive intake of certain nutrients can have side effects. For example, some researchers found higher cancer mortality with total calcium intakes above the acceptable upper intake.

For example, one research reported that total calcium intake of 1,500 mg / day or higher was associated with an increased risk of progressive or fatal prostate cancer among 47,750 men in the cohort [12]. In a systematic review of 11 cohort research, high total calcium intake was associated with an increased risk of prostate cancer [13].

In conclusion, the authors note that dietary supplement use was not associated with mortality benefits among a nationally representative sample of US adults. While adequate nutrient intake from food can help reduce the risk of death and excessive intake of dietary supplements can increase mortality. The potential risks and benefits of dietary supplements require further evaluation in future research.

This article is based on the following work:

Fan Chen, Mengxi Du, Jeffrey B. Blumberg, et al. Association Among Dietary Supplement Use, Nutrient Intake, and Mortality Among U.S. Adults. Ann Intern Med. 2019 May 7;170(9):604-613.

References

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  2. Schwingshackl L, Boeing H, Stelmach-Mardas M, Gottschald M, Dietrich S, Hoffmann G, et al. Dietary supplements and risk of causespecific death, cardiovascular disease, and cancer: a systematic review and meta-analysis of primary prevention trials. Adv Nutr. 2017; 8:27-39. [PMID: 28096125] doi:10.3945/an.116.013516
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