1. This prospective cohort study suggested that nutrients derived from food were associated with lower risks of all-cause death among participants.
2. Excess calcium intake derived from supplement use was associated with increased risk of death from cancer.
Evidence Rating Level: 2 (Good)
Study Rundown: Many questions remain regarding the health benefits of dietary supplements. This study examines the relationship between nutrients derived from food and dietary supplements with regards to all-cause death, as well as mortality related to cardiovascular disease and cancer. In this prospective cohort study, the authors observed that nutrients from food, as opposed to supplements, were associated with reduced mortality risk. Specifically, they noted that adequate intake of vitamin K and magnesium were associated with reduced all-cause death and cancer death. Adequate intake of vitamin A, vitamin K, copper, zinc were also associated with reduced cardiovascular mortality. One of the study strengths is its cohort size, where over 27 000 participants were included in this study. Study limitations included the potential for recall bias, as participants were asked to recount the details of previous supplement use. Overall, the results of this study suggested that adequate intake of nutrients when derived from food reduced risk of death; however, this mortality benefit was not preserved when the nutrients were derived from supplements.
In-Depth [prospective cohort]: The authors of this prospective cohort study used a nationally representative sample of U.S. adults, where over 27 000 participants were included in the analysis. Data was collected from 1999 to 2010. Participants were asked during an in-house interview about whether they had used any dietary supplements in the past 30 days; for those with recent supplement use, further details were obtained during the interview (e.g. frequency, serving form etc.) so that nutrient intake from foods and supplements could be detailed. Study outcomes included mortality from all causes, cardiovascular disease and cancer. A total of 51.2% of participants reported use of dietary supplements in the previous 30 days, while 38.3% reported use of multivitamin and mineral (MVM) supplements during this time period. The authors observed that the most common vitamin supplement was vitamin C (40.3% [95% CI, 39.3% to 41.4%]) and the most common mineral supplement was calcium (38.6% [CI, 37.6% to 39.6%]). At a median follow-up of 6.1 years, adequate intake of vitamin K (RR, 0.79 [CI, 0.70 to 0.90]) and magnesium (RR, 0.85 [CI, 0.74 to 0.98]) were associated with decreased all-cause death risk. However, these results were only true when the nutrients were derived from food. In contrast, excess intake of calcium from supplement use was associated with higher risk of death from cancer.
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