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Dietary Supplement Use Among Adult Cancer Survivors in the United States

37 Pages Posted: 19 Apr 2019

See all articles by Mengxi Du

Mengxi Du

Tufts University - Friedman School of Nutrition Science and Policy

Jeffrey B. Blumberg

Tufts University - Friedman School of Nutrition Science and Policy

Zhilei Shan

Tufts University - Friedman School of Nutrition Science and Policy

Gail Rogers

Tufts University - Friedman School of Nutrition Science and Policy

Fan Chen

Tufts University - Friedman School of Nutrition Science and Policy

Mengyuan Ruan

Tufts University - Friedman School of Nutrition Science and Policy

Emily Biever

Harvard University - Dana-Farber Cancer Institute

Fang Fang Zhang

Tufts University - Friedman School of Nutrition Science and Policy

More...

Abstract

Background: Many cancer survivors initiated dietary supplement use after cancer diagnosis, and some may use supplements at high doses without consulting their healthcare providers.

Methods: We evaluated the prevalence, dose, and reason of dietary supplement use among 3988 adult cancer survivors in the National Health and Nutrition Examination Survey (NHANES) 1999-2014 and compared that to 7770 individuals without a history of cancer who were matched cancer survivors by age, sex, and race/ethnicity.

Findings: Compared to individuals without cancer, cancer survivors reported a higher prevalence of any dietary supplement use (69·9% vs. 63·4%), multivitamin/mineral supplement use (51·1% vs. 46·4%), and individual supplement use for each of the 26 vitamins and minerals being examined. Cancer survivors did not differ from non-cancer individuals for nutrient intake from foods but had higher levels of nutrient intake for five vitamins (vitamin A, retinol, vitamin D, niacin, folate) and five minerals (calcium, selenium, magnesium, zinc, and copper) from supplements than non-cancer individuals. While supplement use contributed to a lower percentage of cancer survivors with inadequate intake (< Estimated Average Requirement) for vitamins C, D, and E, it also increased the percentage of cancer survivors with excess intake (≥Tolerable Upper Intake Levels) for vitamin D, folate, vitamin B6, niacin, and selenium. Nearly half (48·5%) of the cancer survivors used dietary supplements on their own without consulting healthcare providers.

Interpretation: Cancer survivors reported a higher prevalence and dose of dietary supplement use than the general population. The short-term and long-term health impact of dietary supplement use, especially high doses of supplement use among cancer survivors needs to be evaluated.

Funding: This study was supported by NIH/ NIMHD 1R01MD011501 (FFZ).

Declaration of Interest: The authors have no conflicts of interests to disclose.

Ethical Approval: The NHANES study procedures were approved by the research ethics review board of NCHS.

Keywords: Dietary supplements, Cancer Survivors, Dose, Nutrients, Inadequate Intake, Excess Intake

Suggested Citation

Du, Mengxi and Blumberg, Jeffrey B. and Shan, Zhilei and Rogers, Gail and Chen, Fan and Ruan, Mengyuan and Biever, Emily and Zhang, Fang Fang, Dietary Supplement Use Among Adult Cancer Survivors in the United States (April 17, 2019). Available at SSRN: https://ssrn.com/abstract=3373858 or http://dx.doi.org/10.2139/ssrn.3373858

Mengxi Du

Tufts University - Friedman School of Nutrition Science and Policy

150 Harrison Avenue
Boston, MA 02111
United States

Jeffrey B. Blumberg

Tufts University - Friedman School of Nutrition Science and Policy

150 Harrison Avenue
Boston, MA 02111
United States

Zhilei Shan

Tufts University - Friedman School of Nutrition Science and Policy

150 Harrison Avenue
Boston, MA 02111
United States

Gail Rogers

Tufts University - Friedman School of Nutrition Science and Policy

150 Harrison Avenue
Boston, MA 02111
United States

Fan Chen

Tufts University - Friedman School of Nutrition Science and Policy

150 Harrison Avenue
Boston, MA 02111
United States

Mengyuan Ruan

Tufts University - Friedman School of Nutrition Science and Policy

150 Harrison Avenue
Boston, MA 02111
United States

Emily Biever

Harvard University - Dana-Farber Cancer Institute

450 Brookline Avenue
Boston, MA 02215
United States

Fang Fang Zhang (Contact Author)

Tufts University - Friedman School of Nutrition Science and Policy ( email )

150 Harrison Avenue
Boston, MA 02111
United States