Vitamin/mineral supplementation and cancer, cardiovascular, and all-cause mortality in a German prospective cohort (EPIC-Heidelberg).

Abstract

PURPOSE:

To prospectively evaluate the association of vitamin/mineral supplementation with cancer, cardiovascular, and all-cause mortality.

METHODS:

In the Heidelberg cohort of the European Prospective Investigation into Cancer and Nutrition (EPIC-Heidelberg), which was recruited in 1994-1998, 23,943 participants without pre-existing cancer and myocardial infarction/stroke at baseline were included in the analyses. Vitamin/mineral supplementation was assessed at baseline and during follow-up. Cox regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs).

RESULTS:

After an average follow-up time of 11 years, 1,101 deaths were documented (cancer deaths = 513 and cardiovascular deaths = 264). After adjustment for potential confounders, neither any vitamin/mineral supplementation nor multivitamin supplementation at baseline was statistically significantly associated with cancer, cardiovascular, or all-cause mortality. However, baseline users of antioxidant vitamin supplements had a significantly reduced risk of cancer mortality (HR: 0.52; 95% CI: 0.28, 0.97) and all-cause mortality (HR: 0.58; 95% CI: 0.38, 0.88). In comparison with never users, baseline non-users who started taking vitamin/mineral supplements during follow-up had significantly increased risks of cancer mortality (HR: 1.74; 95% CI: 1.09, 2.77) and all-cause mortality (HR: 1.58; 95% CI: 1.17, 2.14).

CONCLUSIONS:

Based on limited numbers of users and cases, this cohort study suggests that supplementation of antioxidant vitamins might possibly reduce cancer and all-cause mortality. The significantly increased risks of cancer and all-cause mortality among baseline non-users who started taking supplements during follow-up may suggest a "sick-user effect," which researchers should be cautious of in future observational studies.

• Authors: Kuanrong Li, Rudolf Kaaks, Jakob Linseisen, Sabine Rohrmann
• Journal: European journal of nutrition (Eur J Nutr) Vol. 51 Issue 4 Pg. 407-13 (Jun 2012) ISSN: 1436-6215 [Electronic] Germany
• PMID: 21779961 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Antioxidants
• Minerals
• Vitamins

Topics

• Adult
• Antioxidants (adverse effects, therapeutic use)
• Cardiovascular Diseases (diet therapy, mortality, prevention & control)
• Cohort Studies
• Dietary Supplements (adverse effects)
• Female
• Follow-Up Studies
• Germany (epidemiology)
• Humans
• Male
• Middle Aged
• Minerals (adverse effects, therapeutic use)
• Mortality
• Neoplasms (diet therapy, mortality, prevention & control)
• Nutrition Surveys
• Proportional Hazards Models
• Prospective Studies
• Risk
• Urban Health
• Vitamins (adverse effects, therapeutic use)