Taking on Supplements; It’s About Time! (Musings of a Dinosaur)

[Sgent]

Hallelujah. At last there is an actual, published paper (full text behind subscription firewall, unfortunately) objectively documenting not only a lack of longevity benefit for several commonly consumed dietary supplements, but a numerical association indicating potential harm. Finally!

Investigators looked at nearly 39,000 women (in scientific terms: a lot) over 19 years of follow up (in scientific terms: a long time) and found increased risk of death in women who took supplemental iron (strongest association), copper, zinc, magnesium, Vitamin B6, and multi-vitamins.

Wow.

If nothing else, that should at least give one pause when considering whether or not to take supplements at all, especially in the demographic studied (the “older female”). But are they overstating their case? Scare-mongering? Not at all. In fact, the following caution was explicitly added by the researchers:

http://dinosaurmusings.wordpress.com/2011/10/16/taking-on-supplements-its-about-time/

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Good study, and the first major one of its kind. So multi-vitamins are worthless, at least at extending life.

[earthside]

1. I can poke holes in this ...

... in just few seconds.

There are lots of common sense factors that could account for the outcome of the study if one accepts its conclusions in the first place.

First, people may take supplements because they have health problem to begin with.
Two, people may take supplements because it is still cheaper that going to the doctor these days.
Three, there are varying degrees of supplement quality.
Four, is there a difference between people who take supplements every single day, year in year out, and those who are sporadic in when they take them?

Those are four items that I thought of in just a couple of minutes.
There are many control factors that would have to be accounted for in any credible study of the advantages or disadvantages of taking vitamins, minerals, herbs, etc.

Frankly, my hunch is that the nutritional quality of our food is such that supplements are probably still a wise addition to ones diet.

[cutlassmama]

5. +1

[klook]

2. "a real stretch"

I wouldn't put too much stock in a study that relies on self-reported data.

"...self-reported data is notoriously unreliable, and since there are no controls, the results are far from conclusive. These types of studies are usually the foundation for further, well-designed and controlled studies....there are, literally, thousands of well-designed, prospective studies worldwide demonstrating the benefits of vitamins for heart disease, diabetes, high blood pressure, pain, Alzheimer’s disease, etc. It is important that accurate information is available to the general public and health care community." - Experts remain split on safety, benefits of vitamins -- dailyherald.com - Patrick B. Massey, M.D., Ph.D, medical director for complementary and alternative medicine for the Alexian Brothers Hospital Network

[TreasonousBastard]

3. Anyone was megadosing? Post-menopausal women still taking iron? There are...

a lot of questions that could skew this one way or the other. On balance, though, it confirms my suspicion that many supplements are unnecessary unless there's a deficiency.

That's not to say they're all unnecessary or useless-- I was curious when a dermatologist suggested 2000mg a day of vitamin C for a minor skin condition. But it worked!

I've asked cardiologists about CoQ10, rheumatologists about Glucosamine, and others about supplements in general and they all said give it a shot in moderation. (Except for stuff like bilberry and echinacea where there is no evidence at all that they do anything but empty you wallet)

Here's my first stop when dealing with supplements:

http://www.nlm.nih.gov/medlineplus/druginfo/herb_All.html#G

[BadgerKid]

4. Original abstract with link

LESS IS MORE
Dietary Supplements and Mortality Rate in Older Women

The Iowa Women's Health Study

Jaakko Mursu, PhD; Kim Robien, PhD; Lisa J. Harnack, DrPH, MPH; Kyong Park, PhD; David R. Jacobs Jr, PhD

Arch Intern Med. 2011;171(18):1625-1633. doi:10.1001/archinternmed.2011.445

Background Although dietary supplements are commonly taken to prevent chronic disease, the long-term health consequences of many compounds are unknown.

Methods We assessed the use of vitamin and mineral supplements in relation to total mortality in 38 772 older women in the Iowa Women's Health Study; mean age was 61.6 years at baseline in 1986. Supplement use was self-reported in 1986, 1997, and 2004. Through December 31, 2008, a total of 15 594 deaths (40.2%) were identified through the State Health Registry of Iowa and the National Death Index.

Results In multivariable adjusted proportional hazards regression models, the use of multivitamins (hazard ratio, 1.06; 95% CI, 1.02-1.10; absolute risk increase, 2.4%), vitamin B6 (1.10; 1.01-1.21; 4.1%), folic acid (1.15; 1.00-1.32; 5.9%), iron (1.10; 1.03-1.17; 3.9%), magnesium (1.08; 1.01-1.15; 3.6%), zinc (1.08; 1.01-1.15; 3.0%), and copper (1.45; 1.20-1.75; 18.0%) were associated with increased risk of total mortality when compared with corresponding nonuse. Use of calcium was inversely related (hazard ratio, 0.91; 95% confidence interval, 0.88-0.94; absolute risk reduction, 3.8%). Findings for iron and calcium were replicated in separate, shorter-term analyses (10-year, 6-year, and 4-year follow-up), each with approximately 15% of the original participants having died, starting in 1986, 1997, and 2004.

Conclusions In older women, several commonly used dietary vitamin and mineral supplements may be associated with increased total mortality risk; this association is strongest with supplemental iron. In contrast to the findings of many studies, calcium is associated with decreased risk.


http://archinte.ama-assn.org/cgi/content/abstract/171/18/1625

[HuckleB]

6. .

:kick: