New Warning of Deadly Danger of Dietary Supplements for Senior Women
‘We cannot recommend the use of vitamin and mineral supplements as a preventive measure…’ - danger from iron increases with
Oct. 10, 2011 – Taking dietary supplements, often on the encouragement of physicians, has been a growing trend in
American, in particular among senior citizens. A new study warns, however, that at least for older women, the risk of death increases with the
consumption of multivitamins, folic acid, iron and copper, among others.
The report appears today in the Archives of Internal Medicine,
one of the JAMA/Archives
journals, as part of the journal's Less Is More series.
What Are Dietary Supplements and How Are They Regulated?
Health Behavior News Service
5, 2011 -
Vitamins, herbs and other dietary supplements are sold as natural
alternatives to pharmaceuticals and many people turn to them in an
attempt to improve their health. Others seek supplements to lose weight
or after hearing that they can help with serious medical conditions.
These products are now used at least monthly by more than half of all
Americans—and their production, marketing and sales have become a $23.7
billion industry, according to the Nutrition Business Journal.
"At the population level, dietary supplements contributed substantially to the total intake of several nutrients,
particularly in elderly individuals," the authors write.
The study used data collected during the Iowa Women's Health Study to examine the association between vitamin and mineral
supplements and mortality (death) rate among 38,772 older women (average age 61.6 years).
Supplement use was self-reported in 1986, 1997 and 2004 via questionnaires.
Among the 38,772 women who started follow-up with the first survey in 1986, 15,594 deaths (40.2 percent) occurred over an
average follow-up time of 19 years.
Self-reported supplement use increased substantially between 1986 and 2004, with 62.7 percent of women reporting use of
at least one supplement daily in 1986, 75.1 percent in 1997 and 85.1 percent in 2004.
Jaakko Mursu, Ph.D., of the University of Eastern Finland, Kuopio, Finland, and the University of Minnesota, Minneapolis,
and colleagues found that use of most supplements was not associated with reduced total mortality in older women, and many supplements
appeared associated with increased mortality risk.
After adjustment, use of multivitamins, vitamin B6,
folic acid, iron, magnesium, zinc and copper, were all associated with increased risk of death in the study population.
Calcium reduces death risk, iron increases it the most
Conversely, calcium supplements appear to reduce risk of mortality.
The association between supplement intake and mortality risk was strongest with iron, and the authors found a
dose-response relationship as increased risk of mortality was seen at progressively lower doses as women aged throughout the study.
Findings for both iron and calcium supplements were replicated in separate, short-term analyses with follow-up occurring
at four years, six years and 10 years.
"Based on existing evidence, we see little justification for the general and widespread use of dietary supplements," the
"We recommend that they be used with strong medically based cause, such as symptomatic nutrient deficiency disease."
The study was partially supported by a grant from the National Cancer Institute, a grant from the Academy of Finland, the
Finnish Cultural Foundation, and the Fulbright program's Research Grant for a Junior Scholar.
Commentary: Vitamin E, A, beta-carotene can cause harm; D3 helpful
In an invited commentary, Goran Bjelakovic, M.D., D.M.Sc., of the University of Nis, Nis, Serbia, and Christian Gluud,
M.D., D.M.Sc., of Copenhagen University Hospital, Copenhagen, Denmark, discuss the findings of Mursu and colleagues saying they "add to the
growing evidence demonstrating that certain antioxidant supplements, such as vitamin E, vitamin A, and beta-carotene, can be harmful."
"Dietary supplementation has shifted from preventing deficiency to trying to promote wellness and prevent disease," the
authors write. "Until recently, the available data regarding the adverse effects of dietary supplements has been limited and grossly
“We think the paradigm 'the more the better' is wrong. One should consider the likely U-shaped relationship between
micronutrient status and health."
"We cannot recommend the use of vitamin and mineral supplements as a preventive measure, at least not in a well-nourished
population," the authors conclude.
"Older women (and perhaps men) may benefit from intake of vitamin D3
supplements, especially if they have insufficient vitamin D supply from the sun and from their diet. The issue of whether to use calcium
supplements may require further study."
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