Use of dietary supplements in the European Prospective Investigation into Cancer and Nutrition calibration study

Abstract

Background: Dietary supplement use is increasing, but there are few comparable data on supplement intakes and how they affect the nutrition and health of European consumers. The aim of this study was to describe the use of dietary Correspondence: G Skeie, Institute of Community Medicine, University of Tromsø, N-9037 Tromsø, Norway. E-mail: Guri.Skeie@uit.no Guarantor: G Skeie Contributors: GS performed statistical analyses and wrote the article. NS was the overall coordinator of this project and of the EPIC nutritional databases (ENDB) project. GS, ML, PA, PJ, VP, AP, EMN, KA, TP, MN, MT, KN, JH, LW, ES, AO, SN, VH, GD, CC, DE contributed to the reclassification of data from their respective countries, and gave input on statistical analyses, interpretation of results and drafting of the article. TB, AH, HV, PW, MCBR, PF, EL, NS gave input on the statistical analyses, interpretation of results and drafting of the manuscript. The other co-authors were local EPIC collaborators involved in the design of the study and data collection. ER is the overall coordinator of the EPIC study. All co-authors provided comments and suggestions on the article and approved the final version. Results: Between countries, the mean percentage of dietary supplement use varied almost 10-fold among women and even more among men. There was a clear north-south gradient in use, with a higher consumption in northern countries. The lowest crude mean percentage of use was found in Greece (2.0% among men, 6.7% among women), and the highest was in Denmark (51.0% among men, 65.8% among women). Use was higher in women than in men. Vitamins, minerals or combinations of them were the predominant types of supplements reported, but there were striking differences between countries. Conclusions: This study indicates that there are wide variations in supplement use in Europe, which may affect individual and population nutrient intakes. The results underline the need to monitor consumption of dietary supplements in Europe, as well as to evaluate the risks and benefits.

Plasma carotenoids, vitamin C, retinol and tocopherols levels and pancreatic cancer risk within the European Prospective Investigation into Cancer and Nutrition: A nested case–control study

“…The difference may also be related to greater use of vitamin supplement use in Northern countries. 30 Additional adjustment for vitamin supplement use did however not noticeably change our results. In addition, separate analyses of nonsupplement users did not change the magnitude of the inverse associations.…”

Dietary intakes and food sources of phytoestrogens in the European Prospective Investigation into Cancer and Nutrition (EPIC) 24-hour dietary recall cohort

“…Further underestimation may be due to the omission of herb/plant supplements in this analysis (up to 5% of the consumers in Denmark, the highest consumer country). 64 In summary, the data presented in this study show the mean intake of phytoestrogens (isoflavones, lignans, coumestans, enterolignans and equol) and their food sources in 10 European countries. The used FCDB comprises the most updated and available worldwide data on phytoestrogen in foods.…”

Flavonoid and lignan intake and pancreatic cancer risk in the European prospective investigation into cancer and nutrition cohort

“…It is also possible that intake of flavonoids and lignans is underestimated due to incomplete information on their content in some foods, such as thearubigins for tea, or unknown compositional data of some lignans,23 and because we could not consider dietary supplements (herbs/plants or their constituents) as another source of intake. The latter should not have affected our results as these types of products represented 8–17% of the supplements used in the EPIC study 45. Residual confounding might be present as we did not control for all potential confounding factors such as family history of pancreatic cancer, history of pancreatitis, and other unmeasured variables or unknown factors.…”