Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02215, USA.
Institute of Environmental Medicine, Karolinska Institutet, 171 77 Stockholm, Sweden.
Nat Rev Endocrinol. 2016 Jul;12(7):407-20. doi: 10.1038/nrendo.2016.54. Epub 2016 May 6.
Dietary supplements are widely used and offer the potential to improve health if appropriately targeted to those in need. Inadequate nutrition and micronutrient deficiencies are prevalent conditions that adversely affect global health. Although improvements in diet quality are essential to address these issues, dietary supplements and/or food fortification could help meet requirements for individuals at risk of deficiencies. For example, supplementation with vitamin A and iron in developing countries, where women of reproductive age, infants and children often have deficiencies; with folic acid among women of reproductive age and during pregnancy; with vitamin D among infants and children; and with calcium and vitamin D to ensure bone health among adults aged ≥65 years. Intense debate surrounds the benefits of individual high-dose micronutrient supplementation among well-nourished individuals because the alleged beneficial effects on chronic diseases are not consistently supported. Daily low-dose multivitamin supplementation has been linked to reductions in the incidence of cancer and cataracts, especially among men. Baseline nutrition is an important consideration in supplementation that is likely to modify its effects. Here, we provide a detailed summary of dietary supplements and health outcomes in both developing and developed countries to help guide decisions about dietary supplement recommendations.
膳食补充剂应用广泛，如果能针对有需要的人群进行适当的靶向治疗，有改善健康的潜力。营养不足和微量营养素缺乏是普遍存在的问题，对全球健康产生不利影响。尽管改善饮食质量对于解决这些问题至关重要，但膳食补充剂和/或食物强化可能有助于满足有缺乏风险的个人的需求。例如，在发展中国家，补充维生素 A 和铁，因为育龄妇女、婴儿和儿童经常缺乏这些营养素；在育龄妇女和怀孕期间补充叶酸；在婴儿和儿童中补充维生素 D；以及在成年人中补充钙和维生素 D，以确保≥65 岁成年人的骨骼健康。对于营养良好的个体，单独补充高剂量微量营养素的益处存在激烈的争论，因为据称对慢性病的有益影响并不总是得到支持。每日低剂量多种维生素补充剂与癌症和白内障发病率的降低有关，尤其是在男性中。补充剂的基础营养是一个重要的考虑因素，可能会改变其效果。在这里，我们详细总结了发展中国家和发达国家的膳食补充剂与健康结果的关系，以帮助指导膳食补充剂建议的决策。
