Sorbonne Paris Cité Epidemiology and Statistics Research Center (CRESS), Nutritional Epidemiology Research Team (EREN), Inserm U1153, Inra U1125, Cnam, SMBH, Paris 13 University, 74 rue Marcel Cachin, 93017, Bobigny Cedex, France.
UFR Pharmacie, Inra, UMR 1019, CRNH Auvergne, Centre Jean-Perrin, CHU Gabriel-Montpied, Unité de Nutrition, Clermont Université Auvergne, Clermont-Ferrand, France.
Eur J Nutr. 2019 Oct;58(7):2679-2692. doi: 10.1007/s00394-018-1815-x. Epub 2018 Oct 6.
Dietary supplements (DS) are largely consumed in Western countries without demonstrating their nutritional benefits and safety in the general population. The aims, in a large population-based study of French adults, were: (1) to compare the prevalence of nutrient intake inadequacy and the proportion of individuals exceeding tolerable upper intake levels (UL) between DS users and non-users, and (2) to quantify the extent of potentially "at-risk" DS use practices (e.g., DS/drugs contraindicated association or use of beta-carotene DS in smokers).
76,925 participants, 47.6% men and 52.4% women, mean age 46.9 ± 16.3 years were enrolled to the NutriNet-Santé cohort and they completed a quantitative DS questionnaire and three 24 h dietary records. A composition database including > 8000 DS was developed. Variance reduction was applied to estimate usual intakes and analyses were weighted according to the French census data.
Among DS users of the specific nutrient, DS contributed to 41% of total intake for vitamin D in men, 55% in women; and to 20% of total intake for pyridoxine in men, 21% in women. Compared to dietary intakes only, their prevalence of inadequacy was reduced by 11% for vitamin C, 9% for magnesium, 6% for pyridoxine in men, and 19% for calcium, 12% for iron, and 11% for magnesium in women (p < 0.0001). The proportion of subjects exceeding UL reached 6% for iron and 5% for magnesium in men, and 9% for iron in women. 6% of DS users had potentially "at-risk" practices.
While DS use contributed to decrease the prevalence of insufficient intake for several nutrients, it also conveyed excessive intake of iron and magnesium. Besides, a substantial proportion of potentially "at-risk" DS use practices was reported.
膳食补充剂（DS）在西方国家被广泛消费，但并未证明其对普通人群的营养价值和安全性。本研究旨在对法国成年人进行一项大型的基于人群的研究，目的是：（1）比较 DS 用户和非用户之间营养摄入不足的患病率和个体超过可耐受最高摄入量（UL）的比例；（2）量化潜在的“危险”DS 使用实践的程度（例如，DS/药物禁忌联合使用或吸烟者使用β-胡萝卜素 DS）。
共有 76925 名参与者（47.6%为男性，52.4%为女性），平均年龄为 46.9±16.3 岁，参加了 NutriNet-Santé 队列研究，他们完成了一份定量的 DS 问卷和三份 24 小时膳食记录。开发了一个包含超过 8000 种 DS 的成分数据库。应用方差缩减法来估计通常的摄入量，分析结果根据法国人口普查数据进行加权。
在特定营养素的 DS 用户中，DS 对男性维生素 D 总摄入量的贡献率为 41%，对女性为 55%；对男性吡哆醇总摄入量的贡献率为 20%，对女性为 21%。与仅饮食摄入相比，男性维生素 C、镁、吡哆醇的不足率分别降低了 11%、9%、6%，女性钙、铁、镁的不足率分别降低了 19%、12%、11%（p<0.0001）。男性铁和镁的 UL 比例分别达到 6%和 5%，女性铁的 UL 比例达到 9%。有 6%的 DS 用户存在潜在的“危险”使用行为。
虽然 DS 的使用有助于降低几种营养素摄入不足的患病率，但也会导致铁和镁摄入过量。此外，还报告了很大一部分潜在的“危险”DS 使用行为。
