美国成年癌症幸存者的膳食补充剂使用情况。
Dietary Supplement Use among Adult Cancer Survivors in the United States.
机构信息
Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA.
Nutrition Department, Dana Farber/Brigham and Women's Cancer Center, Boston, MA, USA.
出版信息
J Nutr. 2020 Jun 1;150(6):1499-1508. doi: 10.1093/jn/nxaa040.
BACKGROUND
Many cancer patients initiate dietary supplement use after cancer diagnosis. How dietary supplement use contributes to the total nutrient intake among cancer survivors as compared with individuals without cancer needs to be determined.
OBJECTIVES
We aimed to evaluate nutrient intakes from dietary supplements among cancer survivors in relation to their total nutrient intake and compare those with individuals without cancer.
METHODS
We evaluated the prevalence, dose, and reason for using dietary supplements among 2772 adult cancer survivors and 31,310 individuals without cancer who participated in the NHANES 2003-2016.
RESULTS
Cancer survivors reported a higher prevalence of any (70.4% vs. 51.2%) and multivitamin/mineral (48.9% vs. 36.6%) supplement use and supplement use of 11 individual vitamins and 8 minerals than individuals without cancer. Overall, cancer survivors had significantly higher amounts of nutrient intake from supplements but lower nutrient intakes from foods for the majority of the nutrients. Compared with individuals without cancer, cancer survivors had a higher percentage of individuals with inadequate intake (total nutrient intake <Estimated Average Requirement or Adequate Intake) for folate, vitamin B-6, niacin, calcium, copper, and phosphorus, due to lower intakes of these nutrients from foods. Cancer survivors also had a higher proportion of individuals with excess intake (total nutrient intake ≥Tolerable Upper Intake Level) for vitamin D, vitamin B-6, niacin, calcium, magnesium, and zinc, contributed by higher intakes of these nutrients from dietary supplements. Nearly half (46.1%) used dietary supplements on their own without consulting health care providers.
CONCLUSIONS
Cancer survivors reported a higher prevalence and dose of dietary supplement use but lower amounts of nutrient intake from foods than individuals without cancer. The inadequate nutrient intake from foods and the short-term and long-term health impact of dietary supplement use, especially at high doses, need to be further evaluated among cancer survivors.
背景
许多癌症患者在确诊癌症后开始使用膳食补充剂。与没有癌症的个体相比，需要确定膳食补充剂的使用如何影响癌症幸存者的总营养素摄入量。
目的
我们旨在评估癌症幸存者从膳食补充剂中摄入的营养素与其总营养素摄入量的关系，并将其与没有癌症的个体进行比较。
方法
我们评估了 2772 名成年癌症幸存者和 31310 名没有癌症的个体在 2003-2016 年 NHANES 中使用膳食补充剂的流行率、剂量和原因。
结果
癌症幸存者报告称，任何一种（70.4% vs. 51.2%）和多种维生素/矿物质（48.9% vs. 36.6%）补充剂以及 11 种维生素和 8 种矿物质补充剂的使用频率均高于没有癌症的个体。总体而言，癌症幸存者从补充剂中摄入的营养素量显著更高，但对于大多数营养素，从食物中摄入的营养素量较低。与没有癌症的个体相比，由于从食物中摄入这些营养素较少，癌症幸存者中存在更多营养素摄入不足（总营养素摄入<估计平均需求量或适宜摄入量）的个体，如叶酸、维生素 B-6、烟酸、钙、铜和磷。由于从膳食补充剂中摄入这些营养素较多，癌症幸存者中也有更多营养素摄入过量（总营养素摄入≥可耐受最高摄入量）的个体，如维生素 D、维生素 B-6、烟酸、钙、镁和锌。近一半（46.1%）的人在没有咨询医疗保健提供者的情况下单独使用膳食补充剂。
结论
与没有癌症的个体相比，癌症幸存者报告称，他们使用膳食补充剂的流行率和剂量更高，但从食物中摄入的营养素量较低。需要进一步评估癌症幸存者从食物中摄入不足的营养素以及膳食补充剂使用，特别是高剂量使用的短期和长期健康影响。
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