According to a study from the February 2011 issue of the Journal of Nutrition, nearly 50 percent of Americans take supplements. The most common? A multivitamin. In fact, one-third of the population takes some form of a daily multivitamin/multimineral supplement.
There are many reasons why people take supplements. For some, it is simply for overall health; for others, it is to retain bone strength or ease painful joints. Still others are hoping to prevent cancer, heart disease or another ailment.
But can supplements really prevent disease? German researchers had the very same question.
Researchers from Heidelberg, Germany, examined supplement use in participants of the Heidelberg cohort of the European Prospective Investigation into Cancer and Nutrition (EPIC-Heidelberg). Specifically, they wanted to know if vitamin and mineral supplementation was associated with all-cause mortality, as well as death from cardiovascular disease and cancer.
After excluding participants that had been diagnosed with cancer or had already suffered a heart attack or stroke, researchers looked at data collected from nearly 24,000 participants, just over 11,000 men and nearly 13,000 women.
Participants were asked at three separate times (baseline, between 2001 and 2003, and again between 2004 and 2006) about their supplement use. Specifically, they were asked, “Did you regularly take any medications or vitamin/mineral supplements in the last 4 weeks.” Regular use was defined as daily use of a week or more, or non-daily use of five more doses at regular intervals. Researchers also asked for brand names.
Additionally, in a food questionnaire, participants were asked if they had taken a vitamin/mineral supplement for four weeks or more in the last 12 months.
Researchers then broke the supplements into three different categories:
- Antioxidants (vitamins A, C, E, or a combination)
They also noted a variety of additional characteristics, including:
- Education level
- Body mass index (BMI)
- Waist-to-hip ratio
- Smoker or non-smoker
- Meat intake
- Use of non-steroidal anti-inflammatory drugs (NSAIDs)
Finally, they also broke participants into five categories of supplement use:
- Never (reported no supplement use all three times)
- New users (didn’t take supplements at baseline, but started taking during study)
- Former users (took supplements at baseline, but stopped taking during study)
- Consistent (reported supplement use on all three occasions)
- Casual (took supplements sporadically and didn’t fit into the other four categories)
Supplements and Mortality
I have to admit, the results surprised me on a number of fronts. First, they found that just over a third (34 percent) of the participants took supplements regularly. Of these, multivitamins and antioxidants were the most common.
Researchers also learned that supplement users were also more likely to be older women who were physically active, have a college degree, a lower BMI and a healthier diet. Shockingly, they were also more likely to have a longer smoking duration and be on more prescriptions, including NSAIDs and drugs to lower blood pressure and cholesterol.
And when it came to mortality, there was no statistically significant association between supplement use and death from cancer or cardiovascular disease. When adjusted for age and sex, though, there was a significant association between supplement use and all-cause mortality, meaning that supplements seemed to protect against all-cause mortality. However, this finding was negated when they factored in other things like BMI, smoking, education and prescription use.
When it came to antioxidants specifically, supplement use was significantly associated with cancer and all-cause mortality, in a protective sense. However, it was not associated with death from cardiovascular disease.
Now here’s the really interesting part. Researchers found that new users (those who started taking supplements during the study, but didn’t start off as supplement users) had a significantly increased risk of cancer and all-cause mortality.
Consistent users had a 50 percent reduced risk of death from cardiovascular disease. Casual users also enjoyed a positive, though not statistically significant, association for cancer and all-cause mortality. There was no statistically significant association either way for former supplement users.
What Does It All Mean?
In a nutshell, the key things the researchers found include:
- Supplements in general were not associated with reduction in death from cancer, heart disease, or all-cause.
- Antioxidants specifically were associated with a reduced risk of death from cancer and all-cause.
- Regular supplement users had a 50 percent reduced risk of death from heart disease.
- People who started taking supplements at some point during the study had an increased risk of death from cancer and all-cause.
There are several issues with the study that jump out. The first (and one that the researchers don’t reference) is that the majority of the supplement users were smokers who had smoked for a long time. One has to consider that the damage done from smoking must play a role on the effectiveness of supplements. There is the distinct possibility that supplement use is offsetting damage but not able to gain a foothold to improve health.
As for the finding related to increased risk of cancer and all-cause mortality for those people kicking off a supplement program, researchers hypothesize that people who have been diagnosed with cancer frequently begin taking supplements, especially antioxidants, after their diagnosis.
To see if this could have contributed to their findings, they excluded participants who received a cancer diagnosis during the course of the study. When they did, they found that the association dropped to a non-significant level.
As for all-cause mortality, researchers point to two other studies that found that smokers who took beta-carotene or vitamin E had increased risk of all-cause mortality. While the number of smokers in this study may have played a role, investigators couldn’t be sure, due to the small number of smokers who took antioxidants specifically.
In the end, they concluded: “This study suggests that supplementation of antioxidant vitamins might possibly reduce cancer and all-cause mortality. The significantly increased risks of cancer and all-cause mortality among baseline non-users who stared taking supplements during follow-up may suggest a ‘sick-user effect,’ which researchers should be cautious of in future observational studies.”
My personal takeaway is this: Based on this study, being a regular user of a multivitamin/mineral and antioxidant supplement can lower your risk of death from cardiovascular disease, cancer and all-cause mortality.
So don’t wait until you get sick to start taking basic supplements. If you aren’t already, make a plan today to make a high-quality multivitamin/mineral supplement and good antioxidant supplement part of your foundation of health. For help determining which vitamins are most important, check out our free report, Top 7 Supplements for Lifetime Vitality.
 Bailey, RL et al. Dietary supplement use in the United States, 2003–2006. J Nutr. 2011;141(2):261-6.
 Li, K et al. Vitamin/mineral supplementation and cancer, cardiovascular, and all-cause mortality in a German prospective cohort (EPIC-Heidelberg). Eur J Nutr. 2011 July 22. [Epub ahead of print].
 Ferrucci, LM et al. Factors related to the use of dietary supplements by cancer survivors. J Altern Complement Med. 2009;15(6):673-80.
 Omenn, GS et al. Effects of a combination of beta-carotene and vitamin A on lung cancer and cardiovascular disease. N Engl. J Med. 1996;334(18):1150-5.
 The alpha-tocopherol, beta-carotene cancer prevention study group. The effect of vitamin E and beta-carotene on the incidence of lung cancer and other cancers in male smokers. N Engl J Med. 1994;330(15):1029-35.