Dietary Supplement Use in Adult Cancer Survivors

ABSTRACT 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.

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Is dietary supplement use longitudinally associated with fatigue in stage I-III colorectal cancer survivors?

Clinical Nutrition ◽

10.1016/j.clnu.2018.12.037 ◽

2020 ◽

Vol 39 (1) ◽

pp. 234-241 ◽

Cited By ~ 3

Author(s):

Janna L. Koole ◽

Martijn J.L. Bours ◽

José J.L. Breedveld-Peters ◽

Eline H. van Roekel ◽

Stéphanie O. Breukink ◽

...

Keyword(s):

Colorectal Cancer ◽

Cancer Survivors ◽

Dietary Supplement ◽

Stage I ◽

Supplement Use ◽

Colorectal Cancer Survivors ◽

Dietary Supplement Use

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Dietary Supplement‐Use and Physical Activity among Long‐Term Cancer Survivors

The FASEB Journal ◽

10.1096/fasebj.21.5.a708 ◽

2007 ◽

Vol 21 (5) ◽

Author(s):

Paige Elizabeth Miller ◽

Terryl J Hartman ◽

Joseph J Vasey ◽

Pamela F Short

Keyword(s):

Physical Activity ◽

Cancer Survivors ◽

Dietary Supplement ◽

Supplement Use ◽

Dietary Supplement Use

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Dietary Supplement Use and Interactions with Tamoxifen and Aromatase Inhibitors in Breast Cancer Survivors Enrolled in Lifestyle Interventions

Nutrients ◽

10.3390/nu13113730 ◽

2021 ◽

Vol 13 (11) ◽

pp. 3730

Author(s):

Maura Harrigan ◽

Courtney McGowan ◽

Annette Hood ◽

Leah M. Ferrucci ◽

ThaiHien Nguyen ◽

...

Keyword(s):

Breast Cancer ◽

Cancer Research ◽

Cancer Survivors ◽

Dietary Supplements ◽

Dietary Supplement ◽

Breast Cancer Survivors ◽

Lifestyle Interventions ◽

Supplement Use ◽

Dietary Supplement Use ◽

Potential Interactions

The use of dietary supplements is common in the general population and even more prevalent among cancer survivors. The World Cancer Research Fund/American Institute for Cancer Research specifies that dietary supplements should not be used for cancer prevention. Several dietary supplements have potential pharmacokinetic and pharmacodynamic interactions that may change their clinical efficacy or potentiate adverse effects of the adjuvant endocrine therapy prescribed for breast cancer treatment. This analysis examined the prevalence of self-reported dietary supplement use and the potential interactions with tamoxifen and aromatase inhibitors (AIs) among breast cancer survivors enrolled in three randomized controlled trials of lifestyle interventions conducted between 2010 and 2017. The potential interactions with tamoxifen and AIs were identified using the Natural Medicine Database. Among 475 breast cancer survivors (2.9 (mean) or 2.5 (standard deviation) years from diagnosis), 393 (83%) reported using dietary supplements. A total of 108 different types of dietary supplements were reported and 36 potential adverse interactions with tamoxifen or AIs were identified. Among the 353 women taking tamoxifen or AIs, 38% were taking dietary supplements with a potential risk of interactions. We observed a high prevalence of dietary supplement use among breast cancer survivors and the potential for adverse interactions between the prescribed endocrine therapy and dietary supplements was common.

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Vitamin and Mineral Supplement Use Among US Adults After Cancer Diagnosis: A Systematic Review

Journal of Clinical Oncology ◽

10.1200/jco.2007.13.5905 ◽

2008 ◽

Vol 26 (4) ◽

pp. 665-673 ◽

Cited By ~ 210

Author(s):

Christine M. Velicer ◽

Cornelia M. Ulrich

Keyword(s):

Cancer Survivors ◽

Cancer Patients ◽

Dietary Supplement ◽

Breast Cancer Survivors ◽

The United States ◽

Cancer Site ◽

Mineral Supplement ◽

Prostate Cancer Survivors ◽

Supplement Use ◽

Dietary Supplement Use

Vitamin and mineral supplement use is thought to be common among the 10 million adults in the United States who have been diagnosed with cancer; however, well-conducted studies of this topic are sparse. Moreover, the biologic effects of supplement use among cancer survivors are not well established and not necessarily beneficial. We present a systematic summary of studies published between 1999 and 2006, 32 in total, addressing vitamin and mineral supplement use among US adult cancer patients and survivors. Supplement use is widespread among cancer patients and longer-term survivors. In studies combining different cancer sites, 64% to 81% of survivors reported using any vitamin or mineral supplements and 26% to 77% reported using any multivitamins. In contrast, approximately 50% of US adults use dietary supplements and 33% use multivitamin/multimineral supplements. Between 14% and 32% of survivors initiate supplement use after diagnosis, and use differs by cancer site. Breast cancer survivors reported the highest use, whereas prostate cancer survivors reported the least. Higher level of education and female sex emerged as factors most consistently associated with supplement use. Up to 68% of physicians are unaware of supplement use among their cancer patients. These results highlight the need for further studies of the association between dietary supplement use and cancer treatment toxicity, recurrence, survival, and quality of life to support evidence-based clinical guidelines for dietary supplement use among cancer patients and longer-term survivors.

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