Skip to main content
Log in

Lifestyle and diet in people using dietary supplements

A German cohort study

  • ORIGINAL CONTRIBUTION
  • Published:
European Journal of Nutrition Aims and scope Submit manuscript

Summary

Background

The use of dietary supplements is often associated with a healthy lifestyle. Due to high variation in supplementation practice by country, these associations will be investigated in a large German cohort study.

Aim of the study

To describe the prevalence of dietary supplement use in the EPIC-Heidelberg cohort and to illuminate differences in health-relevant characteristics between regular users and non-users.

Methods

At cohort recruitment, 13,615 women aged 35–65 and 11,929 men aged 40–65 were asked for regular dietary supplementation over the past year.

Results

Regular use of any supplement was reported by 47% of the women and 41% of the men, vitamin or mineral supplements were taken by 40% and 33%, respectively. The use of vitamin and/or mineral supplements was significantly associated with higher age, being non- or ex-smoker, lower BMI, higher physical leisure time activity, and higher educational level. After adjustment for these factors, we observed positive associations between supplement use and the consumption of milk, milk products, and fish as well as the intake of vitamin C and β-carotene. In contrast, the supplement use was related to lower meat and meat product consumption, saturated fat intake, and n6/n3-fatty acid ratio in the diet, both in women and men. Except for Hemoccult® testing in women, no association with participation in cancer screening was observed.

Conclusions

The high prevalence of supplement use in EPIC-Heidelberg was associated with several presumably healthier lifestyle and diet characteristics. This needs to be considered in further evaluations of the risk of chronic diseases.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Albanes D, Heinonen O, Taylor P, et al. (1996) Alpha-tocopherol and beta-carotene supplements and lung cancer incidence in the alpha-tocopherol, beta-carotene cancer prevention study: effects of base-line characteristics and study compliance. J Natl Cancer Inst 88:1560–1570

    Article  CAS  Google Scholar 

  2. Bairati I, Meyer F, Gelinas M, et al. (2005) A randomized trial of antioxidant vitamins to prevent second primary cancers in head and neck cancer patients. J Natl Cancer Inst 97:481–488

    Article  CAS  Google Scholar 

  3. Becker N (2001) Epidemiologic aspects of cancer prevention in Germany. J Cancer Res Clin Oncol 127:9–19

    Article  CAS  Google Scholar 

  4. Beitz R, Mensink GB, Fischer B, Thamm M (2002) Vitamins–dietary intake and intake from dietary supplements in Germany. Eur J Clin Nutr 56:539–545

    Article  CAS  Google Scholar 

  5. Beitz R, Mensink GBM, Hintzpeter B, Fischer B, Erbersdobler HF (2004) Do users of dietary supplements differ from nonusers in their food consumption? Eur J Epidemiol 19:335–341

    Article  Google Scholar 

  6. Bjelakovic G, Nikolova D, Simonetti RG, Gluud C (2004) Antioxidant supplements for prevention of gastrointestinal cancers: a systematic review and meta-analysis. Lancet 364:1219–1228

    Article  CAS  Google Scholar 

  7. Blair SN, Kohl HW, Gordon NF, Paffenbarger RS (1992) How much physical activity is good for health? Annu Rev Public Health 13:99–126

    CAS  Google Scholar 

  8. Block G, Cox C, Madans J, Schreiber GB, Licitra L, Melia N (1988) Vitamin supplement use, by demographic characteristics. Am J Epidemiol 127:297–309

    CAS  Google Scholar 

  9. Boeing H, Bohlscheid-Thomas S, Voss S, Schneeweiss S, Wahrendorf J (1997) The relative validity of vitamin intakes derived from a food frequency questionnaire compared to 24-hour recalls and biological measurements: results from the EPIC pilot study in Germany. European prospective investigation into cancer and nutrition. Int J Epidemiol 26(Suppl 1):S82–90

    Article  Google Scholar 

  10. Boeing H, Korfmann A, Bergmann MM (1999) Recruitment procedures of EPIC-Germany. European investigation into cancer and nutrition. Ann Nutr Metab 43:205–215

    Article  CAS  Google Scholar 

  11. Boeing H, Wahrendorf J, Becker N (1999) EPIC-Germany–a source for studies into diet and risk of chronic diseases. European investigation into cancer and nutrition. Ann Nutr Metab 43:195–204

    Article  CAS  Google Scholar 

  12. Bohlscheid-Thomas S, Hoting I, Boeing H, Wahrendorf J (1997) Reproducibility and relative validity of energy and macronutrient intake of a food frequency questionnaire developed for the German part of the EPIC project. European prospective investigation into cancer and nutrition. Int J Epidemiol 26(Suppl 1):S71–81

    Article  Google Scholar 

  13. Bohlscheid-Thomas S, Hoting I, Boeing H, Wahrendorf J (1997) Reproducibility and relative validity of food group intake in a food frequency questionnaire developed for the German part of the EPIC project. European prospective investigation into cancer and nutrition. Int J Epidemiol 26(Suppl 1):S59–70

    Article  Google Scholar 

  14. Brandstetter BR, Korfmann A, Kroke A, Becker N, Schulze MB, Boeing H (1999) Dietary habits in the German EPIC cohorts: food group intake estimated with the food frequency questionnaire. European investigation into cancer and nutrition. Ann Nutr Metab 43:246–257

    Article  CAS  Google Scholar 

  15. Bundesfachverband der Arzneimittel-Hersteller e.V (2005) Der Arzneimittelmarkt in Deutschland in Zahlen 2004. Bundesfachverband der Arzneimittel-Hersteller e.V. Wissenschafts- und Wirtschaftsdienst, Bonn

  16. Frank E, Bendich A, Denniston M (2000) Use of vitamin-mineral supplements by female physicians in the United States. Am J Clin Nutr 72:969–975

    CAS  Google Scholar 

  17. Giovannucci E, Stampfer MJ, Colditz GA, et al. (1998) Multivitamin use, folate, and colon cancer in women in the nurses’ health study. Ann Intern Med 129:517–524

    CAS  Google Scholar 

  18. Hoggatt KJ, Bernstein L, Reynolds P, et al. (2002) Correlates of vitamin supplement use in the United States: data from the California teachers study cohort. Cancer Causes Control 13:735–740

    Article  CAS  Google Scholar 

  19. Joint WHO/FAO Expert Consultation on Diet Nutrition and the Prevention of Chronic Diseases (2002) Diet, nutrition and the prevention of chronic diseases: report of a joint WHO/FAO expert consultation. World Health Organization, Geneva

    Google Scholar 

  20. Kirk SF, Cade JE, Barrett JH, Conner M (1999) Diet and lifestyle characteristics associated with dietary supplement use in women. Public Health Nutr 2:69–73

    Article  CAS  Google Scholar 

  21. Klipstein-Grobusch K, Georg T, Boeing H (1997) Interviewer variability in anthropometric measurements and estimates of body composition. Int J Epidemiol 26(Suppl 1):S174–180

    Article  Google Scholar 

  22. Klipstein-Grobusch K, Kroke A, Voss S, Boeing H (1998) Influence of lifestyle on the use of supplements in the Brandenburg nutrition and cancer study. Z Ernahrungswiss 37:38–46

    Article  CAS  Google Scholar 

  23. Knudsen VK, Rasmussen LB, Haraldsdottir J, et al. (2002) Use of dietary supplements in Denmark is associated with health and former smoking. Public Health Nutr 5:463–468

    Article  Google Scholar 

  24. Lampe JW (1999) Health effects of vegetables and fruit: assessing mechanisms of action in human experimental studies. Am J Clin Nutr 70:475S–490S

    CAS  Google Scholar 

  25. Lucock M, Yates Z (2005) Folic acid - vitamin and panacea or genetic time bomb? Nat Rev Genet 6:235–240

    Article  CAS  Google Scholar 

  26. Lyle BJ, Mares-Perlman JA, Klein BE, Klein R, Greger JL (1998) Supplement users differ from nonusers in demographic, lifestyle, dietary and health characteristics. J Nutr 128:2355–2362

    CAS  Google Scholar 

  27. Marques-Vidal P, Arveiler D, Evans A, et al. (2000) Characteristics of male vitamin supplement users aged 50–59 years in France and Northern Ireland: the PRIME study. Prospective epidemiological study of myocardial infarction. Int J Vitam Nutr Res 70:102–109

    Article  CAS  Google Scholar 

  28. McNaughton SA, Mishra GD, Paul AA, Prynne CJ, Wadsworth MEJ (2005) Supplement use is associated with health status and health-related behaviors in the 1946 British birth cohort. J Nutr 135:1782–1789

    CAS  Google Scholar 

  29. Mensink GB, Strobel A (1999) Intake of dietary supplements and nutritional behavior]. Gesundheitswesen 61(Spec No):S132–137

    Google Scholar 

  30. Miller ER III, Pastor-Barriuso R, Dalal D, Riemersma RA, Appel LJ, Guallar E (2004) Meta-analysis: high-dosage vitamin e supplementation may increase all-cause mortality. Ann Intern Med 142:37–46

    Google Scholar 

  31. Nissen SB, Tjonneland A, Stripp C, et al. (2003) Intake of vitamins A, C, and E from diet and supplements and breast cancer in postmenopausal women. Cancer Causes Control 14:695–704

    Article  Google Scholar 

  32. Omenn G, Goodman G, Thornquist M, et al. (1996) Risk factors for lung cancer and for intervention effects in CARET, the beta-carotene and retinol efficacy trial. J Natl Cancer Inst 88:1550–1559

    Article  CAS  Google Scholar 

  33. Paffenbarger RS Jr, Hyde RT, Wing AL, Lee IM, Jung DL, Kampert JB (1993) The association of changes in physical-activity level and other lifestyle characteristics with mortality among men. N Engl J Med 328:538–545

    Article  Google Scholar 

  34. Patterson R, Neuhouser M, White E, Hunt J, Kristal A (1998) Cancer-related behavior of vitamin supplement users. Cancer Epidemiol Biomarkers Prev 7:79–81

    CAS  Google Scholar 

  35. Patterson RE, White E, Kristal AR, Neuhouser ML, Potter JD (1997) Vitamin supplements and cancer risk: the epidemiologic evidence. Cancer Causes Control 8:786–802

    Article  CAS  Google Scholar 

  36. Riboli E, Kaaks R (1997) The EPIC project: rationale and study design. European prospective investigation into cancer and nutrition. Int J Epidemiol 26(Suppl 1):S6–14

    Article  Google Scholar 

  37. Schellhorn B, Doring A, Stieber J (1998) Use of vitamins and minerals all food supplements from the MONICA cross-sectional study of 1994/95 from the Augsburg study region. Z Ernahrungswiss 37:198–206

    Article  CAS  Google Scholar 

  38. Schlehofer B, Heuer C, Blettner M, Niehoff D, Wahrendorf J (1995) Occupation, smoking and demographic factors, and renal cell carcinoma in Germany. Int J Epidemiol 24:51–57

    Article  CAS  Google Scholar 

  39. Statistisches Bundesamt (2000) Bildung im Zahlenspiegel 2000. Statistisches Bundesamt, Wiesbaden

    Google Scholar 

  40. Touvier M, Kesse E, Clavel-Chapelon F, Boutron-Ruault M-C (2005) Dual association of {beta}-carotene with risk of tobacco-related cancers in a cohort of French women. J Natl Cancer Inst 97:1338–1344

    Article  CAS  Google Scholar 

  41. Touvier M, Kesse E, Volatier JL, Clavel-Chapelon F, Boutron-Ruault MC (2006) Dietary and cancer-related behaviors of vitamin/mineral dietary supplement users in a large cohort of French women. Eur J Nutr 45:205–214

    Article  CAS  Google Scholar 

  42. Wallström P, Elmstahl B, Hanson BS, Östergren PO, Johansson U, Janzon L (1996) Demographic and psychosocial characteristics of middle-aged women and men who use dietary supplements. Results from the Malmö diet and cancer study. Eur J Public Health 6:188–195

    Article  Google Scholar 

  43. Winkler G, Doring A, Fischer B (1998) Supplements as a source of micronutrient intake in middle-aged men in southern Germany: results of the MONICA dietary survey 1994/95. Z Ernahrungswiss 37:315–318

    Article  CAS  Google Scholar 

  44. Wolters M, Hahn A (2001) [Nährstoffsupplemente aus Sicht des Konsumenten]. Ernährungs-Umschau 48:136–141

    Google Scholar 

Download references

Acknowledgements

EPIC-Heidelberg is supported by the Deutsche Krebshilfe [Grant-No.:70-488-Ha I], Deutsches Krebsforschungszentrum, and the Program “Europe against Cancer” of the European Commission [Grant-No.:S12.296584 (2000CVG 2–014)].

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Jakob Linseisen.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Reinert, A., Rohrmann, S., Becker, N. et al. Lifestyle and diet in people using dietary supplements. Eur J Nutr 46, 165–173 (2007). https://doi.org/10.1007/s00394-007-0650-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00394-007-0650-2

Keywords

Navigation