A beneficial cardiometabolic health profile associated with long-term multiple dietary supplement use: a cross-sectional study

Authors: JACQUES, PAUL - Jean Mayer Human Nutrition Research Center On Aging At Tufts University; ROGERS, GAIL - Jean Mayer Human Nutrition Research Center On Aging At Tufts University

Submitted to: International Journal for Vitamin and Nutrition Research
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 2/1/2021
Publication Date: 3/1/2021
Citation: Jacques, P.F., Rogers, G. 2021. A beneficial cardiometabolic health profile associated with long-term multiple dietary supplement use: a cross-sectional study. International Journal for Vitamin and Nutrition Research. https://doi.org/10.1024/0300-9831/a000701.
DOI: https://doi.org/10.1024/0300-9831/a000701

Interpretive Summary: Dietary supplement use is widespread in the US. Twenty three percent of supplements were taken based on the recommendation of a physician or other health care provider. Despite this widespread acceptance of supplements on the part of the public and health care providers, questions about both the safety and effectiveness of dietary supplements continue to be raised. In 2007, Block and colleagues considered this question of supplement safety and efficacy by examining the cardiometabolic health of supplement users in an unusual population of long-term use of multiple dietary supplement users defined by their active engagement with the social marketing arm of a supplement company (Shaklee Corp.). From this population, Block and colleagues characterized the health status of a sample of 278 long-term (20+ years) multiple dietary supplement (LTMDS) users. When compared with National Health and Nutrition Examination Survey (NHANES) controls who either took no supplements or took only a multivitamin, the long-term multiple dietary supplement users demonstrated a lower cardiometabolic risk profile. The present study was designed as a follow-up to this earlier study to explore the relation of LTMDS use and cardiometabolic risk after an additional 10 years of LTMDS use to determine if health benefits associated with the long-term use of multiple dietary supplements persisted over time and with aging. NHANES participants were again used as controls for the LTMDS users. We observed that the LTMDS users, who were on average age 72 years, had significantly healthier HDL and LDL cholesterol and fasting glucose levels than NHANES non-supplement users. The prevalence of elevated HbA1c (a marker of uncontrolled diabetes) was approximately 50% lower in LTMDS users than the NHANES non-supplement use group. LTMDS users also had higher HDL cholesterol and lower glucose and HbA1 concentrations than the NHANES participants who used multiple dietary supplements over a shorter time. These findings add to evidence that use of dietary supplements, particularly over the long-term, may provide cardiometabolic health benefits that may result in a lower risk of diabetes and cardiovascular disease and that these benefits appear to extend into older ages.

Technical Abstract: As a follow-up to an earlier study demonstrating healthier cardiometabolic profiles among long-term multiple dietary supplement (LTMDS) users, we examined if cardiometabolic health benefits associated with LTMDS use persisted with aging. The study is based on LTMDS users from North America and 2007-2010 NHANES participants who were used for comparison to the LTMDS users. NHANES subjects were classified as non-dietary supplement (NS) users, single supplement/single purpose supplement (SS) users, multivitamin/mineral supplement (MVMS) users, and multiple dietary supplement (MDS) users. Supplement groups were compared for total, HDL and LDL cholesterol; triglycerides; glucose; insulin; CRP and HbA1c >= 6.5%, adjusting for age, sex, income, education, BMI, history of CVD, and medications for hypercholesterolemia and diabetes. Geometric mean (95% confidence interval) LDL cholesterol was significantly lower (P < 0.05) for all supplement groups (SS: 110 (104-117) mg/dL; MVMS: 113 (107-119) mg/dL; MDS: 115 (111-118) mg/dL; LTMDS: 112 (105, 119) mg/dL) compared with the NS users (122 (118-126) mg/dL). Compared with the NS group, MDS users had significantly (P < 0.05) lower mean total cholesterol (198 (194-201) vs 201 (197, 206) mg/dL), MDS and LTMDS users higher mean HDL cholesterol (54.2 (53.3-55.1) and 60.0 (57.4, 62.7) mg/dL vs 52.0 (50.8-53.3) mg/dL), LTMDS users lower fasting glucose (100 (98-103) vs 105 (103-106) mg/dL), SS and MDS users lower insulin (8.4 (7.4-9.6) and 9.1 (8.3-9.9) vs 10.2 (9.4-11.1) muIU/mL), and MDS users lower CRP (% >= 1.5 mg/L, 50.8 (47.9-53.6) vs 57.0 (52.4-61.6) %). These findings add to the evidence that use of dietary supplements may provide cardiometabolic health benefits.