A recent splash in the media occurred when a paper published by the Archives of internal medicine reported that dietary supplements may increase mortality rates in older women. A write-up from ScienceDaily titled their piece on this, “Certain Dietary Supplements Associated with Increased Risk of Death in Older Women.”
It is unfortunate that this was the portrayal of this information by the media because it lacks accuracy upon a review of the full text. In fact, a decreased mortality was found in the group who took calcium and Vitamin D. The hype in the media clouds the science and gives an erroneous impression about supplement use. The conclusion that there was an increased risk of death in older women was based on the difference in age of 82.3 years in the supplement users versus 82.6 in nonusers. This is hardly a profound difference. However, one must consider that supplements on face did not increase longevity which deserves careful attention.
A huge self-admitted flaw of the study is that they did not control for people who began to take supplements while being tracked. The average age at the onset of the study design was 61.5. If people were supplement naïve at onset but began taking supplements during the study they were then labeled as supplement users. A major reason that people begin supplements is because they have been diagnosed with a condition or begun to have symptoms. For example, it is reported that as many as 60-85% of people diagnosed with cancer take supplements, whereas only about 50% of the general public consumes supplements. It is probable that the diagnosis of a condition of aging, such as cancer, diabetes, or heart disease, would motivate the initiation of supplement use.
The initial statistical analysis found self-reported use of Vitamin B complex, Vitamins C, D, E, and calcium to have a lower risk of total mortality compared to nonusers, however with further adjustment only the use of calcium retained a significantly lower risk of mortality. Iron was found to have a dose-response relationship with mortality. However, it is well known that too much iron will cause an increase in oxidative stress. To parallel iron overload to high use of other nutrients may not be accurate.
One of the more substantial differences between the supplement users and non-users is that supplement users were twice as likely to be on hormones than nonusers. It is possible that the use of hormones confounds the outcomes related to supplement use and may be a reason for mortality being unchanged in the group of users. This demonstrates why Progressive has opted to use bioidentical hormones rather than foreign estrogens from horse urine which is the current standard of care.
Both groups lived to be more than 82 on average. It may also be considered that supplement use is employed not to live longer, but to live better. The supplement group had a significant decrease in diabetes, high blood pressure, and BMI as well as a greater degree of physical activity. Other flaws include that there is no discrimination of what type or quality of supplement was used. This study is evidence that we have to be careful to provide high-quality supplementation with supportive research, which is the philosophy and practice behind Progressive medical. The bottom line message should not be that supplements are harmful, but that care and individualization should be used when considering what supplements to use. Misrepresentations of science in the media do little to help patients or healthcare and it is important that we carefully examine the evidence.
Dr. Cheryl Burdette