The online version of this article (https://doi.org/10.1186/s12885-017-3885-1) contains supplementary material, which is available to authorized users.
Use of dietary supplements among cancer survivors is common and controversial, but information on the amount of nutrients from supplements among cancer survivors is limited. We examined the amount of nutrients and their contribution to total nutrient intake from supplements and compared these data between cancer survivors and cancer-free individuals. We also identified factors associated with supplement use among cancer survivors.
We identified 400 cancer survivors and 10,387 cancer-free individuals, aged ≥ 19 years, from the fifth Korea National Health and Nutrition Examination Survey (KNHANES) V-1, 2 (2010, 2011). We calculated the amount of nutrients consumed from foods and supplements, the percent contributions of supplement nutrients to total nutrient intakes and cancer survivors’ nutrient intakes relative to the Estimated Average Requirements (EARs) and the Tolerable Upper Intake Levels (ULs). We examined factors associated with supplement use among cancer survivors.
We found that 33.3% of cancer survivors and 22.1% of cancer-free individuals reported the use of dietary supplements. Compared to cancer-free individuals, cancer survivors had higher intakes of riboflavin, folate, and iron from foods (p < 0.05 for each), and higher intakes of calcium (p = 0.05) and vitamin C (p = 0.01) from foods and supplements. The similar pattern was observed for the percent contributions to total nutrient intake. Cancer survivors had higher proportion of participants below EARs than cancer-free individuals for thiamin and niacin (p < 0.05 for each). The proportions of cancer survivors below the EARs were 61.2% for calcium, 49.1% for riboflavin, and 43.5% for folate and the proportions of cancer survivors above the ULs were 3.3% for iron, and 2.3% for vitamin A. For female cancer survivors, education above an elementary school level, moderate physical activity, low vegetable intake, and high circulating vitamin D levels were associated with supplement use. For male cancer survivors, living in an urban area, no consumption of alcohol, and lower energy intake, were associated with supplement use.
Korean cancer survivors have higher rate of dietary supplement use and higher contribution from supplements to total nutrient intake than cancer-free individuals. Demographic and lifestyle factors were associated with supplement use among cancer survivors.
Additional file 1: Table S1. Dietary supplement use of study population and according to cancer sites of cancer survivors a without using sampling weight (DOCX 19 kb)
Patterson RE, Neuhouser ML, Hedderson MM, Schwartz SM, Standish LJ, Bowen DJ. Changes in diet, physical activity, and supplement use among adults diagnosed with cancer. J Am Diet Assoc. 2003;103(3):323–8. PubMed
Bours MJ, Beijer S, Winkels RM, van Duijnhoven FJ, Mols F, Breedveld-Peters JJ, Kampman E, Weijenberg MP, Van de poll-Franse LV. dietary changes and dietary supplement use, and underlying motives for these habits reported by colorectal cancer survivors of the patient reported outcomes following initial treatment and long-term evaluation of survivorship (PROFILES) registry. Br J Nutr. 2015;114(2):286–96. CrossRefPubMed
Hardy ML: Dietary supplement use in cancer care: help or harm. Hematol Oncol Clin North Am 2008, 22(4):581–617, vii.
Harvie M. Nutritional supplements and cancer: potential benefits and proven harms. American Society of Clinical Oncology educational book / ASCO American Society of Clinical Oncology Meeting. 2014:e478–86.
Miller P, Demark-Wahnefried W, Snyder DC, Sloane R, Morey MC, Cohen H, Kranz S, Mitchell DC, Hartman TJ. Dietary supplement use among elderly, long-term cancer survivors. Journal of cancer survivorship : research and practice. 2008;2(3):138–48. CrossRef
Jung KW, Won YJ, CM O, Kong HJ, Lee DH, Lee KH. Community of Population-Based Regional Cancer R: cancer statistics in Korea: incidence, mortality, survival, and prevalence in 2014. Cancer research and treatment : official journal of Korean Cancer Association. 2017;49(2):292–305. CrossRef
Ministry of Health and Welfare / Korea Centers for Disease Control and Prevention: Korea Health Statistics 2015 : Korea National Health and Nutrition Examination Survey (KNHANES VI-3). In .; 2016.
Kim IK. The use of the functional foods in elderly patients with digestive system cancers. J Korean Gerontol Nurs. 2010;12(1):51–61.
Kang E, Yang EJ, Kim SM, Chung IY, Han SA, DH K, Nam SJ, Yang JH, Kim SW. Complementary and alternative medicine use and assessment of quality of life in Korean breast cancer patients: a descriptive study. Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer. 2012;20(3):461–73. CrossRef
Hwang JH, Kim W-Y, Ahmed M, Choi S, Kim J, Han DW. the use of complementary and alternative medicine by Korean breast cancer women: is it associated with severity of symptoms? Evid Based Complement Alternat Med. 2015;2015
Yun SH, Kim HJ, Oh K. Development of dietary supplement database and nutrient intakes from dietary supplements. Public Health Weekly Report. 2015;8(10):210–6.
Korea Centers for Disease Control and Prevention: The Fifth Korea National Health and Nutrition Examination Survey (KNHANES V). In . Seoul, Korea: Korea Centers for Disease Control and Prevention, Ministry of Health and Welfare; 2015.
Rural Development Administration: Food composition table, 7th edn. Suwon: Korea National Rural Resources Development Institute; 2006.
Kim JH, Lee E, Hyun T. Dietary folate intake and food sources of children and adolescents in Chungcheong area - using nutrient database revised by measured folate in selected foods. Journal of Nutr Health. 2015;48(1):94–104. CrossRef
Yon M, Hyun T. Additional data for the folate database for foods common in Korea. Korean J Nutr. 2005;38(7):586–604.
The Korean Nutrition Society: Dietary reference intakes for Koreans. In .: the Korean nutrition Society; 2010.
McDavid K, Breslow RA, Radimer K. Vitamin/mineral supplementation among cancer survivors: 1987 and 1992 National Health Interview Surveys. Nutr Cancer. 2001;41(1–2):29–32. PubMed
Greenlee H, White E, Patterson RE, Kristal AR. Supplement use among cancer survivors in the vitamins and lifestyle (VITAL) study cohort. J Altern Complem Med. 2004;10(4):660–6. CrossRef
Luc L, Baumgart C, Weiss E, Georger L, Ambrosone CB, Zirpoli G, McCann SE. Dietary supplement use among participants of a databank and biorepository at a comprehensive cancer centre. Public Health Nutr. 2014:1–11.
Rock CL, Newman VA, Neuhouser ML, Major J, Barnett MJ. Antioxidant supplement use in cancer survivors and the general population. J Nutr. 2004;134(11):3194s–5s. PubMed
- Dietary supplement use among cancer survivors and the general population: a nation-wide cross-sectional study
Yun Jung Lee
Jung Eun Lee
- BioMed Central
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