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Nutrients From Food, Not Supplements, Linked to Lower Risk of Death, Cancer

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Getting sufficient amounts of certain nutrients from food, rather than dietary supplements, is linked to a lower risk of dying from any cause, according to a study. The only exception was taking a lycopene supplement, which was linked to a lower risk of dying of heart disease and cancer.

The research was published online on April 9, 2019, by the Annals of Internal Medicine. Read the abstract of “Association Among Dietary Supplement Use, Nutrient Intake, and Mortality Among U.S. Adults: A Cohort Study.”

Lycopene is a powerful antioxidant and is what makes tomatoes red and gives other orange-colored vegetables their color. Antioxidants protect your body's cells from free radicals — unstable molecules created during normal cell functions. Pollution, radiation, cigarette smoke, and herbicides also can create free radicals in your body. Free radicals can damage a cell's genetic parts and may trigger the cell to grow out of control. These changes may contribute to the development of cancer and other diseases.

How this study was done

To do the study, the researchers analyzed supplement use in the previous 30 days by 30,899 people age 20 and older who answered six cycles of the National Health and Nutrition Examination Surveys from 1999 to 2000 and 2009 to 2010.

The National Health and Nutrition Examination Surveys are a program of studies overseen by the Centers for Disease Control and Prevention (CDC) designed to assess the health and nutritional status of people in the United States. The survey examines a nationally representative sample of about 5,000 people each year.

The researchers also analyzed nutrient intake from supplements and food for 27,725 people age 20 and older who gave the researchers information on what they ate for the previous 24 or 48 hours.

The researchers classified the participants’ intake of nutrients as:

  • Inadequate: total nutrient intake from both food and supplements was below the average requirement.
  • Adequate: total nutrient intake was at the average requirement.
  • Excess: total nutrient intake was more than the average requirement.

People in the study who took supplements had an average age of 50.7 years. People who didn’t take supplements had an average age of 42.8 years.

The researchers then looked at death outcomes for each person in the study through the National Death Index, a centralized database of death record information overseen by the CDC.

The researchers looked for links between supplement use and death from any cause, death from heart disease, and death from cancer. They also looked to see if the nutrient intake levels and the source of the nutrients (from supplements vs. from food), affected the relationship between supplement use and death.

The results

During a follow-up period of about 6 years, 3,613 study participants died:

  • 945 people died from heart disease
  • 805 people died from cancer
  • 1,863 people died from other causes

When looking at the relationship between nutrient intake and risk of death from any cause, the researchers found:

  • Adequate intake of vitamin K and magnesium were linked to a lower risk of death.
  • Adequate intake of vitamin A, vitamin K, copper, and zinc were linked to a lower risk of death from heart disease.
  • Adequate intake of lycopene was linked to a lower risk of death from any cause, as well as a lower risk of death from cancer.
  • Excess intake of calcium was linked to a higher risk of death from cancer.

When looking at whether the nutrients came from supplements or food, the researchers found:

  • The lower risk of death associated with adequate intake of vitamin K and magnesium was only seen when the nutrients came from foods, not from supplements.
  • The lower risk of death from heart disease associated with adequate intake of vitamin A, vitamin K, and zinc was only seen when the nutrients came from foods, not from supplements.
  • Lycopene was the only supplement linked to a lower risk of death. Adequate intake of lycopene from supplements reduced the risk of dying from any cause by 18% and lowered the risk of dying from cancer by 54%.
  • Taking 1,000 mg per day of calcium supplement was linked to a 62% higher risk of death from cancer. This link was only seen for calcium from supplements and was not seen when calcium came from foods.

"Our results support the idea that, while supplement use contributes to an increased level of total nutrient intake, there are beneficial associations with nutrients from foods that aren't seen with supplements," Fang Fang Zhang, M.D., associate professor of nutrition science and policy at Tufts University and senior author of the study, said in a statement. "This study also confirms the importance of identifying the nutrient source when evaluating mortality outcomes."

What this means for you

Taking dietary supplements requires that you do some homework, especially if you're being treated for breast cancer. Before you take anything, make sure you talk to your doctor and a registered dietitian about what you would like to take and discuss all the risks and benefits.

Keep the following points in mind when you’re considering taking any supplements:

  • Some dietary supplements can interfere with breast cancer treatments and prescription medicines. It’s very important to talk to your doctor about any and all supplements you’re considering.
  • Dietary supplements are not regulated by the U.S. government because they’re not classified as medicine. This means you have no guarantee that the supplement contains only the ingredients on the label. Look for reputable manufacturers you can trust to produce consistently high-quality supplements. Prescription and over-the-counter medicines available in the United States must, by federal law, meet the standards of the U.S. Pharmacopeia (USP). The USP also has created a set of standards for dietary supplements. But supplement makers are not required to follow these standards — it's voluntary. A good rule of thumb is to look for a supplement with the USP notation on the label.
  • Just because it’s natural doesn’t mean it’s safe. Many people believe that any food or supplement in its naturally occurring, unprocessed state is better or safer than something that is refined or manufactured. This is not necessarily true. Some of the most toxic substances in the world occur naturally.
  • Most doctors and dietitians recommend getting the nutrients you need from food, not supplements. This study supports that recommendation.

"Though I take supplements, I still believe the overall health benefits I am receiving from my nine-plus servings of fruits and vegetables and one to three serving of soy foods each day are even more important than the benefits of these supplements," said Diana Dyer, M.S., a registered dietitian and member of the Professional Advisory Board. "If I were forced to choose only one approach, I would put my money on maximizing my diet for the largest potential benefit."

For more information, visit the Dietary Supplements pages.

To talk with others about creative ways to get nutrients from foods, join the Discussion Board forum Healthy Recipes for Everyday Living.

Written by: Jamie DePolo, senior editor

Reviewed by: Brian Wojciechowski, M.D., medical adviser

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