Lifestyle and diet in people using dietary supplements: a German cohort study

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.

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.

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.

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 beta-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((R)) testing in women, no association with participation in cancer screening was observed.

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.