Dietary supplement use in elderly, long-term cancer survivors: Who are the users? What proportion benefit? What are the costs? Free

B54

The primary aim of this study was to examine dietary supplement-use among older (>65y), long-term survivors (>5 years post-diagnosis) of breast, prostate and colorectal cancer. Specific objectives were to: 1) identify predictors of supplement use; 2) determine associations between supplement use and overall diet quality; and 3) compare expenditures on supplements across strata of income. The sample was comprised of 753 cancer survivors who participated in telephone screening interviews to determine eligibility for a randomized diet and physical activity intervention trial entitled RENEW: Reach-out to ENhancE Wellness in Cancer Survivors. Telephone surveys were conducted through 2005-2007 by the Diet Assessment Center at Pennsylvania State University and included two 24-hour dietary recalls and items regarding dietary supplement use (type, dose, frequency and duration).
 >Nutrient intakes for 13 vitamins and minerals were determined from diet alone and from diet combined with supplemental intake and compared to the Estimated Average Requirements (EARs) and the Tolerable Upper Intake Levels (ULs). Diet quality was assessed using the revised Healthy Eating Index (HEI). Descriptive statistics were primarily used for this exploratory cross-sectional study with student’s t-tests used for continuous variables and chi-square tests for categorical variables. Multivariate logistic regression was employed to determine demographic, disease and health-related predictors of supplement use.
 >A majority of survivors (74%) reported taking dietary supplements, ranging from 70% among survivors of colorectal cancer to 80% among breast cancer survivors. A wide variety of supplements were taken, though multivitamins (60%), calcium/vitamin D combinations (37%), antioxidant combinations (30%) and fatty acids/oils (21%) were the most prevalent. Results suggest that supplement users had significantly higher mean HEI scores and nutrient intakes for 12 of the 13 vitamins and minerals investigated (all P<.05). Findings also revealed that supplement expenditures were higher among nonsmoking survivors as well as among survivors with higher incomes and educational attainment, with an average of nearly $200 spent per year on supplements. Results from multivariate logistic regression suggest statistically significant associations (p-values <.05) between supplement use and older age (> 70 years), higher levels of education, female gender, non-smoking status and higher HEI scores. Overall, dietary supplements may considerably increase the prevalence of nutrient adequacy among older cancer survivors, but also may contribute to risk of excessive intakes for certain nutrients, especially vitamin A. Future studies investigating long-term use of supplements are warranted to evaluate if intended benefits are achieved while risks of excessive intakes are minimized.