Long-term Use of β-Carotene, Retinol, Lycopene, and Lutein Supplements and Lung Cancer Risk: Results From the VITamins And Lifestyle (VITAL) Study

Departments of Nutrition and Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
American journal of epidemiology (Impact Factor: 5.23). 02/2009; 169(7):815-28. DOI: 10.1093/aje/kwn409
Source: PubMed


High-dose beta-carotene supplementation in high-risk persons has been linked to increased lung cancer risk in clinical trials; whether effects are similar in the general population is unclear. The authors examined associations of supplemental beta-carotene, retinol, vitamin A, lutein, and lycopene with lung cancer risk among participants, aged 50-76 years, in the VITamins And Lifestyle (VITAL) cohort Study in Washington State. In 2000-2002, eligible persons (n = 77,126) completed a 24-page baseline questionnaire, including detailed questions about supplement use (duration, frequency, dose) during the previous 10 years from multivitamins and individual supplements/mixtures. Incident lung cancers (n = 521) through December 2005 were identified by linkage to the Surveillance, Epidemiology, and End Results cancer registry. Longer duration of use of individual beta-carotene, retinol, and lutein supplements (but not total 10-year average dose) was associated with statistically significantly elevated risk of total lung cancer and histologic cell types; for example, hazard ratio = 2.02, 95% confidence interval: 1.28, 3.17 for individual supplemental lutein with total lung cancer and hazard ratio = 3.22, 95% confidence interval: 1.29, 8.07 for individual beta-carotene with small-cell lung cancer for >4 years versus no use. There was little evidence for effect modification by gender or smoking status. Long-term use of individual beta-carotene, retinol, and lutein supplements should not be recommended for lung cancer prevention, particularly among smokers.

10 Reads
  • Source
    • "[63]. As already discussed, an increased risk of lung cancer and prostate cancer has been observed in some trials employing levels of certain micronutrients much higher than the RDA [41-45]. It is possible that the increase in cancer seen in these studies is due to the fact that high levels of individual vitamins may be harmful and should be used with caution. "
    [Show abstract] [Hide abstract]
    ABSTRACT: A balanced and varied diet is the best source of essential vitamins and minerals; however, nutrient deficiencies occur, including in populations with bountiful food supplies and the means to procure nutrient-rich foods. For example, the typical American diet bears little resemblance to what experts recommend for fruit, vegetables, and whole grains, which serve as important sources of an array of vitamins and minerals. With time, deficiencies in one or more micronutrients may lead to serious health issues. A common reason people take multivitamin and mineral (MVM) supplements is to maintain or improve health, but research examining the effectiveness of MVMs in the prevention of certain chronic conditions is ongoing. In addition to the utility of MVMs for filling in relatively small but critical nutritional gaps, which may help prevent conditions such as anemia, neural tube defects, and osteoporosis, some evidence supports possible benefits of MVM supplementation with regard to cancer prevention (particularly in men) and prevention or delay of cataract, as well as some aspects of cognitive performance. Unlike some single-vitamin supplements, MVM supplements are generally well tolerated and do not appear to increase the risk of mortality, cerebrovascular disease, or heart failure. The potential benefits of MVM supplements likely outweigh any risk in the general population and may be particularly beneficial for older people.
    Nutrition Journal 07/2014; 13(1):72. DOI:10.1186/1475-2891-13-72 · 2.60 Impact Factor
  • Source
    • "Several other issues are associated with the use of nutraceutics and concern the dose, activity, and presence of contaminants. Phytochemicals, if in excess, can result in undesirable effects; for example, high doses of carotenoids have been associated with an increased risk of lung cancer in smokers (Satia et al., 2009) and in alcohol drinkers (Ratnasinghe et al., 2000). Moreover, several products present on the market have little or no effect due to incorrect preparation and storage. "
    [Show abstract] [Hide abstract]
    ABSTRACT: In recent years, both food quality and its effect on human health have become a fundamental issue all over the world. As a consequence of this new and increased awareness, American, European, and Asian policymakers have strongly encouraged the research programs on food quality and safety thematic. Attempts to improve human health and to satisfy people's desire for healthcare without intake of pharmaceuticals, has led the food industry to focus attention on functional or nutraceutical food. For a long time, compounds with nutraceutical activity have been produced chemically, but the new demands for a sustainable life have gradually led the food industry to move towards natural compounds, mainly those derived from plants. Many phytochemicals are known to promote good health, but, sometimes, undesirable effects are also reported. Furthermore, several products present on the market show few benefits and sometimes even the reverse - unhealthy effects; the evidence of efficacy is often unconvincing and epidemiological studies are necessary to prove the truth of their claims. Therefore, there is a need for reliable analytical control systems to measure the bioactivity, content, and quality of these additives in the complex food matrix. This review describes the most widespread nutraceutics and an analytical control of the same using recently developed biosensors which are promising candidates for routine control of functional foods.
    Critical reviews in food science and nutrition 10/2012; 53(2):198-213. DOI:10.1080/10408398.2010.520829 · 5.18 Impact Factor
  • Source
    • "In particular, Mannisto et al. [125], using data from seven cohort studies in the United States and Europe, reported that none of the carotenoids evaluated in the study, including lycopene, was associated with lung cancer risk. In the VITAL Study, no significant association of supplemental lycopene with lung cancer risk was observed [131]. On the other hand, in the Health Professionals Follow-up Study and the Nurses' Health Study, lycopene and total carotenoids (from diet) were associated with reduced lung cancer risk. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Increasing evidence suggests that tomato lycopene may be preventive against the formation and the development of lung cancer. Experimental studies demonstrated that lycopene may inhibit the growth of several cultured lung cancer cells and prevent lung tumorigenesis in animal models through various mechanisms, including a modulation of redox status, cell cycle arrest and/or apoptosis induction, a regulation of growth factor signaling, changes in cell growth-related enzymes, an enhancement of gap junction communication and a prevention of smoke-induced inflammation. In addition, lycopene also inhibited cell invasion, angiogenesis, and metastasis. Several lycopene metabolites have been identified, raising the question as to whether the preventive effects of lycopene on cancer risk is, at least in part, due to its metabolites. Despite these promising reports, it is difficult at the moment to directly relate available experimental data to human pathophysiology. More well controlled clinical intervention trials are needed to further clarify the exact role of lycopene in the prevention of lung cancer cell growth. Such studies should take into consideration subject selection, specific markers of analysis, the levels of carotenoids being tested, metabolism and isomerization of lycopene, interaction with other bioactive food components. This article reviews data on the cancer preventive activities of lycopene, possible mechanisms involved, and the relationship between lycopene consumption and human cancer risk.
    Cancers 12/2011; 3(2):2333-57. DOI:10.3390/cancers3022333
Show more


10 Reads
Available from