美國知名醫學期刊《Annals of Internal Medicine》公佈一項研究,美國塔夫茨大學 (Tufts University) 研究人員將一系列營養素的攝入量與所有死亡原因、心血管疾病和癌症的死亡率進行比較,認為雖然補充劑可以提高整體營養素的攝取量,但是食物中天然營養素的好處不見於補充劑之中。尤其是維生素D,如果原本沒有缺乏維生素D的人多吃這類維他命的話,還會增加罹患癌症的風險;另外還發現,每天攝入過量的鈣補充劑,也會增加罹癌的風險。
研究發現,當來自於補充劑的鈣的劑量達到了每天1000毫克以上,癌症的死亡風險會增加。如果來自於補充劑的鈣劑量在1000毫克以內,又或者都是通過食物來獲得的鈣,則不會增加癌症的風險。原因可能是當食物中的鈣攝入較多時,人體的腸道會降低對於鈣的吸收,同時尿鈣排出也會增加,而補充劑的長期使用難以降低血液循環中鈣的水平,進而誘發了一系列複雜的機制。
這項研究中還發現,本身維生素D在20ng/ml以上的人,再攝入每天超過400IU的維生素D補充劑,全因死亡風險就會增加,這個結果也很值得警醒。
小編評:結論,補充維生素礦物質要從食品中補給,不要從營養補給保健品中攝取,而且攝取這些維生素礦物質只對營養不足的人有好處,對於已經營養飽滿的現代人不見得有正面的助益。
其實國健署也有撰文(維生素D – 國健署)說明維生素D過量攝取的問題:
維生素 D 中毒的主要症狀為高鈣血症(hypercalcemia),是因維生素D促進小腸細胞鈣的吸收與骨骼礦物質的再吸收(resorption)所造成。當維生素D攝取量高達每日 1,250 μg(50,000 IU)時,血漿或血清25OHD 濃度可達 2820-4000 nmol/L(正常範圍是 50-200 nmol/L)。高血鈣症會導致腎小管的尿液濃縮機制喪失、正常的再吸收機制受破壞而產生多尿、劇渴及高尿鈣的現象。長期高血鈣造成腎臟、血管、心臟、肺臟等軟組織的轉移性鈣化(metastatic calcification)。攝取量為1,250-5,000 μg(50,000-200,000 IU)/d 時,有中樞神經系統方面的症狀包括:憂鬱、厭食、噁心、嘔吐等。
Parfitt 的研究給予副甲狀腺功能低下患者每天 2,100 μg(84,000 IU)之維生素 D 長達 5 年,認為腎臟、心臟等軟組織的鈣化是維生素 D 的直接影響,而非高血鈣現象的影響。動物研究顯示軟組織鈣化現象會出現在腎臟以外的組織,如心血管系統。人體研究的結果並不一致。雖然軟組織鈣化方面的研究證據尚不足以決定上限攝取量(Tolerable upper intake levels,UL),但顯示長期維生素 D 中毒或過量對健康的負面影響有很大的不確定性,在訂定 UL 時,應採取保守策略。
連結:Nutrients from food, not supplements, linked to lower risks of death, cancer(Tufts University報導)
Adequate intake of certain nutrients is associated with a reduction in all-cause mortality when the nutrient source is foods, but not supplements, according to a new study. There was no association between dietary supplement use and a lower risk of death.
In addition, excess calcium intake was linked to an increased risk of cancer death, which the researchers found was associated with supplemental doses of calcium exceeding 1,000 mg/day. The study was published on April 9 in Annals of Internal Medicine.
連結:Association Among Dietary Supplement Use, Nutrient Intake, and Mortality Among U.S. Adults: A Cohort Study(Annals of Internal Medicine期刊報導)
During a median follow-up of 6.1 years, 3613 deaths occurred, including 945 CVD deaths and 805 cancer deaths. Ever-use of dietary supplements was not associated with mortality outcomes. Adequate intake (at or above the Estimated Average Requirement or the Adequate Intake level) of vitamin A, vitamin K, magnesium, zinc, and copper was associated with reduced all-cause or CVD mortality, but the associations were restricted to nutrient intake from foods. Excess intake of calcium was associated with increased risk for cancer death (above vs. at or below the Tolerable Upper Intake Level: multivariable-adjusted rate ratio, 1.62 [95% CI, 1.07 to 2.45]; multivariable-adjusted rate difference, 1.7 [CI, −0.1 to 3.5] deaths per 1000 person-years), and the association seemed to be related to calcium intake from supplements (≥1000 mg/d vs. no use: multivariable-adjusted rate ratio, 1.53 [CI, 1.04 to 2.25]; multivariable-adjusted rate difference, 1.5 [CI, −0.1 to 3.1] deaths per 1000 person-years) rather than foods.
小編評:附上原始研究連結給大家參考,這樣比較不會被媒體斷章取義。