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International Journal of Epidemiology 2003;32:553-555
© International Epidemiological Association 2003

Special Theme: Nutrition

Commentary: Vitamin supplement use and confounding by lifestyle

Katherine J Hoggatt

Department of Epidemiology, UCLA School of Public Health, Box 951772, Los Angeles, CA 90095–1772, USA. E-mail: khoggatt@ucla.edu

The first 10% of the full text of this article appears below.

The role of micronutrients in the development of chronic disease remains unclear. A number of observational studies have suggested a protective effect of various nutrients—e.g. folic acid and vitamin E with coronary heart disease, antioxidant vitamins, and cancer. However, recent reviews of the literature have described inconsistencies among studies and conflict between the results of observational research and clinical trials.1,2 One explanation for these discrepant findings is that results from observational studies of micronutrient intake and disease may be confounded by variables associated with a ‘healthy lifestyle’.3–6 As one review of supplement use and cancer put it, ‘[s]upplement use may be a behavioral marker for other factors related to cancer risk ... Control in analyses for major health-related behaviors may reduce this confounding effect, but completeness of adjustment can never be assured’.1 . . . [Full Text of this Article]


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