Association between dietary vitamin intake and mortality in US adults with diabetes: A prospective cohort study.

Abstract

To explore the association of dietary vitamin intake from food and/or supplement with mortality in US adults with diabetes. This prospective cohort study was conducted on 5418 US adults with diabetes from the National Health and Nutrition Examination Survey 1999-2018. Vitamin intake from food and supplements was estimated via dietary recall. Sufficient intake from food or food+supplement was defined as≥estimated average requirement (EAR) and≤tolerable upper intake level (UL), insufficient intake, <EAR; and excess intake, >UL. Medium supplementary intake was classified as>median level and ≤75th percentile; low intake,≤median level; and high intake, >75th percentile, as reported by supplement users. A total of 1601 deaths occurred among the participants over a median follow-up of 11.0years. Cox regression analysis of the single-vitamin model demonstrated that sufficient vitamin A and folate intake from food and food+supplement and medium vitamin A and folate intake from supplement; sufficient riboflavin, niacin, and vitamin B6 intake from food and food+supplement; and sufficient thiamin and vitamin E intake from food+supplement were significantly associated with reduced all-cause mortality (all p<0.05). In the multivitamin model, sufficient vitamin A and folate intake from food and food+supplement, medium vitamin A and folate intake from the supplement, and sufficient niacin intake from food and food+supplement were inversely associated with mortality (all p<0.05). Vitamin A and folate intake from food or supplement and niacin intake from food were significantly associated with reduced mortality in US adults with diabetes.