瑞典的最新研究顯示，每天服用綜合維他命的中老年婦女，罹患乳癌機率較其他女性提高19%。國內有醫師認為，攝取維生素還是以天然蔬果最好，特別是已罹患 乳癌，更不建議補充保健食品，也有醫師建議，服用綜合維他命，最好一天不超過一粒。
瑞典一項研究發現，追蹤超過3萬5000名、49至83歲婦女，並排除抽菸、家族病史、過重等危險因子，發現每天服用不特定品牌綜合維他命的婦女，罹患乳 癌機率比其他婦女增加19%。推測可能是綜合維他命中含葉酸，會增加乳房組織密度。
振興醫院腫瘤外科主任常傳訓表示，過去研究中，營養劑中以荷爾蒙跟乳癌的關連性最大，並沒有提到維生素也會有負面影響。不過他認為，天然蔬果還是比補充劑好，而且維他命開瓶後，遇到潮濕等保存條件不適當，很快就會變質，會有失效的問題，民眾卻不自知。
不鼓勵補充保健食品
有些乳癌病友擔心飲食不均衡，而攝取綜合維他命。常傳訓說，乳癌病友常需要化療、電療，服用維他命可能增強或是抵消藥物作用，因此不鼓勵乳癌患者服用保健 食品。
基隆長庚血液腫瘤科主治醫師王正旭則表示，這份研究未提到每天攝取的維他命劑量，但提醒民眾使用健康食品要更小心，他認為一天一粒應是可接受範圍，服用不應過量。 【聯合晚報╱記者黃玉芳/台北報導】
台灣媒體較偏好斷章取義, 而且一家刊出後其他家也會紛紛跟進(台灣新生報亦有完全一樣的報導), 在這個資訊爆炸的年代一般大眾更應審慎檢視並在採信前多方求證, 以下幾點是消費者應先省思的:
1. 劑量問題: 文中提到醫師建議一天一粒綜合維他命即可不宜過量, 然而過量與否是看劑量而非顆數, 如果ㄧ粒綜合維他命 C含量 10,000 毫克這樣也不過量嗎?
2. 荷爾蒙與乳癌的關連性: 乳癌成因常為荷爾蒙攝取過量( 包括環境荷爾蒙, 或是動物荷爾蒙), 然而天然萃取的維他命營養品較不含荷爾蒙, 即使有也是植物性的, 相對安全許多
在英國的另一篇報導更為全面而完整: 連結在此 , 可前往閱讀全文.
以下是部份重點節錄:
Dr Susanna C Larsson and colleagues from the Karolinska Institutet and a hospital in Sweden carried out this research.
這項研究是由瑞典的 Karolinska 機構的 Susanna C Larsson 及其團隊與一家醫院所進行的
It found that women who regularly took multivitamins were 19% more likely to develop a breast tumour than women who did not take multivitamins.
發現定期服用綜合維他命的婦女較無服用的婦女多出19%罹患乳癌的機率
However, it is difficult to draw firm conclusions on whether a link between multivitamins and breast cancer exists, particularly as other studies have had mixed findings on the matter. As the researchers have suggested, further research is needed to clarify whether there is a link and, if so, which component(s) of the multivitamin supplements may be responsible.
然而, 要充分證明綜合維他命與乳癌間存有某種關係是非常困難的, 尤其是其他相關主題的研究都有歧異的結果, 研究者並建議需要進一步的研究來證明是否有這種關係存在, 如存在亦須找出綜合維他命中造成乳癌的成份 (這部份國內的新聞完全未提及)
It is also important to note that the risk of developing breast cancer in this research was low, with only 2.8% of women affected. Although many people take multivitamins, a balanced and varied diet is usually enough to provide most people with the daily levels of vitamins and minerals they require.
需要特別強調的是, 研究中婦女罹患乳癌的機率相當低, 僅約 2.8%, 雖然相當多的人服用綜合維他命, 大多數的人透過均衡而多種類的飲食即可獲取所需要的維生素
The researchers reported that multivitamins in Sweden generally contain doses of vitamins and minerals close to the recommended daily allowances of each constituent: vitamin A (0.9 mg), vitamin C (60 mg), vitamin D (5 micrograms), vitamin E (9 mg), thiamine (1.2 mg), riboflavin (1.4 mg), vitamin B-6 (2.1 mg), vitamin B-12 (3 micrograms) and folic acid (300–400 micrograms). The minerals usually included were reported to be iron (10 mg), zinc (12 mg), copper (2 mg), chromium (50 micrograms), selenium (40 micrograms) and iodine (150 micrograms).
研究者指出在瑞典所販售的綜合維他命通常含有以下的維生素及礦物質:
維生素A 9毫克, 維生素C 60毫克, 維生素D 5微克, 維生素E 9毫克, 維生素B1 1.2毫克, 維生素B2 1.4毫克, 維生素B6 2.1毫克, 維生素B12 3微克, 葉酸 300-400 微克, 鐵 10毫克, 鋅 12毫克, 銅 2毫克, 鉻 50 毫克, 硒 40毫克, 碘 150 微克
The proportion of women who developed breast cancer was compared between the group that used multivitamins and the group that did not. This analysis took into account a number of risk factors for breast cancer, including age, education, history of benign breast disease, family history of breast cancer, number of children, age when first child was born, age at first period, age at menopause, use of oral contraceptives, use of hormone treatment after menopause, body mass index (BMI), physical activity, smoking, calcium supplement use and alcohol intake.
罹患乳癌的比例是將服用綜合維他命與未服用的婦女做比較, 分析中亦將 年齡, 教育, 良性乳房腫瘤病史, 家族乳癌病史, 子女數量, 初次生育年齡, 初經年齡, 更年期年齡, 是否使用口服避孕藥及更年期後荷爾蒙藥劑, 身體質量指數, 運動量, 吸菸, 服用鈣補充劑以及飲酒等乳癌相關因子一併考量進去
Just over a quarter of women (25.5%) reported using multivitamins, and nearly all of those reported that at least some of the multivitamins they took also contained minerals (23.9%). Women who took multivitamins were more likely to have received post-secondary education, have a history of benign breast disease, have no children and to have used oral contraceptives and postmenopausal hormone replacement than women who did not use multivitamins. Multivitamin users had lower BMIs than non-users and were less likely to smoke.
超過 1/4 (25.5%) 的女性服用綜合維他命, 服用礦物質補充劑有 23.9% (綜合維他命中幾乎都含有一項以上的礦物質). 服用綜合維他命的婦女群組比較起來有以下的特徵: 有較高的教育水準(專科以上), 有乳房良性腫瘤的病史, 無小孩且服用口服避孕劑及接受更年期後荷爾蒙補充療法(服用荷爾蒙), 身體質量指數較低(體型較苗條)且較少吸菸
*從這裡可看出來服用綜合維他命的瑞典婦女平常也會服用避孕藥等影響身體荷爾蒙運作的藥劑, 而乳癌成因有很大一部份是體內荷爾蒙異常所造成, 研究中並未提及良性腫瘤轉為惡性的比率, 但良性腫瘤較多很可能也是因服用避孕藥造成, 只是尚未轉換為癌症
During the study, 974 women (2.8%) developed breast cancer. Women who took multivitamins were more likely to have developed breast cancer than those who did not. After taking into account other factors that could affect results, multivitamin users had a 19% greater risk of developing breast cancer than non-users (relative risk 1.19, 95% confidence interval 1.04 to 1.37).
研究期間, 974 位婦女罹患乳癌 (2.8%), 在將上述各項相關因子納入考量後, 服用綜合維他命的婦女較未服用的罹患乳癌機率多出 19%, 相對風險 1.19, 95% 信心水準 (1.04至 1.37)
Conclusion 結論
This study has some strengths, including its large size. However, it also has some limitations:此項研究有其參考價值, 尤其是大量的採樣標準 (35329位婦女), 然而亦有其限制:
As with all studies of this type, it is possible that factors other than the one of interest (multivitamin use) could have affected the results. The researchers took into account a number of these factors, but they may not have completely accounted for their effects or the effect of an unknown or unmeasured factor.
就像其他類似的研究一樣, 很可能除了服用綜合維他命外有其他的因素影響研究結果, 雖然研究者已納入相當多的因素來考量, 但仍可能未完全考量這些因素或是有未知或無法計量的因素存在而造成影響
*原文中有提及, 只要一週服食一粒, 或是持續服食超過一年即納入服用綜合維他命那一組, 大家都知道一週服食一粒之影響對身體的影響其實不大, 服用避孕劑及荷爾蒙對身體的戕害應遠大於此
The researchers note that other studies of multivitamin use have had mixed findings. Some studies found an increase in breast cancer risk with multivitamin use, but not all of these findings were statistically significant. Other cohort studies found no link between multivitamin use and breast cancer. They also report that a French randomised controlled trial found that a combination of vitamins C and E, b-carotene, selenium and zinc did not affect the risk of breast cancer. A systematic review of existing studies could give a comprehensive picture of what is known to date about this question.
研究者指出其他關於服用綜合維他命的研究有著分歧的結論, 有些研究發現服用綜合維他命增加乳癌罹患率, 但並沒有強而有力的數據報告, 有些研究則證明兩者間無關連, 也提及法國一項隨機的測試研究發現維生素C, E, beta 胡蘿蔔素, 硒及鋅合併使用並不影響罹患乳癌的機率 針對現有的研究做有系統的回顧應可獲得較完整的觀點
Vitamin use was based on self-reported questionnaire data taken at one point only. It is possible that some women may not have reported their supplement use accurately, or that their use changed over the ten-year follow-up period. This could potentially affect the results.
維他命的使用與否數據資料是根據一次的問卷調查獲得, 有可能部份受測女性未確實回覆, 或者在十年間她們的使用習慣改變, 這些都可能影響研究結果
It is not possible to say from this study which of the component(s) of the multivitamin supplements may affect breast cancer risk.
此項研究並無法獲知哪項成份影響罹患乳癌的風險
Overall, it is difficult to draw firm conclusions based on this study alone. Further research is likely to be needed to clarify whether there is a link between multivitamin use and breast cancer risk and, if so, which component(s) of the multivitamin supplements are responsible. Most people can get their daily requirement of vitamins and minerals from a healthy, balanced diet.
總之, 根據此項研究並無法定論乳癌與服用綜合維他命間的關係, 需要更進一步的研究來證明是否有這種關係存在, 如存在亦須找出綜合維他命中造成乳癌的成份而大多數的人透過均衡而多種類的飲食即可獲取所需要的維生素
*文中強調均衡而多樣健康飲食可取代綜合維他命, 但在當下這樣的環境, 你我能做到嗎?
