Popular retinol supplements ‘causally’ associated with lung cancer

Dr Chris discusses CT scans detecting lung cancer

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A recent study, published in the journal Frontiers in Nutrition, has “causally” associated vitamin A supplementation with lung cancer. This is not the first time vitamin A, also known as retinol, has been associated with cancer. However, prior to this study, researchers have not uncovered a link to lung cancer.

Researchers employed the Mendelian randomisation (MR) method, which investigates the causal relationship between risk factors and outcomes from a genetic perspective.

Data on 11,348 cases and 15,861 controls were extracted from the International Lung Cancer Consortium (ILCCO) – an international group of lung cancer researchers, established in 2004 with the aim of sharing comparable data from ongoing lung cancer case-control and cohort studies.

The researchers, from Pecking University in China, found that high intake of vitamin A increases the risk of squamous cell and adenocarcinoma lung cancers – two common types of lung cancer.

“The results showed that higher dietary retinol intake was causally associated with lung cancer overall squamous cell lung cancer and lung adenocarcinoma.”

The researchers concluded: “Our research showed that dietary retinol intake has an adverse impact on lung cancer, and carotene might increase the risk of adenocarcinoma.

“This highlights the importance of revealing the underlying mechanisms of dietary antioxidant vitamins in lung cancer and delivers an important health message that dietary antioxidant vitamin intake may not be necessary for the prevention of lung cancer. It also provides a basis for future research.”

Indeed, more research is needed before conclusions can be drawn.

However, vitamin A has previously been associated with prostate cancer.

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A pooled analysis of 15 different clinical studies published in the American Journal of Clinical Nutrition in 2015, looked at over 11,000 cases, to determine association of levels of vitamins and cancer risk.

In this very large sample size, levels of retinol were positively associated with prostate cancer risk.

Furthermore, an observational analysis of over 29,000 samples from the alpha-tocopherol, beta-carotene cancer prevention study conducted by National Cancer Institute (NCI), National Institute of Health (NIH), USA, reported that at the three year follow-up, men with higher serum retinol (Vitamin A) concentration had an elevated risk of prostate cancer.

Finally, a more recent analysis of the same NCI driven alpha-tocopherol, beta-carotene cancer prevention study of over 29,000 participants between 1985-1993 with a follow-up to 2012, confirmed the earlier findings of the association of higher serum retinol concentration with increased risk of prostate cancer.

Higher serum retinol was not associated with overall cancer risk and observed to lower risk of liver and lung cancer, but across multiple studies there has been a positive correlation seen between serum Retinol (Vitamin A) levels and elevated risk of prostate cancer.

It must be noted that the findings do not mean you should shun vitamin A from your diet – the vitamin performs several important functions. However, it matters how you consume it.

Good sources of vitamin A (retinol) include:

• Cheese
• Eggs
• Oily fish
• Fortified low-fat spreads
• Milk and yoghurt
• Liver and liver products such as liver pâté – this is a particularly rich source of vitamin A, so you may be at risk of having too much vitamin A if you have it more than once a week (if you’re pregnant you should avoid eating liver or liver products).

What does the Department of Health and Social Care (DHSC) advise?

If you take a supplement that contains vitamin A, do not take too much because this could be harmful.

“Liver is a very rich source of vitamin A. Do not eat liver or liver products, such as pâté, more than once a week,” advises the health body.

“You should also be aware of how much vitamin A there is in any supplements you take.”

It notes that having an average of 1.5mg a day or less of vitamin A from diet and supplements combined is unlikely to cause any harm.

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