Association Between use of Specialty Dietary Supplements and C-Reactive Protein Concentrations

Elizabeth D. Kantor; Johanna W. Lampe; Thomas L. Vaughan; Ulrike Peters; Colin D. Rehm; Emily White


Am J Epidemiol. 2012;176(11):1002-1013. 

In This Article

Abstract and Introduction


Laboratory evidence suggests that certain specialty dietary supplements have antiinflammatory properties, though evidence in humans remains limited. Data on a nationally representative sample of 9,947 adults from the 1999–2004 cycles of the National Health and Nutrition Examination Survey were used to assess the associations between specialty supplement use and inflammation, as measured by serum high-sensitivity C-reactive protein (hs-CRP) concentration. Using survey-weighted multivariate linear regression, significant reductions in hs-CRP concentrations were associated with regular use of glucosamine (17%, 95% confidence interval (CI): 7, 26), chondroitin (22%, 95% CI: 8, 33), and fish oil (16%, 95% CI: 0.3, 29). No associations were observed between hs-CRP concentration and regular use of supplements containing methylsulfonylmethane, garlic, ginkgo biloba, saw palmetto, or pycnogenol. These results suggest that glucosamine and chondroitin supplements are associated with reduced inflammation in humans and provide further evidence to support an inverse association between use of fish oil supplements and inflammation. It is important to further investigate the potential antiinflammatory role of these supplements, as there is a need to identify safe and effective ways to reduce inflammation and the burden of inflammation-related diseases such as cancer and cardiovascular disease.


Inflammation has been implicated in the etiology of several chronic diseases, including cardiovascular disease and several types of cancer.[1–4] Consistent with these observations, the antiinflammatory drug aspirin has been found to reduce the risk of cardiovascular disease[5,6] and colorectal cancer[7] in randomized controlled trials and has been associated with reduced risk of other cancers in observational studies.[8–10] Concerns remain about the adverse effects of long-term use of aspirin and other nonsteroidal antiinflammatory drugs (NSAIDs);[6,11–13] consequently, there is a need to identify other safe and effective measures for reducing inflammation and inflammation-related diseases.

Laboratory studies suggest that certain nonvitamin, nonmineral "specialty" supplements may act to reduce inflammation. These include glucosamine,[14–19] chondroitin,[20,21] methylsulfonylmethane (MSM),[22] fish oil supplements containing omega-3 polyunsaturated fatty acids (PUFAs),[23,24] garlic,[25–27] ginseng,[28,29] ginkgo biloba,[30] saw palmetto,[31] and pycnogenol-containing supplements.[32,33] Despite the suggested antiinflammatory properties of these supplements, evidence in humans remains limited. Of these supplements, omega-3 PUFA supplementation has been the best studied, with recent randomized controlled trial evidence suggesting that omega-3 supplements reduce inflammation.[34,35]

Given the current gap in our knowledge about the biologic effects of these supplements and the need for safe and effective measures to reduce inflammation, study of these supplements is warranted. We used data collected in the National Health and Nutrition Examination Survey (NHANES) to assess whether the aforementioned supplements are associated with inflammation in US adults, with inflammation being measured by serum high-sensitivity C-reactive protein (hs-CRP) concentration.