title: Risk of Type 2 Diabetes Is Lower in US Adults Taking Chromium-Containing Supplements.
abstract: BACKGROUND
  Dietary supplement use is widespread in the United States. Although it has been suggested in both in vitro and small in vivo human studies that chromium has potentially beneficial effects in type 2 diabetes (T2D), chromium supplementation in diabetes has not been investigated at the population level.
  
  
  OBJECTIVE
  The objective of this study was to examine the use and potential benefits of chromium supplementation in T2D by examining NHANES data.
  
  
  METHODS
  An individual was defined as having diabetes if he or she had a glycated hemoglobin (HbA1c) value of ≥6.5%, or reported having been diagnosed with diabetes. Data on all consumed dietary supplements from the NHANES database were analyzed, with the OR of having diabetes as the main outcome of interest based on chromium supplement use.
  
  
  RESULTS
  The NHANES for the years 1999-2010 included information on 62,160 individuals. After filtering the database for the required covariates (gender, ethnicity, socioeconomic status, body mass index, diabetes diagnosis, supplement usage, and laboratory HbA1c values), and when restricted to adults, the study cohort included 28,539 people. A total of 58.3% of people reported consuming a dietary supplement in the previous 30 d, 28.8% reported consuming a dietary supplement that contained chromium, and 0.7% consumed supplements that had "chromium" in the title. Compared with nonusers, the odds of having T2D (HbA1c ≥6.5%) were lower in persons who consumed chromium-containing supplements within the previous 30 d than in those who did not (OR: 0.73; 95% CI: 0.62, 0.86; P = 0.001). Supplement use alone (without chromium) did not influence the odds of having T2D (OR: 0.89; 95% CI: 0.77, 1.03; P = 0.11).
  
  
  CONCLUSIONS
  Over one-half the adult US population consumes nutritional supplements, and over one-quarter consumes supplemental chromium. The odds of having T2D were lower in those who, in the previous 30 d, had consumed supplements containing chromium. Given the magnitude of exposure, studies on safety and efficacy are warranted.
authors.affiliation: Boston Children's Hospital, Boston, MA; Harvard Medical School, Boston, MA; and david.mciver@childrens.harvard.edu.
authors.forename: David J
authors.identifier: http://orcid.org/0000-0002-9507-1674
authors.initials: DJ
authors.lastname: McIver
authors.affiliation: Harvard Medical School, Boston, MA; and Joslin Diabetes Center, Boston, MA.
authors.forename: Ana Maria
authors.initials: AM
authors.lastname: Grizales
authors.affiliation: Boston Children's Hospital, Boston, MA; Harvard Medical School, Boston, MA; and.
authors.forename: John S
authors.identifier: http://orcid.org/0000-0001-8568-5317
authors.initials: JS
authors.lastname: Brownstein
authors.affiliation: Harvard Medical School, Boston, MA; and Joslin Diabetes Center, Boston, MA.
authors.forename: Allison B
authors.initials: AB
authors.lastname: Goldfine
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002857:Chromium / Q000008:administration & dosage*; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology*; D019587:Dietary Supplements; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D008297:Male; D008875:Middle Aged; D009749:Nutrition Surveys; D016017:Odds Ratio; D012307:Risk Factors; D014481:United States / Q000453:epidemiology; D055815:Young Adult
chemical_list: D002857:Chromium; D006442:Glycated Hemoglobin
keywords: NHANES; chromium; diabetes; dietary supplements; glucose intolerance; insulin resistance; safety