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Dietary Supplement Use in the USA: Who's Using What and Why

Session #250, American Dietetic Association's Food & Nutrition Conference & Expo (FNCE)
Monday, October 24, 2005, St. Louis, Missouri

Dietary supplement use is so pervasive in the United States today that it is becoming impossible to obtain estimates of total nutrient intakes without accounting for them. This session at the 2005 American Dietetic Association's Food & Nutrition Conference & Expo presented current data on, why people use dietary supplements, how to collect and assess information about them, and some authoritative resources that dietitians can use.

Program and Speaker Presentations

    Opening Comments: What are Dietary Supplements? Introduction. (PDF, 344kB)
    Leila G Saldanha, PhD, RD, Scientific Consultant, Office of Dietary Supplements (ODS), National Institutes of Health (NIH), Bethesda, MD

    Who Is Using Dietary Supplements and What are They Using? (PDF, 318kB)
    Mary Frances Picciano, PhD, ODS, NIH, Bethesda, MD

      This presentation focused on the most recent analyses of The National Health and Nutrition Examination Survey (NHANES), a nationally representative survey that includes medical examinations and tests as well as detailed questions about participants' health, lifestyle, and diet, including dietary supplement use. Data on the prevalence and use of dietary supplements including specific vitamin and mineral supplements for the US population aged 20 years and older, and the associations of use with select demographic and lifestyle characteristics were presented.

      Millen AE, Dodd KW, Subar AF. Use of vitamin, mineral, nonvitamin, and nonmineral supplements in the United States: The 1987, 1992, and 2000. National Health Interview Survey results. J Am Diet Assoc. 2004;104(6):942-50.

      Radimer KL, Subar AF, Thompson FE. Nonvitamin, nonmineral dietary supplements: Issues and findings from NHANES III. J Am Diet Assoc. 2000;100(4):447-54.

      Radimer K, Bindewald B, Hughes J, Ervin B, Swanson C, Picciano MF. Dietary supplement use by US adults: data from the National Health and Nutrition Examination Survey, 1999-2000. Am J Epidemiol. 2004;60(4):339-49.

    Why do Americans Use Dietary Supplements? Motivations For Dietary Supplement Use (PDF, 638kB)
    Johanna Dwyer, DSc, RD, ODS, NIH, Bethesda, MD

      This presentation focused on findings from the 2003 National Family Opinion survey of 2000 American adults who are representative of the primary grocery shopper/head of household in the American population. Findings included prevalence of dietary supplement use by demographics (age, sex, race/ethnicity, and other factors) and current health status. Which supplements are popular among American adults, factors affecting their use, reasons for use, and perceptions about nutrient deficiencies. The presentation also includes implications for dietitians.

      Prochaska JO, DiClemente C. The transtheoretical approach: Crossing traditional boundaries of therapy. Homewood, IL: Dow Jones-Irwin. 1984.

      Rossi J S, Rossi S R, Velicer W F, Prochaska JO. To change or not to change: That is the question. In D. B. Allison (Ed.), Handbook of assessment methods for changing eating behavior and weight management. Newbury Park, CA: Sage. 1995;387-430.

      Balk E, Chung M, Chew P, Ip S, Raman G, Kupelnick B, Tatsioni A, Sun Y Wolk B, DeVine D, Lau J. Effects of soy on health outcomes. Summary, evidence report/technology assessment No 126 (Prepared by the Tufts-New England Medical Center Evidence-based Practice Center under Contract No. 290-02-0022). AHRQ. Publication No 05-E024-1. Rockville, MD: July 2005.

    The Dietary Supplement Information Database: Results of USDA Pilot Studies (PDF, 451kB)
    Joanne Holden, MS, Agricultural Research Service (ARS), United States Department of Agriculture (USDA), Beltsville, MD

      This presentation provided results from pilot studies designed to assist with the planning and development of the Dietary Supplement Ingredient Database (DSID). In the pilot studies, methods of analysis and sample handling procedures and protocols for addressing nutrient stability and encapsulation, sample homogenization and storage conditions were compared and evaluated. Multivitamin/minerals were analyzed for nutrients by qualified laboratories and their methods and protocols compared and evaluated. Representative multivitamin/mineral supplement products were then identified from NHANES data using statistical sampling techniques. These will be tested for any systematic relationship between label values and actual values and to assess the nutrient variability between products labeled at the same level. The results of these pilot studies will be used to plan a nationwide sampling of multivitamin products. The major product of this research will be a publicly available database containing a mix of data types and product types. This will enable dietitians and other nutrition professionals to assess the total nutrient intake from foods, beverages, and dietary supplements. The DSID will be maintained and made available to the public at

      Andrews KW, Zhao C, Holden J, Perry CR, Schweitzer A, Wolf W, Harnly J, Dwyer JT, Picciano MF, Saldanha LG, Fisher K, Betz JM, Yetley E, Radimer K, Bindewald B. Selection of Representative Multivitamin Products Based on % Daily Value Levels for Specific Nutrients. Poster session, Experimental Biology Conference. San Diego, CA. April 2005.

      Holden J, Andrews KW, Zhao C, Schweitzer A, Perry CR, Harnly J, Wolf W, Dwyer JT, Picciano MF, Saldanha LG, Yetley E, Fisher K, Sharpless K, Radimer K, Bindewald B. Dietary Supplement Ingredient Database Project: Protocol Development. Poster session, Experimental Biology Conference. San Diego, CA. April 2005.

      Andrews KW, Zhao C, Holden J, Schweitzer A, Harnly J, Wolf W, Dwyer JT, Picciano MF, Betz JM, Saldanha LG, Yetley E, Fisher K, Radimer K, Bindewald B. A Review of Multivitamin/Multimineral Supplement Products Reported in the National Health and Nutrition Examination Survey (NHANES) 1999-2000. Poster session, 29th US National Nutrient Databank Conference. San Diego, CA. April 2005.

Panel Discussion: Questions and Answers

Panelists: Mary Frances Picciano, Johanna Dwyer, and Joanne Holden.
Moderator: Leila Saldanha
  • How do dietitians handle the content of sports drinks, nutrition supplements, and powders containing nutrient and other supplements?
  • Discussions of other practical issues in counseling that involve assessment of dietary supplements.
  • Other: audience questions.

Government Resources on Dietary Supplements