Institute for Advancing Health Through Agriculture, Texas A&M University, College Station, TX, USA.
Wake Forest School of Medicine, Winston-Salem, NC, USA.
J Nutr. 2023 Jan 14;152(12):2789-2801. doi: 10.1093/jn/nxac168.
Dietary supplement (DS) use is widespread in the United States and contributes large amounts of micronutrients to users. Most studies have relied on data from 1 assessment method to characterize the prevalence of DS use. Combining multiple methods enhances the ability to capture nutrient exposures from DSs and examine trends over time.
The objective of this study was to characterize DS use and examine trends in any DS as well as micronutrient-containing (MN) DS use in a nationally representative sample of the US population (≥1 y) from the 2007-2018 NHANES using a combined approach.
NHANES obtains an in-home inventory with a frequency-based dietary supplement and prescription medicine questionnaire (DSMQ), and two 24-h dietary recalls (24HRs). Trends in the prevalence of use and selected types of products used were estimated for the population and by sex, age, race/Hispanic origin, family income [poverty-to-income ratio (PIR)], and household food security (food-secure vs. food-insecure) using the DSMQ or ≥ 1 24HR. Linear trends were tested using orthogonal polynomials (significance set at P < 0.05).
DS use increased from 50% in 2007 to 56% in 2018 (P = 0.001); use of MN products increased from 46% to 49% (P = 0.03), and single-nutrient DS (e.g., magnesium, vitamins B-12 and D) use also increased (all P < 0.001). In contrast, multivitamin-mineral use decreased (70% to 56%; P < 0.001). In adults (≥19 y), any (54% to 61%) and MN (49% to 54%) DS use increased, especially in men, non-Hispanic blacks and Hispanics, and low-income adults (PIR ≤130%). In children (1-18 y), any DS use remained stable (∼38%), as did MN use, except for food-insecure children, whose use increased from 24% to 31% over the decade (P = 0.03).
The prevalence of any and MN DS use increased over time in the United States. This may be partially attributed to increased use of single-nutrient products. Population subgroups differed in their DS use.
膳食补充剂(DS)在美国的使用非常广泛,为使用者提供了大量的微量营养素。大多数研究都依赖于单一评估方法来描述 DS 使用的流行率。结合多种方法可以提高从 DS 中捕捉营养素暴露的能力,并研究随时间推移的趋势。
本研究的目的是使用综合方法,在具有代表性的美国人口(≥1 岁)的 2007-2018 年 NHANES 中,使用基于频率的膳食补充剂和处方药问卷(DSMQ)和两份 24 小时膳食回忆(24HR)来描述 DS 使用情况,并研究任何 DS 以及含微量营养素(MN)的 DS 使用的趋势。通过 DSMQ 或≥1 份 24HR 对人群以及按性别、年龄、种族/西班牙裔来源、家庭收入[贫困收入比(PIR)]和家庭粮食安全状况(粮食安全与不安全)来估计使用的流行率和选定类型的产品。使用正交多项式测试线性趋势(显著性设定为 P<0.05)。
从 2007 年的 50%到 2018 年的 56%,DS 使用增加(P<0.001);MN 产品的使用从 46%增加到 49%(P=0.03),单一营养素 DS(如镁、维生素 B-12 和 D)的使用也增加(均 P<0.001)。相反,多种维生素矿物质的使用减少(70%降至 56%;P<0.001)。在成年人(≥19 岁)中,任何(54%至 61%)和 MN(49%至 54%)DS 使用增加,特别是在男性、非西班牙裔黑人以及西班牙裔和低收入成年人(PIR≤130%)中。在儿童(1-18 岁)中,任何 DS 使用保持稳定(约 38%),MN 使用也保持稳定,除了粮食不安全的儿童,他们在这十年中的使用从 24%增加到 31%(P=0.03)。
在美国,任何和 MN DS 使用的流行率随着时间的推移而增加。这可能部分归因于单一营养素产品使用的增加。人口亚组在 DS 使用方面存在差异。