A Free New Dietary Supplement Label Database for Registered Dietitian Nutritionists

Abstract

The Academy of Nutrition and Dietetics recognizes the importance of including dietary supplements (DS) in assessing and planning dietary intakes. 1 Position of the American Dietetic AssociationNutrient Supplementation. J Am Diet Assoc. 2009; 109: 2073-2085 Abstract Full Text Full Text PDF PubMed Google Scholar DS use in the United States has increased markedly during the past 30 years and is now widespread across all segments of society. 2 Briefel R. Johnson C.L. Secular trends in dietary intake in the United States. Ann Rev Nutr. 2004; 24: 401-431 Crossref PubMed Scopus (478) Google Scholar , 3 Radimer K.L. Bindewald B. Hughes J. Ervin B. Swanson C. Picciano M.F. Dietary supplement use by US adults: data from the National Health and Nutrition Examination Survey, 1999-2000. Am J Epidemiol. 2004; 160: 339-349 Crossref PubMed Scopus (647) Google Scholar , 4 Picciano M.F. Dwyer J.T. Radimer K.L. et al. Dietary supplement use among infants, children, and adolescents in the United States, 1999-2002. Arch Pediatr Adolesc Med. 2007; 161: 978-985 Crossref PubMed Scopus (116) Google Scholar , 5 Bailey R.L. Gahche J.J. Lentino C.V. et al. Dietary supplement use in the United States, 2003-2006. J Nutr. 2011; 141: 261-266 Crossref PubMed Scopus (585) Google Scholar , 6 Gahche J, Bailey R, Burt V, et al. Dietary supplement use among US adults has increased since NHANES III (1988-1994). NCHS Data Brief, No. 61. US Department of Health and Human Services. April 2011. Google Scholar At present, more than half of adults and a third of US children have used one or more DS within the past 30 days, with multivitamin, multimineral (MVMM) products especially common. 7 Dwyer J. Nahin R.L. Rogers G.T. et al. Prevalence and predicators of children's dietary supplement use: The 2007 National Health Interview Survey. Am J Clin Nutr. 2013; 97: 1331-1337 Crossref PubMed Scopus (67) Google Scholar , 8 Bailey R.L. Fulgoni V.L. Keast D.R. Lentino C.V. Dwyer J.T. Do dietary supplements improve micronutrient sufficiency in children and adolescents?. J Pediatr. 2012; 161: 837-842 Abstract Full Text Full Text PDF PubMed Scopus (96) Google Scholar Because supplements are now major sources of several nutrients, such as calcium and vitamin D, in American diets, it is important for registered dietitian nutritionists (RDNs) to include their contributions when assessing intakes or planning diets. 9 Fulgoni V.L. Keast D.R. Bailey R.L. Dwyer J.T. Foods, fortificants and supplements: where do Americans get their nutrients?. J Nutr. 2011; 141: 1847-1854 Crossref PubMed Scopus (339) Google Scholar , 10 Bailey R.L. Fulgoni V.L. Keast D.R. Dwyer J. Dietary supplement use is associated with higher intakes of minerals from food sources. Am J Clin Nutr. 2011; 94: 1376-1381 Crossref PubMed Scopus (120) Google Scholar , 11 Bailey R.L. Fulgoni V.L. Keast D.R. Dwyer J.T. Examination of vitamin intakes among US adults by dietary supplement use. J Acad Nutr Diet. 2012; 112: 657-663 Abstract Full Text PDF PubMed Scopus (109) Google Scholar Likewise, for national nutrition surveillance, the contributions to nutrient intakes from supplements must be considered to identify groups at dietary risk because their intakes decrease below the estimated average requirement (EAR) or above the upper tolerable intake level. 12 Dwyer J. Picciano M.F. Raiten D.J. Estimation of usual intakes: What we eat in America–NHANES. J Nutr. 2003; 133: 609S-623S Crossref PubMed Google Scholar For example, when supplements are included in assessments, the proportion of the US population that is below the EAR is much less for several vitamins 11 Bailey R.L. Fulgoni V.L. Keast D.R. Dwyer J.T. Examination of vitamin intakes among US adults by dietary supplement use. J Acad Nutr Diet. 2012; 112: 657-663 Abstract Full Text PDF PubMed Scopus (109) Google Scholar and fewer women are “at risk” (defined as below the EAR) for folate intake than when they are not. 13 Bailey R.L. Dodd K.W. Gahche J.J. et al. Total folate and folic acid intake from foods and dietary supplements in the United States: 2003-2006. Am J Clin Nutr. 2010; 91: 231-237 Crossref PubMed Scopus (185) Google Scholar , 14 Branum A.M. Bailey R. Singer B.J. Dietary supplement use and folate status during pregnancy in the United States. J Nutr. 2013; 143: 486-492 Crossref PubMed Scopus (102) Google Scholar For some nutrients, like folic acid, the upper tolerable intake level is established based solely for the form that comes from fortificants in foods and in dietary supplements. RDNs, epidemiologists, and public health officials also need accurate dietary supplement databases to evaluate possible associations between nutrient intake and disease outcomes.