Contribution of Dietary Supplements to Nutritional Adequacy by Socioeconomic Subgroups in Adults of the United States.

Jeffrey Blumberg,Connie Weaver,Balz Frei,Victor Fulgoni,Steven Zeisel

doi:10.3390/nu10010004

Abstract

Many Americans have inadequate intakes of several nutrients, and the Dietary Guidelines for Americans 2015–2020 identified vitamins A, C, D, and E, in addition to calcium, magnesium, iron, potassium, choline, and fiber as “underconsumed nutrients”. Based on nationally representative data on 10,698 adults from National Health and Nutrition Examination Surveys (NHANES), 2009–2012, assessments were made of socioeconomic differences, based on the Poverty Income Ratio (PIR), in terms of the association of dietary supplement use on nutrient intake and nutrient inadequacies. Compared to food alone, the use of any dietary supplement plus food was associated with significantly (p < 0.01) higher intakes of 15–16 of 19 nutrients examined in all socioeconomic groups; and significantly reduced rates of inadequacy for 10/17 nutrients in the subgroup PIR > 1.85 (not poor), but only 4–5/17 nutrients (calcium and vitamins A, C, D, E) for the poor and nearly poor subgroups (PIR < 1.35 and PIR 1.35 to ≤1.85, respectively). An increased prevalence of intakes above the Tolerable Upper Intake Level (UL) was seen for 3–9/13 nutrients, but all were less than 5% in the PIR subgroups. In conclusion, dietary supplement use was associated with an increased micronutrient intake, decreased inadequacies, and a slight increase in the prevalence of intakes above the UL, with greater benefits seen in the PIR > 1.85 subgroup.

Highlights

Micronutrients are required for most metabolic and developmental/growth processes, and adequate intakes are needed for overall health, growth and development, healthy aging, and well-being across the lifespan
We used the data from National Health and Nutrition Examination Survey (NHANES) surveys examining a representative sample of the civilian, non-institutionalized US population
Regarding the percentage of the population with inadequate intakes from food alone (Table 2), consumers of dietary supplements in the PIR < 1.35 subgroup had a lower inadequacy for vitamin A than non-consumers, while those in the PIR 1.35–1.85 subgroup had a lower inadequacy for vitamin A and a greater percentage of the population exceeding the Adequate Intake (AI) for vitamin K

Summary

Introduction

Micronutrients are required for most metabolic and developmental/growth processes, and adequate intakes are needed for overall health, growth and development, healthy aging, and well-being across the lifespan. The Dietary Guidelines for Americans 2015–2020 (DGA) recommends consuming nutrient-dense foods as part of a healthy eating pattern and, in some cases, fortified foods and dietary supplements to help achieve and maintain a healthy body weight, support nutrient adequacy, and reduce the risk of chronic disease [1]. The DGA identified vitamin A, vitamin C, vitamin D, vitamin E, choline, calcium, iron (for certain age/gender groups), magnesium, potassium, and fiber as “underconsumed nutrients”, and vitamin D, calcium, Nutrients 2018, 10, 4; doi:10.3390/nu10010004 www.mdpi.com/journal/nutrients. Nutrients 2018, 10, 4 iron, potassium, and fiber as “nutrients of public health concern” because low intakes are associated with a risk for the development of chronic disease [1]. Socioeconomic status (SES) is being routinely included in dietary studies as an independent variable in the analysis of nutrition and health status [3]

Methods

Results

Conclusion