Rapid growth has been found in the market of dietary supplements (DSs) in China. However, studies about the knowledge level, intentions, and behavior related to DS remained limited in the Chinese population. This study aimed to explore the knowledge level, perception, and practice toward DS among Chinese adults. This is a cross-sectional design among 1,714 participants aged between 18 and 65 years. A total of 54.1% of participants reported purchasing supplements in the past 6 months. Knowledge levels were assessed with a score from 1 to 10 based on correct answers to 10 binary questions about supplements. Only 29.1% of participants answered seven or more questions correctly, while 7.9% answered three or fewer questions correctly. Participants with high and middle knowledge levels were more likely to seek medical advice when experiencing discomfort symptoms and were less likely to choose DS, with corresponding odd ratios (ORs) of 1.58 (95% CI: 1.16, 2.13) and 0.69 (95% CI: 0.52, 0.91) in high knowledge group and ORs of 1.36 (95% CI: 1.03, 1.80) and 0.96 (95% CI: 0.72, 1.30) in middle knowledge group (P for trend = 0.003 and 0.028, respectively). No significant differences were found in the motivation of DS use between knowledge levels. Although higher knowledge levels were associated with less spending on DS (OR high = 0.69; 95% CI: 0.49, 0.99; OR middle = 0.88; 95% CI: 0.64, 1.20; P for trend = 0.038), it did not guarantee better and more accurate awareness toward DS use. In conclusion, there is a growing demand for supplements among Chinese adults, but a significant gap between knowledge and behavior exists, affecting decision-making behaviors regarding DS.
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