Trends in overall and micronutrient-containing dietary supplement use among U.S. adults and children, NHANES 2007-2018

Dietary supplement (DS) use is widespread in the U.S. and contributes large amounts of micronutrients to users. Most studies have relied on data from one assessment method to characterize the prevalence of DS use. Combining multiple methods enhances the ability to capture nutrient exposures from DS 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 among a nationally representative sample of the U.S. population (≥1y) from the 2007-2018 NHANES using a combined approach (i.e., DSMQ and/or ≥1 24HR).NHANES obtains an in-home inventory with a frequency-based DS and Prescription Medicine Questionnaire (DSMQ), and two 24-hr recalls (24HR). The objective of this study was to characterize DS use and examine trends in any and micronutrient-containing (MN) DS use among a nationally representative sample of the U.S. population (≥1y) from the 2007-2018 NHANES, using a combined approach (i.e., DSMQ and/or ≥1 24HR). 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). Linear trends were tested using orthogonal polynomials (significance set at p0.05).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 B12 and D) use also increased (all p0.001). In contrast, multivitamin-mineral use decreased (70% to 56%; p0.001). Among adults (≥19y), any (54% to 61%) and MN (49% to 54%) DS use increased, especially among men, non-Hispanic Blacks and Hispanics, and low-income adults (PIR≤130%). Among children (1-18y), 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 U.S. This may be partially attributed to increased use of single-nutrient products. Population subgroups differed in their DS use.