Data from the 1999-2000 National Health and Nutrition Examination Survey, a nationally representative, cross-sectional survey of US health and nutrition, were analyzed to assess prevalence of dietary supplement use overall and in relation to lifestyle and demographic characteristics. Fifty-two percent of adults reported taking a dietary supplement in the past month; 35% took a multivitamin/multimineral. Vitamin C, vitamin E, B-complex vitamins, calcium, and calcium-containing antacids were taken by more than 5% of adults. In bivariate analyses, female gender, older age, more education, non-Hispanic White race/ethnicity, any physical activity, normal/underweight, more frequent wine or distilled spirit consumption, former smoking, and excellent/very good self-reported health were associated with greater use of any supplement and of multivitamin/multiminerals; in multivariable comparisons, the latter three characteristics were not associated with supplement use. Most supplements were taken daily and for at least 2 years. Forty-seven percent of adult supplement users took just one supplement; 55% of women and 63% of adults aged >or=60 years took more than one. These findings suggest that, to minimize possible spurious associations, epidemiologic studies of diet, demography, or lifestyle and health take dietary supplement use into account because of 1) supplements' large contribution to nutrient intake and 2) differential use of supplements by demographic and lifestyle characteristics.

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Despite widespread concern about hunger in America, efforts to monitor and assess the extent of hunger have been hampered by lack of consensus on an appropriate meaning for the term hunger and by the lack of valid indicators to assess it. The first phase of the research used qualitative methods to derive a socially-appropriate definition of hunger. Thirty-two women in Upstate New York were interviewed regarding their experience with food problems and hunger. The interviews were analyzed using the constant comparative method. Results indicated that women had a narrow and a broad concept of hunger. The narrow concept focused on going without food for a specified period of time and the physical sensation of hunger. The broad one included two dimensions: household and individual hunger. Each had quantitative, qualitative, psychological, and social components. The second phase of the research used survey methodology to examine the validity and reliability of items designed to measure the conceptual definition of hunger. The survey was administered to 189 women in Upstate New York who participated in programs designed for low-income households or households in need of food. The second phase confirmed the conceptualization of hunger developed in the first phase. A subset of valid and reliable items that represented each of the major dimensions and components of hunger was identified as being useful for monitoring and assessing hunger.

Approximately 10.2 million persons in the United States sometimes or often do not have enough food to eat, a condition known as food insufficiency. Using cross-sectional data from the Third National Health and Nutrition Examination Survey (NHANES III), we examined whether dietary intakes and serum nutrients differed between adults from food-insufficient families (FIF) and adults from food-sufficient families (FSF). Results from analyses, stratified by age group and adjusted for family income and other important covariates, revealed several significant findings (P < 0.05). Compared with their food-sufficient counterparts, younger adults (aged 20-59 y) from FIF had lower intakes of calcium and were more likely to have calcium and vitamin E intakes below 50% of the recommended amounts on a given day. Younger adults from FIF also reported lower 1-mo frequency of consumption of milk/milk products, fruits/fruit juices and vegetables. In addition, younger adults from FIF had lower serum concentrations of total cholesterol, vitamin A and three carotenoids (alpha-carotene, beta-cryptoxanthin and lutein/zeaxanthin). Older adults (aged > or =60 y) from FIF had lower intakes of energy, vitamin B-6, magnesium, iron and zinc and were more likely to have iron and zinc intakes below 50% of the recommended amount on a given day. Older adults from FIF also had lower serum concentrations of high-density lipoprotein cholesterol, albumin, vitamin A, beta-cryptoxanthin and vitamin E. Both younger and older adults from FIF were more likely to have very low serum albumin (<35 g/L) than were adults from FSF. Our findings show that adults from FIF have diets that may compromise their health.