Objective: The aims were to collect data on consumption of different food supplements in a sample of the adult Italian population and to characterize users by demographic, physical and health-related characteristics, lifestyle and behaviour. Design: Cross-sectional survey. Setting: The study was conducted in 2008 in ten towns of Italy (two towns from each of the five macro-areas: Northwest, Northeast, Centre, South and Islands). Subjects: Adults (n 10 000) aged $18 years were randomly selected and asked to fill in a self-administered questionnaire regarding their use of food supplements and the above variables. The effect of these variables on food supplement use was evaluated by univariate and multivariate logistic regression. Results: Of the 1723 individuals who returned the questionnaire, 49 % were users of food supplements. A large proportion (54 %) of users used more than one category of food supplement: vitamin and/or mineral supplements were the most used (61 %), followed by supplements with botanicals and botanical extracts (28 %). The results obtained by logistic regression showed that gender, town size, education level, sports practice, regular use of wholemeal cereal-based foods and presence of a low stress level were determinants for the use of food supplements in the examined population. However, these determinants were not shared by all categories of supplements. Conclusions:The results of this preliminary study highlight that associations between demographic, dietary and lifestyle factors and use of different categories of food supplements differ according to products, and cannot be accounted for simply by dichotomizing individuals as users or non-users.

The objective of this study was to evaluate the reliability of a self-administered postal questionnaire on the use of food supplements. The study was carried out in subjects representative of an Italian adult population. Eight thousand eight hundred twenty-three subjects received the questionnaire; 1723 subjects completed it of which 102 twice (baseline and 1-month re-administration). The latter 204 questionnaires were used to test reliability using Cohen’s kappa statistic (k) and the intra-class correlation coefficient (ICC) for categorical and quantitative variables, respectively. Subjects’ characteristics such as sociodemographic and physical data, lifestyles, dietary habits, and most health characteristics showed very good agreement (ICC or k 1.00 - 0.55) between questionnaires, with the exception of answers about the consumption of some medicines (k 0.37 - 0.40). The reliability concerning the use of food supplements was satisfactory on the whole (k 0.69) and fairly satisfactory for different categories of food supplements (k 0.83 - 0.41). With regard to additional information about users of food supplements, the reliability of responses was fairly satisfactory on the whole (k 0.93 - 0.41), with some exceptions. The concordance/correlation coefficient values generally showed that the questionnaire is fairly reliable over the entire sample for collecting information on the use of food supplements.

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This study describes a practical and suitable approach to solve a real problem: the analysis of polyherbal products for which some specifications addressing the composition are lacking (e.g. chemical components). It is reported that an analytical procedure to verify the possible presence in a botanical supplement of a plant is not authorised for use in Italy. No reference of chemical standards for the known components of the plant is commercially available. For this reason and because a rapid response was required, more selective chromatographic techniques such as high-performance liquid chromatography, gas chromatography and liquid chromatography-mass spectrometry were excluded and thin layer chromatography was chosen for applying different experimental procedures. The original English label of the product, which is made by a leading US manufacturer and sold online by American and Italian distributors, lists the same herbal ingredients as the Italian label, but with an addition of Eurycoma longifolia Jack, which is not included in the list of plants admitted in supplements compiled by the Italian Ministry of Health. For greater certainty of the result, a high-performance thin layer chromatography method was then applied. On the basis of the results obtained, it was possible to confirm that E. longifolia Jack was not present in the product.