Dietary Supplement Use in Children and Adolescents Aged ≤19 Years — United States, 2017–2018

Stierman, Bryan; Mishra, Suruchi; Gahche, Jaime J; Potischman, Nancy; Hales, Craig M.

doi:10.15585/mmwr.mm6943a1

Cited by 38 publications

(41 citation statements)

References 7 publications

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“…An analysis of NHANES data from 1999–2012 among adults, showed the 30-day use of vitamin C supplements, including from multi-vitamins decreased significantly from 42% to 36% [ 57 ], but more recent data are not available. Published data on trends among children/adolescents are not available but data from 2017–2018 NHANES show only 3.0% were taking a single ingredient vitamin C supplement and 23.8% were taking some type of multivitamin/multimineral supplement, which usually contain vitamin C [ 58 ].…”

Section: Discussionmentioning

confidence: 99%

Trends in Vitamin C Consumption in the United States: 1999–2018

2021

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Low intakes of fruits and vegetables have resulted in suboptimal intakes of several micronutrients, including vitamin C. This cross-sectional study used data from 84,902 children/adults (≥1 y) who completed a 24-h dietary recall as part of the United States National Health and Nutrition Examination Survey (1999–2018). Mean vitamin C intakes from foods/beverages were calculated as were trends in major food/beverage sources of vitamin C. Percentages below the Estimated Average Requirement (EAR) were estimated. Overall, mean vitamin C consumption declined by 23% (97–75 mg/d; p-value for trend < 0.001). 100% fruit juice was the leading source of vitamin C (25.6% of total or 21.7mg/d), but this declined by 48% (25–13 mg/d; p-value for trend < 0.001). Whole fruit increased among children/adolescents (+75.8%;10–17 mg/d; p-value for trend < 0.001), but not adults, while the vegetable contribution was generally unchanged. The proportion of the population below the EAR increased by 23.8% on a relative scale or 9 percentage points on an absolute scale (38.3–47.4%). Declines in vitamin C intake is driven largely by decreases in fruit juice coupled with modest increases in whole fruit. Due to associations between vitamin C intake and numerous health outcomes these trends warrant careful monitoring moving forward.

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Section: Discussionmentioning

confidence: 99%

Trends in Vitamin C Consumption in the United States: 1999–2018

2021

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“…Similar to prior reports in children, the most frequently used supplements were multivitamin/mineral products. 5,31 Female youth runners were more likely to use dietary supplements than male runners. Several prior investigations also report higher use of supplements in female youth athletes.…”

Section: Discussionmentioning

confidence: 99%

“…Our reported prevalence (26.1%) of supplement use is lower than estimates previously reported in youth athletes and the general population. 5,[29][30][31][32] This might be related to many of our respondents being younger than athlete respondents from prior investigations, as increasing age has been associated with higher supplement use in athletes. 26,27 We identified that each year older at time of survey completion was associated with a 20% higher likelihood of supplement use.…”

Section: Discussionmentioning

confidence: 99%

“…This study also evaluated supplements based on a specific frequency and time frame, thus representing consistent and prolonged intake compared with general use or use during the previous 30 days. 4,5,33,34 Furthermore, dietary supplements were separated from sport foods; other prior investigations included sport foods in their reported prevalence of supplement users. 27,30,32 In addition, a recent investigation in elite collegiate endurance runners also described a notably higher prevalence of supplement use compared with the present study.…”

Section: Discussionmentioning

confidence: 99%

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Dietary Supplement Intake and Factors Associated with Increased Use in Preadolescent Endurance Runners

Barrack¹,

Sassone²,

Dizon³

et al. 2022

Journal of the Academy of Nutrition and Dietetics

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Background The prevalence of dietary supplement intake among preadolescent endurance runners is currently unknown.Objective Our aim was to describe use of dietary supplements, higher-risk supplements, and sport foods among preadolescent endurance athletes and identify associated characteristics of dietary supplement users in this population.Design This was a retrospective, cross-sectional study. Participants/setting Participants were 2,113 preadolescent endurance runners (male: n ¼ 1,255, female: n ¼ 858; mean age AE standard deviation ¼ 13.2 AE 0.9 years).Main outcome measures Use of dietary supplements, higher-risk dietary supplements, and sport foods on 2 or more days per week during the past year. Statistical analyses performedMann-Whitney U tests, c 2 tests, univariate and multivariate analyses.Results Twenty-six percent (n ¼ 551) of preadolescent runners used dietary supplements on 2 or more days per week during the past year; 1.3% (n ¼ 27) reported taking higher-risk supplements. Compared with male runners, female runners reported higher use of 1 or more supplements (32.5% vs 21.7%; P < .001) and 4 or more supplements (4.0% vs 1.9%; P ¼ 0.005), multivitamin/minerals (24.2% vs 14.4%; P < .001), vitamin D (12.4% vs 5.6%; P < .001), calcium (8.9% vs 4.8%; P < .001), iron (3.1 vs 1.1%; P < .001), probiotic supplements (8.2% vs 1.3%; P < .001), and diet pills (0.5% vs 0.0%; P ¼ .02). Male runners reported higher use of creatine (1.3% vs 0.0%; P < .001) and sport foods, including protein bars and drinks (19.5% vs 8.4%; P < .001), energy bars (23.5% vs 9.7%; P < .001), and carbohydrate-electrolyte drinks (27.9% vs 13.3%; P < .001) than female runners. Factors independently associated with a higher likelihood for dietary supplement use included weight loss in the past year, female (vs male) gender, following a vegetarian diet, skipping meals, attempting to gain weight, and history of a runningrelated bone stress injury.Conclusions More than one-quarter of preadolescent runners regularly consumed dietary supplements. Behaviors consistent with dietary restriction and history of bone stress injury were associated with higher likelihood for supplement use. Further work to understand supplement use patterns and potential value for nutrition education is advised to optimize health of preadolescent runners.

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“…The NHANES 2017-2018 survey also evaluated MVM use among children, with 23.8% of children using a MVM product in the past 30 days. 3 This included 11% of those <2 years old, 34.6% between 2 and 5 years old, 29.5% between 6 and 11 years old, and 17.3% between 12 and 19 years old. 3…”

Section: Introductionmentioning

confidence: 99%

Lead in Mineral or Multivitamin-Multimineral Products

White

2021

Ann Pharmacother

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Objective Assess the current daily interim reference level of lead and the amount contained in current mineral and multivitamin-multimineral (MVM) products. Data Sources PubMed search from 1980 to May 15, 2021, limited to the English language, via the search strategy ((mineral OR multivitamin OR calcium OR iron OR magnesium OR copper OR zinc OR chromium OR selenium) AND (heavy metals OR Pb OR lead)). Study Selection and Data Extraction Narrative review of studies assessing lead content in mineral or MVM products. Data Synthesis Products containing different calcium forms (dolomite, bone meal, natural carbonate) have historically had higher lead levels than others (refined carbonate, lactate, gluconate, acetate, sevelamer), but the gap has closed considerably since the year 2000. Although only limited assessments of magnesium and zinc supplements have been conducted, no alarming average lead amounts were found. MVM products assessed since 2007 had low median or mean lead concentrations. However, large interproduct differences exist, with many products having very little lead and some products having concerning amounts. Relevance to Patient Care and Clinical Practice It is difficult for pharmacists and consumers to know the amount of lead in an actual product unless it is tested in an independent third-party lab. The United States Pharmacopeia and NSF International will provide a seal on the products stating that the products have a low level of lead, but even so, children could receive more lead than the Food and Drug Administration’s Interim Reference Level. Conclusions The threat from lead exposure in mineral and MVM products have diminsihed considerably over time but some products can still have excessive amounts. Without third-party testing, it is difficult for clinicians and consumers to know which outlier products to avoid.

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Dietary Supplement Use in Children and Adolescents Aged ≤19 Years — United States, 2017–2018

Cited by 38 publications

References 7 publications

Trends in Vitamin C Consumption in the United States: 1999–2018

Trends in Vitamin C Consumption in the United States: 1999–2018

Dietary Supplement Intake and Factors Associated with Increased Use in Preadolescent Endurance Runners

Lead in Mineral or Multivitamin-Multimineral Products

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