Objective: To determine the levels of and factors associated with the use of nutritional supplements by children participating in the National Study of Health and Growth (NSHG). Design: Cross-sectional study. Setting: Fifty-six study areas in England and Scotland. Subjects: Fifteen thousand, two hundred and seventy ®ve children aged between 4 and 12 y. Interventions: Parental completion of a self-administered questionnaire on the child's health, social background and supplement use. Height, weight and skinfold measurements. Results: An 88% response rate to the supplement question, 15.9% of responders reported using a supplement. Multivitamins were the most commonly consumed supplement (84%) with 52% taking a supplement daily. Younger children, those whose mothers reached further education, whose fathers were in non-manual occupations or who lived in the Midlands or South were signi®cantly more likely to use a supplement, as were children from smaller families or whose parents were non-smokers. There was no signi®cant association between supplement use and sex, height, birthweight, length of gestation, father's education, number of parents in the home or vegetarianism. Signi®cant differences were found in the use of supplements between the ethnic origin groups. Children of Afro-Caribbean, Asian or other origin were more likely to take a supplement compared to white English and Scottish groups. There were differences in the type of supplements used with Afro-Caribbean and other origin children using more cod liver oil.
Conclusion:We support the ®ndings of other studies which show that children with the least need for supplements as de®ned by socio-economic variables are more likely to receive them and suggest that cultural background is also an important factor in in¯uencing supplement use.