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  Vol. 9 No. 3, March 2000 TABLE OF CONTENTS
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Vitamin and Mineral Supplement Use in the United States

Results From the Third National Health and Nutrition Examination Survey

Lina S. Balluz, ScD, MPH; Stephanie M. Kieszak, MA, MPH; Rossanne M. Philen, MD, MS; Joseph Mulinare, MD

Arch Fam Med. 2000;9:258-262.

Context  The use of supplements remains a widespread behavior among people motivated by general health concerns. We analyzed data from the third National Health and Nutrition Examination Survey (NHANES III) to provide new and current information on supplement use in the United States.

Objectives  To determine the prevalence of vitamin and mineral supplement use in the US population, to quantify the use of folic acid, and to examine the relationship between supplement intake and demographic factors.

Design  National, population-based, cross-sectional survey of monthly use of vitamin and mineral supplements by NHANES III participants (n = 33 905).

Results  More than 11 000 respondents reported taking at least 1 vitamin or mineral supplement at any time in the past month. The highest use of vitamin and mineral supplements was among non-Hispanic whites (42.6%), with a mean age of 37 years. Approximately 29.2% of people in the United States, and 33.2% of women of reproductive age, reported taking at least 1 product that contained folic acid any time in the past month. The use of products containing folic acid was highest among non-Hispanic whites (32.1%), and 62.1% of all those taking folic acid (71.5% among females of reproductive age) took at least 12 000 µg/mo (equivalent to the recommended daily dose of 400 µg/d). Participants reported using more than 300 nonvitamin and nonmineral products, some of which are documented as having serious adverse health effects.

Conclusions  Consumption of vitamin and mineral supplements is a common behavior in the United States. We recommend that physicians and health professionals include questions about the use of dietary supplements when obtaining a medical history from their patients, that all dietary supplements clearly list ingredients and known contraindications to use, and that all those planning to use supplements first have their dietary practices and lifestyle evaluated by a health professional.


From the National Center for Environmental Health, Centers for Disease Control and Prevention, US Public Health Service, Atlanta, Ga.


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