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Mary Frances Picciano - One of the best experts on this subject based on the ideXlab platform.
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Dietary Supplement use among u s adults has increased since nhanes iii 1988 1994
NCHS data brief, 2011Co-Authors: Jaime J Gahche, Mary Frances Picciano, Regan L Bailey, Jeffery P Hughes, Vicki L Burt, Elizabeth A Yetley, Margaret A Mcdowell, Johanna T Dwyer, Christopher T SemposAbstract:KEY FINDINGS: Use of Dietary Supplements is common among the U.S. adult population. Over 40% used Supplements in 1988-1994, and over one-half in 2003-2006. Multivitamins/multiminerals are the most commonly used Dietary Supplements, with approximately 40% of men and women reporting use during 2003-2006. Use of Supplemental calcium increased from 28% during 1988-1994 to 61% during 2003-2006 among women aged 60 and over. Use of Supplements containing folic acid among women aged 20-39 did not increase since 1988-1994. In 2003-2006, 34% of women aged 20-39 used a Dietary Supplement containing folic acid. Use of Dietary Supplements containing vitamin D increased from 1988-1994 through 1999-2002 for men and women in most age groups. Dietary Supplements can contain nutrients in amounts as high as or higher than the Institute of Medicine's Recommended Dietary Reference Intakes, therefore contributing substantially to total nutrient intake. Dietary Supplements are widely available to U.S. consumers, and monitoring their use over time is an important component of the National Nutrition Monitoring System. Failure to include these nutrients when assessing the adequacy of diets and nutrition in the U.S. population may lead to inaccurate and misleading results. This report provides estimates of Dietary Supplement use for specific population groups over time. In addition to overall use of Dietary Supplements, this report focuses on estimates for specific nutrients consumed through Dietary Supplement use.
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Dietary Supplement use in the united states 2003 2006
Journal of Nutrition, 2011Co-Authors: Regan L Bailey, Jaime J Gahche, Cindy V Lentino, Jody S Engel, Paul R Thomas, Joseph M Betz, Christopher T Sempos, Johanna T Dwyer, Mary Frances PiccianoAbstract:Dietary Supplement use has steadily increased over time since the 1970s; however, no current data exist for the U.S. population. Therefore, the purpose of this analysis was to estimate Dietary Supplement use using the NHANES 2003–2006, a nationally representative, cross-sectional survey. Dietary Supplement use was analyzed for the U.S. population (≥1 y of age) by the DRI age groupings. Supplement use was measured through a questionnaire and was reported by 49% of the U.S. population (44% of males, 53% of females). Multivitamin-multimineral use was the most frequently reported Dietary Supplement (33%). The majority of people reported taking only 1 Dietary Supplement and did so on a daily basis. Dietary Supplement use was lowest in obese adults and highest among non-Hispanic whites, older adults, and those with more than a high-school education. Between 28 and 30% reported using Dietary Supplements containing vitamins B-6, B-12, C, A, and E; 18–19% reported using iron, selenium, and chromium; and 26–27% reported using zinc- and magnesium-containing Supplements. Botanical Supplement use was more common in older than in younger age groups and was lowest in those aged 1–13 y but was reported by ~20% of adults. About one-half of the U.S. population and 70% of adults ≥ 71 y use Dietary Supplements; one-third use multivitamin-multimineral Dietary Supplements. Given the widespread use of Supplements, data should be included with nutrient intakes from foods to correctly determine total nutrient exposure.
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Dietary Supplement ingredient database dsid preliminary usda studies on the composition of adult multivitamin mineral Supplements
Journal of Food Composition and Analysis, 2008Co-Authors: Janet M Roseland, Joanne M Holden, Karen W Andrews, Cuiwei Zhao, Amy Schweitzer, Wayne R Wolf, Charles R Perry, James M. Harnly, Johanna T Dwyer, Mary Frances PiccianoAbstract:The Nutrient Data Laboratory of the United States Department of Agriculture (USDA) is collaborating with the Office of Dietary Supplements (ODS), the National Center for Health Statistics (NCHS), and other government agencies to design and populate a Dietary Supplement ingredient database (DSID). This analytically based, publicly available database will provide reliable estimates of vitamin and mineral content of Dietary Supplement (DS) products. The DSID will initially be populated with multivitamin/mineral (MVM) products because they are the most commonly consumed Supplements. Challenges associated with the analysis of MVMs were identified and investigated. A pilot study addressing the identification of appropriate analytical methods, sample preparation protocols, and experienced laboratories for the analysis of 12 vitamins and 11 minerals in adult MVM Supplement products was completed. Preliminary studies support the development of additional analytical studies with results that can be applied to the DSID. Total intakes from foods and Supplements are needed to evaluate the associations between Dietary components and health. The DSID will provide better estimates of actual nutrient intake from Supplements than databases that rely on label values alone.
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Dietary Supplement use among infants children and adolescents in the united states 1999 2002
JAMA Pediatrics, 2007Co-Authors: Mary Frances Picciano, Alanna J. Moshfegh, Paul R Thomas, Kathy Radimer, Elizabeth A Yetley, David H Wilson, Kenneth D Fisher, Paul S Levy, Johanna T Dwyer, Samara Joy NielsenAbstract:Objective To describe Dietary Supplement use among US children. Design Analysis of nationally representative data from the 1999-2002 National Health and Nutrition Examination Survey (NHANES). Setting Home interviews and a mobile examination center. Participants Children from birth through 18 years who participated in NHANES (N = 10 136). Main Exposure Frequency of use of any Dietary Supplement product. Outcome Measure Prevalence of use and intake of key nutrients from Supplements among children. Results In 1999-2002, 31.8% of children used Dietary Supplements, with the lowest use reported among infants younger than 1 year (11.9%) and teenagers 14 to 18 years old (25.7%) and highest use among 4- to 8-year-old children (48.5%). Use was highest among non-Hispanic white (38.1%) and Mexican American (22.4%) participants, lowest among non-Hispanic black participants (18.8%), and was not found to differ by sex. The type of Supplement most commonly used was multivitamins and multiminerals (18.3%). Ascorbic acid (28.6%), retinol (25.8%), vitamin D (25.6%), calcium (21.1%), and iron (19.3%) were the primary Supplemental nutrients consumed. Supplement use was associated with families with higher incomes; a smoke-free environment; not being certified by the US Department of Agriculture Special Supplemental Nutrition Program for Women, Infants and Children in the last 12 months; lower child body mass index; and less daily recreational screen time (television, video games, computers, etc) ( P P P Conclusions More than 30% of children in the United States take Dietary Supplements regularly, most often multivitamins and multiminerals. Given such extensive use, nutrient intakes from Dietary Supplements must be included to obtain accurate estimates of overall nutrient intake in children.
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Dietary Supplement use by us adults data from the national health and nutrition examination survey 1999 2000
American Journal of Epidemiology, 2004Co-Authors: Kathy Radimer, Bernadette Bindewald, Jeffery P Hughes, Bethene Ervin, Christine A Swanson, Mary Frances PiccianoAbstract:Data from the 1999–2000 National Health and Nutrition Examination Survey, a nationally representative, crosssectional 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 selfreported 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 ≥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. adult; antacids; Dietary Supplements; health surveys; minerals; nutrition surveys; vitamins
Johanna T Dwyer - One of the best experts on this subject based on the ideXlab platform.
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the Dietary Supplement label database recent developments and applications
Journal of Nutrition, 2018Co-Authors: Johanna T Dwyer, Regan L Bailey, Jaime J Gahche, Joseph M Betz, Leila G Saldanha, Richard Bailen, Rebecca B Costello, Cindy D Davis, Nancy Potischman, Abby G ErshowAbstract:Objective To describe the history, key features, recent enhancements, and common applications of the Dietary Supplement Label Database (DSLD). Background and history Although many Americans use Dietary Supplements, databases of Dietary Supplements sold in the United States have not been widely available. The DSLD, an easily accessible public-use database was created in 2008 to provide information on Dietary Supplement composition for use by researchers and consumers. Rationale Accessing current information easily and quickly is crucial for documenting exposures to Dietary Supplements because they contain nutrients and other bioactive ingredients that may have beneficial or adverse effects on human health. This manuscript details recent developments with the DSLD to achieve this goal and provides examples of how the DSLD has been used. Recent developments With periodic updates to track changes in product composition and capture new products entering the market, the DSLD currently contains more than 71,000 Dietary Supplement labels. Following usability testing with consumer and researcher user groups completed in 2016, improvements to the DSLD interface were made. As of 2017, both a desktop and mobile device version are now available. Since its inception in 2008, the use of the DSLD has included research, exposure monitoring, and other purposes by users in the public and private sectors. Future directions Further refinement of the user interface and search features to facilitate ease of use for stakeholders is planned. Conclusions The DSLD can be used to track changes in product composition and capture new products entering the market. With over 71,000 DS labels it is a unique resource that policymakers, researchers, clinicians, and consumers may find valuable for multiple applications.
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federal monitoring of Dietary Supplement use in the resident civilian noninstitutionalized us population national health and nutrition examination survey
Journal of Nutrition, 2018Co-Authors: Jaime J Gahche, Regan L Bailey, Nancy Potischman, Abby G Ershow, Kirsten A Herrick, Namanjeet Ahluwalia, Johanna T DwyerAbstract:Objective This review summarizes the current and previous data on Dietary Supplement (DS) use collected from participants in the National Health and Nutrition Examination Survey (NHANES), describes the NHANES Dietary Supplement database used to compute nutrient intakes from DSs, discussed recent developments and future direction, and describes many examples to demonstrate the utility of these data in informing nutrition research and policy. Background and history Since 1971, NHANES, has been collecting information on the use of DSs from participants. These data are critical to national nutrition surveillance and have been used to characterize usage patterns, examine trends over time, assess the percentage of the population meeting or exceeding nutrient recommendations, and to help elucidate the sources contributing nutrients to the diet of the US population. Rationale Over half of adults and about one-third of children in the United States use at least one Dietary Supplement in the past 30 days. Dietary Supplements contribute to the Dietary intake of nutrients and bioactive compounds in the US and therefore need to be assessed when monitoring nutritional status of the population and when studying diet-health associations. Recent developments With the recent development and availability of the Dietary Supplement Label Database (DSLD), a comprehensive DS database that will eventually contain labels for all products marketed in the US, NHANES DS data will be more easily linked to product information to estimate nutrient intake from DS. Future directions Over time, NHANES has both expanded and improved collection methods. The continued understanding of sources of error in collection methods will continue to be explored and is critical to improved accuracy. Conclusions NHANES provides a rich source of nationally representative data on the usage of Dietary Supplements in the US.
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a free new Dietary Supplement label database for registered dietitian nutritionists
Journal of the Academy of Nutrition and Dietetics, 2014Co-Authors: Johanna T Dwyer, Regan L Bailey, Joseph M Betz, Karen W Andrews, Leila G Saldanha, Richard Bailen, Rebecca B Costello, Florence Chang, Jeanne Goshorn, Pamela R. PehrssonAbstract:The Academy of Nutrition and Dietetics recognizes the importance of including Dietary Supplements in assessing and planning Dietary intakes.1 Dietary Supplement (DS) use in the United States has increased markedly during the last 30 years and is now widespread across all segments of society.2,3,4,5,6 Today, over half of adults and a third of US children have used one or more DS within the past 30 days, with multi-vitamin, multi-mineral (MVMM) products especially common.7, 8 Since Supplements are now major sources of several nutrients such as calcium and vitamin D in American diets, it is important for registered dietitians and nutritionists (RDNs) to include their contributions when assessing intakes or planning diets.9,10,11 Likewise, for national nutrition surveillance the contributions to nutrient intakes from Supplements must be considered in order to identify groups at Dietary risk because their intakes fall below the estimated average requirement (EAR) or above the upper tolerable intake level (UL).12 For example, when Supplements are included in assessments, the proportion of the United States population that is below the EAR is much less for several vitamins11 and fewer women are “at risk” (defined as below the EAR) for folate intake than when they are not.13,14 For some nutrients, like folic acid, the UL is established based solely for the form that comes from fortificants in foods and in Dietary Supplements. RDNs, epidemiologists, and public health officials also need accurate Dietary Supplement databases in order to evaluate possible associations between nutrient intake and disease outcomes. The National Health and Nutrition Examination Survey (NHANES) Dietary Supplement label database contains label-derived information from Supplement products that is updated every two years. Information contained in the database is driven by what is reported by survey participants. The currently available database contains Supplement label information for products reported from 1999–2010. While the NHANES DS database provides useful information, it is not comprehensive and is more likely to contain commonly used Supplements and less likely to contain infrequently used Supplements.15 In fact, MVMM products account for only about half of all Supplements used.3 Additionally, not all information from the label is recorded and released in the database. For example, the NHANES database does not contain information such as health claims, other ingredients and warning statements that may have been on the label.
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prevalence and predictors of children s Dietary Supplement use the 2007 national health interview survey
The American Journal of Clinical Nutrition, 2013Co-Authors: Johanna T Dwyer, Christopher T Sempos, Gail Rogers, Richard L Nahin, Patricia M Barnes, Paul M Jacques, Regan L BaileyAbstract:Background: Little is known about the characteristics of US children who are Dietary Supplement users. Objective: We described the prevalence and predictors of and reasons for giving children Dietary Supplements. Design: The study included children <18 y of age who participated in the Complementary and Alternative Medicine Supplement of the National Health Interview Survey of 2007 whose proxies provided complete information on child Dietary Supplement use. Results: A total of 37% of subjects used Dietary Supplements, 31% of subjects used multivitamin mineral (MVM) products exclusively, 4% of subjects used single vitamins or minerals solely or in combination with MVMs, and 2% of subjects used nonvitamin, nonmineral products either solely or in combination with other Supplements. Users were more likely than nonusers to be Asian, white, or non-Hispanic; belong to families with higher parental education and income levels; reside in areas other than the South; be in good, very good, or excellent health; have private health insurance; and have a usual place at which they received conventional medical care. Children (3%) with the most disease burden and health care were more likely to use Supplements than were healthier children. Supplements were given for the prevention or treatment of many illnesses and conditions. Neither the caregiver's reasons nor specific Supplements used were consistently associated with particular conditions. Conclusions: The 37% of US children who used any type of Dietary Supplements differed from nonusers in family socioeconomic status and many other health-related characteristics. Users were given Supplements to prevent or treat many illnesses and conditions for which there is only limited evidence of their efficacy.
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Dietary Supplement use among u s adults has increased since nhanes iii 1988 1994
NCHS data brief, 2011Co-Authors: Jaime J Gahche, Mary Frances Picciano, Regan L Bailey, Jeffery P Hughes, Vicki L Burt, Elizabeth A Yetley, Margaret A Mcdowell, Johanna T Dwyer, Christopher T SemposAbstract:KEY FINDINGS: Use of Dietary Supplements is common among the U.S. adult population. Over 40% used Supplements in 1988-1994, and over one-half in 2003-2006. Multivitamins/multiminerals are the most commonly used Dietary Supplements, with approximately 40% of men and women reporting use during 2003-2006. Use of Supplemental calcium increased from 28% during 1988-1994 to 61% during 2003-2006 among women aged 60 and over. Use of Supplements containing folic acid among women aged 20-39 did not increase since 1988-1994. In 2003-2006, 34% of women aged 20-39 used a Dietary Supplement containing folic acid. Use of Dietary Supplements containing vitamin D increased from 1988-1994 through 1999-2002 for men and women in most age groups. Dietary Supplements can contain nutrients in amounts as high as or higher than the Institute of Medicine's Recommended Dietary Reference Intakes, therefore contributing substantially to total nutrient intake. Dietary Supplements are widely available to U.S. consumers, and monitoring their use over time is an important component of the National Nutrition Monitoring System. Failure to include these nutrients when assessing the adequacy of diets and nutrition in the U.S. population may lead to inaccurate and misleading results. This report provides estimates of Dietary Supplement use for specific population groups over time. In addition to overall use of Dietary Supplements, this report focuses on estimates for specific nutrients consumed through Dietary Supplement use.
Fang Fang Zhang - One of the best experts on this subject based on the ideXlab platform.
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Dietary Supplement use among adult cancer survivors in the united states
Journal of Nutrition, 2020Co-Authors: Hanqi Luo, Gail Rogers, Fan Chen, Jeffrey B Blumberg, Mengyuan Ruan, Zhilei Shan, Emily Biever, Fang Fang ZhangAbstract:BACKGROUND Many cancer patients initiate Dietary Supplement use after cancer diagnosis. How Dietary Supplement use contributes to the total nutrient intake among cancer survivors as compared with individuals without cancer needs to be determined. OBJECTIVES We aimed to evaluate nutrient intakes from Dietary Supplements among cancer survivors in relation to their total nutrient intake and compare those with individuals without cancer. METHODS We evaluated the prevalence, dose, and reason for using Dietary Supplements among 2772 adult cancer survivors and 31,310 individuals without cancer who participated in the NHANES 2003-2016. RESULTS Cancer survivors reported a higher prevalence of any (70.4% vs. 51.2%) and multivitamin/mineral (48.9% vs. 36.6%) Supplement use and Supplement use of 11 individual vitamins and 8 minerals than individuals without cancer. Overall, cancer survivors had significantly higher amounts of nutrient intake from Supplements but lower nutrient intakes from foods for the majority of the nutrients. Compared with individuals without cancer, cancer survivors had a higher percentage of individuals with inadequate intake (total nutrient intake
nutrient intake ≥Tolerable Upper Intake Level) for vitamin D, vitamin B-6, niacin, calcium, magnesium, and zinc, contributed by higher intakes of these nutrients from Dietary Supplements. Nearly half (46.1%) used Dietary Supplements on their own without consulting health care providers. CONCLUSIONS Cancer survivors reported a higher prevalence and dose of Dietary Supplement use but lower amounts of nutrient intake from foods than individuals without cancer. The inadequate nutrient intake from foods and the short-term and long-term health impact of Dietary Supplement use, especially at high doses, need to be further evaluated among cancer survivors. -
association among Dietary Supplement use nutrient intake and mortality among u s adults a cohort study
Annals of Internal Medicine, 2019Co-Authors: Fan Chen, Gail Rogers, Jeffrey B Blumberg, Kenneth Chui, Mengyuan Ruan, Zhilei Shan, Luxian Zeng, Fang Fang ZhangAbstract:Background The health benefits and risks of Dietary Supplement use are controversial. Objective To evaluate the association among Dietary Supplement use, levels of nutrient intake from foods and Supplements, and mortality among U.S. adults. Design Prospective cohort study. Setting NHANES (National Health and Nutrition Examination Survey) data from 1999 to 2010, linked to National Death Index mortality data. Participants 30 899 U.S. adults aged 20 years or older who answered questions on Dietary Supplement use. Measurements Dietary Supplement use in the previous 30 days and nutrient intake from foods and Supplements. Outcomes included mortality from all causes, cardiovascular disease (CVD), and cancer. Results During a median follow-up of 6.1 years, 3613 deaths occurred, including 945 CVD deaths and 805 cancer deaths. Ever-use of Dietary Supplements was not associated with mortality outcomes. Adequate intake (at or above the Estimated Average Requirement or the Adequate Intake level) of vitamin A, vitamin K, magnesium, zinc, and copper was associated with reduced all-cause or CVD mortality, but the associations were restricted to nutrient intake from foods. Excess intake of calcium was associated with increased risk for cancer death (above vs. at or below the Tolerable Upper Intake Level: multivariable-adjusted rate ratio, 1.62 [95% CI, 1.07 to 2.45]; multivariable-adjusted rate difference, 1.7 [CI, -0.1 to 3.5] deaths per 1000 person-years), and the association seemed to be related to calcium intake from Supplements (≥1000 mg/d vs. no use: multivariable-adjusted rate ratio, 1.53 [CI, 1.04 to 2.25]; multivariable-adjusted rate difference, 1.5 [CI, -0.1 to 3.1] deaths per 1000 person-years) rather than foods. Limitations Results from observational data may be affected by residual confounding. Reporting of Dietary Supplement use is subject to recall bias. Conclusion Use of Dietary Supplements is not associated with mortality benefits among U.S. adults. Primary funding source National Institutes of Health.
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Dietary Supplement use among adult cancer survivors in the united states
Social Science Research Network, 2019Co-Authors: Jeffrey B Blumberg, Gail Rogers, Fan Chen, Mengyuan Ruan, Zhilei Shan, Emily Biever, Fang Fang ZhangAbstract:Background: Many cancer survivors initiated Dietary Supplement use after cancer diagnosis, and some may use Supplements at high doses without consulting their healthcare providers. Methods: We evaluated the prevalence, dose, and reason of Dietary Supplement use among 3988 adult cancer survivors in the National Health and Nutrition Examination Survey (NHANES) 1999-2014 and compared that to 7770 individuals without a history of cancer who were matched cancer survivors by age, sex, and race/ethnicity. Findings: Compared to individuals without cancer, cancer survivors reported a higher prevalence of any Dietary Supplement use (69·9% vs. 63·4%), multivitamin/mineral Supplement use (51·1% vs. 46·4%), and individual Supplement use for each of the 26 vitamins and minerals being examined. Cancer survivors did not differ from non-cancer individuals for nutrient intake from foods but had higher levels of nutrient intake for five vitamins (vitamin A, retinol, vitamin D, niacin, folate) and five minerals (calcium, selenium, magnesium, zinc, and copper) from Supplements than non-cancer individuals. While Supplement use contributed to a lower percentage of cancer survivors with inadequate intake (< Estimated Average Requirement) for vitamins C, D, and E, it also increased the percentage of cancer survivors with excess intake (≥Tolerable Upper Intake Levels) for vitamin D, folate, vitamin B6, niacin, and selenium. Nearly half (48·5%) of the cancer survivors used Dietary Supplements on their own without consulting healthcare providers. Interpretation: Cancer survivors reported a higher prevalence and dose of Dietary Supplement use than the general population. The short-term and long-term health impact of Dietary Supplement use, especially high doses of Supplement use among cancer survivors needs to be evaluated. Funding: This study was supported by NIH/ NIMHD 1R01MD011501 (FFZ). Declaration of Interest: The authors have no conflicts of interests to disclose. Ethical Approval: The NHANES study procedures were approved by the research ethics review board of NCHS.
Gail Rogers - One of the best experts on this subject based on the ideXlab platform.
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Dietary Supplement use among adult cancer survivors in the united states
Journal of Nutrition, 2020Co-Authors: Hanqi Luo, Gail Rogers, Fan Chen, Jeffrey B Blumberg, Mengyuan Ruan, Zhilei Shan, Emily Biever, Fang Fang ZhangAbstract:BACKGROUND Many cancer patients initiate Dietary Supplement use after cancer diagnosis. How Dietary Supplement use contributes to the total nutrient intake among cancer survivors as compared with individuals without cancer needs to be determined. OBJECTIVES We aimed to evaluate nutrient intakes from Dietary Supplements among cancer survivors in relation to their total nutrient intake and compare those with individuals without cancer. METHODS We evaluated the prevalence, dose, and reason for using Dietary Supplements among 2772 adult cancer survivors and 31,310 individuals without cancer who participated in the NHANES 2003-2016. RESULTS Cancer survivors reported a higher prevalence of any (70.4% vs. 51.2%) and multivitamin/mineral (48.9% vs. 36.6%) Supplement use and Supplement use of 11 individual vitamins and 8 minerals than individuals without cancer. Overall, cancer survivors had significantly higher amounts of nutrient intake from Supplements but lower nutrient intakes from foods for the majority of the nutrients. Compared with individuals without cancer, cancer survivors had a higher percentage of individuals with inadequate intake (total nutrient intake
nutrient intake ≥Tolerable Upper Intake Level) for vitamin D, vitamin B-6, niacin, calcium, magnesium, and zinc, contributed by higher intakes of these nutrients from Dietary Supplements. Nearly half (46.1%) used Dietary Supplements on their own without consulting health care providers. CONCLUSIONS Cancer survivors reported a higher prevalence and dose of Dietary Supplement use but lower amounts of nutrient intake from foods than individuals without cancer. The inadequate nutrient intake from foods and the short-term and long-term health impact of Dietary Supplement use, especially at high doses, need to be further evaluated among cancer survivors. -
association among Dietary Supplement use nutrient intake and mortality among u s adults a cohort study
Annals of Internal Medicine, 2019Co-Authors: Fan Chen, Gail Rogers, Jeffrey B Blumberg, Kenneth Chui, Mengyuan Ruan, Zhilei Shan, Luxian Zeng, Fang Fang ZhangAbstract:Background The health benefits and risks of Dietary Supplement use are controversial. Objective To evaluate the association among Dietary Supplement use, levels of nutrient intake from foods and Supplements, and mortality among U.S. adults. Design Prospective cohort study. Setting NHANES (National Health and Nutrition Examination Survey) data from 1999 to 2010, linked to National Death Index mortality data. Participants 30 899 U.S. adults aged 20 years or older who answered questions on Dietary Supplement use. Measurements Dietary Supplement use in the previous 30 days and nutrient intake from foods and Supplements. Outcomes included mortality from all causes, cardiovascular disease (CVD), and cancer. Results During a median follow-up of 6.1 years, 3613 deaths occurred, including 945 CVD deaths and 805 cancer deaths. Ever-use of Dietary Supplements was not associated with mortality outcomes. Adequate intake (at or above the Estimated Average Requirement or the Adequate Intake level) of vitamin A, vitamin K, magnesium, zinc, and copper was associated with reduced all-cause or CVD mortality, but the associations were restricted to nutrient intake from foods. Excess intake of calcium was associated with increased risk for cancer death (above vs. at or below the Tolerable Upper Intake Level: multivariable-adjusted rate ratio, 1.62 [95% CI, 1.07 to 2.45]; multivariable-adjusted rate difference, 1.7 [CI, -0.1 to 3.5] deaths per 1000 person-years), and the association seemed to be related to calcium intake from Supplements (≥1000 mg/d vs. no use: multivariable-adjusted rate ratio, 1.53 [CI, 1.04 to 2.25]; multivariable-adjusted rate difference, 1.5 [CI, -0.1 to 3.1] deaths per 1000 person-years) rather than foods. Limitations Results from observational data may be affected by residual confounding. Reporting of Dietary Supplement use is subject to recall bias. Conclusion Use of Dietary Supplements is not associated with mortality benefits among U.S. adults. Primary funding source National Institutes of Health.
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Dietary Supplement use among adult cancer survivors in the united states
Social Science Research Network, 2019Co-Authors: Jeffrey B Blumberg, Gail Rogers, Fan Chen, Mengyuan Ruan, Zhilei Shan, Emily Biever, Fang Fang ZhangAbstract:Background: Many cancer survivors initiated Dietary Supplement use after cancer diagnosis, and some may use Supplements at high doses without consulting their healthcare providers. Methods: We evaluated the prevalence, dose, and reason of Dietary Supplement use among 3988 adult cancer survivors in the National Health and Nutrition Examination Survey (NHANES) 1999-2014 and compared that to 7770 individuals without a history of cancer who were matched cancer survivors by age, sex, and race/ethnicity. Findings: Compared to individuals without cancer, cancer survivors reported a higher prevalence of any Dietary Supplement use (69·9% vs. 63·4%), multivitamin/mineral Supplement use (51·1% vs. 46·4%), and individual Supplement use for each of the 26 vitamins and minerals being examined. Cancer survivors did not differ from non-cancer individuals for nutrient intake from foods but had higher levels of nutrient intake for five vitamins (vitamin A, retinol, vitamin D, niacin, folate) and five minerals (calcium, selenium, magnesium, zinc, and copper) from Supplements than non-cancer individuals. While Supplement use contributed to a lower percentage of cancer survivors with inadequate intake (< Estimated Average Requirement) for vitamins C, D, and E, it also increased the percentage of cancer survivors with excess intake (≥Tolerable Upper Intake Levels) for vitamin D, folate, vitamin B6, niacin, and selenium. Nearly half (48·5%) of the cancer survivors used Dietary Supplements on their own without consulting healthcare providers. Interpretation: Cancer survivors reported a higher prevalence and dose of Dietary Supplement use than the general population. The short-term and long-term health impact of Dietary Supplement use, especially high doses of Supplement use among cancer survivors needs to be evaluated. Funding: This study was supported by NIH/ NIMHD 1R01MD011501 (FFZ). Declaration of Interest: The authors have no conflicts of interests to disclose. Ethical Approval: The NHANES study procedures were approved by the research ethics review board of NCHS.
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prevalence and predictors of children s Dietary Supplement use the 2007 national health interview survey
The American Journal of Clinical Nutrition, 2013Co-Authors: Johanna T Dwyer, Christopher T Sempos, Gail Rogers, Richard L Nahin, Patricia M Barnes, Paul M Jacques, Regan L BaileyAbstract:Background: Little is known about the characteristics of US children who are Dietary Supplement users. Objective: We described the prevalence and predictors of and reasons for giving children Dietary Supplements. Design: The study included children <18 y of age who participated in the Complementary and Alternative Medicine Supplement of the National Health Interview Survey of 2007 whose proxies provided complete information on child Dietary Supplement use. Results: A total of 37% of subjects used Dietary Supplements, 31% of subjects used multivitamin mineral (MVM) products exclusively, 4% of subjects used single vitamins or minerals solely or in combination with MVMs, and 2% of subjects used nonvitamin, nonmineral products either solely or in combination with other Supplements. Users were more likely than nonusers to be Asian, white, or non-Hispanic; belong to families with higher parental education and income levels; reside in areas other than the South; be in good, very good, or excellent health; have private health insurance; and have a usual place at which they received conventional medical care. Children (3%) with the most disease burden and health care were more likely to use Supplements than were healthier children. Supplements were given for the prevention or treatment of many illnesses and conditions. Neither the caregiver's reasons nor specific Supplements used were consistently associated with particular conditions. Conclusions: The 37% of US children who used any type of Dietary Supplements differed from nonusers in family socioeconomic status and many other health-related characteristics. Users were given Supplements to prevent or treat many illnesses and conditions for which there is only limited evidence of their efficacy.
Regan L Bailey - One of the best experts on this subject based on the ideXlab platform.
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the Dietary Supplement label database recent developments and applications
Journal of Nutrition, 2018Co-Authors: Johanna T Dwyer, Regan L Bailey, Jaime J Gahche, Joseph M Betz, Leila G Saldanha, Richard Bailen, Rebecca B Costello, Cindy D Davis, Nancy Potischman, Abby G ErshowAbstract:Objective To describe the history, key features, recent enhancements, and common applications of the Dietary Supplement Label Database (DSLD). Background and history Although many Americans use Dietary Supplements, databases of Dietary Supplements sold in the United States have not been widely available. The DSLD, an easily accessible public-use database was created in 2008 to provide information on Dietary Supplement composition for use by researchers and consumers. Rationale Accessing current information easily and quickly is crucial for documenting exposures to Dietary Supplements because they contain nutrients and other bioactive ingredients that may have beneficial or adverse effects on human health. This manuscript details recent developments with the DSLD to achieve this goal and provides examples of how the DSLD has been used. Recent developments With periodic updates to track changes in product composition and capture new products entering the market, the DSLD currently contains more than 71,000 Dietary Supplement labels. Following usability testing with consumer and researcher user groups completed in 2016, improvements to the DSLD interface were made. As of 2017, both a desktop and mobile device version are now available. Since its inception in 2008, the use of the DSLD has included research, exposure monitoring, and other purposes by users in the public and private sectors. Future directions Further refinement of the user interface and search features to facilitate ease of use for stakeholders is planned. Conclusions The DSLD can be used to track changes in product composition and capture new products entering the market. With over 71,000 DS labels it is a unique resource that policymakers, researchers, clinicians, and consumers may find valuable for multiple applications.
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federal monitoring of Dietary Supplement use in the resident civilian noninstitutionalized us population national health and nutrition examination survey
Journal of Nutrition, 2018Co-Authors: Jaime J Gahche, Regan L Bailey, Nancy Potischman, Abby G Ershow, Kirsten A Herrick, Namanjeet Ahluwalia, Johanna T DwyerAbstract:Objective This review summarizes the current and previous data on Dietary Supplement (DS) use collected from participants in the National Health and Nutrition Examination Survey (NHANES), describes the NHANES Dietary Supplement database used to compute nutrient intakes from DSs, discussed recent developments and future direction, and describes many examples to demonstrate the utility of these data in informing nutrition research and policy. Background and history Since 1971, NHANES, has been collecting information on the use of DSs from participants. These data are critical to national nutrition surveillance and have been used to characterize usage patterns, examine trends over time, assess the percentage of the population meeting or exceeding nutrient recommendations, and to help elucidate the sources contributing nutrients to the diet of the US population. Rationale Over half of adults and about one-third of children in the United States use at least one Dietary Supplement in the past 30 days. Dietary Supplements contribute to the Dietary intake of nutrients and bioactive compounds in the US and therefore need to be assessed when monitoring nutritional status of the population and when studying diet-health associations. Recent developments With the recent development and availability of the Dietary Supplement Label Database (DSLD), a comprehensive DS database that will eventually contain labels for all products marketed in the US, NHANES DS data will be more easily linked to product information to estimate nutrient intake from DS. Future directions Over time, NHANES has both expanded and improved collection methods. The continued understanding of sources of error in collection methods will continue to be explored and is critical to improved accuracy. Conclusions NHANES provides a rich source of nationally representative data on the usage of Dietary Supplements in the US.
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a free new Dietary Supplement label database for registered dietitian nutritionists
Journal of the Academy of Nutrition and Dietetics, 2014Co-Authors: Johanna T Dwyer, Regan L Bailey, Joseph M Betz, Karen W Andrews, Leila G Saldanha, Richard Bailen, Rebecca B Costello, Florence Chang, Jeanne Goshorn, Pamela R. PehrssonAbstract:The Academy of Nutrition and Dietetics recognizes the importance of including Dietary Supplements in assessing and planning Dietary intakes.1 Dietary Supplement (DS) use in the United States has increased markedly during the last 30 years and is now widespread across all segments of society.2,3,4,5,6 Today, over half of adults and a third of US children have used one or more DS within the past 30 days, with multi-vitamin, multi-mineral (MVMM) products especially common.7, 8 Since Supplements are now major sources of several nutrients such as calcium and vitamin D in American diets, it is important for registered dietitians and nutritionists (RDNs) to include their contributions when assessing intakes or planning diets.9,10,11 Likewise, for national nutrition surveillance the contributions to nutrient intakes from Supplements must be considered in order to identify groups at Dietary risk because their intakes fall below the estimated average requirement (EAR) or above the upper tolerable intake level (UL).12 For example, when Supplements are included in assessments, the proportion of the United States population that is below the EAR is much less for several vitamins11 and fewer women are “at risk” (defined as below the EAR) for folate intake than when they are not.13,14 For some nutrients, like folic acid, the UL is established based solely for the form that comes from fortificants in foods and in Dietary Supplements. RDNs, epidemiologists, and public health officials also need accurate Dietary Supplement databases in order to evaluate possible associations between nutrient intake and disease outcomes. The National Health and Nutrition Examination Survey (NHANES) Dietary Supplement label database contains label-derived information from Supplement products that is updated every two years. Information contained in the database is driven by what is reported by survey participants. The currently available database contains Supplement label information for products reported from 1999–2010. While the NHANES DS database provides useful information, it is not comprehensive and is more likely to contain commonly used Supplements and less likely to contain infrequently used Supplements.15 In fact, MVMM products account for only about half of all Supplements used.3 Additionally, not all information from the label is recorded and released in the database. For example, the NHANES database does not contain information such as health claims, other ingredients and warning statements that may have been on the label.
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prevalence and predictors of children s Dietary Supplement use the 2007 national health interview survey
The American Journal of Clinical Nutrition, 2013Co-Authors: Johanna T Dwyer, Christopher T Sempos, Gail Rogers, Richard L Nahin, Patricia M Barnes, Paul M Jacques, Regan L BaileyAbstract:Background: Little is known about the characteristics of US children who are Dietary Supplement users. Objective: We described the prevalence and predictors of and reasons for giving children Dietary Supplements. Design: The study included children <18 y of age who participated in the Complementary and Alternative Medicine Supplement of the National Health Interview Survey of 2007 whose proxies provided complete information on child Dietary Supplement use. Results: A total of 37% of subjects used Dietary Supplements, 31% of subjects used multivitamin mineral (MVM) products exclusively, 4% of subjects used single vitamins or minerals solely or in combination with MVMs, and 2% of subjects used nonvitamin, nonmineral products either solely or in combination with other Supplements. Users were more likely than nonusers to be Asian, white, or non-Hispanic; belong to families with higher parental education and income levels; reside in areas other than the South; be in good, very good, or excellent health; have private health insurance; and have a usual place at which they received conventional medical care. Children (3%) with the most disease burden and health care were more likely to use Supplements than were healthier children. Supplements were given for the prevention or treatment of many illnesses and conditions. Neither the caregiver's reasons nor specific Supplements used were consistently associated with particular conditions. Conclusions: The 37% of US children who used any type of Dietary Supplements differed from nonusers in family socioeconomic status and many other health-related characteristics. Users were given Supplements to prevent or treat many illnesses and conditions for which there is only limited evidence of their efficacy.
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Dietary Supplement use among u s adults has increased since nhanes iii 1988 1994
NCHS data brief, 2011Co-Authors: Jaime J Gahche, Mary Frances Picciano, Regan L Bailey, Jeffery P Hughes, Vicki L Burt, Elizabeth A Yetley, Margaret A Mcdowell, Johanna T Dwyer, Christopher T SemposAbstract:KEY FINDINGS: Use of Dietary Supplements is common among the U.S. adult population. Over 40% used Supplements in 1988-1994, and over one-half in 2003-2006. Multivitamins/multiminerals are the most commonly used Dietary Supplements, with approximately 40% of men and women reporting use during 2003-2006. Use of Supplemental calcium increased from 28% during 1988-1994 to 61% during 2003-2006 among women aged 60 and over. Use of Supplements containing folic acid among women aged 20-39 did not increase since 1988-1994. In 2003-2006, 34% of women aged 20-39 used a Dietary Supplement containing folic acid. Use of Dietary Supplements containing vitamin D increased from 1988-1994 through 1999-2002 for men and women in most age groups. Dietary Supplements can contain nutrients in amounts as high as or higher than the Institute of Medicine's Recommended Dietary Reference Intakes, therefore contributing substantially to total nutrient intake. Dietary Supplements are widely available to U.S. consumers, and monitoring their use over time is an important component of the National Nutrition Monitoring System. Failure to include these nutrients when assessing the adequacy of diets and nutrition in the U.S. population may lead to inaccurate and misleading results. This report provides estimates of Dietary Supplement use for specific population groups over time. In addition to overall use of Dietary Supplements, this report focuses on estimates for specific nutrients consumed through Dietary Supplement use.