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Annual Review of Nutrition

Volume 43, 2023

Major Gaps in Understanding Dietary Supplement Use in Health and Disease

Abstract

Precise dietary assessment is critical for accurate exposure classification in nutritional research, typically aimed at understanding how diet relates to health. Dietary supplement (DS) use is widespread and represents a considerable source of nutrients. However, few studies have compared the best methods to measure DSs. Our literature review on the relative validity and reproducibility of DS instruments in the United States [e.g., product inventories, questionnaires, and 24-h dietary recalls (24HR)] identified five studies that examined validity ( = 5) and/or reproducibility ( = 4). No gold standard reference method exists for validating DS use; thus, each study's investigators chose the reference instrument used to measure validity. Self-administered questionnaires agreed well with 24HR and inventory methods when comparing the prevalence of commonly used DSs. The inventory method captured nutrient amounts more accurately than the other methods. Reproducibility (over 3 months to 2.4 years) of prevalence of use estimates on the questionnaires was acceptable for common DSs. Given the limited body of research on measurement error in DS assessment, only tentative conclusions on these DS instruments can be drawn at present. Further research is critical to advancing knowledge in DS assessment for research and monitoring purposes.

Keyword(s): dietary assessment, dietary supplement, measurement error, methodology, reproducibility, validity
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/content/journals/10.1146/annurev-nutr-011923-020327
2023-08-21
2024-04-29
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Literature Cited

  1. 1.
    Appel LJ, Moore TJ, Obarzanek E, Vollmer WM, Svetkey LP et al. 1997. A clinical trial of the effects of dietary patterns on blood pressure. N. Engl. J. Med. 336:1117–24
     [Google Scholar]
  2. 2.
    Bailey RL. 2020. Current regulatory guidelines and resources to support research of dietary supplements in the United States. Crit Rev. Food Sci. Nutr. 60:298–309
     [Google Scholar]
  3. 3.
    Bailey RL. 2021. Overview of dietary assessment methods for measuring intakes of foods, beverages, and dietary supplements in research studies. Curr. Opin. Biotechnol. 70:91–96
     [Google Scholar]
  4. 4.
    Bailey RL, Dodd KW, Gahche JJ, Dwyer JT, Cowan AE et al. 2019. Best practices for dietary supplement assessment and estimation of total usual nutrient intakes in population-level research and monitoring. J. Nutr. 149:181–97
     [Google Scholar]
  5. 5.
    Bailey RL, Fulgoni VL 3rd, Keast DR, Dwyer JT. 2011. Dietary supplement use is associated with higher intakes of minerals from food sources. Am. J. Clin. Nutr. 94:1376–81
     [Google Scholar]
  6. 6.
    Bailey RL, Fulgoni VL 3rd, Keast DR, Dwyer JT. 2012. Examination of vitamin intakes among US adults by dietary supplement use. J. Acad. Nutr. Diet. 112:657–63.e4
     [Google Scholar]
  7. 7.
    Bailey RL, Gahche JJ, Lentino CV, Dwyer JT, Engel JS et al. 2011. Dietary supplement use in the United States, 2003–2006. J. Nutr. 141:261–66
     [Google Scholar]
  8. 8.
    Bailey RL, Gahche JJ, Miller PE, Thomas PR, Dwyer JT. 2013. Why US adults use dietary supplements. JAMA Intern. Med. 173:355–61
     [Google Scholar]
  9. 9.
    Bailey RL, Pac SG, Fulgoni VL 3rd, Reidy KC, Catalano PM. 2019. Estimation of total usual dietary intakes of pregnant women in the United States. JAMA Netw. Open 2:e195967
     [Google Scholar]
  10. 10.
    Bingham S, Cummings JH. 1983. The use of 4-aminobenzoic acid as a marker to validate the completeness of 24 h urine collections in man. Clin. Sci. 64:629–35
     [Google Scholar]
  11. 11.
    Block G, Sinha R, Gridley G. 1994. Collection of dietary-supplement data and implications for analysis. Am. J. Clin. Nutr. 59:232S–39S
     [Google Scholar]
  12. 12.
    Blumberg JB, Bailey RL, Sesso HD, Ulrich CM. 2018. The evolving role of multivitamin/multimineral supplement use among adults in the age of personalized nutrition. Nutrients 10:248
     [Google Scholar]
  13. 13.
    Branum AM, Bailey R, Singer BJ. 2013. Dietary supplement use and folate status during pregnancy in the United States. J. Nutr. 143:486–92
     [Google Scholar]
  14. 14.
    Cowan AE, Jun S, Gahche JJ, Tooze JA, Dwyer JT et al. 2018. Dietary supplement use differs by socioeconomic and health-related characteristics among U.S. adults, NHANES 2011–2014. Nutrients 10:1114
     [Google Scholar]
  15. 15.
    Cowan AE, Jun S, Tooze JA, Dodd KW, Gahche JJ et al. 2020. Comparison of 4 methods to assess the prevalence of use and estimates of nutrient intakes from dietary supplements among US adults. J. Nutr. 150:884–93
     [Google Scholar]
  16. 16.
    Cowan AE, Jun S, Tooze JA, Eicher-Miller HA, Dodd KW et al. 2019. Total usual micronutrient intakes compared to the dietary reference intakes among U.S. adults by food security status. Nutrients 12:38
     [Google Scholar]
  17. 17.
    Cowan AE, Tooze JA, Gahche JJ, Eicher-Miller HA, Guenther PM et al. 2023. Trends in overall and micronutrient-containing dietary supplement use in US adults and children, NHANES 2007–2018. J. Nutr. 152:2789–801
     [Google Scholar]
  18. 18.
    Cox L, Guberg K, Young S, Nicholson S, Steer T et al. 2018. Validation of the use of p-aminobenzoic acid to determine completeness of 24h urine collections in surveys of diet and nutrition. Eur. J. Clin. Nutr. 72:1180–82
     [Google Scholar]
  19. 19.
    Dickinson A, MacKay D. 2014. Health habits and other characteristics of dietary supplement users: a review. Nutr. J. 13:14
     [Google Scholar]
  20. 20.
    Du M, Luo H, Blumberg JB, Rogers G, Chen F et al. 2020. Dietary supplement use among adult cancer survivors in the United States. J. Nutr. 150:1499–508
     [Google Scholar]
  21. 21.
    Dwyer JT, Coates PM, Smith MJ. 2018. Dietary supplements: regulatory challenges and research resources. Nutrients 10:41
     [Google Scholar]
  22. 22.
    Ferrucci LM, McCorkle R, Smith T, Stein KD, Cartmel B. 2009. Factors related to the use of dietary supplements by cancer survivors. J. Altern. Complement. Med. 15:673–80
     [Google Scholar]
  23. 23.
    Foote JA, Murphy SP, Wilkens LR, Hankin JH, Henderson BE, Kolonel LN. 2003. Factors associated with dietary supplement use among healthy adults of five ethnicities: the Multiethnic Cohort Study. Am. J. Epidemiol. 157:888–97
     [Google Scholar]
  24. 24.
    Freedman LS, Commins JM, Moler JE, Willett W, Tinker LF et al. 2015. Pooled results from 5 validation studies of dietary self-report instruments using recovery biomarkers for potassium and sodium intake. Am. J. Epidemiol. 181:473–87
     [Google Scholar]
  25. 25.
    Gahche JJ, Bailey RL. 2021. Accurate measurement of nutrients and nonnutritive dietary ingredients from dietary supplements is critical in the precision nutrition era. J. Nutr. 151:2094–95
     [Google Scholar]
  26. 26.
    Gahche JJ, Bailey RL, Potischman N, Dwyer JT. 2017. Dietary supplement use was very high among older adults in the United States in 2011–2014. J. Nutr. 147:1968–76
     [Google Scholar]
  27. 27.
    Gahche JJ, Bailey RL, Potischman N, Ershow AG, Herrick KA et al. 2018. Federal monitoring of dietary supplement use in the resident, civilian, noninstitutionalized US population: National Health and Nutrition Examination Survey. J. Nutr. 148:Suppl. 21436S–44S
     [Google Scholar]
  28. 28.
    Gleason PM, Harris J, Sheean PM, Boushey CJ, Bruemmer B. 2010. Publishing nutrition research: validity, reliability, and diagnostic test assessment in nutrition-related research. J. Am. Diet. Assoc. 110:409–19
     [Google Scholar]
  29. 29.
    Hartman TJ, Wang Y, Hodge RA, Mitchell DC, Flanders WD et al. 2021. Self-reported dietary supplement use is reproducible and relatively valid in the Cancer Prevention Study-3 diet assessment substudy. J. Acad. Nutr. Diet. 122:1665–76.e2
     [Google Scholar]
  30. 30.
    Jun S, Cowan AE, Tooze JA, Gahche JJ, Dwyer JT et al. 2018. Dietary supplement use among U.S. children by family income, food security level, and nutrition assistance program participation status in 2011–2014. Nutrients 10:1212
     [Google Scholar]
  31. 31.
    Jun S, Gahche JJ, Potischman N, Dwyer JT, Guenther PM et al. 2020. Dietary supplement use and its micronutrient contribution during pregnancy and lactation in the United States. Obstet. Gynecol. 135:623–33
     [Google Scholar]
  32. 32.
    Kantor ED, Rehm CD, Du M, White E, Giovannucci EL. 2016. Trends in dietary supplement use among US adults from 1999–2012. JAMA 316:1464–74
     [Google Scholar]
  33. 33.
    Kipnis V, Subar AF, Midthune D, Freedman LS, Ballard-Barbash R et al. 2003. Structure of dietary measurement error: results of the OPEN biomarker study. Am. J. Epidemiol. 158:14–21; discuss. 22–26
    [Google Scholar]
  34. 34.
    Kirkpatrick SI, Baranowski T, Subar AF, Tooze JA, Frongillo EA. 2019. Best practices for conducting and interpreting studies to validate self-report dietary assessment methods. J. Acad. Nutr. Diet. 119:1801–16
     [Google Scholar]
  35. 35.
    McHugh ML. 2012. Interrater reliability: the kappa statistic. Biochem. Med. 22:276–82
     [Google Scholar]
  36. 36.
    Miller PE, Demark-Wahnefried W, Snyder DC, Sloane R, Morey MC et al. 2008. Dietary supplement use among elderly, long-term cancer survivors. J. Cancer Surviv. 2:138–48
     [Google Scholar]
  37. 37.
    Miller PE, Vasey JJ, Short PF, Hartman TJ. 2009. Dietary supplement use in adult cancer survivors. Oncol. Nurs. Forum. 36:61–68
     [Google Scholar]
  38. 38.
    Mishra S, Stierman B, Gahche JJ, Potischman N. 2021. Dietary supplement use among adults: United States, 2017–2018. NCHS Data Brief 399:. https://doi.org/10.15620/cdc:101131
     [Google Scholar]
  39. 39.
    Mukaka MM. 2012. Statistics corner: A guide to appropriate use of correlation coefficient in medical research. Malawi Med. J. 24:69–71
     [Google Scholar]
  40. 40.
    Murphy SP, Wilkens LR, Hankin JH, Foote JA, Monroe KR et al. 2002. Comparison of two instruments for quantifying intake of vitamin and mineral supplements: a brief questionnaire versus three 24-hour recalls. Am. J. Epidemiol. 156:669–75
     [Google Scholar]
  41. 41.
    Murphy SP, Wilkens LR, Monroe KR, Steffen AD, Albright C et al. 2009. Comparison of nutrient intakes from three self-reported measures of dietary supplement use: results from the SURE Study. FASEB J. 23:S1341.1
     [Google Scholar]
  42. 42.
    Murphy SP, Wilkens LR, Monroe KR, Steffen AD, Yonemori KM et al. 2011. Dietary supplement use within a multiethnic population as measured by a unique inventory method. J. Am. Diet. Assoc. 111:1065–72
     [Google Scholar]
  43. 43.
    Nicastro HL, Bailey RL, Dodd KW. 2015. Using 2 assessment methods may better describe dietary supplement intakes in the United States. J. Nutr. 145:1630–34
     [Google Scholar]
  44. 44.
    Pannucci TE, Thompson FE, Bailey RL, Dodd KW, Potischman N et al. 2018. Comparing reported dietary supplement intakes between two 24-hour recall methods: the Automated Self-Administered 24-Hour Dietary Assessment Tool and the interview-administered Automated Multiple Pass Method. J. Acad. Nutr. Diet. 118:1080–86
     [Google Scholar]
  45. 45.
    Patterson RE, Kristal AR, Levy L, McLerran D, White E. 1998. Validity of methods used to assess vitamin and mineral supplement use. Am. J. Epidemiol. 148:643–49
     [Google Scholar]
  46. 46.
    Patterson RE, Neuhouser ML, Hedderson MM, Schwartz SM, Standish LJ, Bowen DJ. 2003. Changes in diet, physical activity, and supplement use among adults diagnosed with cancer. J. Am. Diet. Assoc. 103:323–28
     [Google Scholar]
  47. 47.
    Patterson RE, Neuhouser ML, White E, Kristal AR, Potter JD. 1998. Measurement error from assessing use of vitamin supplements at one point in time. Epidemiology 9:567–69
     [Google Scholar]
  48. 48.
    Picciano MF, McGuire MK. 2009. Use of dietary supplements by pregnant and lactating women in North America. Am. J. Clin. Nutr. 89:663S–67S
     [Google Scholar]
  49. 49.
    Rios-Avila L, Dwyer JT, Costello RB, Potischman N. 2017. Dietary supplement items on commonly used food frequency questionnaires. FASEB J. 31:647.13
     [Google Scholar]
  50. 50.
    Rock CL. 2007. Multivitamin-multimineral supplements: Who uses them?. Am. J. Clin. Nutr. 85:277S–79S
     [Google Scholar]
  51. 51.
    SAS Inst. Inc 2010. SAS/STAT(R) 9.22 User's Guide. SAS Inst. Inc. https://support.sas.com/documentation/cdl/en/statug/63347/HTML/default/viewer.htm#titlepage.htm
    [Google Scholar]
  52. 52.
    Satia JA, Campbell MK, Galanko JA, James A, Carr C, Sandler RS. 2004. Longitudinal changes in lifestyle behaviors and health status in colon cancer survivors. Cancer Epidemiol. Biomark. Prev. 13:1022–31
     [Google Scholar]
  53. 53.
    Satia-Abouta J, Patterson RE, King IB, Stratton KL, Shattuck AL et al. 2003. Reliability and validity of self-report of vitamin and mineral supplement use in the Vitamins and Lifestyle Study. Am. J. Epidemiol. 157:944–54
     [Google Scholar]
  54. 54.
    Steffen AD, Wilkens LR, Monroe K, Albright C, Yonemori K et al. 2009. Objective and self-reported recall measurements for nutrient intakes from dietary supplements: results from the SURE study. FASEB J. 23:341.3
     [Google Scholar]
  55. 55.
    Steffen AD, Wilkens LR, Yonemori KM, Albright CL, Murphy SP. 2021. A dietary supplement frequency questionnaire correctly ranks nutrient intakes in US older adults when compared to a comprehensive dietary supplement inventory. J. Nutr. 151:2486–95
     [Google Scholar]
  56. 56.
    Stierman B, Mishra S, Gahche JJ, Potischman N, Hales CM. 2020. Dietary supplement use in children and adolescents aged ≤19 years—United States, 2017–2018. Morb. Mortal. Wkly. Rep. 69:1557–62
     [Google Scholar]
  57. 57.
    Subar AF, Kipnis V, Troiano RP, Midthune D, Schoeller DA et al. 2003. Using intake biomarkers to evaluate the extent of dietary misreporting in a large sample of adults: the OPEN study. Am. J. Epidemiol. 158:1–13
     [Google Scholar]
  58. 58.
    Subar AF, Midthune D, Tasevska N, Kipnis V, Freedman LS. 2013. Checking for completeness of 24-h urine collection using para-amino benzoic acid not necessary in the Observing Protein and Energy Nutrition study. Eur. J. Clin. Nutr. 67:863–67
     [Google Scholar]
  59. 59.
    Thompson FE, Kirkpatrick SI, Subar AF, Reedy J, Schap TE et al. 2015. The National Cancer Institute's Dietary Assessment Primer: a resource for diet research. J. Acad. Nutr. Diet. 115:1986–95
     [Google Scholar]
  60. 60.
    USDA Agric. Res. Serv 2021. Total usual nutrient intake from food, beverages, and dietary supplements, by gender and age. What we eat in America, NHANES 2015–2018 Rep. USDA Agric. Res. Serv. Washington, DC: https://www.ars.usda.gov/ARSUserFiles/80400530/pdf/usual/Usual_Intake_Gender_WWEIA_2015_2018_Tables_TA.pdf
    [Google Scholar]
  61. 61.
    Velicer CM, Ulrich CM. 2008. Vitamin and mineral supplement use among US adults after cancer diagnosis: a systematic review. J. Clin. Oncol. 26:665–73
     [Google Scholar]
  62. 62.
    Viteri FE. 2011. Iron endowment at birth: maternal iron status and other influences. Nutr. Rev. 69:Suppl. 1S3–16
     [Google Scholar]
  63. 63.
    Wilkens LR, Murphy SP, Monroe KR, Steffen AD, Albright CL et al. 2009. Regularity of use of supplements over a one-month period: results from the SURE Study. FASEB J. 23:341.2
     [Google Scholar]
  64. 64.
    Yonemori KM, Morimoto Y, Wilkens LR, Murphy SP. 2009. Development of a supplement composition database for the SURE Study. J. Food Compost. Anal. 22:S83–S87
     [Google Scholar]
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Major Gaps in Understanding Dietary Supplement Use in Health and Disease
Annual Review of Nutrition 43, 179 (2023); https://doi.org/10.1146/annurev-nutr-011923-020327
/content/journals/10.1146/annurev-nutr-011923-020327
/content/journals/10.1146/annurev-nutr-011923-020327
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