Table 2.
Trends in Overall Supplement Use, as well as Use of MVMM, Vitamins and Minerals, and Common MVMM Components: US Adults,a 1999–2000 through 2011–2012b,c
| 30-day prevalence of use % (95% confidence interval [CI])d
|
p-trend | 2011–2012 vs 1999–2000 |
||||||||
|---|---|---|---|---|---|---|---|---|---|---|
| 1999–2000 (n=4,863) |
2001–2002 (n=5,396) |
2003–2004 (n=5,028) |
2005–2006 (n=4,972) |
2007–2008 (n=5,930) |
2009–2010 (n=6,213) |
2011–2012 (n=5,556) |
Ratio | Difference | ||
| SUMMARY USE | ||||||||||
|
| ||||||||||
| Any supplement product | 52 (49, 54) | 51 (50, 53) | 54 (51, 57) | 54 (51, 56) | 49 (45, 53) | 50 (47, 52) | 52 (49, 55) | .19 | 1.0 (0.93, 1.1) | 0.0 (−3.6, 3.6) |
| Excluding MVMM | 34 (32, 37) | 34 (32, 36) | 36 (33, 39) | 36 (33, 38) | 34 (31, 38) | 34 (32, 36) | 39 (36, 42) | .063 | 1.1 (1.0, 1.3) | 5.0 (1.0, 8.9) |
| ≥4 supplement products | 8.7 (7.5, 10) | 9.8 (8.3, 12) | 10 (8.7, 12) | 9.9 (8.5, 11) | 9.0 (7.1, 11) | 7.8 (6.8, 9.0) | 9.9 (8.6, 11) | .60 | 1.1 (0.92, 1.4) | 1.1 (−0.8, 3.0) |
| MVMMe | 37 (35, 39) | 38 (35, 40) | 38 (36, 41) | 40 (38, 42) | 33 (30, 36) | 32 (31, 34) | 31 (29, 33) | <.001 | 0.85 (0.78, 0.92) | −5.7 (−8.6, −2.7) |
| MVMM (alternative definition)f | 39 (37, 42) | 40 (38, 42) | 42 (40, 44) | 43 (41, 45) | 36 (33, 40) | 37 (35, 38) | 36 (34, 38) | <.001 | 0.91 (0.83, 0.99) | −3.6 (−6.8, −0.4) |
| Any vitamin | 47 (44, 50) | 47 (46, 49) | 49 (46, 52) | 49 (47, 51) | 44 (41, 48) | 45 (43, 47) | 48 (45, 50) | .30 | 1.0 (0.94, 1.1) | 0.8 (−3.1, 4.6) |
| Excluding MVMM | 25 (23, 28) | 27 (25, 28) | 28 (25, 31) | 26 (24, 28) | 26 (23, 29) | 26 (24, 28) | 31 (28, 34) | .047 | 1.2 (1.1, 1.4) | 5.7 (1.9, 9.5) |
| Any mineral/element | 42 (39, 45) | 43 (41, 45) | 45 (43, 48) | 46 (43, 49) | 40 (36, 43) | 39 (38, 41) | 39 (37, 41) | <.001 | 0.93 (0.85, 1.0) | −3.0 (−6.5, 0.4) |
| Excluding MVMM | 18 (16, 20) | 20 (18, 22) | 22 (20, 25) | 20 (18, 22) | 19 (16, 22) | 17 (16, 18) | 18 (17, 20) | .054 | 1.0 (0.89, 1.2) | 0.3 (−2.0, 2.6) |
|
| ||||||||||
| INCREASED | ||||||||||
|
| ||||||||||
| Lutein/zeaxanthin | 8.5 (5.8, 12) | 18 (17, 20) | 22 (20, 24) | 21 (20, 23) | 18 (16, 20) | 12 (11, 13) | 10 (9.2, 12) | .019 | 1.2 (0.82, 1.8) | 1.9 (−1.6, 5.3) |
| Lycopene (men only)* | 1.9 (1.2, 2.9) | 2.9 (2.3, 3.8) | 21 (19, 24) | 25 (23, 27) | 22 (20, 26) | 18 (16, 20) | 16 (14, 18) | <.001 | 8.7 (5.5, 14) | 14 (12, 16) |
| Vitamin B12 (Cobalamin), Excluding MVMM* | 5.7 (4.7, 6.8) | 5.6 (4.8, 6.5) | 5.9 (5.0, 7.0) | 6.8 (5.6, 8.2) | 6.8 (5.6, 8.3) | 6.1 (5.5, 6.7) | 8.1 (6.9, 9.5) | .002 | 1.4 (1.1, 1.8) | 2.4 (0.8, 4.1) |
| Vitamin D, Excluding MVMM* | 5.1 (4.3, 6.1) | 8.7 (7.7, 9.9) | 8.5 (7.1, 10) | 8.6 (7.7, 9.6) | 11 (9.4, 12) | 15 (14, 16) | 19 (17, 22) | <.001 | 3.8 (3.0, 4.6) | 14 (12, 17) |
|
| ||||||||||
| DECREASED | ||||||||||
|
| ||||||||||
| Boron | 24 (22, 26) | 25 (23, 27) | 26 (23, 28) | 25 (23, 27) | 19 (17, 22) | 20 (19, 21) | 17 (16, 18) | <.001 | 0.7 (0.63, 0.78) | −7.2 (−9.6, −4.9) |
| Calcium* | 38 (35, 41) | 39 (37, 41) | 42 (39, 45) | 44 (41, 46) | 36 (33, 40) | 37 (35, 38) | 35 (33, 37) | .002 | 0.93 (0.84, 1.0) | −2.8 (−6.2, 0.5) |
| Chromium | 28 (26, 30) | 30 (28, 32) | 30 (28, 33) | 32 (30, 34) | 28 (25, 31) | 28 (26, 30) | 27 (25, 28) | .041 | 0.94 (0.84, 1.0) | −1.8 (−4.6, 1.0) |
| Copper | 31 (28, 33) | 31 (29, 33) | 32 (30, 34) | 34 (32, 36) | 29 (26, 31) | 29 (27, 31) | 27 (25, 28) | <.001 | 0.87 (0.8, 0.96) | −3.8 (−6.5, −1.1) |
| Iodine | 29 (27, 31) | 29 (27, 31) | 28 (26, 31) | 28 (26, 31) | 22 (20, 25) | 22 (21, 24) | 20 (18, 21) | <.001 | 0.68 (0.61, 0.75) | −9.4 (−11.9, −6.8) |
| Iron* | 31 (27, 34) | 29 (27, 30) | 27 (25, 29) | 27 (24, 30) | 21 (19, 23) | 21 (20, 22) | 19 (17, 20) | <.001 | 0.61 (0.53, 0.7) | −12 (−15, −8.3) |
| Magnesium | 33 (30, 35) | 34 (32, 36) | 35 (33, 38) | 37 (35, 39) | 31 (28, 34) | 30 (29, 32) | 28 (27, 30) | <.001 | 0.87 (0.79, 0.96) | −4.2 (−7.2, −1.1) |
| Manganese | 28 (26, 31) | 30 (28, 32) | 31 (28, 33) | 32 (30, 34) | 28 (26, 31) | 28 (26, 30) | 26 (25, 27) | .009 | 0.91 (0.83, 1.0) | −2.5 (−5.1, 0.2) |
| Molybdenum | 25 (23, 28) | 27 (26, 29) | 27 (25, 30) | 26 (25, 28) | 21 (18, 24) | 21 (20, 23) | 18 (17, 19) | <.001 | 0.71 (0.64, 0.79) | −7.4 (−9.8, −5.0) |
| Phosphorus | 25 (23, 27) | 24 (23, 26) | 25 (22, 27) | 23 (22, 25) | 18 (16, 21) | 18 (17, 20) | 15 (14, 17) | <.001 | 0.61 (0.53, 0.7) | −9.6 (−12, −6.9) |
| Potassium | 28 (26, 30) | 28 (26, 30) | 28 (26, 31) | 28 (26, 30) | 23 (20, 25) | 22 (21, 24) | 18 (16, 19) | <.001 | 0.63 (0.55, 0.71) | −10 (−13, −7.8) |
| Selenium* | 28 (26, 31) | 30 (28, 32) | 30 (28, 33) | 32 (30, 34) | 28 (25, 31) | 27 (26, 29) | 26 (24, 27) | .002 | 0.9 (0.82, 0.99) | −2.8 (−5.4, −0.1) |
| Selenium Excluding MVMM* | 2.6 (2.2, 3.2) | 2.6 (2.1, 3.3) | 2.1 (1.4, 3.1) | 1.5 (1.2, 2) | 1.1 (0.7, 1.6) | 0.9 (0.6, 1.4) | 0.7 (0.4, 1.2) | <.001 | 0.28 (0.16, 0.48) | −1.9 (−2.5, −1.3) |
| Vanadium | 22 (20, 25) | 22 (21, 24) | 24 (21, 26) | 23 (21, 25) | 18 (16, 21) | 18 (17, 20) | 14 (13, 16) | <.001 | 0.65 (0.57, 0.74) | −7.9 (−10, −5.3) |
| Vitamin A* | 36 (33, 38) | 37 (35, 40) | 37 (35, 40) | 39 (37, 42) | 33 (30, 36) | 33 (31, 34) | 31 (30, 33) | <.001 | 0.88 (0.81, 0.96) | −4.3 (−7.2, −1.4) |
| Vitamin B1 (Thiamin) | 37 (35, 40) | 38 (36, 41) | 38 (35, 41) | 40 (38, 43) | 33 (30, 36) | 32 (31, 34) | 30 (28, 32) | <.001 | 0.81 (0.74, 0.89) | −6.9 (−10, −3.8) |
| Vitamin B2 (Riboflavin) | 37 (35, 40) | 38 (36, 40) | 38 (35, 41) | 40 (38, 43) | 33 (30, 36) | 32 (31, 34) | 30 (28, 32) | <.001 | 0.82 (0.75, 0.9) | −6.8 (−9.9, −3.6) |
| Vitamin B3 (Niacin) | 37 (35, 40) | 38 (36, 40) | 38 (35, 41) | 40 (38, 43) | 34 (30, 37) | 33 (31, 35) | 31 (29, 33) | <.001 | 0.84 (0.76, 0.92) | −6.1 (−9.2, −2.9) |
| Vitamin B5 (Pantothenic acid) | 34 (32, 37) | 36 (34, 38) | 36 (33, 38) | 38 (35, 40) | 32 (29, 35) | 31 (29, 33) | 30 (28, 31) | <.001 | 0.87 (0.79, 0.96) | −4.5 (−7.5, −1.4) |
| Vitamin B6 (Pyridoxine) | 38 (36, 41) | 39 (37, 41) | 39 (37, 42) | 41 (39, 44) | 35 (32, 38) | 34 (32, 36) | 32 (30, 35) | <.001 | 0.85 (0.78, 0.93) | −5.6 (−8.8, −2.4) |
| Vitamin B9 (Folic acid) | 38 (35, 40) | 38 (36, 41) | 39 (36, 42) | 41 (38, 44) | 35 (32, 38) | 34 (32, 36) | 33 (30, 35) | <.001 | 0.87 (0.78, 0.95) | −5.1 (−8.5, −1.7) |
| Vitamin B12 (Cobalamin)* | 38 (35, 40) | 39 (37, 41) | 39 (36, 41) | 41 (39, 44) | 36 (32, 39) | 35 (33, 37) | 35 (33, 37) | .001 | 0.92 (0.85, 1.0) | −2.9 (−6.1, 0.2) |
| Vitamin C | 42 (39, 44) | 42 (40, 45) | 43 (40, 46) | 45 (42, 47) | 38 (34, 41) | 37 (35, 38) | 36 (34, 38) | <.001 | 0.86 (0.79, 0.93) | −5.9 (−9.0 −2.8) |
| Vitamin E | 41 (38, 43) | 41 (40, 43) | 42 (39, 45) | 42 (40, 45) | 35 (32, 38) | 34 (32, 36) | 34 (32, 36) | <.001 | 0.83 (0.76, 0.91) | −6.9 (−10, −3.6) |
| Zinc | 35 (32, 38) | 36 (34, 38) | 37 (35, 39) | 39 (37, 42) | 32 (29, 35) | 32 (30, 33) | 30 (28, 32) | <.001 | 0.86 (0.78, 0.94) | −5.0 (−8.1, −1.8) |
|
| ||||||||||
| STABLE | ||||||||||
|
| ||||||||||
| Biotin | 30 (27, 32) | 30 (28, 32) | 31 (28, 34) | 33 (31, 35) | 29 (26, 33) | 30 (28, 32) | 29 (27, 31) | .51 | 0.98 (0.89, 1.1) | −0.5 (−3.5, 2.5) |
| Calcium, Excluding MVMM* | 13 (12, 15) | 15 (14, 17) | 17 (15, 20) | 16 (14, 18) | 15 (12, 17) | 13 (13, 14) | 14 (12, 15) | .15 | 1.0 (0.86, 1.2) | 0.4 (−1.9, 2.8) |
| Choline | 5.1 (4, 6.3) | 5.1 (4.1, 6.3) | 4.5 (3.8, 5.4) | 6.3 (5, 7.8) | 4.6 (3.6, 5.7) | 4.7 (4.1, 5.5) | 6.3 (5.5, 7.3) | .23 | 1.2 (0.95, 1.6) | 1.3 (−0.2, 2.7) |
| Inositol | 4.9 (4, 6) | 5.2 (4.2, 6.4) | 4.7 (3.9, 5.5) | 6.3 (5.1, 7.7) | 5.1 (4, 6.4) | 4.6 (4, 5.2) | 6.5 (5.5, 7.6) | .16 | 1.3 (1.0, 1.7) | 1.5 (0.1, 3.0) |
| Iron, Excluding MVMM* | 2.9 (2.6, 3.2) | 3.1 (2.5, 3.9) | 3.1 (2.5, 3.8) | 3.2 (2.4, 4.3) | 3.8 (3, 4.8) | 2.9 (2.4, 3.5) | 3 (2.5, 3.7) | .65 | 1.1 (0.85, 1.3) | 0.2 (−0.5, 0.8) |
| Lycopene Excluding MVMM (men only)* | - | - | 0.8 (0.4, 1.5) | 0.7 (0.3, 1.3) | 0.6 (0.4, 1.1) | 0.5 (0.2, 0.9) | 0.7 (0.3, 1.4) | .24 | 5.6 (1.3, 24) | 0.5 (0.1, 1.1) |
| Vitamin A, Excluding MVMM* | 3.1 (2.7, 3.5) | 4.1 (3.3, 5.1) | 3.2 (2.6, 3.9) | 3.4 (2.7, 4.2) | 3 (2.4, 3.7) | 2.8 (2.1, 3.7) | 3.5 (2.8, 4.4) | .43 | 1.1 (0.88, 1.5) | 0.4 (−0.4, 1.3) |
| Vitamin D* | 37 (34, 39) | 38 (36, 40) | 39 (36, 42) | 41 (39, 43) | 36 (33, 39) | 39 (37, 41) | 40 (38, 43) | .14 | 1.1 (1.0, 1.2) | 3.9 (0.5, 7.4) |
| Vitamin K | 24 (22, 26) | 24 (23, 26) | 27 (24, 29) | 28 (26, 30) | 25 (22, 27) | 25 (24, 27) | 23 (22, 25) | .53 | 0.97 (0.86, 1.1) | −0.8 (−3.6, 2.0) |
ABBREVIATIONS: MVMM (Multivitamin/multimineral)
*
Indicates that the trend markedly varied for overall use and use excluding MVMM, and therefore both trends are presented. Detailed information on each trend, both overall and exclusive of MVMM is presented in eTable 2.
a
Among adults ages ≥ 20 years.
b
Results are presented for any use of each individual supplement, regardless of whether taken as an individual supplement or as a combination supplement, such as a MVMM. Results are also presented exclusive of MVMM if the two trends markedly varied. In these cases, both results (inclusive and exclusive of MVMM) are marked by a star so as to indicate that results are presented both ways.
c
A ‘decrease’ corresponds to a ratio<1 and p-trend<0.05, an ‘increase’ represents a ratio>1 and p-trend<0.05, and ‘stable’ represents a p-trend≥0.05.
d
Data are weighted to be nationally representative. If the relative standard error exceeds 30%, data are suppressed (as indicated by a dash), consistent with NHANES reporting guidelines.20
e
Defined as supplement products containing ten or more vitamins and/or minerals. This is the primary definition used in this paper, and is the variable used when defining use exclusive of MVMM elsewhere in the paper and tables.
f
Defined as supplements containing three or more vitamins and 1 or more minerals