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. 2017 Aug 9;9(8):849.
doi: 10.3390/nu9080849.

Impact of Frequency of Multi-Vitamin/Multi-Mineral Supplement Intake on Nutritional Adequacy and Nutrient Deficiencies in U.S. Adults

Jeffrey B Blumberg  1 , Balz B Frei  2 , Victor L Fulgoni  3 , Connie M Weaver  4 , Steven H Zeisel  5
Affiliations

Impact of Frequency of Multi-Vitamin/Multi-Mineral Supplement Intake on Nutritional Adequacy and Nutrient Deficiencies in U.S. Adults

Jeffrey B Blumberg et al. Nutrients. .

Abstract

Although >50% of U.S. adults use dietary supplements, little information is available on the impact of supplement use frequency on nutrient intakes and deficiencies. Based on nationally representative data in 10,698 adults from the National Health and Nutrition Examination Surveys (NHANES) 2009 to 2012, assessments were made of intakes from food alone versus food plus multi-vitamin/multi-mineral supplements (MVMS) of 17 nutrients with an Estimated Average Requirement (EAR) and a Tolerable Upper Intake Level (UL), and of the status of five nutrients with recognized biomarkers of deficiency. Compared to food alone, MVMS use at any frequency was associated with a lower prevalence of inadequacy (p < 0.01) for 15/17 nutrients examined and an increased prevalence of intakes >UL for 7 nutrients, but the latter was ≤4% for any nutrient. Except for calcium, magnesium, and vitamin D, most frequent MVMS use (≥21 days/30 days) virtually eliminated inadequacies of the nutrients examined, and was associated with significantly lower odds ratios of deficiency for the examined nutrient biomarkers except for iron. In conclusion, among U.S. adults, MVMS use is associated with decreased micronutrient inadequacies, intakes slightly exceeding the UL for a few nutrients, and a lower risk of nutrient deficiencies.

Keywords: NHANES; dietary supplements; micronutrient; multi-vitamin/multi-mineral; nutrient deficiencies; nutritional adequacy; nutritional supplements; vitamins.

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Conflict of interest statement

In addition to consulting work for the Campaign for Essential Nutrients (CFEN), the authors receive research support from USDA ARS grant 58-1950-014 (J.B.B.), NIH grant AT008754 (C.M.W.) and Nestle Nutrition (S.H.Z.). The authors serve on scientific advisory boards for AdvoCare (J.B.B.), Pfizer Consumer Healthcare (B.B.F., J.B.B.), Pharmavite (C.M.W., J.B.B.) and Metabolon (S.H.Z.). S.H.Z. is a founder of Nutrigene Sciences, LLC, a company in which he owns stock equity. V.L.F., as Senior Vice President of Nutrition Impact LLC, performs consulting and database analyses for various food and beverage companies and related entities. Neither CFEN nor its individual company members had any role in the design of this study; collection, analyses or interpretation of the data; or writing of the manuscript. The authors made the final decision to publish these findings.

Figures

Figure 1
Figure 1
Prevalence of inadequacy (% of population below EAR) for “underconsumed nutrients” identified in 2015–2020 Dietary Guidelines for Americans from food only and food + MVMS among adults age 19 years and older reporting taking a MVMS. NHANES 2009–2012. * Significantly different from Food only at p < 0.01. EAR: estimated average requirement; MVMS: multi-vitamin/multi-mineral supplements; NHANES: National Health and Nutrition Examination Survey.
Figure 2
Figure 2
Prevalence of inadequacy (% of population below EAR) of intakes of other micronutrients from food only and food + MVMS among females and males age 19 years and older reporting taking a MVMS. NHANES 2009–2012. (A) Females; (B) Males. * Significantly different from Food only at p < 0.01. EAR: estimated average requirement; MVMS: multi-vitamin/multi-mineral supplements; NHANES: National Health and Nutrition Examination Survey.
Figure 3
Figure 3
Prevalence of inadequacy (% of population below EAR) of “underconsumed nutrients” identified in 2015–2020 Dietary Guidelines for Americans for food + MVMS by frequency of MVMS intake among all adults (A); females (B); and males (C) age 19 years and older. NHANES 2009–2012. * Significantly different from 0 days per month at p < 0.01. a,b,c Values by frequency of MVMS with different superscripts are significantly different at p < 0.01. EAR: estimated average requirement; MVMS: multi-vitamin/multi-mineral supplements; NHANES: National Health and Nutrition Examination Survey.
Figure 3
Figure 3
Prevalence of inadequacy (% of population below EAR) of “underconsumed nutrients” identified in 2015–2020 Dietary Guidelines for Americans for food + MVMS by frequency of MVMS intake among all adults (A); females (B); and males (C) age 19 years and older. NHANES 2009–2012. * Significantly different from 0 days per month at p < 0.01. a,b,c Values by frequency of MVMS with different superscripts are significantly different at p < 0.01. EAR: estimated average requirement; MVMS: multi-vitamin/multi-mineral supplements; NHANES: National Health and Nutrition Examination Survey.
Figure 4
Figure 4
Prevalence of inadequacy (% of population below the EAR) and % population above the UL of other micronutrient intakes from food + MVMS by frequency of MVMS intake among adult females and males age 19 years and older. NHANES 2009–2012. (A) Females below EAR; (B) Males below EAR; (C) Females above UL; (D) Males above UL. * Significantly different from 0 days per month at p < 0.01. a,b,c Values by frequency of MVMS with different superscripts are significantly different at p < 0.01. EAR: estimated average requirement; MVMS: multi-vitamin/multi-mineral supplements; NHANES: National Health and Nutrition Examination Survey; UL: upper tolerable intake level.
Figure 4
Figure 4
Prevalence of inadequacy (% of population below the EAR) and % population above the UL of other micronutrient intakes from food + MVMS by frequency of MVMS intake among adult females and males age 19 years and older. NHANES 2009–2012. (A) Females below EAR; (B) Males below EAR; (C) Females above UL; (D) Males above UL. * Significantly different from 0 days per month at p < 0.01. a,b,c Values by frequency of MVMS with different superscripts are significantly different at p < 0.01. EAR: estimated average requirement; MVMS: multi-vitamin/multi-mineral supplements; NHANES: National Health and Nutrition Examination Survey; UL: upper tolerable intake level.
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