|Picciano, Mary Frances - NATL INSTITUTES OF HEALTH|
|Dwyer, Johanna - NATL INSTITUTES OF HEALTH|
|Radimer, Kathy - NATL CTR.-HEALTH STATICS|
|Wilson, David - RTI INTERNATIONAL|
|Fisher, Kenneth - NATL INSTITUTES OF HEALTH|
|Thomas, Paul - NATL INSTITUTES OF HEALTH|
|Yetley, Elizabeth - NATL INSTITUTES OF HEALTH|
|Levy, Paul - RTI INTERNATIONAL|
|Nielsen, Samara Joy - RTI INTERNATIONAL|
|Marriott, Bernadette - ABT ASSOCIATES, INC.|
Submitted to: Pediatrics and Adolescent Medicine Archives
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: May 1, 2007
Publication Date: October 1, 2007
Citation: Picciano, M.F., Dwyer, J.T., Radimer, K.L., Wilson, D.H., Fisher, K.D., Thomas, P.R., Yetley, E.A., Moshfegh, A.J., Levy, P.S., Nielsen, S.J., Marriott, B.M. 2007. Dietary supplement use among infants, children, and adolescents in the United States, 1999-2002. Archives of Pediatrics & Adolescent Medicine. 161(10)978-985. Interpretive Summary: A little more than half of adults in the United States take dietary supplements, and they typically have higher incomes and education levels, are more physically active, and have diets that more closely follow dietary guidelines than nonusers. In contrast, little is known about supplement use by infants, children, and adolescents. This study describes reported dietary supplement use among a nationally representative sample of more than 10,000 children from birth through 18 years of age derived from the 1999-2002 National Health and Nutrition Examination Survey and identifies nutrients contributed from supplement, and demographic and household characteristics of supplement users that are unique to them. Dietary supplements provided a consistent daily source of nutrients for nearly one-third of U.S. children. Children who were underweight or at risk of underweight had the highest prevalence of supplement use. Furthermore, children that were from higher-income families, in smoke-free households, and had less recreational screen time were the most likely to use supplements. In contrast, children that were non-Hispanic black, from families with lower income and without health insurance, in households where people smoke, and spent more time engaged in recreational screen time were the least likely to take supplements. This research will benefit nutrition researchers and educators who are assessing diets of children for nutrient adequacy and intervening with nutrition education programs to improve overall nutrient status of children.
Technical Abstract: This study describes dietary supplement use among 10,136 children from birth through 18 years of age who participated in the 1999-2002 National Health and Nutrition Examination Surveys (NHANES). Thirty-two percent of children used dietary supplements in 1999-2002, with lowest use reported among infants <1 year (11.9%) and teenagers 14-18 years (25.7%) and highest use among 4-8 year olds (48.5%). Use was highest among non-Hispanic whites (38.1%), followed by Mexican Americans (22.4%), and lowest among non-Hispanic blacks (18.8%), and did not differ by gender. The most commonly used type of supplement was multivitamins/multiminerals (18.3%). Vitamins C (28.6%), A (25.8%), 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 and, not being WIC certified in the last 12 months, lower child body mass index, and less daily recreational screen time (TV, video games, computers, etc.) (P<.005). Children who were underweight or at risk of underweight had the highest prevalence of supplement use (P<.005). Given that more than 30% of children in the United States take dietary supplements regularly, most often multivitamins/multiminerals, nutrient intakes from dietary supplements must be included to obtain accurate estimates of overall nutrient intake in children.