Submitted to: Journal Of The American Dietetic Association
Publication Type: Peer reviewed journal
Publication Acceptance Date: 12/11/2006
Publication Date: 8/1/2007
Citation: Sebastian, R.S., Cleveland, L.E., Goldman, J.D., Moshfegh, A.J. 2007. Older adults who use vitamin/mineral supplements differ from nonusers in nutrient intake adequacy and dietary attitudes. Journal of the American Dietetic Association. 107(8):1322-1332. Interpretive Summary: A secondary analysis of data from the Continuing Survey of Food Intakes by Individuals 1994-96 was conducted to study the dietary intakes and vitamin/mineral supplement use of Americans 51 years and older. Due to conditions present in this population, including decreased dietary intake, chronic disease, and absorption problems, older adults have been identified as a group susceptible to nutritional shortfalls. The objective of this study was to measure nutrient intake adequacy from food sources and determine the efficacy of current supplement use in appropriately compensating for dietary deficits in this population. Sociodemographic and attitudinal data were also analyzed to identify predictors of supplement use. This study identified nutrients consumed in acceptable amounts by older adults, and nutrients for which vitamin/mineral supplements significantly improved intake. Nutrients at risk of overconsumption were identified. Characteristics associated with supplement use, including some modifiable factors, were also determined. This information is useful to nutrition professionals including educators, dietitians, and food service providers who must be aware of these dietary inadequacies, supplement use practices, and attitudes when providing guidance in meeting dietary recommendations and other nutrition services to clients in this age group.
Technical Abstract: The purpose of this study was to measure nutrient intake adequacy of vitamin/mineral supplement users and nonusers 51 years and older, determine the efficacy of current supplement practices, and identify predictors of supplement use. Two 24-hour recalls, and demographic and attitude information from 3956 adults 51 years and older collected during the Continuing Survey of Food Intakes by Individuals (CSFII) and Diet and Health Knowledge Survey (DHKS) in 1994-96 were analyzed. Data were weighted to be representative of older Americans. Usual nutrient intake distributions were estimated and the Estimated Average Requirement (EAR) cut-point method was applied to determine the proportion of older adults not meeting requirements before and after accounting for nutrient intake from supplements. A significantly smaller proportion of supplement users than non-users had intakes from food alone below the EAR for most nutrients studied. Even so, less than 50% of both users and non-users met the EAR for folate, vitamin E, and magnesium from food sources alone. After accounting for the contribution of supplements, 90% or more of the population met the EAR for most of the nutrients studied. However, some supplement users, particularly men, exceeded Tolerable Upper Intake Levels (ULs) for iron and zinc and a small percentage of women exceeded the UL for vitamin A. Sociodemographic factors related to supplement use varied by gender; however, attitude about the importance of following a healthy diet was a consistent predictor for both men and women. A large proportion of older adults do not consume sufficient amounts of many nutrients from foods alone. Supplements compensate to some extent, but only an estimated half of this population uses them daily. Modifying dietary attitudes may result in a higher rate of supplement use in this at-risk population. This information is beneficial to nutrition professionals including educators, dieticians, and food service providers who must be aware of these dietary inadequacies, supplement practices, and attitudes when providing guidance and other nutrition services to clients in this age group.