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Title: Diet- and Body Size-related Attitudes and Behaviors Associated with Vitamin Supplement Use in a Representative Sample of Fourth-grade Students in Texas

item GEORGE, GOLDY - National Cancer Institute (NCI, NIH)
item HOELSCHER, DEANNA - University Of Texas
item NICKLAS, THERESA - Children'S Nutrition Research Center (CNRC)
item KELDER, STEVEN - University Of Texas

Submitted to: Journal of Nutrition Education and Behavior
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 3/1/2008
Publication Date: 3/1/2009
Citation: George, G.C., Hoelscher, D.M., Nicklas, T.A., Kelder, S.H. 2009. Diet- and body size-related attitudes and behaviors associated with vitamin supplement use in a representative sample of fourth-grade students in Texas. Journal of Nutrition Education and Behavior. 41(2):95-102.

Interpretive Summary: A substantial proportion (29%) of students in this multi-ethnic representative sample of Texas fourth graders reported previous day consumption of a vitamin or mineral supplement. Vitamin or mineral supplement use was associated with more healthful food choices and greater physical activity, suggesting that the use of vitamin or mineral supplements may serve as a marker for healthful lifestyle behaviors, even in elementary school-aged children. Fourth-grade boys and girls with poorer dietary profiles were less likely to report vitamin or mineral supplement consumption. This finding raises the interesting question of whether students who might benefit most from use of a vitamin pill are actually taking these supplements. Further research is needed to validate the need for and long-term effects of widespread supplement use in children, especially in those who are healthy and well nourished. In addition, attention should be focused on elucidating the parental constructs that contribute to vitamin supplement intake, as well as other health-related behaviors in this age group.

Technical Abstract: The objective of this research was to examine diet- and body size-related attitudes and behaviors associated with supplement use in a representative sample of fourth-grade students in Texas. The research design consisted of cross-sectional data from the School Physical Activity and Nutrition study, a probability-based sample of schoolchildren. Children completed a questionnaire that assessed supplement use, food choices, diet-related attitudes, and physical activity; height and weight were measured. Participants include a representative sample of fourth-grade students in Texas (n = 5967; mean age = 9.7 years standard error of the mean [SEM] = .03 years, 46% Hispanic, 11% African-American). Previous day vitamin supplement consumption, diet- and body size-related attitudes, food choices, demographic factors, and physical activity were the main outcome measures. Using multivariable logistic regression models, our results indicated the prevalence of supplement use was 29%. Supplement intake was associated with physical activity. Girls who used supplements were more likely to report positive body image and greater interest in trying new food. Relative to nonusers, supplement users were less likely to perceive that they always ate healthful food, although supplement use was associated with more healthful food choices in boys and girls (P < .001). We conclude that the widespread use of supplements and clustering of supplement use with healthful diet and greater physical activity in fourth graders suggest that supplement use be closely investigated in studies of diet–disease precursor relations and lifestyle factors in children.