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October 2007

Dietary Supplement Use Among Infants, Children, and Adolescents in the United States, 1999-2002

Author Affiliations

Author Affiliations: Office of Dietary Supplements, National Institutes of Health, Bethesda, Maryland (Drs Picciano, Dwyer, Fisher, Thomas, and Yetley); Division of Health Examination Statistics/National Health and Nutrition Examination Survey, National Center for Health Statistics, Hyattsville, Maryland (Dr Radimer); RTI International, Research Triangle Park, North Carolina (Drs Wilson, Levy, and Nielsen); Beltsville Human Nutrition Research Center, US Department of Agriculture, Beltsville, Maryland (Ms Moshfegh); and Abt Associates Inc, Cambridge, Massachusetts (Dr Marriott).

Arch Pediatr Adolesc Med. 2007;161(10):978-985. doi:10.1001/archpedi.161.10.978

Objective  To describe dietary supplement use among US children.

Design  Analysis of nationally representative data from the 1999-2002 National Health and Nutrition Examination Survey (NHANES).

Setting  Home interviews and a mobile examination center.

Participants  Children from birth through 18 years who participated in NHANES (N = 10 136).

Main Exposure  Frequency of use of any dietary supplement product.

Outcome Measure  Prevalence of use and intake of key nutrients from supplements among children.

Results  In 1999-2002, 31.8% of children used dietary supplements, with the lowest use reported among infants younger than 1 year (11.9%) and teenagers 14 to 18 years old (25.7%) and highest use among 4- to 8-year-old children (48.5%). Use was highest among non-Hispanic white (38.1%) and Mexican American (22.4%) participants, lowest among non-Hispanic black participants (18.8%), and was not found to differ by sex. The type of supplement most commonly used was multivitamins and multiminerals (18.3%). Ascorbic acid (28.6%), retinol (25.8%), vitamin 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; not being certified by the US Department of Agriculture Special Supplemental Nutrition Program for Women, Infants and Children in the last 12 months; lower child body mass index; and less daily recreational screen time (television, video games, computers, etc) (P < .005). The highest prevalence of supplement use (P < .005) was in children who were underweight or at risk for underweight (P < .005).

Conclusions  More than 30% of children in the United States take dietary supplements regularly, most often multivitamins and multiminerals. Given such extensive use, nutrient intakes from dietary supplements must be included to obtain accurate estimates of overall nutrient intake in children.