Dietary supplement use among infants, children, and adolescents in the United States, 1999-2002.
OBJECTIVE
To describe dietary supplement use among US children.


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


METHODS
Home interviews and a mobile examination center.


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


METHODS
Frequency of use of any dietary supplement product.


METHODS
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.
Picciano
Mary Frances
MF
Office of Dietary Supplements, National Institutes of Health, 6100 Executive Blvd, 3B01, Bethesda, MD 20892-7517, USA. piccianm@od.nih.gov
Dwyer
Johanna T
JT
Radimer
Kathy L
KL
Wilson
David H
DH
Fisher
Kenneth D
KD
Thomas
Paul R
PR
Yetley
Elizabeth A
EA
Moshfegh
Alanna J
AJ
Levy
Paul S
PS
Nielsen
Samara Joy
SJ
Marriott
Bernadette M
BM
D000293:Adolescent; D000367:Age Factors; D015992:Body Mass Index; D002648:Child; D002669:Child Welfare / Q000706:statistics & numerical data*; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004032:Diet; D019587:Dietary Supplements / Q000145:classification / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007407:Interviews as Topic; D008297:Male; D009749:Nutrition Surveys; D009753:Nutritive Value; D015995:Prevalence; D014481:United States