Supplement Use Continues to Rise in the U.S.

When the Dietary Supplement Health and Education Act (DSHEA) was passed by Congress in 1994, it was assumed by lawmakers and consumers that the legislation would help pave the way for the dissemination of meaningful, objective information on vitamins, minerals, herbs, botanicals and other supplements. Seven years later, dietary supplements have become a multibillion dollar business, with hundreds of products already available for consumption, and dozens more being introduced to the market each year.

Since the passage of DSHEA, there has been mounting evidence that supplements can play an important role in the maintenance of health and the prevention of disease. To see what role that evidence has played in the public's perception, a national telephone survey, the Dietary Supplement Barometer Survey, was commissioned to track attitudes and beliefs about vitamins, minerals and other products. Conducted in June and July by Harris Interactive, the survey polled 1,027 Americans aged 18 or older to determine which supplements they used, how often they used them and why. The poll also examined the knowledge level of each respondent by asking questions about specific supplements and their role in general health and well-being.

The survey found that a majority of Americans regularly incorporate supplements as part of their health care regimen, and that they do so for a variety of reasons. However, while many Americans are happy with the quality of the supplements they consume, they are unclear about the specific uses for each product; furthermore, they often fail to share information about supplement use with their primary care provider. As a result, a greater information campaign needs to be undertaken to make people aware of the benefits (and risks) associated with dietary supplements.

The Dietary Supplement Barometer Survey:Results

Use and Popularity

Nearly six in ten American adults (59%) reported taking dietary supplements on a regular basis. Among regular supplement users, almost half (46%) take a multivitamin or multi-mineral product. Thirty-five percent take single vitamins, the most popular of which are vitamins C, E and B, respectively.

Use of herbals and specialty supplements, while not as widespread, was nevertheless significant; 23% of American adults reported using one of these products regularly. Approximately 15% of adults now take herbal supplements such as garlic, ginseng and St. John's wart; almost eight percent use a specialty supplement such as glucosamine, chondroiton or S-adenosylmethionine (SAM-E).

Reasons for Supplementation

The most common reason for taking supplements, according to the Harris survey, is to feel better. Two-thirds take supplements to prevent from getting sick, while 51% use them to facilitate healing. Interestingly, a third of adult supplement users said they took supplements on the advice of their health care provider.

Aside from specific instances, a majority of Americans reported using supplements for more general reasons. Slightly more than half (51%) agreed that supplements help insure that people get the nutrition they need for good health; 53% believed that some dietary supplements provide benefits that are not matched by conventional drugs; and 56% said that supplements offer benefits comparable to those of drugs, but with fewer side-effects.

Consumer Satisfaction

Americans are by and large happy with the supplements they are taking; nearly three-fourths of those surveyed (72%) reported being "extremely satisfied" or "very satisfied" with dietary supplements. Only one percent said they were not satisfied at all.

Common Misperceptions

Despite the widespread use of dietary supplements, there appear to be considerable gaps in information about specific substances and their importance to general health and well-being. For example:

• 58% of those surveyed said that calcium was more important for women after menopause than any other group. This shows an apparent lack of understanding in the role calcium plays during one's lifetime, especially during childhood, when calcium plays a crucial factor in the development and growth of bone tissue.
• Another 41% thought the main reason for taking iron supplements was to "get more energy." (Iron supplements are typically used to increase the production of red blood cells in the body.) Thirteen percent of the survey respondents didn't know why iron supplements should be taken.
• Approximately one in five Americans (21%) believed that most supplements would provide a noticeable benefit within one week of consumption; another 12% were unsure about the time needed for supplements to achieve their reported benefits. In reality, it usually takes several weeks of supplementation -- in conjunction with proper diet and exercise -- to produce the desired effect in the body.

Information and Communication

The results of the survey also show that consumers need to receive better education about the benefits (and risks) associated with dietary supplements, and that there needs to be increased communication between patients and practitioners:

• While 91% of those surveyed thought it necessary to follow dosage recommendations for prescriptions, only 71% expressed those same concerns for supplements.
• This lack of concern about supplement dosages was augmented by a similar lack of communication between consumers and health care providers. While 92% of consumers said they consult their doctor about taking prescription drugs, only 49% said they discussed supplement use with their physician.

Fortunately, there appears to be a growing number of people who want to be more well-informed about what supplements have to offer. Thirty-seven percent of the survey participants believe they would benefit from having more information that details the potential adverse reactions of supplements; 28% said they would like more information about their health benefits.

Knowledge Is the Key

How can the knowledge gleaned from scientific studies of supplements make its way into the hands of the average consumer? At a news conference in New York City announcing the results of the study this past July, several legislators and health care advocates offered their opinions, stressing the importance of access to information and following the directions on a product label.

"As more and more Americans are taking an active role in maintaining and improving their health, they need god, reliable information about the health benefits and responsible use of dietary supplements," said Senator Tom Harkin (D-IA), a well-known supporter of alternative care and one of the original sponsors of the DSHEA legislation. "We need to make sure that consumers have ready access to the latest science-based facts so that they can evaluate these products and use them effectively."

"If there is one message that consumers need to hear, it is that dietary supplements are very safe when taken as directed. But that means following the information on the label and learning about possible interactions with prescription drugs," added James Lavelle, an associate professor of pharmacy practice at the University of Cincinnati College of Pharmacy.

The results of the Dietary Supplement Barometer Survey add credence to the belief that an increasing number of Americans want reliable, objective information on herbs, vitamins and other supplements. The survey should also serve as a reminder to acupuncturists and doctors of Oriental medicine that while many of their patients take supplements, they do not always know what effects those products may have, nor do they discuss supplement use with their provider. Most patients still need to be educated about the positive and negative effects of supplementation, and until such information becomes more accessible, increased communication between all parties will remain a key factor in the maintenance of optimal health and wellness.

References

1. The Dietary Supplement Barometer Survey. Executive summary available online at www.supplementinfo.org.
2. Dietary supplements are an American standard. PR Newswire, July 30, 2001.