Consumer attitudes about the role of multivitamins and other dietary supplements: report of a survey

Assessing a Fermented Whey Beverage Biofortified with Folate as a Potential Folate Source for Humans

Folate, a vital water-soluble vitamin (B9), requires specific attention as its recommended daily intake frequently is not reached in countries without mandatory fortification. In this regard, biofortification with microorganisms like Bifidobacterium and Streptococcus offers a compelling approach for enhancing food with natural folates. A randomized, nonblinded, and monocentric human pilot study is conducted to assess the bioavailability of a folate-biofortified fermented whey beverage, comprising 3 intervention days and a controlled replenishment phase before and during the assay. Folate plasma concentration (5-CH3-H4folate) is determined using a stable isotope dilution assay and LC-MS/MS detection. Biokinetic parameters (cmax and tmax) are determined, and areas under the curve (AUC) normalized to the basal folate plasma concentration are calculated. An average bioavailability of 17.1% in relation to the 5-CH3-H4folate supplement, ranging from 0% to 39.8%, is obtained. These results reiterate the significance of additional research into folate bioavailability in general and dairy products. Further investigations are warranted into folate-binding proteins (FBP) and other potential limiting factors within the food and individual factors. In summary, biofortification via fermentation emerges as a promising avenue for enhancing the natural folate content in dairy and other food products.

Consumption of Dietary Supplements among Working-Age Residents of Lithuania in the Period from 2021 to 2023

Background and Objectives: The aim of this study was to assess the consumption of dietary supplements (DS) among working-age residents of Lithuania from 2021 to 2023 with respect to social and demographic factors and an assessment of personal health. Materials and Methods: Using stratified sampling techniques, this study included three samples of working-age residents (1600 each year, 4800 total). Three surveys were conducted, the distribution of the respondents between groups was compared using the χ2 test. Results: The consumption of DS significantly differed each year and accounted for 78.1%, 71.6%, and 72.7% of the respondents, respectively (p < 0.05). In 2022, the prevalence of the consumption of DS was lower in the majority of social and demographic groups (p < 0.05). In 2023, it was higher among females, younger residents, and those from larger families, who suffered from COVID-19 (p < 0.05). Despite similar changes found in the consumption of DS among those who negatively assessed their health, this group showed more prevalent consumption of DS among residents with non-university education, unemployed respondents, and those with lower income (p < 0.05). Conclusions: Despite a significantly lower prevalence in the consumption of DS in 2022, it was higher again in 2023. The assessment of personal health shows different habits in the consumption of DS.

Collagen Hydrolysates: A Source of Bioactive Peptides Derived from Food Sources for the Treatment of Osteoarthritis

Osteoarthritis (OA) is the most common joint disorder, with a social and financial burden that is expected to increase in the coming years. Currently, there are no effective medications to treat it. Due to limited treatment options, patients often resort to supplements, such as collagen hydrolysates (CHs). CHs are products with low molecular weight (MW) peptides, often between 3 and 6 kDa, and are a result of industrialized processed collagen. Collagen extraction is often a by-product of the meat industry, with the main source for collagen-based products being bovine, although it can also be obtained from porcine and piscine sources. CHs have demonstrated positive results in clinical trials related to joint health, such as decreased joint pain, increased mobility, and structural joint improvements. The bioactivity of CHs is primarily attributed to their bioactive peptide (BAP) content. However, there are significant knowledge gaps regarding the digestion, bioavailability, and bioactivity of CH-derived BAPs, and how different CH products compare in that regard. The present review discusses CHs and their BAP content as potential treatments for OA.

Assessment of Nutrient Intake and Diet Quality in Adolescent Dietary Supplement Users vs. Non-Users: The CRO-PALS Longitudinal Study

Dietary supplement users tend to have a better diet quality and overall prudent lifestyle. The main goals of this research were to report the prevalence and type of dietary supplements among Croatian adolescents and to examine the differences in the diet quality among dietary supplement users vs. non-users at the beginning (15/16 y) and at the end of high school education (18/19 y). This research is based on results of the longitudinal CRO-PALS study in which 607 adolescents participated, who had complete dietary, anthropometric, and physical activity data at the beginning (15/16 y) and at the end of their high school education (18/19 y). The dietary assessment method used was a single multi-pass 24 h recall. Dietary supplement users were divided into two groups for the purposes of statistical analysis-users of vitamin and multivitamin preparations (VMV) and users of mineral and multivitamin preparations (MMV). As they aged, there was an increase in the consumption of dietary supplements, and the most frequently used preparation in both age groups was vitamin C (23.7% of users). Dietary supplement users had a higher intake of non-carbonated sweetened drinks and a lower intake of fruits and vegetables in both genders and both age groups. Fast food intake was higher among dietary supplement girl users and boys who were not dietary supplements users in both age groups. Dietary supplement users had a higher achieved average intake of most micronutrients (values obtained only from food) in both genders and both age groups (with exceptions for certain vitamins and minerals). By observing other parameters for assessing the diet quality in this research, we can conclude that girls who do not use dietary supplements have a better diet quality in both age groups.

Dietary Supplement Use and Associated Factors Among Adults Working in Urban Settings in Tanzania: A Cross-Sectional Study

Dietary supplements are products consumed to provide nutrients or other substances that the user may not consume in sufficient amounts through normal diets. Despite their increased global popularity, there is still scant information regarding the use of dietary supplements and associated factors among adult populations in Tanzania. This study aimed to assess the extent of dietary supplement use and factors associated with use among adults working in urban settings. This was a cross-sectional study involving 419 adults working in public and private institutions within the Ilala District of Dar es Salaam who were selected using stratified and simple random sampling techniques. The study's data was collected using quantitative methods through a self-administered questionnaire. Data analysis was done through descriptive statistics for frequencies, means, standard deviations, and proportions; cross-tabulations with chi-square tests for comparing observed differences in supplement use; and multivariable logistic regression for identifying factors associated with supplement use. A P-value of <.05 was considered statistically significant in the analysis. The prevalence of dietary supplement use among working adults was 46.5%, where 36.9% reported regular and 63.1% occasional supplement use, respectively. Seven types of dietary supplements were identified to be consumed, of which 45.1% of the respondents consumed more than one type of dietary supplement. Multivitamins (64.1%) were the most frequently reported type of supplement consumed, followed by Mineral (34.9%) and Herbal/Botanical (26.7%) supplements. The most commonly reported reason for dietary supplement use among working adults was to improve overall health (67.1%). A third of the users (35.9%) admitted to self-prescribing dietary supplements without seeking professional medical advice. The use of dietary supplements was significantly associated with being female (AOR = 2.243, 95% CI 1.415-3.555, P = .001) and knowledgeable of supplements (AOR = 6.756, 95% CI 4.092-11.154, P < .001). Overall, the use of dietary supplements is popular among adults working within urban settings, but its use is exacerbated by perceived knowledge and self-prescription instead of health professional advice. Therefore, there is a need for further studies to explain better the underlying drivers for perceived knowledge on decision-making. There is also a strong need for extensive health education to prevent inappropriate or excessive use of supplements which might lead to potential adverse events.

Autopercepción y uso de suplementos nutricionales en usuarios de gimnasios

La insatisfacción con la imagen corporal puede desencadenar preocupación excesiva por la estética conduciendo a una utilización indiscriminada de suplementos nutricionales. Por ello, el objetivo de este estudio fue investigar la relación entre percepción y conformidad de imagen corporal al uso de suplementos nutricionales en usuarios regulares de gimnasios de la región del Biobío, Chile. La investigación corresponde a un estudio analítico transversal realizado en el segundo semestre del año 2018, en el que participaron 262 personas mayores de 18 años. Se observó una asociación estadísticamente significativa entre el uso de suplementos nutricionales y la percepción de la imagen corporal (OR 0,58, IC95%0,34–0,98; p=0,045), y entre el uso de suplementos nutricionales y la conformidad con la imagen corporal (OR 0,43, IC95%0,25–0,75; p=0,003). En conclusión, a mayor disconformidad con la imagen corporal o la presencia de una percepción alterada de ésta, mayor es la probabilidad de consumir suplementos nutricionales.

Use of Dietary Supplements and Perceived Knowledge among Adults Living with Fibromyalgia in Norway: A Cross-Sectional Study

Fibromyalgia syndrome (FMS) is a complex medical condition characterized by widespread musculoskeletal pain. To date, no gold standard treatment has been developed, and persons with FMS often seek alternative methods to control their symptoms, such as dietary supplements (DS). This study aimed to describe the use of DS in persons living with FMS and examine the associations between the use of DS and its potential predictors. We recruited a convenience sample of 504 participants (≥18 years) living with FMS. The main outcome variables included estimated expenditure on DS in the last 12 months in Norwegian kroner (NOK) and the differences between the groups of users and non-users of DS. Of the 504 participants, 430 reported having used DS, and the mean amount of money spent in the previous year was determined to be NOK 2300. The most common DS reported were vitamin D, magnesium, and omega-3 fatty acids. The predictors of being a DS user were high education, high self-reported knowledge of DS but low overall knowledge of health claims. Users of DS marketed for muscles/joints appear to spend more money on DS. The increasing availability of DS and aggressive advertising in the media through health claims stipulate the need for interventions that lead to informed decisions about DS.

Gastrointestinal Digestion Model Assessment of Peptide Diversity and Microbial Fermentation Products of Collagen Hydrolysates

Osteoarthritis (OA), the most common form of arthritis, is associated with metabolic diseases and gut microbiome dysbiosis. OA patients often take supplements of collagen hydrolysates (CHs) with a high peptide content. Following digestion, some peptides escape absorption to induce prebiotic effects via their colonic fermentation to generate short-chain fatty acids (SCFAs), branched-chain fatty acids (BCFAs) and colonic gases (NH₄ and H₂S). The capacity of CHs to generate microbial metabolites is unknown. Proteomic analysis of two CHs (CH-GL and CH-OPT) demonstrated different native peptide profiles with increased peptide diversity after in vitro gastric and small intestinal digestion. Subsequent 24 h fermentation of the CH digests in a dynamic gastrointestinal (GI) digestion model containing human fecal matter showed that CH-OPT increased (p < 0.05) H₂S, SCFAs (propionic, butyric and valeric acids), BCFAs, and decreased NH₄ in the ascending colon reactor with no major changes seen with CH-GL. No major effects were observed in the transverse and descending vessels for either CH. These findings signify that CHs can induce prebiotic effects in the ascending colon that are CH dependent. More studies are needed to determine the physiological significance of CH-derived colonic metabolites, in view of emerging evidence connecting the gut to OA and metabolic diseases.

Total estimated usual nutrient intake and nutrient status biomarkers in women of childbearing age and women of menopausal age

BACKGROUND

Women of childbearing age (WCBA) and women of menopausal age (WMENO) have distinct nutritional needs. Understanding nutrient intake and status in these life stages is critical for tailoring dietary recommendations.

OBJECTIVES

The objectives of this study were to evaluate total estimated usual nutrient intakes from food and food plus supplements and to compare these to established recommendations for WCBA and WMENO life stages and examine associations between self-reported estimated usual intakes and nutrient status biomarkers.

METHODS

Twenty-four-hour dietary recall data from 2011-2016 NHANES were used to estimate usual intake of nutrients from food and food plus supplements for WCBA (aged 15-44 y, n = 4,134) and WMENO (aged 40-65 y, n = 3,438). Estimates of mean usual intake were derived and compared across clinically defined nutrient biomarker categories.

RESULTS

Both young (aged 15-30 y) and older (aged 31-44 y) WCBA had intakes from food below the Estimated Average Requirement (EAR) for calcium (49% and 44%, respectively), magnesium (62%, 44%), and vitamins A (50%, 44%), C (47%, 46%), D (>97%, >97%), and E (92%, 88%). Similarly, perimenopausal (aged 40-50 y) and menopausal (aged 51-65 y) women had intakes from food below the EAR for calcium (48% and 74%, respectively), magnesium (50%, 49%), and vitamins A (44%, 37%), C (44%, 41%), D (>97%, >97%), and E (88%, 86%). Nutrient gaps decreased with supplement usage. For folate, vitamins D and B-12, and DHA, women in the lowest biomarker category (indicating increased risk of deficiency) had significantly lower intake from food (315.2 ± 25.9 compared with 463.8 ± 5.2 µg dietary folate equivalents, 3.5 ± 0.1 compared with 4.2 ± 0.1 µg, 3.6 ± 0.2 compared with 4.3 ± 0.1 µg, and 0.037 ± 0.005 compared with 0.070 ± 0.006 g, respectively; P < 0.01) of the corresponding nutrient compared with the highest biomarker category.

CONCLUSIONS

Substantial percentages of WCBA and WMENO are not meeting recommendations for multiple nutrients, whereas supplement usage partially fills nutrient gaps. Dietary intake was positively associated with most nutrient status biomarkers. Specific guidance is needed to ensure adequate nutrient intakes and nutrient status during these critical life stages.

What Do Polish Parents and Caregivers Think ofDietary Supplements for Children Aged 3-12?

Background: The aim of this study was to specify the amounts and the types of dietary supplements (DS) taken by children and define the attitudes of caregivers towards DS and towards administering them to children aged 3–12. An analysis of the reasons for using DSs, and of expected benefits and awareness of health risks associated with administering DSs, was conducted. Methods: The online questionnaire collected information on sociodemographic characteristics and use of dietary supplements. Multiple analyses were used to describe the relationship between demographic factors and dietary supplement intake. In particular cases, strength and correlation were also calculated. Results: In total, 54.89% of participants were administering dietary supplements to children at the time of completing the questionnaire—a weak linear relationship (Cramer’s V = 0.21) between child’s age and the child taking dietary supplements. Respondents for whom DSs are equivalents of medicines tend not to see that dietary supplements may cause side-effects and interact. Conclusions: Parents who administer dietary supplements to children show a tendency to have more trust in this type of product than the people who do not do so. It was also confirmed that the people who take dietary supplements transfer their behavioral patterns by also administering them to their children.

Dietary patterns according to vitamin supplement use. A cross-sectional study in Switzerland

Background: consumers of dietary supplements (DS) or vitamin-mineral supplements (VMS) have a better health profile than nonconsumers; whether this also applies to healthier dietary patterns has seldom been assessed. We aimed to assess the dietary intake of subjects according to their consumption of DS or VMS. Methods: Cross-sectional, population-based studies conducted in 2009-2012 (3773 participants, 52.4% women, 57.0 ± 10.0 years) and 2014-2017 (2536 participants, 52.4% women, 60.0 ± 10 years) in Lausanne, Switzerland. Dietary intake was assessed via a 97-item food frequency questionnaire. Nutrients, consumption of specific food groups, dietary scores, and compliance with the Swiss nutritional guidelines were compared between VMS/DS consumers and nonconsumers. Results: In 2009-2012, after multivariable adjustment for gender, age, body mass index, education, smoking, country of birth, sedentariness, diet and total energy intake, VMS/DS consumers had a higher score for the "Fruits & vegetables"(-0.09 ± 0.02 vs. 0.15 ± 0.05) dietary pattern and a lower score for the "Fatty & sugary" dietary pattern (0.02 ± 0.02 vs. -0.14 ± 0.04) and had a lower likelihood to comply with the guideline on total fat [odds ratio and 95 %CI: 0.72 (0.57-0.89)] than nonconsumers. In 2014-2017, after multivariable adjustment, no differences (at p < 0.005) were found between VMS/DS consumers and nonconsumers. Conclusion: VMS/DS consumers tend to have healthier dietary choices than nonconsumers. The beneficial effect of VMS and/or DS consumption is decreased, as it does not target subjects who really need them.

Supplement (mis)use in adolescents

PURPOSE OF REVIEW

Dietary supplement usage by adolescents has been on the rise in the last decade and is expected to continue to grow, although the evidence of their benefits in healthy individuals remains unclear. This review aims to spread awareness about the poorly regulated supplements and their effects on the health of adolescents to minimize medical hazards.

RECENT FINDINGS

In this review, we have attempted to summarize some of the commonly consumed supplements, their alleged benefits, effects and side effects, along with the motivation that drives adolescents into consuming them.

SUMMARY

The widespread use of dietary supplements among adolescents, in the background of lack of knowledge and medical guidance, predisposes adolescents to significant health risks. Although supplements may be necessary and safely consumed in certain specific situations, most healthy adolescents do not need them. The lack of regulation of supplements encourages contamination and ensures indiscriminate, easy access.

The Prevalence and Awareness Concerning Dietary Supplement Use among Saudi Adolescents

Current dietary supplement (DS) use among Saudi school students is not well described. In this study, we aim to investigate the prevalence and predictors of DS use among adolescents. This cross-sectional study collected data via self-administered questionnaire from 1221 students (12 to 18 years). The overall prevalence of DS use was 26.2%, significantly higher in females than males (33% vs. 17.9%, p < 0.001). High proportion of female DS users demonstrated normal BMI than males (84% vs. 56.5%, p < 0.001). High percentage of male DS users were engaged in vigorous and/or high physical activity (PA) levels than female DS users (58.2% vs. 43%, p = 0.022; and 57.1% vs. 20.7%, p < 0.001, respectively). The main reasons for DS use among females were vitamin deficiency (63.3%), hair condition (37.6%) and nail health (23.5%) while in males, the main reasons were vitamin deficiency (58.4%) and body building (34.4%). The predictors of DS use in Saudi adolescents included being female, having high family income and being physically active. In conclusion, the overall prevalence and preference of DS use, though low among Saudi adolescents, was driven mostly by gender, physical activity levels and socioeconomic factors like family income. DS use guidelines and counselling among Saudi adolescents are warranted to improve public health.

General public knowledge and use of dietary supplements in Riyadh, Saudi Arabia

Context:

Dietary supplements is a growing industry, pharmaceuticals are having several types of similar supplements and multivitamins as over-the-counter products, a complete diet is necessary for a healthy body which leads to the usage of supplements or multivitamins complementing diets as needed, therefore leading to its encouraged usage among the population worldwide.

Aims:

The study was aimed to determine the public's knowledge and their use of dietary supplements.

Settings and Design:

A cross-sectional study was conducted among the general public of Riyadh, Saudi Arabia.

Methods and Materials:

The sample consisted of 679 participants including 41% males and 59% females. The ethnicity of the participants is 100% Arabs.

Statistical Analysis Used:

SPSS.

Results:

The sociodemographic data showed there were more female participants than males (59.1% vs. 40.9%), most of our participants had at least bachelor degree (64.4%), most of our participants had normal BMI (62.3%). 88.5% had knowledge on supplements and only 11.5% stated they were not aware at all.

Conclusions:

Dietary supplements and multivitamins consumption is prevalent among Saudi Arabian population. Our study suggests the majority of consumers understand the supportive role of dietary supplements and are aware of risks and side effects.

Different Socio-Demographic and Lifestyle Factors Can Determine the Dietary Supplement Use in Children and Adolescents in Central-Eastern Poland

Vitamin/mineral supplement (VMS) use has become increasingly popular in children and adolescents; however, different predictors may be associated with their usage. Therefore, the aim of this study was to compare determinants of VMS use in 1578 children and adolescents. Data was collected among parents of children (≤12 years old) and among adolescents (>12 years old) who attended public schools by a self-administered questionnaire. Multivariate-adjusted logistic regression models were used to estimate odds ratios (ORs) and 95% confidence intervals (95% CIs) for determining the predictors of VMS use. In children, the following determinants of VMS use were indicated: socioeconomic status (average vs. very good/good; OR: 1.69, 95% CI: 1.16–2.48), physical activity (1–5 vs. <1 h/week; OR: 1.44, 95% CI: 1.02–2.04), BMI (≥25 vs. 18.5–24.9 kg/m²; OR: 0.67, 95% CI: 0.46–0.98), and presence of chronic diseases (yes vs. no; OR: 2.32, 95% CI: 1.46–3.69). In adolescents, gender (male vs. female; OR: 0.56, 95% CI: 0.37–0.87), residential area (rural vs. urban; OR: 0.63, 95% CI: 0.40–0.99), BMI (<18.5 vs. 18.5–24.9 kg/m²; OR: 0.35, 95% CI: 0.17–0.73), and health status (average/poor vs. at least good; OR: 1.96, 95% CI: 1.13–3.39) were factors of VMS use. In both groups, the mother’s higher educational level, fortified food consumption and diet modification towards better food choices were predictors of VMS use. In conclusion, most of the predictors of VMS use were different in children and adolescents.

College Education on Dietary Supplements May Promote Responsible Use In Young Adults

Dietary supplement (DS) use is increasing among college students. Early adulthood is a critical developmental stage when behavioral trends are established with potential health implications. Many studies have suggested a proper college education on DSs is needed, but no follow-up reports exist in the literature. The purpose of the study was to compare DS use in college students with and without a formal education on DSs. An anonymous survey was sent over electronic mailing lists of different social and professional student groups, including students in the health and wellness studies (HWS) minor (HM) at Binghamton University. A total of 308 students completed the study. A statistical framework using multivariate analyses was designed to assess pattern of use and identify variables of interest. Principal component analysis recognized five patterns collectively contributing to 66.75% of the variance. PC 1 characterized as tobacco use, PC 2 labeled as body weight, PC 3 categorized as exercise, PC 4 labeled as educated use, and PC 5 is considered Greek-life lifestyle. Participants were then partitioned into HM versus HWS nonminor (NM). Common factor analysis was performed to extract significant variables pertaining to each pattern. Results reflected driving forces common to both groups. However, new trends surfaced in HM. A regression analysis suggests that DS use in HM is based on knowledge, whereas NM use is specifically targeted toward certain lifestyles. In addition, HM are more likely to discontinue a DS with formal knowledge. Therefore, college education on DS may be promoting a healthy pattern of supplement use.

Dietary supplement use, perceptions, and associated lifestyle behaviors in undergraduate college students, student-athletes, and ROTC cadets

OBJECTIVE

To identify the prevalence of dietary supplement (DS) use, perceptions of DS efficacy, and lifestyle behaviors of DS users and non-users.

PARTICIPANTS

Undergraduate students, student-athletes, and ROTC cadets at a Midwestern University between September 2014 and January 2015.

METHODS

A cross-sectional online survey was administered. Analysis included descriptive statistics, chi-square, and independent sample t-tests.

RESULTS

At least 50% of respondents from each group reported DS use. Users generally reported favorable perceptions of efficacy. Undergraduate student DS users reported more exercise and more healthful dietary habits compared to non-users; however, nearly 72% of undergraduates who reported tobacco use also reported DS use. Less significant differences were observed in the student-athlete and cadet samples.

CONCLUSIONS

DS use is common on college campuses, and many DS users report favorable perceptions of efficacy. With the exception of tobacco use, collegiate DS users generally report lifestyles that are as healthy or healthier than non-users.

Contribution of Dietary Supplements to Nutritional Adequacy by Socioeconomic Subgroups in Adults of the United States

Many Americans have inadequate intakes of several nutrients, and the Dietary Guidelines for Americans 2015–2020 identified vitamins A, C, D, and E, in addition to calcium, magnesium, iron, potassium, choline, and fiber as “underconsumed nutrients”. Based on nationally representative data on 10,698 adults from National Health and Nutrition Examination Surveys (NHANES), 2009–2012, assessments were made of socioeconomic differences, based on the Poverty Income Ratio (PIR), in terms of the association of dietary supplement use on nutrient intake and nutrient inadequacies. Compared to food alone, the use of any dietary supplement plus food was associated with significantly (p < 0.01) higher intakes of 15–16 of 19 nutrients examined in all socioeconomic groups; and significantly reduced rates of inadequacy for 10/17 nutrients in the subgroup PIR > 1.85 (not poor), but only 4–5/17 nutrients (calcium and vitamins A, C, D, E) for the poor and nearly poor subgroups (PIR < 1.35 and PIR 1.35 to ≤1.85, respectively). An increased prevalence of intakes above the Tolerable Upper Intake Level (UL) was seen for 3–9/13 nutrients, but all were less than 5% in the PIR subgroups. In conclusion, dietary supplement use was associated with an increased micronutrient intake, decreased inadequacies, and a slight increase in the prevalence of intakes above the UL, with greater benefits seen in the PIR > 1.85 subgroup.

Contribution of Dietary Supplements to Nutritional Adequacy in Various Adult Age Groups

Many Americans have inadequate intakes of several nutrients. The Dietary Guidelines for Americans 2015–2020 specifically identified vitamins A, C, D and E, calcium, magnesium, iron, potassium, choline and fiber as “underconsumed nutrients”. Based on nationally representative data in 10,698 adults from National Health and Nutrition Examination Surveys (NHANES), 2009–2012, assessments were made of age-group differences in the impact of dietary supplements on nutrient intake and inadequacies. Compared to food alone, use of any dietary supplement plus food was associated with significantly (p < 0.01) higher intakes of 15–16 of 19 nutrients examined in all age groups; and significantly reduced rates of inadequacy for 10/17, 8/17 and 6/17 nutrients examined among individuals age ≥71, 51–70 and 19–50 years, respectively. Compared to the other age groups, older adults (≥71 years) had lower rates of inadequacy for iron and vitamins A, C, D and E, but higher rates for calcium. An increased prevalence of intakes above the Tolerable Upper Intake Level was seen for 8–9 of 13 nutrients, but were mostly less than 5% of the population. In conclusion, dietary supplement use is associated with increased micronutrient intake, decreased inadequacies, and slight increases in prevalence above the UL, with greater benefits seen among older adults.

Contribution of Dietary Supplements to Nutritional Adequacy in Race/Ethnic Population Subgroups in the United States

The U.S. Centers for Disease Control and Prevention has reported that nutritional deficiencies in the U.S. population vary by age, gender, and race/ethnicity, and could be as high as nearly one third of certain population groups. Based on nationally representative data in 10,698 adults from National Health and Nutrition Examination Surveys (NHANES) primarily from 2009-2012, assessments were made of race/ethnic differences in the impact of dietary supplements on nutrient intake and prevalence of inadequacies. Compared to food alone, use of any dietary supplement plus food was associated with significantly higher intakes of 14 to 16 of 19 nutrients examined in all race/ethnic groups; and significantly (p < 0.01) reduced rates of inadequacy for 8/17 nutrients examined in non-Hispanic whites, but only 3-4/17 nutrients (calcium, and vitamins A, D, and E) for other race/ethnic groups. Across race/ethnic groups an increased prevalence of intakes above the Tolerable Upper Intake Level (UL) was seen for 1-9/13 nutrients, but all were less than 5% of the population. In conclusion, use of dietary supplements is associated with increased micronutrient intake, decreased nutrient inadequacies, and slight increases in prevalence above the UL in all race/ethnicities examined, with greater benefits among non-Hispanic whites.

Impact of Frequency of Multi-Vitamin/Multi-Mineral Supplement Intake on Nutritional Adequacy and Nutrient Deficiencies in U.S. Adults

Although >50% of U.S. adults use dietary supplements, little information is available on the impact of supplement use frequency on nutrient intakes and deficiencies. Based on nationally representative data in 10,698 adults from the National Health and Nutrition Examination Surveys (NHANES) 2009 to 2012, assessments were made of intakes from food alone versus food plus multi-vitamin/multi-mineral supplements (MVMS) of 17 nutrients with an Estimated Average Requirement (EAR) and a Tolerable Upper Intake Level (UL), and of the status of five nutrients with recognized biomarkers of deficiency. Compared to food alone, MVMS use at any frequency was associated with a lower prevalence of inadequacy (p < 0.01) for 15/17 nutrients examined and an increased prevalence of intakes >UL for 7 nutrients, but the latter was ≤4% for any nutrient. Except for calcium, magnesium, and vitamin D, most frequent MVMS use (≥21 days/30 days) virtually eliminated inadequacies of the nutrients examined, and was associated with significantly lower odds ratios of deficiency for the examined nutrient biomarkers except for iron. In conclusion, among U.S. adults, MVMS use is associated with decreased micronutrient inadequacies, intakes slightly exceeding the UL for a few nutrients, and a lower risk of nutrient deficiencies.

Valorization of Proteins from Co- and By-Products from the Fish and Meat Industry

Large volumes of protein-rich residual raw materials, such as heads, bones, carcasses, blood, skin, viscera, hooves and feathers, are created as a result of processing of animals from fisheries, aquaculture, livestock and poultry sectors. These residuals contain proteins and other essential nutrients with potentially bioactive properties, eligible for recycling and upgrading for higher-value products, e.g. for human, pet food and feed purposes. Here, we aim to cover all the important aspects of achieving optimal utilization of proteins in such residual raw materials, identifying those eligible for human consumption as co-products and for feed applications as by-products. Strict legislation regulates the utilization of various animal-based co- and by-products, representing a major hurdle if not addressed properly. Thorough understanding and optimization of all parts of the production chain, including conservation and processing, are important prerequisites for successful upgrading and industrial implementation of such products. This review includes industrially applied technologies such as freezing/cooling, acid preservation, salting, rendering and protein hydrolysis. In this regard, it is important to achieve stable production and quality through all the steps in the manufacturing chain, preferably supported by at- or online quality control points in the actual processing step. If aiming for the human market, knowledge of consumer trends and awareness are important for production and successful introduction of new products and ingredients.