MD, PhD, FMedSci, FRSB, FRCP, FRCPEd

I have often remarked on the fact that, in alternative medicine, more surveys get published than in any other medical field. Typically these surveys are not just useless but overtly counter-productive:

  • they tend to be of very poor quality;
  • their results are not generalizable and thus meaningless;
  • they show that a sizable proportion of the population uses alternative therapies, pay out of their own pocket for them, and are satisfied with them;
  • the authors then state that it must be unfair that only the affluent can benefit from alternative medicine;
  • eventually, the conclusion is reached that alternative medicine should be paid for by the healthcare system and be free for all at the point of usage.

Therefore, I find that it is a waste of time to even read surveys of alternative medicine usage. But every now and then, one does come along that is worth discussing – like this one, for instance.

The survey evaluated dietary supplements (DS) usage by US adults aged ≥60 y to characterize the use of DSs, determine the motivations for use, and examine the associations between the use of DSs and selected demographic, lifestyle, and health characteristics. Data from 3469 older adults aged ≥60 y from the 2011-2014 NHANES were analyzed. DSs used in the past 30 d were ascertained via an interviewer-administered questionnaire in participants’ homes. The prevalence of overall DS use and specific types of DSs were estimated. The number of DSs reported and the frequency, duration, and motivation(s) for use were assessed. Logistic regression models were constructed to examine the association between DS use and selected characteristics.

Seventy percent of older adults reported using ≥1 DS in the past 30 d; 54% of users took 1 or 2 products, and 29% reported taking ≥4 products. The most frequently reported products were multivitamin or mineral (MVM) (39%), vitamin D only (26%), and omega-3 fatty acids (22%). Women used DSs almost twice as often as men. Those not reporting prescription medications were less likely to take a DS than those reporting ≥3 prescription medications. The most frequently reported motivation for DS use was to improve overall health (41%).

The authors concluded that the use of DSs among older adults continues to be high in the United States, with 29% of users regularly taking ≥4 DSs, and there is a high concurrent usage of them with prescription medications.

I find these data impressive – but not in a positive sense, I hasten to add.

The level of DS use in the US is staggering. Considering that 90% (my estimate) of the supplements are completely useless, the amount of money that is being wasted is huge. Even more concerning is the frequency of drug interactions that are being provoked by DS-intake.

And what’s the solution?

Obviously, it is better information for consumers (which is easier said than done – but I am trying my best!).

4 Responses to Dietary supplements: US consumers waste billions of $s

  • I don’t think just information alone is sufficient. Supplement and vitamin taking is often accompanied by a religious like belief system. These consumers are often members of like minded groups. Long term indoctrination in the form of advertising, popular press articles and TV information, inoculate many to facts. Even suggesting facts is usually unwelcome. For this age group specific drug interaction warnings by their GPs might help a little.

    • drug interaction warnings are also information, I’d say.

    • Supervisory health authorities, consumer protection agencies and professional organisations (namely pharmacists) need to get engaged and involved. The marketing of more or less unnecessary, sometimes faked ( e.g. pulverised cherries as sleeping aid or redbeet powder for hypertension) and even hazardous goods to consumers who are practically unable to make Informed choices on their own, in my eyes borders on fraud.

      • It is fraud because it is not the exploitation of gullibility anymore, but it is the exploitation of knowledge. Unlike homeopathy, for example, which, if explained properly to a reasonable person, the premises appear as if trying to draw with the wrong end of a pencil, vitamins and minerals and substances in general have various well-documented actions. It is the in-vitro vs. in-vivo problem that stands in the middle and to understand the subtle points of the vast difference, people must first know the existence of the problem.

        In homeopathy, the way forward is to attempt to assign a magical content to the truth (e.g. dilutions make the preparation more potent). In this case, the way forward is to hide the truth, so it is not an exploitation of gullibility, it is more proximate to lying. And then, there is also the case when certain supplements do have a proper position in a person’s diet. But they are really few and the difference they make is usually only important under very specific conditions.

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