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

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          Abstract

          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.

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          Most cited references34

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          Trends in Dietary Supplement Use Among US Adults From 1999-2012.

          Dietary supplements are commonly used by US adults; yet, little is known about recent trends in supplement use.
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            Why US adults use dietary supplements.

            Dietary supplements are used by more than half of adults, although to our knowledge, the reasons motivating use have not been previously examined in US adults using nationally representative data. The purpose of this analysis was to examine motivations for dietary supplement use, characterize the types of products used for the most commonly reported motivations, and to examine the role of physicians and health care practitioners in guiding choices about dietary supplements. Data from adults (≥20 years; n = 11 956) were examined in the 2007-2010 National Health and Nutrition Examination Survey, a nationally representative, cross-sectional, population-based survey. The most commonly reported reasons for using supplements were to "improve" (45%) or "maintain" (33%) overall health. Women used calcium products for "bone health" (36%), whereas men were more likely to report supplement use for "heart health or to lower cholesterol" (18%). Older adults (≥60 years) were more likely than younger individuals to report motivations related to site-specific reasons like heart, bone and joint, and eye health. Only 23% of products were used based on recommendations of a health care provider. Multivitamin-mineral products were the most frequently reported type of supplement taken, followed by calcium and ω-3 or fish oil supplements. Supplement users are more likely to report very good or excellent health, have health insurance, use alcohol moderately, eschew cigarette smoking, and exercise more frequently than nonusers. Supplement users reported motivations related to overall health more commonly than for supplementing nutrients from food intakes. Use of supplements was related to more favorable health and lifestyle choices. Less than a quarter of supplements used by adults were recommended by a physician or health care provider.
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              Low micronutrient intake may accelerate the degenerative diseases of aging through allocation of scarce micronutrients by triage.

              B N AMES (2006)
              Inadequate dietary intakes of vitamins and minerals are widespread, most likely due to excessive consumption of energy-rich, micronutrient-poor, refined food. Inadequate intakes may result in chronic metabolic disruption, including mitochondrial decay. Deficiencies in many micronutrients cause DNA damage, such as chromosome breaks, in cultured human cells or in vivo. Some of these deficiencies also cause mitochondrial decay with oxidant leakage and cellular aging and are associated with late onset diseases such as cancer. I propose DNA damage and late onset disease are consequences of a triage allocation response to micronutrient scarcity. Episodic shortages of micronutrients were common during evolution. Natural selection favors short-term survival at the expense of long-term health. I hypothesize that short-term survival was achieved by allocating scarce micronutrients by triage, in part through an adjustment of the binding affinity of proteins for required micronutrients. If this hypothesis is correct, micronutrient deficiencies that trigger the triage response would accelerate cancer, aging, and neural decay but would leave critical metabolic functions, such as ATP production, intact. Evidence that micronutrient malnutrition increases late onset diseases, such as cancer, is discussed. A multivitamin-mineral supplement is one low-cost way to ensure intake of the Recommended Dietary Allowance of micronutrients throughout life.
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                Author and article information

                Journal
                Nutrients
                Nutrients
                nutrients
                Nutrients
                MDPI
                2072-6643
                28 November 2017
                December 2017
                : 9
                : 12
                : 1295
                Affiliations
                [1 ]Antioxidants Research Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging, and the Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA 02111, USA; jeffrey.blumberg@ 123456tufts.edu
                [2 ]Linus Pauling Institute and Department of Biochemistry & Biophysics, Oregon State University, Corvallis, OR 97331, USA; balz.frei@ 123456oregonstate.edu
                [3 ]Nutrition Impact, LLC, Battle Creek, MI 49014, USA
                [4 ]Department of Nutrition Science, Purdue University, West Lafayette, IN 47907, USA; weavercm@ 123456purdue.edu
                [5 ]Nutrition Research Institute, Department of Nutrition, University of North Carolina, Kannapolis, NC 28081, USA; steven_zeisel@ 123456unc.edu
                Author notes
                [* ]Correspondence: VIC3RD@ 123456aol.com ; Tel.: +1-269-962-0448
                Author information
                https://orcid.org/0000-0003-3871-8635
                Article
                nutrients-09-01295
                10.3390/nu9121295
                5748746
                29182574
                2282a3cc-26c8-4cea-9b16-4282b43ed9c6
                © 2017 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 06 October 2017
                : 20 November 2017
                Categories
                Article

                Nutrition & Dietetics
                vitamin/mineral supplement,nhanes,micronutrients,non-hispanic white,non-hispanic black,hispanic,non-hispanic asian

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