The National Health and Nutrition
Examination Surveys (NHANES) show that most American diet fall short in
vitamins A, C, D, and E and minerals such as calcium, zinc, magnesium and iron.
The American Dietetic
Association, now known as the Academy of Nutrition and Dietetics, recommend
improvement in overall dietary habits but recognize that dietary supplements
can help consumers achieve nutritional goals. For example, women of
childbearing age may require folic acid supplements, or, people over the age of
50 may require vitamin B12 supplementation. Again, some people may require
vitamin D to build and maintain optimum bone mass and so on.
It has also been reported that
usage is higher among:
older adults than among younger
women than men
more educated than less
Although consumer usage of
dietary supplements is well documented, not much data is available regarding
usage among health professionals and whether they recommend dietary supplements
To examine the extent of usage
and recommendations of dietary supplements by the dieticians, Annette Dickinson
and colleagues conducted an online survey of 300 registered dietitians in
America who practiced in a clinic or have private practice and saw at least one
patient per week at their practice site. They were also asked the reason for
using and recommending dietary supplements.
Here's what the surveyors found:
96 percent of the dietitians
surveyed who used dietary supplements were women and 74 percent of them were regular
72 percent of them dietitians
surveyed had at least one other member of the household who used dietary
The top three reasons for
taking dietary supplements were:
1. bone health (58 percent),
2. overall health and wellness
benefits (53 percent), and
3. to fill nutrient gaps in the
diet (42 percent).
84 percent of the respondents
used multivitamin either regularly or occasionally; next was calcium with 63
percent. Vitamins C and D were used as dietary supplements by 43 percent and 47
percent of respondents respectively.
97 percent of the dietitians
surveyed recommended dietary supplements to clients.
The top reasons for
recommending dietary supplements were:
1. bone health (70 percent),
2. filling nutrition gaps (67
3. overall health and wellness
benefits (49 percent),
4. lowering cholesterol (46
5. heart health (46 percent),
6. dietary pattern (vegetarian /
vegan) (43 percent)
27 percent of the dietitians
surveyed recommended dietary supplements for diabetes or glucose control and 19
percent recommended it for eating disorders. Interestingly, dietitians
themselves didn't use dietary supplements for these conditions.
Special diets, pregnancy and
sports nutrition were also reasons for recommending dietary supplements to
clients but were not the reasons for personal use.
87 percent of the registered
dietitians surveyed said their clients are 'generally comfortable telling me
about their dietary supplement usage'. But, only 23 percent of the respondents
believe that their clients 'have a good understanding of the appropriate daily
intake for dietary supplements'.
95 percent of respondents were
interested in continuing education about dietary supplements on a variety of
topics, especially, interactions of drugs and dietary supplements, basics about
dietary supplements, how to counsel clients about dietary supplements and even
The authors concluded that
dietitians use dietary supplements themselves and also recommend dietary
supplements to their patients, especially for the reasons of 'bone health,
overall health and wellness and filling nutrient gaps in the diet'.
Dickinson, A. et al. Dietitians use and recommend
dietary supplements: report of a survey. Nutrition Journal 2012, 11:14.