As Americans tuck into supplements like their health depends on it, specialized products are displacing multivitamins

American adults are taking more dietary supplements than ever before, but their regimens have changed. Where once the runaway winners were multivitamin-multiminerals—One-A-Day, Centrum, Nature Made Multi and so on—the field is presently crowded by specific vitamins, minerals, botanicals and herbs. 

Some of today’s most popular products promise better immune, adaptogenic, anti-inflammatory, gut, skin or joint health—or combinations of two or more of the above.  

The findings are from a new analysis of 11 cycles in the CDC’s annual National Health and Nutrition Examination Survey, aka NHANES, which represents the full U.S. population and releases data every other year. 

Researchers from Memorial Sloan Kettering Cancer Center and Harvard T.H. Chan School of Public Health looked at survey results spanning from 1999 to 2023. 

The cohort included more than 63,400 individuals.

Lead author Jason Lam Chun Sing, PhD, senior author Elizabeth Kantor, PhD, MPH, and colleagues had their study published June 15 in JAMA Network Open. 

Did marketers respond to rising demand or create it? 

Over the nearly 25-year stretch of the study period, total supplement use increased from 51% to 60%, the researchers report. 

Much of the growth came after 2009-10, possibly due to supplement marketers stepping up consumer advertising in the years since then. 

The demographic with the largest increases in supplement intake was older adults, and the COVID-19 pandemic seemed to boost sales of products with perceived immune-support use among all age groups. 

“As trends varied by subgroup and product type, these findings highlight a sustained diversification of supplement use in the U.S.,” the authors write.

Sing and co-authors suggest their study’s results “underscore the need for continued comprehensive monitoring and research on efficacy, safety and health implications across different populations.”

Pick your unproven preventative or antidote

More findings from the study report:

• Use of multivitamin-multiminerals (MVMMs) decreased from 35% in 1999 to 31% in 2023. Meanwhile use of particular vitamins, minerals and botanicals outside of MVMM increased by varying rates across the category. 
   
• Notable increases were observed for vitamin D, vitamin K, zinc and turmeric and curcumin. Similar trends emerged for nonvitamin-nonminerals, which gained much steam toward the end of the study period with such now-popular preparations as ashwagandha, hyaluronic acid, elderberry, collagen and prebiotics/probiotics. 
   
• Notable declines occurred for trace minerals and several botanicals like ephedra and ginseng. 
   
• Supplement use increased most conspicuously among adults aged 65 years and older, rising from 62% in 1999 to 78% in 2023.  

OK Boomers driving the bus 

In the present study’s discussion section, Sing and co-authors comment on the steady rise of supplement sales in the years since 2009-10. 

This growth spurt “coincided with rapid market expansion over the past 10 to 20 years, reflecting increasing interest in health maintenance and the rise of social media enabling direct-to-consumer marketing,” they note. 

Readers may wonder if the market expansion also had something to do with the rising costs of reactive care, i.e., doctor visits and prescription drugs. 

“Importantly, our study reveals notable differences by supplement category and sociodemographic subgroup, showing that national patterns cannot be characterized by a single trajectory,” Sing et al. report, underscoring that older adults had the highest supplement use and the largest increases. 

“As the baby boom cohort ages, the growing older adult population—many of whom have multiple chronic conditions and polypharmacy—may face increasing risks of drug-supplement interactions and rely on supplements for disease management and health promotion,” they write. 

“This underscores the need to document and understand patterns of use in the population, and the need to evaluate the efficacy and safety of supplements.”

The study is available in full for free. 

NIH on the case  

For its part, the National Institutes of Health advises consumers to be aware that that “some dietary supplements may have some benefit.”

The agency mentions melatonin as having some scientific evidence supporting its use for jet lag. On the other hand is ginkgo for dementia, which “may have little or no benefit.” 

“Supplements you buy from stores or online may differ in important ways from products tested in studies,” NIH’s National Center for Complementary and Integrative Health states. 

What’s more, “most research shows that taking multivitamins doesn’t result in living longer, slowing cognitive decline or lowering the chance of getting cancer, heart disease or diabetes.”

The NIH has more on this topic here.