Abstract
Objective
To measure nutrient intake adequacy of vitamin/mineral supplement users and nonusers
aged 51 years and older, determine the efficacy of supplement practices in compensating
for dietary deficits, and identify predictors of supplement use.
Design
Analyses of two 24-hour recalls, demographic variables, and attitude questions collected
during the Continuing Survey of Food Intakes by Individuals and Diet and Health Knowledge
Survey in 1994 to 1996. Data were weighted to be representative of older Americans.
Subjects
Four thousand three hundred eighty-four adults aged 51 years and older (1,777 daily
supplement users, 428 infrequent users, and 2,179 nonusers) residing in households
in the United States.
Statistical analyses
Usual nutrient intake distributions were estimated using the Iowa State University
method. The Estimated Average Requirement (EAR) cutpoint method was applied to determine
the proportion of older adults not meeting requirements before and after accounting
for nutrient intake from supplements. Student t tests were used to assess differences between users and nonusers. Logistic regression
was used to determine sociodemographic and attitudinal predictors of supplement use.
Results
For one or more of the sex-age groups studied, a significantly smaller proportion
of supplement users than nonusers had intakes from food alone below the EAR for vitamins
A, B-6, and C; folate; zinc; and magnesium. Even so, less than 50% of both users and
nonusers met the EAR for folate, vitamin E, and magnesium from food sources alone.
Overall, supplements improved the nutrient intake of older adults. After accounting
for the contribution of supplements, 80% or more of users met the EAR for vitamins
A, B-6, B-12, C, and E; folate; iron; and zinc, but not magnesium. However, some supplement
users, particularly men, exceeded Tolerable Upper Intake Levels for iron and zinc
and a small percentage of women exceeded the Tolerable Upper Intake Level for vitamin
A. Significant sociodemographic factors related to supplement use for older men were
age group, metropolitan area, and educational status. Race, region, smoking status,
and vegetarian status were significant factors for women. Attitude about the importance
of following a healthful diet was a consistent predictor of supplement use for both
men and women.
Conclusions
A large proportion of older adults do not consume sufficient amounts of many nutrients
from foods alone. Supplements compensate to some extent, but only an estimated half
of this population uses them daily. These widespread inadequacies should be considered
when developing recommendations for supplement use for clients in this age group.
Modifying dietary attitudes may result in a higher rate of supplement use in this
at-risk population.
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Biography
R. S. Sebastian is a nutritionist, J. D. Goldman is a statistician, and A. J. Moshfegh is research leader, US Department of Agriculture, Agricultural Research Service, Food Surveys Research Group, Beltsville, MD.
Biography
L. E. Cleveland is retired; at the time of the study, she was a supervisory nutritionist, US Department of Agriculture, Agricultural Research Service, Food Surveys Research Group, Beltsville, MD.
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© 2007 American Dietetic Association. Published by Elsevier Inc. All rights reserved.
