Supplement Use Rises Significantly: 25-Year NHANES Study

According to 25 years of data from the National Health and Nutrition Examination Survey (NHANES), supplement usage rates in the U.S. have risen significantly, from an estimated 51% of Americans in 1999 to 60% in 2023. The nationally representative study enrolled 63,442 adults, who were asked about their supplement usage over the prior 30 days.

The analysis, published in JAMA, concluded that growth was largely driven by increased use among older adults and a shift toward single-ingredient and specialty nutrients, whereas in earlier years there was a preference for multivitamin and multimineral products.

The authors reported that the biggest acceleration in supplement usage took place in 2009-2010.

The most significant increases were observed among adults aged 65 years or older (62% to 78%), followed by those with less than high school education (33% to 48%), and Mexican-American individuals (32% to 49%).

Supplements were broken down into different categories: vitamins, minerals, multivitamin-multimineral, and nonvitamin nonmineral categories.

Multivitamin-multimineral use decreased from 35% to 31%. In contrast, the use of single-vitamin products increased from 25% to 39%. Minerals increased from 18% to 27%; and botanicals increased from 11% to 13%.

The most notable increases were observed for single vitamin and mineral supplements, including vitamins D and K and zinc. The fastest-growing nonvitamin nonmineral supplements included turmeric/curcumin, omega-3, ashwagandha, hyaluronic acid, elderberry, collagen, and prebiotics/probiotics.

“Vitamins, minerals, and several non-vitamin non-mineral supplements, including products marketed for immune support, increased during the pre-pandemic and early-pandemic periods compared with later-pandemic and post-pandemic periods. Across the 25-year span, emerging trends were also observed for supplements perceived to support micronutrient intake, adaptogenic, anti-inflammatory, gut, skin, and joint health. These findings highlight a broad diversification of supplement behaviors over time,” the authors wrote. “Overall, our study provides one of the most comprehensive assessments to date of long-term supplement trends across product types and demographic subgroups, offering important insights for informing health care practitioners and public health decision-making.”