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Quantitative assessment of dietary supplement intake in 77,000 French adults: impact on nutritional intake inadequacy and excessive intake

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Abstract

Background

Dietary supplements (DS) are largely consumed in Western countries without demonstrating their nutritional benefits and safety in the general population. The aims, in a large population-based study of French adults, were: (1) to compare the prevalence of nutrient intake inadequacy and the proportion of individuals exceeding tolerable upper intake levels (UL) between DS users and non-users, and (2) to quantify the extent of potentially “at-risk” DS use practices (e.g., DS/drugs contraindicated association or use of beta-carotene DS in smokers).

Methods

76,925 participants, 47.6% men and 52.4% women, mean age 46.9 ± 16.3 years were enrolled to the NutriNet-Santé cohort and they completed a quantitative DS questionnaire and three 24 h dietary records. A composition database including > 8000 DS was developed. Variance reduction was applied to estimate usual intakes and analyses were weighted according to the French census data.

Results

Among DS users of the specific nutrient, DS contributed to 41% of total intake for vitamin D in men, 55% in women; and to 20% of total intake for pyridoxine in men, 21% in women. Compared to dietary intakes only, their prevalence of inadequacy was reduced by 11% for vitamin C, 9% for magnesium, 6% for pyridoxine in men, and 19% for calcium, 12% for iron, and 11% for magnesium in women (p < 0.0001). The proportion of subjects exceeding UL reached 6% for iron and 5% for magnesium in men, and 9% for iron in women. 6% of DS users had potentially “at-risk” practices.

Conclusion

While DS use contributed to decrease the prevalence of insufficient intake for several nutrients, it also conveyed excessive intake of iron and magnesium. Besides, a substantial proportion of potentially “at-risk” DS use practices was reported.

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Abbreviations

DS:

Dietary supplements

EAR:

Estimated average requirement

OR:

Odds ratio

CI:

Confidence interval

SFA:

Saturated fatty acids

MUFA:

Monounsaturated fatty acids

PUFA:

Polyunsaturated fatty acids

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Acknowledgements

The authors thank all the volunteers of the NutriNet-Santé cohort. We extend special thanks to Ludivine Ursule, Cédric Agaesse, Claudia Chahine, Marion Genest and Anne-Elise Dussouiler, dietitians, for the elaboration of the DS composition database. We also thank Véronique Gourlet, Nathalie Arnault, Stephen Besseau, Laurent Bourhis, Yasmina Chelghoum, Than Duong Van, Younes Esseddik, Paul Flanzy, Julien Allègre, Mac Rakotondrazafy, Fabien Szabo, Roland Andrianasolo, and Fatoumata Diallo for their technical contribution to the NutriNet-Santé study. This work was conducted in the framework of the French network for Nutrition and Cancer Research (NACRe network), https://www6.inra.fr/nacre/.

Funding

This work was funded by the Cancéropôle Ile de France/Région Ile de France. Philippine Fassier and Mélanie Deschasaux were funded by PhD grants from the Cancéropôle Ile de France/Région Ile-de-France. The NutriNet-Santé study was supported by the following public institutions: Ministère de la Santé, Institut de Veille Sanitaire (InVS), Institut National de la Prévention et de l’Education pour la Santé (INPES), Région Ile-de-France (CORDDIM), Fondation pour la Recherche Médicale (FRM), Institut National de la Santé et de la Recherche Médicale (INSERM), Institut National de la Recherche Agronomique (INRA), Conservatoire National des Arts et Métiers (CNAM) and Université Paris 13.

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Authors and Affiliations

  1. Sorbonne Paris Cité Epidemiology and Statistics Research Center (CRESS), Nutritional Epidemiology Research Team (EREN), Inserm U1153, Inra U1125, Cnam, SMBH, Paris 13 University, 74 rue Marcel Cachin, 93017, Bobigny Cedex, France

    Philippine Fassier, Manon Egnell, Camille Pouchieu, Pilar Galan, Emmanuelle Kesse-Guyot, Paule Latino-Martel, Serge Hercberg, Mélanie Deschasaux & Mathilde Touvier

  2. UFR Pharmacie, Inra, UMR 1019, CRNH Auvergne, Centre Jean-Perrin, CHU Gabriel-Montpied, Unité de Nutrition, Clermont Université Auvergne, Clermont-Ferrand, France

    Marie-Paule Vasson

  3. Sociology Department, University of Rouen, DySola, EA 4701, 76821, Rouen, France

    Patrice Cohen

  4. Public Health Department, Avicenne Hospital, 93017, Bobigny Cedex, France

    Serge Hercberg

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  1. Philippine Fassier
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  2. Manon Egnell
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  3. Camille Pouchieu
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  4. Marie-Paule Vasson
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Correspondence to Philippine Fassier.

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Fassier, P., Egnell, M., Pouchieu, C. et al. Quantitative assessment of dietary supplement intake in 77,000 French adults: impact on nutritional intake inadequacy and excessive intake. Eur J Nutr 58, 2679–2692 (2019). https://doi.org/10.1007/s00394-018-1815-x

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