Introduction: Studies indicate that 17.9% - 60% of adults in Germany and Europe regularly use food supplements. Some reports suggest that their use might be responsible for excessive nutrient intake. The purpose of this survey was to examine the quantitative mineral intakes from food supplements: whether the tolerable upper intake levels (ULs) with supplements alone, or in combination with food was exceeded was checked. Methods: The survey was carried out by the Association for Consumer Research, Nürnberg, Germany. Anonymous data of 1070 supplement users (40.8% men, 59.2% women) aged 18 - 93 years were available. Three groups were examined based on dietary and supplemental mineral intakes: average, middle-high and high intake. Results: The mean number of supplements reported was 1.6 ± 1.1 products in men and 1.5 ± 0.9 products in women. The minerals most frequently consumed were magnesium, followed by calcium, zinc and selenium. The percentage of the supplement users with total intakes greater than the UL was minimal for all minerals. Supplement use in 143 cases increased the likelihood of intakes above the UL only for magnesium. Subjects particularly in the high intake group—as a worst case scenario—had intakes above the UL in the case of calcium (n = 23) and zinc (n = 34). The percentage of subjects taking several products was greater in subjects exceeding the UL than in those below (P < 0.001). Multiple use was seen significantly more often in men than in women (P < 0.01). Conclusions: In this survey, supplement use was generally not associated with excessive intake. Supplement use resulted in intakes above the UL in only a few cases relating to magnesium, calcium and zinc. This applies more often to elderly subjects and particularly to those who already have a high mineral intake from food in the model calculation.
Schwab, S., Heier, M., Schneider, A., Fischer, B., Huth, C., Peters, A. and Thorand, B. (2014) The Use of Dietary Supplements among Older Persons in Southern Germany—Results from the KORA—Age Study. The Journal of Nutrition Health and Aging, 18, 510-519. http://dx.doi.org/10.1007/s12603-013-0418-8
Giammarioli, S., Boniglia, C., Carratù, B., Ciarrocchi, M., Chiarotti, F., Mosca, M. and Sanzini, E. (2013) Use of Food Supplements and Determinants of Usage in a Sample Italian Adult Population. Public Health Nutrition, 16, 1768-1781. http://dx.doi.org/10.1017/S1368980012004314
Denison, H.J., Jameson, K.A., Syddall, H.E., Dennison, E.M., Cooper, C., Sayer, A.A. and Robinson, S.M. (2012) Patterns of Dietary Supplement Use among Older Men and Women in the UK: Findings from the Hertfordshire Cohort Study. The Journal of Nutrition Health and Aging, 16, 307-311. http://dx.doi.org/10.1007/s12603-012-0016-1
Tetens, I., Biltoft-Jensen, A., Spagner, C., Christensen, T., Gille, M., Bügel, S. and Banke, R.L. (2011) Intake of Micronutrients among Danish Adult Users and Non-Users of Dietary Supplements. Food Nutrition Research, 55, 1. http://dx.doi.org/10.3402/fnr.v55i0.7153
Marques-Vidal, P., Pécoud, A., Hayoz, D., Paccaud, F., Mooser, V., Waeber, G. and Vollenweider, P. (2009) Prevalence and Characteristics of Vitamin or Dietary Supplement Users in Lausanne, Switzerland: The CoLaus Study. European Journal of Clinical Nutrition, 63, 273-281. http://dx.doi.org/10.1038/sj.ejcn.1602932
Messerer, M., Johansson, S.E. and Wolk, A. (2001) Sociodemographic and Health Behaviour Factors among Dietary Supplement and Natural Remedy Users. European Journal of Clinical Nutrition, 55, 1104-1110. http://dx.doi.org/10.1038/sj.ejcn.1601272
Flynn, A., Hirvonen, T., Mensink, G.B.M., Ocké, M.C., Serra-Majem, L., Stos, K., Szponar, L., Tetens, I., Turrini, A., Fletcher, R. and Wildemann, T. (2009) Intake of Selected Nutrients from Foods, from Fortification and from Supplements in Various European Countries. Food Nutrition Research, 53, 1-51. http://dx.doi.org/10.3402/fnr.v53i0.2038
Reinert, A., Rohrmann, S., Becker, N. and Linseisen, J. (2007) Lifestyle and Diet in People Using Dietary Supplements: A German Cohort Study. European Journal of Nutrition, 46, 165-173. http://dx.doi.org/10.1007/s00394-007-0650-2
Max Rubner Institute (2008) National Nutrition Survey II. Final Report Part 2. Nationale Verzehrsstudie II. Ergebnisbericht Teil 2. (In German) http://www.was-esse-ich.de/uploads/media/NVSII_Abschlussbericht_Teil_2.pdf
Strohle, A. and Hahn, A. (2013) Nutrient Supplements—Possibilities and Limitations. Part 1: From the Regulatory Framework to Supplementary Function. Nahrstoffsupplemente—Moglichkeiten und Grenzen. Teil 1: Von den rechtlichen Rahmenbedingungen zur Erganzungsfunktion. Medizinische Monatsschrift für Pharmazeuten, 36, 179-190. (In German)
Kelly, J.P., Kaufman, D.W., Kelley, K., Rosenberg, L., Anderson, T.E. and Mitchell, A.A. (2005) Recent Trends in Use of Herbal and Other Natural Products. Archives of Internal Medicine, 165, 281-286. http://dx.doi.org/10.1001/archinte.165.3.281
Shakur, Y.A., Tarasuk, V., Corey, P. and O’Connor, D.L. (2012) A Comparison of Micronutrient Inadequacy and Risk of High Micronutrient Intakes among Vitamin and Mineral Supplement Users and Nonusers in Canada. Journal of Nutrition, 142, 534-540. http://dx.doi.org/10.3945/jn.111.149450
Touvier, M., Boutron-Ruault, M.C., Volatier, J.L. and Martin, A. (2005) Efficacy and Safety of Regular Vitamin and Mineral Supplement Use in France: Results from the ECCA Study. International Journal for Vitamin and Nutrition Research, 75, 201-209. http://dx.doi.org/10.1024/0300-9831.75.3.201
Kiely, M., Flynn, A., Harrington, K.E., Robson, P.J., O’Connor, N., Hannon, E.M., O’Brien, M.M., Bell, S. and Strain, J.J. (2001) The Efficacy and Safety of Nutritional Supplement Use in a Representative Sample of Adults in the North/ South Ireland Food Consumption Survey. Public Health Nutrition, 4, 1089-1097.
Renwick, A.G. (2006) Toxicology of Micronutrients: Adverse Effects and Uncertainty. Journal of Nutrition, 136, S493-S501.
EFSA Scientific Committee on Food (2006) Tolerable Upper Intake Levels for Vitamins and Minerals. http://www.efsa.europa.eu/de/ndatopics/docs/ndatolerableuil.pdf
Bailey, R.L., Gahche, J.J., Lentino, C.V., Dwyer, J.T., Engel, J.S., Thomas, P.R., Beth, J.M., Sempos, C.T. and Picciano, M.F. (2011) Dietary Supplement Use in the United States, 2003-2006. Journal of Nutrition, 141, 261-266. http://dx.doi.org/10.3945/jn.110.133025
Wallace, T.C., McBurney, M. and Fulgoni 3rd, V.L. (2014) Multivitamin/Mineral Supplement Contribution to Micronutrient Intakes in the United States, 2007-2010. Journal of the American College of Nutrition, 33, 94-102. http://dx.doi.org/10.1080/07315724.2013.846806
German Nutrition Society, Austrian Nutrition Society, Swiss Society for Nutrition Research, Swiss Nutrition Association-DACH (2013) Reference Values for Nutrient Intake. DACH Referenzwerte für die Nahrstoffzufuhr. Neustadt an der WeinstraBe: Neuer Umschau Buchverlag. (In German)
Food and Nutrition Board/Institute of Medicine (2001) Dietary Reference Intakes for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc. National Academy Press, Washington DC.
Food and Nutrition Board/Institute of Medicine (1997) Dietary Reference Intakes for Calcium, Phosphorus, Magnesium, Vitamin D, and Fluoride. National Academy Press, Washington DC.
Scientific Committee on Food (2001) Opinion on the Tolerable Upper Intake Level of Magnesium. http://ec.europa.eu/food/fs/sc/scf/out105_en.pdf
Heinemann, M., Willers, J., Bitterlich, N. and Hahn, A. (2014) Use of Food Supplements with Vitamins and Minerals —Results of a Nationwide Consumer Survey. Verwendung von Nahrungserganzungsmitteln mit Vitaminen und Mineralstoffen—Ergebnisse einer deutschlandweiten Verbraucherbefragung. Journal für Verbraucherschutz und Lebensmittelsicherheit. (In German)
Beitz, R., Mensink, G.B.M., Hintzpeter, B., Fischer, B. and Erbersdobler, H.F. (2004) Do Users of Dietary Supplements Differ from Nonusers in Their Food Consumption? European Journal of Epidemiology, 19, 335-341. http://dx.doi.org/10.1023/B:EJEP.0000024698.76843.3b
Beitz, R., Mensink, G.B.M., Fischer, B. and Thamm, M. (2002) Vitamins—Dietary Intake and Intake from Dietary Supplements in Germany. European Journal of Clinical Nutrition, 56, 539-545. http://dx.doi.org/10.1038/sj.ejcn.1601346
Mensink, G.B.M. and Strobel, A. (1999) Intake of Dietary Supplements and Nutritional Behaviour. Einnahme von Nahrungserganzungspraparaten und Ernahrungsverhalten. Gesundheitswesen, 61, S132-S137. (In German)
Guo, X., Willows, N., Kuhle, S., Jhangri, G. and Veugelers, P.J. (2009) Use of Vitamin and Mineral Supplements among Canadian Adults. Canadian Journal of Public Health, 100, 357-360.
Schwarzpaul, S., Strassburg, A., Lührmann, P.M. and Neuhauser-Berthold, M. (2006) Intake of Vitamin and Mineral Supplements in an Elderly German Population. Annals of Nutrition and Metabolism, 50, 155-162. http://dx.doi.org/10.1159/000090728
Knudsen, V.K., Rasmussen, L.B., Haraldsdóttir, J., Ovesen, L., Bülow, I., Knudsen, N., Jorgensen, T., Laurberg, P. and Perrild, H. (2002) Use of Dietary Supplements in Denmark Is Associated with Health and Former Smoking. Public Health Nutrition, 5, 463-468. http://dx.doi.org/10.1079/PHN2001276
Timbo, B.B., Ross, M.P., McCarthy, P.V. and Lin, C.T. (2006) Dietary Supplements in a National Survey: Prevalence of Use and Reports of Adverse Events. Journal of the Academy of Nutrition and Dietetics, 106, 1966-1974. http://dx.doi.org/10.1016/j.jada.2006.09.002
Burnett-Hartman, A.N., Fitzpatrick, A.L., Gao, K., Jackson, S.A. and Schreiner, P.J. (2009) Supplement Use Contributes to Meeting Recommended Dietary Intakes for Calcium, Magnesium, and Vitamin C in Four Ethnicities of Middle-Aged and Older Americans: The Multi-Ethnic Study of Atherosclerosis. Journal of the Academy of Nutrition and Dietetics, 109, 422-429. http://dx.doi.org/10.1016/j.jada.2008.11.023
Plum, L.M., Rink, L. and Haase, H. (2010) The Essential Toxin: Impact of Zinc on Human Health. International Journal of Environmental Research and Public Health, 7, 1342-1365. http://dx.doi.org/10.3390/ijerph7041342
Bailey, R.L., Gahche, J.J., Miller, P.E., Thomas, P.R. and Dwyer, J.T. (2013) Why US Adults Use Dietary Supplements. JAMA Internal Medicine, 173, 355-361. http://dx.doi.org/10.1001/jamainternmed.2013.2299
Rock, C.L. (2007) Multivitamin-Multimineral Supplements: Who Uses Them? American Journal of Clinical Nutrition, 85, S277-S279.
Sebastian, R.S., Cleveland, L.E., Goldman, J.D. and Moshfegh, A.J. (2007) Older Adults Who Use Vitamin/Mineral Supplements Differ from Nonusers in Nutrient Intake Adequacy and Dietary Attitudes. Journal of the Academy of Nutrition and Dietetics, 107, 1322-1332. http://dx.doi.org/10.1016/j.jada.2007.05.010
Berner, L.A., Keast, D.R., Bailey, R.L. and Dwyer, J.T. (2014) Fortified Foods Are Major Contributors to Nutrient Intakes in Diets of US Children and Adolescents. Journal of the Academy of Nutrition and Dietetics, 114, 1009-1022. http://dx.doi.org/10.1016/j.jand.2013.10.012
Freisling, H., Elmadfa, I. and Schmid, I.T. (2008) A High Proportion of Nutrient-Enriched Food in the Vitamin Supply of Austrian Adults. Nahrstoffangereicherte Lebensmittel haben einen hohen Anteil an der Vitaminversorgung bei osterreichischen Erwachsenen. Ernahrungs Umschau, 55, 158-164. (In German)