This analysis characterizes the use of dietary supplements (DS) and motivations for DS use among US children (≤18 years) by family income level, food security status, and federal nutrition assistance program using the 2011-2014 National Health and Nutrition Examination Survey data. About one-third (32%) of children used DS, mostly multivitamin-minerals (MVM, 24%).

Dietary supplement (DS) use is widespread in the United States. More than half of adults and approximately one-third of infants, children, and adolescents (henceforth children) use DS. The use of DS is associated with socioeconomic status indicators such as family income level and food security in adults and children.

For example, data from the 2007-2010 National Health and Nutrition Examination Survey (NHANES) demonstrated that children using DS tended to have a higher income. In a study using the 1999-2004 NHANES data, children using micronutrient supplement were more likely to have higher food security.

Dietary supplement

However, if the type of DS used and motivations for their use differ by socioeconomic status remain unclear. DS and MVM use was associated with higher family income and higher household food security level.

DS was used among children participating in the Supplemental Nutrition Assistance Program (SNAP; 20%) and those participating in the Special Supplemental Nutrition Assistance Program for Women, Infants, and Children (WIC; 26%) compared to both income-eligible and income-ineligible nonparticipants.

Most children who used DS took only one (83%) or two (12%) products; although children in low-income families had fewer products than those in higher income families. The most common motivations for DS and MVM were used to "improve (42% or 46%)" or "maintain (34 or 38%)" health, followed by "to supplement the diet (23 or 24%)" for DS or MVM, respectively.

High-income children were more likely to use DS and MVM "to supplement the diet" than middle- or low-income children. Only 18% of child DS users took DS based on a health practitioner's recommendation.

DS is used by about a third of US children, with most child DS users using MVM or multivitamins and taking only one product in a 30-d period. DS use was greater among children in families with a higher household income and a higher level of household food security and was lower among children living in lower-income families who were participating in WIC or SNAP.

In conclusion, DS use was lower among children who were in low-income or food-insecure families, or families participating in nutrition assistance programs.