Dietary Supplement Use: United States, August 2021–August 2023

NCHS Data Brief No. 561, May 2026

[PDF - 245 KB] (246 KB)

Bryan Stierman, M.D., M.P.H., Catharine A. Couch, Ph.D., R.D., Jaime J. Gahche, Ph.D., M.P.H., and Suruchi Mishra, Ph.D.

Introduction

Dietary supplements are commonly used in the United States and contribute considerably to total nutrient intake in the population (1). People take dietary supplements for many reasons, including improving and maintaining health, preventing disease, and targeting specific organ systems such as skeletal or cardiovascular health (2,3). Dietary supplement use can help lessen nutritional deficiencies but may also lead to intake of nutrients above tolerable upper intake levels (4,5). This report presents estimates of any dietary supplement use in the past 30 days and the number of dietary supplements taken among youth ages 0-19 years and adults age 20 and older during August 2021-August 2023, as well as trends in usage from 2013-2014 through August 2021-August 2023.

Dietary supplement use by sex

• Overall, 35.7% of youth ages 0-19 years took any dietary supplement in the past 30 days during August 2021-August 2023. No differences were seen by sex (Figure 1, Table 1).
• Overall, 60.2% of adults age 20 and older took any dietary supplement.
• More women age 20 and older (66.1%) than men (53.9%) took any dietary supplement.

Dietary supplement use by age

• Youth ages 2-11 years were more likely to take any dietary supplement in the past 30 days (41.9%) than youth ages 0-1 (28.6%) or 12-19 (30.1%) (Figure 2, Table 2).
• The percentage of adults taking any dietary supplement increased with age, from 46.3% among those ages 20-39 to 60.3% among those 40-59 to 75.9% among those 60 and older.

Two or more dietary supplements

• Among youth, 11.3% used two or more dietary supplements in the past 30 days (Figure 3, Table 3).
• Use of two or more dietary supplements was lower among youth ages 0-1 year (5.9%) than ages 2-11 (13.0%) and 12-19 (10.5%).
• Overall, 38.7% of adults took two or more dietary supplements. The percentage of adults taking two or more dietary supplements increased with age, from 23.4% among those ages 20-39 to 56.4% among those 60 and older.

Trends

• No significant changes were seen in the use of any dietary supplement in the past 30 days among youth from 2013-2014 through August 2021-August 2023 (Figure 4, Table 4).
• The percentage of youth taking two or more dietary supplements increased from 2013-2014 (6.4%) through August 2021-August 2023 (11.3%).
• The percentage of adults taking any dietary supplement increased from 2013-2014 (53.8%) through August 2021-August 2023 (60.2%).
• The percentage of adults taking two or more dietary supplements increased from 2013-2014 (30.9%) through August 2021-August 2023 (38.7%).

Summary

Dietary supplement use remains common in the United States. During August 2021-August 2023, 35.7% of youth and 60.2% of adults used any dietary supplement in the past 30 days, and 11.3% of youth and 38.7% of adults used two or more. Among youth, dietary supplement use was most common among those ages 2-11 years. Among adults, dietary supplement use overall increased with age and was more common among women age 20 and older than men. Use of two or more dietary supplements also increased with age among adults. From 2013-2014 through August 2021-August 2023, use of two or more dietary supplements increased among both youth and adults. Use of any dietary supplement also increased among adults.

People often use dietary supplements to meet nutrient needs and support specific health goals. Because of relatively high usage in the population, the Academy of Nutrition and Dietetics stresses the need to watch for overlapping ingredients, potential excesses, and interactions, as well as the need for accessible, evidence-based information for both consumers and healthcare professionals (6).

Definition

Dietary supplement: A product, other than tobacco, intended to supplement diet and not intended to replace food. Dietary supplements contain vitamins, minerals, herbs or botanicals, amino acids, or other substances. They are intended for ingestion and are labeled as dietary supplements (7). Participants were asked if they had used or taken any vitamins, minerals, herbals, or other dietary supplements in the past 30 days, including prescription and over-the-counter supplements. Participants who answered yes were asked additional information about each dietary supplement taken. Nonprescription antacids intended for use as antacids are not included.

Data source and methods

The National Health and Nutrition Examination Survey (NHANES) is a cross-sectional survey designed to monitor the health and nutrition of the U.S. civilian noninstitutionalized population using a complex, multistage probability design. Since 1971, NHANES has collected information on dietary supplement use among participants, including 30-day dietary supplement use since 1988 (2). Before August 2021-August 2023, these questions were asked during an in-home interview. During August 2021-August 2023, the questions were asked during a telephone dietary interview following examination in a mobile examination center to minimize in-person interactions to reduce exposure to SARS-CoV-2, the virus that causes COVID-19 (8). Additional details are available on changes to the dietary supplement data collection during August 2021-August 2023 (8).

Analyses for years before August 2021-August 2023 used full sample interview weights to account for nonresponse, noncoverage, and differential probability of selection. Analyses for August 2021-August 2023 used Dietary Day 1 sample weights, which accounted for additional nonresponse to the telephone interview and day of the week of interview. Variance estimates were computed using Taylor series linearization. Statistical testing was performed for increasing or decreasing trends using linear regression and for comparisons between groups using t tests. Trend tests over time were performed using orthogonal polynomial regression with linear and quadratic terms and account for the unequal duration and spacing of time between each survey cycle. All differences were considered statistically significant at a p value of 0.05 unless otherwise noted.

Statistical analyses were performed using R (version 4.4.0) software, including the Survey package (version 4.4-2) (9).

About the authors

Bryan Stierman, Catharine A. Couch, and Suruchi Mishra are with the National Center for Health Statistics, Division of Health and Nutrition Examination Surveys. Jaime J. Gahche is with the National Institutes of Health, Office of Dietary Supplements.

References

1. Mishra S, Gahche JJ, Ogden CL, Dimeler M, Potischman N, Ahluwalia N. Dietary supplement use in the United States: National Health and Nutrition Examination Survey, 2017-March 2020. Natl Health Stat Report. 2023 Apr;(183):1-14. DOI: https://dx.doi.org/10.15620/cdc:124677.
2. Gahche JJ, Bailey RL, Potischman N, Ershow AG, Herrick KA, Ahluwalia N, et al. Federal monitoring of dietary supplement use in the resident, civilian, noninstitutionalized US population, National Health and Nutrition Examination Survey. J Nutr. 2018 Aug;148(Suppl 2):1436S-44S. DOI: https://doi.org/10.1093/jn/nxy093. PMID: 31105335.
3. Bailey RL, Gahche JJ, Miller PE, Thomas PR, Dwyer JT. Why US adults use dietary supplements. JAMA Intern Med. 2013 Mar;173(5):355-61. DOI: https://doi.org/10.1001/jamainternmed.2013.2299. PMID: 23381623.
4. Bailey RL, Pac SG, Fulgoni VL 3rd, Reidy KC, Catalano PM. Estimation of total usual dietary intakes of pregnant women in the United States. JAMA Netw Open. 2019 Jun;2(6):e195967. DOI: https://doi.org/10.1001/jamanetworkopen.2019.5967. PMID: 31225890.
5. Wallace TC, Frankenfeld CL, Frei B, Shah AV, Yu CR, van Klinken BJ, et al. Multivitamin/multimineral supplement use is associated with increased micronutrient intakes and biomarkers and decreased prevalence of inadequacies and deficiencies in middle-aged and older adults in the United States. J Nutr Gerontol Geriatr. 2019;38(4):307-28. DOI: https://doi.org/10.1080/21551197.2019.1656135. PMID: 31502930.
6. Marra MV, Bailey RL. Position of the Academy of Nutrition and Dietetics: Micronutrient supplementation. J Acad Nutr Diet. 2018 Nov;118(11):2162-73. DOI: https://doi.org/10.1016/j.jand.2018.07.022. PMID: 30366569.
7. Dietary Supplement Health and Education Act of 1994, Pub. L. No. 103-417 (Oct 25, 1994).
8. Stierman B, Mishra S. Changes to dietary supplement and non-prescription antacid data collection during the NHANES August 2021-August 2023 cycle. National Center for Health Statistics. 2025 Mar. Available from: https://wwwn.cdc.gov/nchs/data/Nhanes/Public/2021/Whitepapers/Aug2023-Dietary-Supplement-Mode-Changes-Whitepaper.pdf.
9. Lumley T. Analysis of complex survey samples (Release 4.4-2) [computer software]. 2024.

Suggested citation

Stierman B, Couch CA, Gahche JJ, Mishra S. Dietary supplement use: United States, August 2021-August 2023. NCHS Data Brief. 2026 May;(561):1─11. DOI: https://dx.doi.org/10.15620/cdc/252445.

Copyright information

All material appearing in this report is in the public domain and may be reproduced or copied without permission; citation as to source, however, is appreciated.

National Center for Health Statistics

Carolyn M. Greene, M.D., Acting Director
Amy M. Branum, Ph.D., Associate Director for Science

Division of Health and Nutrition Examination Surveys

Alan E. Simon, M.D., Director
Lara J. Akinbami, M.D., Associate Director for Science