Self-Perceived Health and Chronic Conditions Among Users of Supplements With and Without Botanical Ingredients: Findings from the 2009–2014 National Health and Nutrition Examination Survey

Abstract

The objective of this research was to investigate associations among self-reported health status, chronic conditions, and use of dietary supplements containing botanicals and describe reasons for use among U.S. adult supplement users. This was a cross-sectional analysis using data from the 2009–2014 National Health and Nutrition Examination Survey (NHANES). Supplement information was collected with a 30-day recall interview. Self-reported general health status and doctor-informed diagnoses of chronic conditions were assessed using a health status questionnaire. We used weighted multivariate logistic regressions to assess associations between supplement use and perceived health and number of chronic conditions. Participants were 16,958 non-institutionalized U.S. adults aged 20 years and older. Adults with excellent or very good self-perceived health were more likely to use botanical supplements than adults with good perceived health (adjusted odds ratio [aOR], 1.48; 95% confidence interval [CI], 1.28–1.74). Adults with three or more chronic conditions were more likely to report using botanical supplements than adults with no chronic conditions (aOR, 1.49; 95% CI, 1.13–1.69). The most frequently reported reasons for both non-botanical and botanical supplements use were “personal choice or influenced by advertisements or word of mouth,” “improve health,” and “specific health conditions” (93.3%, 84.2%, and 64.7%, respectively). While perceptions of health are more positive among adults using botanical supplements, chronic conditions and reasons for botanical supplements use related to personal choice, improving health, or addressing specific conditions were more likely. Differentiating botanical supplements from other complementary and integrative therapies may be useful for facilitating a deeper understanding of the reasons.

Keywords:

• NHANES
• self-perceived health
• botanicals
• dietary supplements

Acknowledgements

Critical feedback during the final stages of manuscript development was provided by Dr. Adam Haley and Valerie Goodsman of the Oregon State University Graduate Writing Center.

Disclosure statement

The authors report no conflict of interest.

Additional information

Notes on contributors

Ellen M. Alonso Street

Ellen M. Alonso Street is a registered dietitian serving the County of Napa WIC program as a nutrition counselor and breastfeeding coordinator. She received a Master's degree in Human Nutrition from Oregon State University in 2020.

Stephanie Grutzmacher

Ellen Smit, PhD, RD, is an epidemiologist and professor at Oregon State University. Her research interests include methods for the analysis of public health surveillance data, nutrition, food insecurity, frailty, and health disparities.

Adam Branscum

Stephanie Grutzmacher is an Assistant Professor of Nutrition and Global Health at the Oregon State University College of Public Health and Human Sciences. She received her PhD in Family Science from the University of Maryland School of Public Health in 2007. Stephanie’s work aims to understand food insecurity among vulnerable populations in order to identify best practices for food safety net, food access, and nutrition education programs. She works with SNAP-Ed, extension, and community collaborators to develop, implement, and evaluate programmatic strategies in family, school, retail, worksite, service agency, and community settings. Current projects include a study of farmworker and farmer safety net utilization, a study of older adults’ SNAP participation, a statewide evaluation of the SNAP incentive program Double Up Food Bucks Oregon, and a study of college and university responses to student food and housing insecurity.

Ellen Smit

Adam Branscum is Professor and Director of Biostatistics in the College of Public Health and Human Sciences at Oregon State University. He received an MS in Epidemiology and PhD in Statistics from UC Davis. He is Associate Editor of Biometrics. Previously he was Editor of Statistical Methods in Medical Research and Associate Editor of The American Statistician and Bayesian Analysis. He co-authored the book Bayesian Ideas and Data Analysis. Dr Branscum’s research focuses on nonparametric Bayesian methodology, epidemiology, and diagnostic test protocols.