The Use of Dietary Supplements and Their Association with COVID-19-Related Anxiety among Non-Institutionalized Elderly in Northern Greece

Abstract

The elderly constitute a vulnerable group for increased anxiety and poor diet during the COVID-19 pandemic. There is limited research on the levels of COVID-19-related anxiety and dietary habits including dietary supplementation practices among the elderly and very elderly in Greece. A cross-sectional survey was conducted in 364 non-institutionalized elderly (65–74 y) and very elderly (≥75 y) living in northern Greece, with the aim to investigate the use of dietary supplements and their association with other factors, particularly the COVID-19-related anxiety. Levels of anxiety were assessed with the use of the Coronavirus Anxiety Scale (CAS-5). The percentage of dietary supplement users was 62.6%. The most popular dietary supplements used were vitamin D followed by vitamin C and multivitamin and mineral supplements. Multivariate analysis showed that the very elderly and overweight individuals were less likely to consume vitamin D supplements. Approximately a third of the participants (33.8%) exhibited signs of COVID-19-related anxiety but only 8% showed dysfunctional levels of anxiety. Regression analysis indicated that women, former smokers, and people exhibiting any sign of COVID-19 anxiety were approximately two times more likely to consume dietary supplements of any kind (Gender: OR 2.34, 95% CI 1.30–4.19; Smoking: OR 2.15, 95% CI: 1.08–4.26; COVID-19 anxiety: OR 2.16, 95 % CI: 1.20–3.91). Our results provide useful insights into the current practices of dietary supplement use in this population group and could be used by dietetic and medical associations as well as public authorities in the formulation of targeted, safe, and effective interventions for the protection of public health.

Keywords:

• Anxiety
• CAS-5
• COVID-19
• dietary supplements
• elderly

Acknowledgements

The authors would like to express their gratitude to Ms. Eva Paraskevadaki for her assistance with statistical analysis. In addition, our special thanks go to the volunteers who participated in this survey.

Disclosure statement

Authors confirm that they have no conflicts of interest with respect to the work described in this manuscript. GM is a scientific officer of the Hellenic Food Authority. The author alone is responsible for the content and views expressed in this publication and he does not necessarily represent the decisions, policy or views of the Hellenic Food Authority.

Funding

The author(s) reported there is no funding associated with the work featured in this article.

Additional information

Notes on contributors

Georgios Marakis

Georgios Marakis holds a PhD in Human Nutrition and is currently the Deputy Head of the Nutrition and Food Standards Unit of the Directorate of Risk Assessment and Nutrition at the Hellenic Food Authority in Greece. His interests include public health nutrition, metabolic diseases, micronutrients, and medicinal plants.

Lamprini Kontopoulou

Lamprini Kontopoulou is a Dietician and currently works as Laboratory Teaching staff at the University of Thessaly in Greece. Her research interests are clinical nutrition and public health nutrition.

Georgios Konstantinidis

Georgios Konstantinidis is undergraduate student at the School of Biology of the Aristotle University of Thessaloniki. As part of his final year dissertation, he participated in a research program concerning dietary supplements.

Ioanna V. Papathanasiou

Ioanna V. Papathanasiou is an Associate Professor of Nursing - Community Psychiatry and Head of the Nursing Department of the University of Thessaly. Her research interests include health care of elderly people and factors that affect their mental health status.

Georgios Karpetas

Georgios Karpetas has a PhD in the field of Medical Informatics and works as a Laboratory Teaching Staff in the Medical Department of the University of Thessaly.

Daphne Mirkopoulou

Daphne Mirkopoulou holds a BSc and a PhD in Nutrition and Dietetics, a MPh as well as a degree in Medicine (with specialization in General Medicine). She is affiliated to the 1^st Propedeutic Department of Internal Medicine in Thessaloniki (Greece) and her research interests include clinical nutrition and metabolic diseases.

Ann F. Walker

Ann F. Walker is a retired Senior Lecturer in Human Nutrition from the University of Reading (UK) with publications in clinical research into dietary supplementation. She runs a clinic in natural medicine.

Eleni Vasara

Eleni Vasara has PhD in Biology. Her research concerns human health indicators and nutrition status, dietary intake and nutrient metabolism, dietary habits related to public health. She is academic staff in the School of Biology of the Aristotle University of Thessaloniki, where she is lecturing on Physiology.