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Trends in vitamin D supplement use

Posted on: July 25, 2013   by  tom.weishaar@gmail.com

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Last month I reported on a study’s results regarding trends in vitamin D testing in Medicare patients, where we saw that the number of tests given per 10,000 enrollees jumped from near zero in 2000 to about 1,300 in 2010. In this blog we’re going to look at vitamin D supplement usage in the United States over the same period.

The data come from the National Health and Nutrition Examination Survey (NHANES), which releases new data sets every two years. When analyzed using statistical software that accommodates the data’s “complex survey” design, as done here, the results can be generalized to the non-institutionalized population of the United States.

The continuous version of NHANES (prior to releasing data every two years, there were gaps between surveys) began with data for the years 1999-2000. The most current supplement usage data is for the years 2009-2010. Supplement usage was collected for all participants in every two-year cohort.

Figure 1 summarizes the data. The blue section of each bar represents the percentage of people in that cohort who take no supplements at all. The red section represents those who take at least one supplement, but no supplement containing vitamin D. The green section represents those who get 1 to 999 IUs of vitamin D per day from supplements. The purple section represents those who get 1000 IUs or more a day.

July 2013 Blog 2 graphic

The results are mixed. As you can see, there has been a huge jump in the number of people taking 1000 IUs/day or more. In the first four cohorts, the percentage of the population getting this much vitamin D from supplements was half of 1% or less. In the most recent cohort, this jumped to over 6%.

On the other hand, the number of people taking vitamin D supplements at all, which is 35.3% in the most recent cohort, is actually less than the 36.5% taking vitamin D in 2005-2006. So what we see is that those who have supplemented with vitamin D all along are taking more of it, but those who haven’t used vitamin D supplements in the past still aren’t.

If we look at the results by specific characteristics of the population, older, better educated, and wealthier people are more likely to take vitamin D supplements. Over 50% of those 60 and older now take vitamin D and more than 15% of this group takes more than 1000 IUs/day. Over 50% of college graduates took vitamin D in the two cohorts from 2003 to 2006, but they have dropped back down to 47.5% in the most recent cohort. In the highest income group, over 9% take 1000 IUs/day or more.

Pregnant women constitute the most likely group to take a vitamin D supplement, but in the most recent cohort the number dropped to 59.2% from over 69% in most of the earlier cohorts.

We still have a lot of work to do.

15 Responses to Trends in vitamin D supplement use

  1. Mark Richards

    Tom (and others): have you read Paul Offit’s new book which is critical of supplements? I am curious (but unwilling to pay to support him) as to what he has to say about Vitamin D.

    Today, in the Guardian Newspaper (online), Offit is promoting his book and has so far managed to demonstrate his Vitamin D ignorance. See http://www.guardian.co.uk/lifeandstyle/2013/jul/26/vitamins-health-paul-offit-qanda Perhaps this is consistent with his book.

    I’ve posted a response to his overall dismissal of Vitamin D and would invite others to pile it on.

  2. Rita and Misty

    @Mark Richards~~

    In my opinion:

    There will always be naysayers of vitamin D. After all, aren’t there are always naysayers on every single conceivable subject? Why should D be any different?

    It is tough for a non-medical person or non-scientific researcher to combat a naysayer when he happens to be a medical doctor. We certainly may try, and we certainly may have some significantly valid points. And the medical doctor might even privately agree with us. But, the average person unfamiliar with D, and reading the physician’s blog, will tend to side with the physician…just my opinion…but I’ve been chatting up D now for over a year with non-medical people…and I know what I hear: “Well, Rita, D sounds good! Let me check with my doctor.”

    This is why I now say that we will only make substantial progress via coaching the medical community.

    And guess what? I’ll tell you what!! And, what I say it true.

    The MEDICAL COMMUNITY is only going to listen to a MEDICAL DOCTOR…and even then, they will do it begrudgingly. It will have to be a forceful thing.

    The push as to come from the top and trickle down.

    Quick Change always starts at the top.

    IMO

    This is the way it works.

  3. Rita and Misty

    **Forceful doesn’t necessarily need carry a negative connotation. Some of the most charismatic people have also been forceful. Look to JFK, for example.

  4. Ian

    Part of the problem is that nutrient and mineral supplementation is considered, “complementary and alternative medicine”. The purveyors of which are often non medically qualified people such as: self, naturopath, chiropractor etc.

    This argument also confuses two concepts “medicine” and “health”. When a person takes a nutrient in addition to their diet they are not practicing medicine, even if they think it will help them avoid or treat a pathology. They have the right to do so. What I would like to see is greater involvement of medically trained people being positively involved in “training” people to help themselves. Not denigrating their action.

    People tend to take “supplements” for three main reasons, as a prophylactic, as a treatment of an illness or syndrome they suffer from or to enhance performance, athletic or mental.

    Admittedly the evidence for taking nutritional supplements is fluid and fraught with poor scientific validity but there are many good studies in relation to all nutrients, particularly vitamin D of course. What we must not allow is the medicalisation of dietary supplementation. People need help not control. This is why the Vitamin D Council is exemplary.

  5. Ian

    Mark I saw your comments and thought you made some great points. I hope Offit sees them. Thanks for calling our attention to the article.

  6. Rita and Misty

    @Ian~~

    I talk of Change Management.

    Principle #1–change starts from the top. Leadership is required.

    Principle #2–take inventory of your stakeholders.

    I am happily willing to provide a primer for those interested: Umileritac@aol.com

    Change can come from the masses, but that takes much more time. And, even THEN, the masses must select a leader. Leadership is always required.

    Always.

    People do need help, they just don’t know the help that they need. And, the vast majority will turn to a medically licensed doctor for medical advice. Plain and simple. This is the truth.

    @ Ian: I speak of Leadership rather than control. Control is your word, Ian. Leadership is my word.

    And Leadership is why I consider the Vitamin D Council to be exemplary.

    What a wonderful opportunity to make a “forever” difference in this world.

  7. Rita and Misty

    Let us remember that we have an opportunity to save lives.

  8. Rita and Misty

    @Ian:

    “Strange times are these in which we live when old and young are taught falsehoods in school. And the person that dares to tell the truth is called at once a lunatic and fool”

    Plato (427 BC)

  9. Magic

    Why is it that the graphs always go all the way up………to three or four years ago? I have been telling the story for more than four years and have done good. Lot’s of friends tell me. Others talked to their doctor like Rita said. Some of those are dead now.

    Costco jumped on D3 at least 2 years ago and they sell LOTS.. Fred Meyer employees hardly knew what it was two years ago. Now they are doing a better job.

    It always bothers me that nursing homes let people exist in the shade with no pills when every one of those people should get at least 5000 iu a day. There’s a big turnover at those places and it isn’t because they went back home.

    I believe there has been a large upward swing in usage……..BUT NOT NEARLY ENOUGH. IMO we should get Michelle Obama working on this. Rita has a good relationship with the NCAAP … Anybody have a connection to help her??

    Magic

  10. Rita and Misty

    Last week I wrote on how life turns on a dime.

    The life of someone I love dearly has turned on a dime just within a few short days.
    And, subsequently, my life has also changed direction.

    I am sorry. It is what it is. And, priorities call to me, as she is a dear friend–really, she is closer to me than a sister would be. She is the world to me.

    Her health and well-being must now take precedence in my life.

    I am certain most here will understand.

    It has to do with the meaning of LOYALTY.
    I am loyal to my friends.
    That is all there is in life.
    Loyalty.
    It counts more to me than anything else.

    Regardless, even if things had remained status quo in my life, I am of the solid opinion that only a medical doctor will make headway on this vitamin d issue–in particular with the Obama administration.

    My vote is for Dr. John Cannell. IMO–He will be the best choice to step up to that political plate.

    And, I fully support him on this matter. As we all should. He deserves all our best.

    Be well (and please send good karma and kind prayers to my friend),
    Rita

  11. Rita and Misty

    We need to recognize that Dr. Cannell has been an instrumental force in educating the public regarding vitamin d deficiency.

    John Cannell has put his reputation on the line every day, for at least 10 years, perhaps longer, regarding a very serious public health matter. Even though vitamin d deficiency has been a controversial topic, he has spoken openly and fearlessly.

    That deserves credit and honor–in my opinion.

    And he deserves a place in history.

  12. askew@bellaliant.net

    Agree

  13. Rita and Misty

    “The history of the role of vitamin D in human health is rich and much of that history is yet to be written not only by scientists, but by policy makers with the vision and leadership necessary to bridge the gap between research and policy.”

    (I think it is time to speak louder…)

    http://www.ncbi.nlm.nih.gov/pubmed/19185802

  14. Ron Carmichael

    I am a pharmacist in the Austin, TX area. Several years ago I militantly went out on the limb and gently/respectfully communicated via repeated faxes and emails to certain physicians appropriate studies and information regarding vitamin D and their particular specialties – identified because they were prescribing for my customer patients and I therefore had professional cause and excuse.
    In some few cases I was thanked, but in most it was simply a black hole – no feedback, and primarily they continued prescribing D2 50,000iu either per week or per month, while a few switched to D3 50,000iu but still at a paltry rate.
    But this morning I filled a prescription from one of those doctors, for D3 5,000iu orally every day.
    I was happy all day long.
    It CAN happen. You can make a difference. (snoopy dance)

  15. Rita and Misty

    @Ron–I applaud you! A pharmacist is in a very good perch to influence physicians and other healthcare professionals. Nurses, APRNs in particular, are also in the catbird’s seat to outreach in the medical community.

    And certainly, the old fashioned, door-to-door, person-to-person neighborhood, workplace and family outreach is also good–and necessary–BUT, not enough.

    If I had to place my hope for success anywhere, it would be in policy and in legal action.

    Dr. Cannell has been doing this for at least ten years; we need to get behind him and move this educational campaign forward and faster.

    (imo)

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