Supplement Industry Statistics: Use, Efficacy, & Safety

57.6% of US adults aged 20 and over used at least one dietary supplement in the past 30 days in 2017-2018: 63.8% of women and 50.8% of men

National Health and Nutrition Examination Survey data.

Supplement use rose with age to 80.2% of women and 67.3% of men aged 60 and over

Multivitamin-minerals were the most common type (39.4% of adults 60 and over), followed by vitamin D (36.9%) and omega-3 fatty acids (21.8%).

Supplement firms, not the FDA, are responsible for evaluating the safety and labelling of their products before marketing

The FDA can act against adulterated or misbranded supplements once they are on the market.

An estimated 23,005 emergency department visits a year in the US were attributed to adverse events from dietary supplements, leading to about 2,154 hospitalizations

Nationally representative surveillance from 63 emergency departments, 2004-2013. 28.0% of visits involved adults aged 20-34 and 21.2% unsupervised children.

Weight-loss or energy products caused 71.8% of supplement-related emergency visits involving palpitations, chest pain or rapid heartbeat

Among adults 65 and over, choking or swallowing problems caused 37.6% of supplement-related visits, mostly from micronutrient pills.

Creatine improved upper-limb strength over placebo with an effect size of 0.317 across 53 randomized trials

Benefit held regardless of age, sex, training status, dose or duration in meta-regression. Creatine is among the few supplements with consistent trial evidence.

Across 11 reviews containing 21 meta-analyses, caffeine improved aerobic endurance, strength, muscular endurance, power, jumping and speed

Evidence quality was mostly moderate, the effect generally larger for aerobic than anaerobic exercise, and most studies were in young men.

Protein supplementation added 2.49 kg to 1RM strength and 0.30 kg to fat-free mass during resistance training, with no further gain above about 1.62 g/kg a day of total protein

Meta-analysis of 49 randomized trials with 1,863 participants. Powders help mainly by making the total easier to reach.

No human study has measured the muscle protein synthesis response to oral BCAAs alone; the two intravenous studies found BCAAs decreased it

Without the other essential amino acids, the theoretical ceiling is a rise of about 30% in synthesis, and the author concludes the anabolic claim is unwarranted.

Beta-alanine improved exercise outcomes by a median of 2.85% after a median total intake of 179 g

Meta-analysis of 15 studies with 360 participants. Efforts of 60-240 seconds and longer improved; efforts under 60 seconds did not.

Multi-ingredient pre-workout supplements may improve muscular endurance and mood, but proprietary blends make most dose comparisons impossible

Review. Effects on force and power were mixed, safety data rarely ran past 8 weeks, and some products contain banned substances, deliberately or as contaminants.

Vitamin D at 700-1,000 IU a day cut the risk of falling in older people by 19%; lower doses did not reduce falls

Meta-analysis of 8 double-blind trials with 2,426 people aged 65 or older; reaching blood levels of at least 60 nmol/L gave a 23% reduction.

Omega-3 supplements had no significant association with coronary heart disease death (rate ratio 0.93) or major vascular events (0.97)

Meta-analysis of 10 large trials with 77,917 high-risk people over a mean of 4.4 years, including those with prior heart disease or diabetes.

Multivitamin use was not associated with lower mortality (hazard ratio 1.04) in 390,124 US adults followed for up to 27 years

Three prospective cohorts of adults without cancer or other chronic disease at baseline.

Iron supplementation raised VO2max by 2.35 mL/kg/min in women of reproductive age

Meta-analysis of 22 trials; submaximal heart rate fell by about 4 beats a minute. Only 3 studies were at low risk of bias, and iron deficiency is common in this group.