Use of dietary supplements and plant extracts products in the Spanish population: a cross-sectional study.

Authors

  • Eduard Baladia Editorial Board of theSpanish Journal of Human Nutrition & Dietetics
  • Manuel Moñino Academia Española de Nutrición y Dietética, Pamplona, España; CIBEROBN Instituto de Salud Carlos III, Madrid, España
  • Rodrigo Martínez-Rodríguez Academia Española de Nutrición y Dietética, Pamplona, España
  • Martina Miserachs Academia Española de Nutrición y Dietética, Pamplona, España
  • Giuseppe Russolillo Academia Española de Nutrición y Dietética, Pamplona, España
  • Óscar Picazo Fundación MAPFRE, Madrid, España
  • Teresa Fernández Actual Research, Madrid, España
  • Morte Morte Actual Research, Madrid, España

DOI:

https://doi.org/10.14306/renhyd.26.3.1693

Keywords:

Dietary Supplements, SPORT dietary supplement, Herbal Supplements, Cross-Sectional Studies, Spain

Abstract

Introduction: The supplements market registers large sales, however, prevalence and reasons for supplements use data in Spain are scarce. The study aimed i) to evaluate the prevalence of use of supplements, and ii) to identify why they are used, their purposes, who prescribe them and where they are purchased.

Methods: Cross-sectional study using an ad-hoc online self-administered questionnaire to 2,630 participants (50% women) with sociodemographic characteristics assimilated to the Spanish population. The survey consisted of 24 items to assess population's practices and attitudes in relation to supplements, 9 items on sociodemographic indicators and 6 items on lifestyle habits. A descriptive analysis was carried out, frequency of use of supplements, reasons for their use and their prescribers by the main sociodemographic variables. The IBM SPSS Statistics 25 was used for statistical analysis, placing the p value of statistical significance at <0.05.  

Results: 75.1% of the studied population (n = 1,976) claimed to have consumed some kind of supplements in the last year (63.4% dietary supplements; 30.2% products for special medical uses; 28.6% herbal extracts; 19.9% ​​products intended for athletes; and 13.8% products for weight loss). 70% of the sample claimed to have consumed nutritional or herbals supplements to improve their health, while among the consumers of sports supplements, 50% did it to improve performance. 77% of people who referred consumption of products for weight loss would do so to supplement their diet. Prescribers and points of sales were highly dependent on the type of supplements. Supplements were generally perceived as safe, while their effectiveness was mild to transitory.

Conclusions: The prevalence of use of dietary supplements is high. Improving the general health status, losing weight, and enhancing sports performance are the main motivators for their consumption. A high percentage of the supplements might be self-administered.

Author Biography

Eduard Baladia, Editorial Board of theSpanish Journal of Human Nutrition & Dietetics

 

Nombre: Eduard Baladia

Afiliación: Centro de Análisis de la Evidencia Científica, Academia Española de Nutrición y Dietética, Pamplona, España.  

Correo electrónico: e.baladia@academianutricion.org 

Líneas o intereses de investigación: revisiones sistemáticas, revisiones sistemáticas vivas, metaanálisis, revisiones críticas, sumarios de evidencia, guías basadas en la evidencia, investigación basada en la evidencia, mapas de evidencia, metodología de investigación, nutrición, dietética

Enlace a perfil de Twitter: @EBaladia

ORCID: 0000-0002-8123-8736

Research ID: J-9965-2019

Enlace a pubmed: https://pubmed.ncbi.nlm.nih.gov/?term=Baladia+E%5BAuthor%5D

Enlace al cuadro de conflictos de interés: http://www.renhyd.org/index.php/renhyd/pages/view/editorCOIs#ebaladia

References

(1) Fortune Business Insights. Europe Dietary Supplements market size, share & industry analysis, by type (vitamins, minerals, enzymes, fatty acids, proteins, and others), from (tablets, capsules, powder, and liquid), and regional forecast, 2019-2026. Disponible en: https://www.fortunebusinessinsights.com/industry-reports/europe-dietary-supplements-market-101918.

(2) Research and Markets Europe. Nutrition and Supplements Market Size, Share & Trend Analysis Report, By Function, By Formulation, By Consumer, By Distribution Channel, By Region and Segment Forecasts, 2018 – 2025. Disponible en: https://www.researchandmarkets.com/reports/4582049/europe-nutrition-and-supplements-market-size.

(3) Directiva 2002/46/CE del Parlamento Europeo y del Consejo, de 10 de junio de 2002, relativa a la aproximación de las legislaciones de los Estados miembros en materia de complementos alimenticios. Disponible en: https://www.boe.es/buscar/doc.php?id=DOUE-L-2002-81266.

(4) Directiva 2001/83/CE del Parlamento Europeo y del Consejo, de 6 de noviembre de 2001, por la que se establece un código comunitario sobre medicamentos para uso humano. Disponible en: https://eur-lex.europa.eu/legal-content/ES/ALL/?uri=CELEX:32001L0083.

(5) Comité Científico de la Agencia Española de Seguridad Alimentaria y Nutrición (AESAN). Líneas directrices del Comité Científico de la Agencia Española de Seguridad Alimentaria y Nutrición (AESAN) para la evaluación de los complementos alimenticios elaborados a base de componentes de origen vegetal y sus preparaciones. AESAN-2007-003. Disponible en: http://www.aecosan.msssi.gob.es/AECOSAN/docs/documentos/seguridad_alimentaria/evaluacion_riesgos/informes_comite/COMPLEMENTOS_ALIMENTICIOS_O.VEGETAL.pdf.

(6) Coppens P, Delmulle L, Gulati O, Richardson D, Ruthsatz M, Sievers H, et al. Use of botanicals in food supplements. Regulatory scope, scientific risk assessment and claim substantiation. 2005. Ann Nutr Metab. 2006;50(6):538-54, doi: 10.1159/000098146.

(7) European Comission. The use of substances with nutritional or physiological effect other than vitamins and minerals in food supplements. SANCO/2006/E4/018. Disponible en: https://ec.europa.eu/food/sites/food/files/safety/docs/labelling_nutrition-supplements-2007_a540169_study_other_substances_en.pdf.

(8) Skeie G, Braaten T, Hjartåker A, Lentjes M, Amiano P, Jakszyn P, et al. Use of dietary supplements in the European Prospective Investigation into Cancer and Nutrition calibration study. Eur J Clin Nutr. 2009;63 Suppl 4:S226-238, doi: 10.1038/ejcn.2009.83.

(9) Agencia Española de Consumo, Seguridad Alimentaria y Nutrición (AECOSAN). Encuesta ENALIA. Encuesta Nacional de Alimentación en la población Infantil y Adolescente - Frecuencia de consumo de alimentos y suplementos alimenticios. Disponible en: http://www.aecosan.msssi.gob.es/AECOSAN/web/seguridad_alimentaria/subdetalle/enalia.htm#5

(10) Knapik JJ, Steelman RA, Hoedebecke SS, Austin KG, Farina EK, Lieberman HR. Prevalence of Dietary Supplement Use by Athletes: Systematic Review and Meta-Analysis. Sports Med. 2016 Jan;46(1):103-123. doi: 10.1007/s40279-015-0387-7

(11) Rovira MA, Grau M, Castañer O, Covas MI, Schröder H; REGICOR Investigators. Dietary supplement use and health-related behaviors in a Mediterranean population. J Nutr Educ Behav. 2013 Sep-Oct;45(5):386-91. doi: 10.1016/j.jneb.2012.03.007

(12) Klein JD, Wilson KM, Sesselberg TS, Gray NJ, Yussman S, West J. Adolescents’ knowledge of and beliefs about herbs and dietary supplements: a qualitative study. J Adolesc Health. 2005 Nov;37(5):409

(13) Baltazar-Martins G, Brito de Souza D, Aguilar-Navarro M, Muñoz-Guerra J, Plata MDM, Del Coso J Prevalence and patterns of dietary supplement use in elite Spanish athletes. J Int Soc Sports Nutr. 2019;16(1):30, doi: 10.1186/s12970-019-0296-5

(14) Güemes Heras I, Santamaría-Orleans A, Colinas Herrero JF, Gómez Sorrigueta P, Ortiz González L, de la Iglesia-Arnaez R, et al. Use of Dietary Supplements among Spanish Pediatricians in Daily Practice: A Cross-Sectional Survey Study. J Nutr Metab. 2019;2019:5819305, doi: 10.1155/2019/5819305

(15) Serra Majem L, Ribas L, Sáiz de Bustamante P, López Blanco F, Barbachano M. Consumo de suplementos vitamínico-minerales en la población española (1996). Nutrición Clínica 1996; 16:7-15. s. f.

(16) Lachat C, Hawwash D, Ocké MC, Berg C, Forsum E, Hörnell A, et al. Strengthening the Reporting of Observational Studies in Epidemiology-Nutritional Epidemiology (STROBE-nut): An Extension of the STROBE Statement. PLoS Med. 2016;13(6):e1002036, doi: 10.1371/journal.pmed.1002036.

(17) Instituto Nacional de estadística (INE). Estadística del Padrón continuo. 01/01/2020. Disponible en: https://www.ine.es/dyngs/INEbase/es/operacion.htm?c=Estadistica_C&cid=1254736177012&menu=ultiDatos&idp=1254734710990.

(18) Bailey RL, Dodd KW, Gahche JJ, Dwyer JT, Cowan AE, Jun S, et al. Best Practices for Dietary Supplement Assessment and Estimation of Total Usual Nutrient Intakes in Population-Level Research and Monitoring. J Nutr. 2019;149(2):181-97, doi: 10.1093/jn/nxy264.

(19) Dwyer JT, Costello RB, Merkel J Chapter 2 - Assessment of Dietary Supplement Use. En: Coulston AM, Boushey CJ, Ferruzzi MG, Delahanty LM, editores. Nutrition in the Prevention and Treatment of Disease (Fourth Edition). Academic Press; 2017. p. 49-70.

(20) Marcos SV, Rubio MJ, Sanchidrián FR, Robledo D de Spanish National dietary survey in adults, elderly and pregnant women. EFSA Support Publ. 2016;13(6):1053E, doi: https://doi.org/10.2903/sp.efsa.2016.EN-1053.

(21) Ambrus Á, Horváth Z, Farkas Z, Dorogházi E, Cseh J, Petrova S, et al. Pilot study in the view of a Pan-European dietary survey – adolescents, adults and elderly. EFSA Support Publ. 2013;10(11):508E, doi: https://doi.org/10.2903/sp.efsa.2013.EN-508.

(22) Caldwell JA, McGraw SM, Thompson LA, Lieberman HR A Survey Instrument to Assess Intake of Dietary Supplements, Related Products, and Caffeine in High-Use Populations. J Nutr. 2018;148(suppl_2):1445S-1451S, doi: 10.1093/jn/nxy124.

(23) Lieberman HR, Stavinoha TB, McGraw SM, White A, Hadden LS, Marriott BP Use of dietary supplements among active-duty US Army soldiers. Am J Clin Nutr. 2010;92(4):985-95, doi: 10.3945/ajcn.2010.29274.

(24) National Intitute of Healt, National Cancer Institute. Diet History Questionnaire III (DHQ III). Disponible en: https://epi.grants.cancer.gov/dhq3/ y https://epi.grants.cancer.gov/dhq2/forms/.

(25) Aguilar-Navarro M, Muñoz-Guerra J, Plata MDM, Del Coso J [Validation of a questionnaire to study the prevalence of nutritional supplements used by elite Spanish athletes]. Nutr Hosp. 2018;35(6):1366-71, doi: 10.20960/nh.1851.

(26) Subar AF, Ziegler RG, Thompson FE, Johnson CC, Weissfeld JL, Reding D, et al. Is shorter always better? Relative importance of questionnaire length and cognitive ease on response rates and data quality for two dietary questionnaires. Am J Epidemiol. 2001;153(4):404-9, doi: 10.1093/aje/153.4.404.

(27) Cervera Barba, Emilio- Estudio epidemiológico sobre la prevalencia de uso de medicinas alternativas y complementarias para la población general y de un grupo de médico y estudiantes de medicina de la Comunidad de Madrid. 2011–Tesis Doctoral - 10.13140/RG.2.1.4725.9127.

(28) Garcia-Alvarez A, Egan B, de Klein S, Dima L, Maggi FM, Isoniemi M, et al. Usage of plant food supplements across six European countries: findings from the PlantLIBRA consumer survey. PloS One. 2014;9(3):e92265, doi: 10.1371/journal.pone.0092265.

(29) Centro de investigación sobre Fitoterapia. Estudio INFITO sobre el Consumo de Plantas Medicinales en España. 2007. Disponible en: https://docplayer.es/212885-Estudio-infito-sobre-el-consumo-de-plantas-medicinales-en-espana-2007.html

(30) Bailes MG, Torres RM, Martín A, Roig AM, Royo I, Orfila F. Hábitos de consumo de plantas medicinales en un centro de salud de Barcelona. Revista de Fitoterapia 2011; 11(1)45-51. https://www.fitoterapia.net/php/descargar_documento.php?id=4454&doc_r=sn&num_volumen=28&secc_volumen=5961.

(31) Enguídanos SV. Estudio descriptivo sobre la utilización de plantas medicinales tradicionales y autóctonas de la Comunidad Valenciana con propiedades ansiolíticas y antidepresivas. Tesis Doctoral. 2017. Disponible en: https://repositorioinstitucional.ceu.es/handle/10637/8629.

(32) Ronis MJJ, Pedersen KB, Watt J. Adverse Effects of Nutraceuticals and Dietary Supplements. Annu Rev Pharmacol Toxicol. 2018 Jan 6;58:583-601. doi: 10.1146/annurev-pharmtox-010617-052844

Published

2022-09-29

How to Cite

Baladia, E., Moñino, M., Martínez-Rodríguez, R., Miserachs, M. ., Russolillo, G., Picazo, Óscar ., Fernández, T., & Morte, M. (2022). Use of dietary supplements and plant extracts products in the Spanish population: a cross-sectional study. Spanish Journal of Human Nutrition and Dietetics, 26(3), 217–229. https://doi.org/10.14306/renhyd.26.3.1693

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