It is complicated to ascertain the composition and prevalence of the use of highly fortified food and supplement products (HFPs) because HFP foods and HFP supplements have different labeling requirements. However, HFPs (energy bars, energy drinks, sports drinks, protein bars, energy shots, and fortified foods/beverages) are popular in the United States. A Web-based survey balanced to reflect US census data was used to describe their use in a sample of 2355 US adults older than 18 years in 2011 and trends in their use from 2005. In 2011, 33% of adults reported using HFPs; use was significantly higher among males, African Americans, Hispanics, and more highly educated individuals (eg, some college or more) and those younger than 45 years compared with nonusers. Multiple product use was common. Of users, 46% consumed sports drinks, 37% fortified foods/beverages, 32% protein bars, 27% energy drinks, 24% energy bars, and 12% consumed energy shots. For those HFP products as a group, prevalence of use was 36% (n = 2039) in 2005, 35% in 2009 (n = 2010), and 30% in 2011 (n = 2355). Although use was significantly lower in 2011 than in 2005 especially among females, non-Hispanics, and those with high school education or less (P ≤ .05), HFPs, particularly energy and sports drinks, continue to be widely used by many US adults.
Rebecca B. Costello, PhD, FAHA, is a nutritionist and scientific consultant with the Office of Dietary Supplements, National Institutes of Health, Bethesda, Maryland. Her research interests include evaluation of research methods for capturing information on the use of dietary supplements and dietary interventions to reduce cardiovascular disease.
Johanna T. Dwyer, DSc, RD, is a senior nutrition scientist at the Office of Dietary Supplements, National Institutes of Health, Bethesda, Maryland, where her work involves the development of a federally funded Dietary Supplement Ingredient Database and research into the motivation of use for dietary supplements. Dr Dwyer is also professor medicine and community health at Tufts University School of Medicine, Boston, Massachusetts. She is the editor of Nutrition Today and is a public trustee of International Life Sciences Institute North America.
Regan L. Bailey, PhD, MPH, RD, is an associate professor in the Department of Nutrition Science at Purdue University, West Lafayette, Indiana, and a consulting nutritional epidemiologist at the Office of Dietary Supplements, National Institutes of Health, Bethesda, Maryland. Her research interests include nutritional epidemiology, 1-carbon metabolism, particularly B vitamins, dietary assessment methods and measurement error, dietary patterns, and dietary supplements.
Leila G. Saldanha, PhD, RD, FAND, is a nutritionist and scientific consultant with the Office of Dietary Supplements, National Institutes of Health, Bethesda, Maryland. Her research areas at the National Institutes of Health include the development and use of dietary supplement composition databases.
Steven French, MBA, is a managing partner at National Marketing Institute, Harleysville, Pennsylvania, a leading strategic marketing consultancy and market research firm specializing in health and wellness. He has more than 25 years of strategic marketing expertise and experience across a wide range of industries and organizations. He has pioneered a range of global consumer research databases and tracking studies.
This work was funded by the Department of Health Human Services, Office of Dietary Supplements of the National Institutes of Health.
Correspondence: Rebecca B. Costello, PhD, Office of Dietary Supplements, 3B01, MSC 75117 National Institutes of Health, 6100 Executive Blvd, Bethesda MD 20892 (firstname.lastname@example.org).