Nutritional Epidemiology Study: Prevalence of Vitamin and Mineral Supplement Use and Correlated Factors among University Students in Jordan
DOI:
https://doi.org/10.3923/pjn.2018.654.660Keywords:
Jordanian population, micronutrients, multivitamins, supplement users, vitamin and mineralAbstract
Objective: This study was carried out to determine the prevalence and associated factors of vitamin-mineral supplements use among University students. Methods: A cross-sectional study applied a quantitative research approach using a self- administrated questionnaire given to University students in Jordan. Results: The prevalence of vitamin-mineral supplement use was 23%. The main reasons for using vitamin mineral supplements were ‘to maintain good health’ (73%), followed by ‘to lose weight’ (11%). Vitamin-mineral supplement use among participants was significantly (p<0.05) associated with gender, age, BMI, family monthly income, physical activity, smoking status and vegetarian status. The main source of information of supplement use was doctors (60.5%). "Maintaining good health" was the most frequently given reason for using supplements (73%). The major frequently used supplements were vitamin only supplements (51.5%), followed by vitamin-mineral combinations supplements (44%). Conclusion: This study highlighted that although the prevalence of vitamin-mineral supplement use among university students is relatively high, many of them do not have accurate information about supplements. Therefore, there is a need to provide them with education and access to scientific and unbiased information.
References
Diaz, J.R., A. de las Cagigas and R. Rodriguez, 2003. Micronutrient deficiencies in developing and affluent countries. Eur. J. Clin. Nutr., 57: S70-S72.
Archer, S.L., J. Stamler, A. Moag-Stahlberg, L. Van Horn and D. Garside et al., 2005. Association of dietary supplement use with specific micronutrient intakes among middle-aged American men and women: The INTERMAP study. J. Am. Dietet. Assoc., 105: 1106-1114.
World Cancer Research Fund, 1997. Food, nutrition and the prevention of cancer: A global perspective. American Institute for Cancer Research, Washington, DC., USA.
Earnest, C., K.H. Cooper, A. Marks and T.L. Mitchell, 2002. Efficacy of a complex multivitamin supplement. Nutrition, 18: 738-742.
Olney, R.S. and J. Mulinare, 2002. Trends in neural tube defect prevalence, folic acid fortification and vitamin supplement use. Semin. Perinatol., 26: 277-285.
Schuurman, A.G., R.A. Goldbohm, H.A. Brants and P.A. van den Brandt, 2002. A prospective cohort study on intake of retinol, vitamins C and E and carotenoids and prostate cancer risk (Netherlands). Cancer Causes Control, 13: 573-582.
Knekt, P., J. Ritz, M.A. Pereira, E.J. O'Reilly and K. Augustsson et al., 2004. Antioxidant vitamins and coronary heart disease risk: A pooled analysis of 9 cohorts. Am. J. Clin. Nutr., 80: 1508-1520.
White, E., J.S. Shannon and R.E. Patterson, 1997. Relationship between vitamin and calcium supplement use and colon cancer. Cancer Epidemiol. Prevent. Biomarkers, 6: 769-774.
Fawzi, W.W., G.I. Msamanga, D. Spiegelman, R. Wei and S. Kapiga et al., 2004. A randomized trial of multivitamin supplements and HIV disease progression and mortality. N. Engl. J. Med., 351: 23-32.
Carr, A.C. and B. Frei, 1999. Toward a new recommended dietary allowance for vitamin C based on antioxidant and health effects in humans. Am. J. Clin. Nutr., 69: 1086-1107.
Barringer, T.A., J.K. Kirk, A.C. Santaniello, K.L. Foley and R. Michielutte, 2003. Effect of a multivitamin and mineral supplement on infection and quality of life: A randomized, double-blind, placebo-controlled trial. Ann. Internal Med., 138: 365-371.
Sauberlich, H.E. and L.J. Machlin, 1992. Beyond Deficiency: New Views on the Function and Health Effects of Vitamins. Academy of Sciences, New York, USA.
Block, G., R. Sinha and G. Gridley, 1994. Collection of dietary-supplement data and implications for analysis. Am. J. Clin. Nutr., 59: 232S-239S.
Baeksgaard, L., K.P. Andersen and L. Hyldstrup, 1998. Calcium and vitamin D supplementation increases spinal BMD in healthy, postmenopausal women. Osteoporosis Int., 8: 255-260.
Kampman, E., M.L. Slattery, B. Caan and J.D. Potter, 2000. Calcium, vitamin D, sunshine exposure, dairy products and colon cancer risk (United States). Cancer Causes Control, 11: 459-466.
Peacock, M., G. Liu, M. Carey, R. McClintock, W. Ambrosius, S. Hui and C.C. Johnston, 2000. Effect of calcium or 25OH vitamin D3 dietary supplementation on bone loss at the hip in men and women over the age of 60. J. Clin. Endocrinol. Metab., 85: 3011-3019.
Jorde, R., K. Szumlas, E. Haug and J. Sundsfjord, 2002. The effects of calcium supplementation to patients with primary hyperparathyroidism and a low calcium intake. Eur. J. Nutr., 41: 258-263.
Bostick, R.M., J.D. Potter, D.R. McKenzie, T.A. Sellers, L.H. Kushi, K.A. Steinmetz and A.R. Folsom, 1993. Reduced risk of colon cancer with high intake of vitamin E: The Iowa women's health study. Cancer Res., 53: 4230-4237.
Giovannucci, E., M.J. Stampfer, G.A. Colditz, D.J. Hunter and C. Fuchs et al., 1998. Multivitamin use, folate and colon cancer in women in the nurses' health study. Ann. Internal Med., 129: 517-524.
Baron, J.A., M.F. Beach, J.S. Mandel, R.U. Van Stolk and R.W. Haile et al., 1999. Calcium supplements for the prevention of colorectal adenomas. N. Engl. J. Med., 340: 101-107.
Albanes, D., N. Malila, P.R. Taylor, J.K. Huttunen and J. Virtamo et al., 2000. Effects of supplemental α-tocopherol and β-carotene on colorectal cancer: Results from a controlled trial (Finland). Cancer Causes Control, 11: 197-205.
Jacobs, E.J., C.J. Connell, A.V. Patel, A. Chao and C. Rodriguez et al., 2001. Multivitamin use and colon cancer mortality in the Cancer prevention study II cohort (United States). Cancer Causes Control, 12: 927-934.
Willett, W.C. and B. MacMahon, 1984. Diet and cancer-An overview. N. Engl. J. Med., 310: 633-638.
Willet, W.C. and B. MacMahon, 1984. Diet and cancer-An overview. N. Engl. J. Med. 310: 697-703.
Block, G., 1991. Vitamin C and cancer prevention: The epidemiologic evidence. Am. J. Clin. Nutr., 53: 270S-282S.
Hathcock, J.N., 1997. Vitamins and minerals: Efficacy and safety. Am. J. Clin. Nutr., 66: 427-437.
Huang, H.Y., B. Caballero, S. Chang, A.J. Alberg and R.D. Semba et al., 2006. The efficacy and safety of multivitamin and mineral supplement use to prevent cancer and chronic disease in adults: A systematic review for a National Institutes of Health state-of-the-science conference. Ann. Internal Med., 145: 372-385.
Cho, E., D.J. Hunter, D. Spiegelman, D. Albanes and W.L. Beeson et al., 2006. Intakes of vitamins A, C and E and folate and multivitamins and lung cancer: A pooled analysis of 8 prospective studies. Int. J. Cancer, 118: 970-978.
Miller, E.R., R. Pastor-Barriuso, D. Dalal, R.A. Riemersma, L.J. Appel and E. Guallar, 2005. Meta-analysis: High-dosage vitamin E supplementation may increase all-cause mortality. Ann. Int. Med., 142: 37-46.
NIH., 2006. National institutes of healt state-of-the-science conference on multivitamin/mineral supplements and chronic disease prevention. May 15-17, 2006, National Institutes of Health, Bethesda, Maryland.
Muller, O. and M. Krawinkel, 2005. Malnutrition and health in developing countries. Can. Med. Assoc. J., 173: 279-286.
Caballero, B., 2003. Fortification, supplementation and nutrient balance. Eur. J. Clin. Nutr., 57: S76-S78.
Blendon, R.J., C.M. DesRoches, J.M. Benson, M. Brodie and D.E. Altman, 2001. Americans' views on the use and regulation of dietary supplements. Arch. Internal Med., 161: 805-810.
Directorate of Disease Surveillance, Department of Noncommunicable Disease, Ministry of Health, 2004. Behavioral risk factor survey. Directorate of Disease Surveillance, Department of Noncommunicable Disease, Ministry of Health, Amman, Jordan.
Alwan, A. and S. Kharabsheh, 2006. Nutrition in Jordan: A review of the current nutritional trends and major strategic directions of the national food and nutrition policy. WHO/MOH/MOA., Amman, Jordan. http://www.moh.gov.jo.
Khatib, I.M., 2002. High prevalence of subclinical vitamin A deficiency in Jordan: A forgotten risk. Food Nutr. Bull., 23: 228-236.
DOS., 2002. Household income and expenditure survey. Department of Statistics, Amman, Jordan. http://www.dos.gov.jo.
US Department of Health and Human Services, US Department of Agriculture, 2015. Dietary guidelines for Americans 2015. 8th Edn., US Government Printing Office, Washington, DC., USA.
WHO., 2003. Global cancer rates could increase by 50% to 15 million by 2020. World Health Organization, Geneva, Switzerland. http://www.who.int/mediacentre/news/releases/2003/pr27/en/
UNDP., 2000. Jordan human development report. Ministry of Planning and United Nation Development Program, Amman, Jordan.
Haddad, L.G. and M.Z. Malak, 2002. Smoking habits and attitudes towards smoking among university students in Jordan. Int. J. Nurs. Stud., 39: 793-802.
Cross, C.E., M. Traber, J. Eiserich and A. Van Der Vliet, 1999. Micronutrient antioxidants and smoking. Br. Med. Bull., 55: 691-704.
Gutteridge, J.M., 1995. Lipid peroxidation and antioxidants as biomarkers of tissue damage. Clin. Chem., 41: 1819-1828.
WHO., 1997. Report of a WHO, consultation on obesity. Preventing and managing the global, epidemic. World Health Organization, Geneva. http:// www.who.int/nut/obs.htm.
Alwan, A., 1997. Noncommunicable diseases: A major challenge to public health in the region. East. Mediterr. Health J., 3: 6-16.
MoH., 2006. Annual Statistical Book. Ministry of Health, Amman, Jordan.
Karabsheh, S. and W.A. Qarqash, 2002. National survey on iron deficiency anemia and vitamin A deficiency. Ministry of Health (MoH) in Collaboration with WHO, UNICEF and CDC, Amman, Jordan.
Ranelli, P.L., R.N. Dickerson and K.G. White, 1993. Use of vitamin and mineral supplements by pharmacy students. Am. J. Hosp. Pharm., 50: 674-678.
Spencer, E.H., A. Bendich and E. Frank, 2006. Vitamin and mineral supplement use among US medical students: A longitudinal study. J. Am. Dietet. Assoc., 106: 1975-1983.
Driskell, J.A., C.J. Krumbach and D.R. Ellis, 1998. Vitamin and mineral supplement use among college athletes. J. Am. Dietet. Assoc., 98: A17-A17.
Moore, K.L. and A.M. Saddam, 1999. Dietary supplement use among undergraduate college students. J. Am. Dietet. Assoc., 99: A96-A96.
Herbold, N.H., B.K. Visconti, S. Frates and L. Bandini, 2004. Traditional and nontraditional supplement use by collegiate female varsity athletes. Int. J. Sport Nutr. Exercise Metab., 14: 586-593.
Steele, M. and M. Senekal, 2005. Dietary supplement use and associated factors among university students. S. Afr. J. Clin. Nutr., 18: 17-30.
Kim, S.H., J.H. Han, Q.Y. Zhu and C.L. Keen, 2003. Use of vitamins, minerals and other dietary supplements by 17-and 18-year-old students in Korea. J. Med. Food, 6: 27-42.
Knudsen, V.K., L.B. Rasmussen, J. Haraldsdottir, L. Ovesen and I. Bulow et al., 2002. Use of dietary supplements in Denmark is associated with health and former smoking. Public Health Nutr., 5: 463-468.
Messerer, M., S.E. Johansson and A. Wolk, 2001. Sociodemographic and health behaviour factors among dietary supplement and natural remedy users. Eur. J. Clin. Nutr., 55: 1104-1110.
Ishihara, J., T. Sobue, S. Yamamoto, S. Sasaki and S. Tsugane, 2003. Demographics, lifestyles, health characteristics and dietary intake among dietary supplement users in Japan. Int. J. Epidemiol., 32: 546-553.
Tsang, S.N., N.H. Herbold and L. Pycz, 2007. Dietary supplement use among active multi-ethnic adults. J. Am. Dietet. Assoc., 107: A34-A34.
Radimer, K., B. Bindewald, J. Hughes, B. Ervin, C. Swanson and M.F. Picciano, 2004. Dietary supplement use by US adults: Data from the national health and nutrition examination survey, 1999-2000. Am. J. Epidemiol., 160: 339-349.
Lyle, B.J., J.A. Mares-Perlman, B.E. Klein, R. Klein and J.L. Greger, 1998. Supplement users differ from nonusers in demographic, lifestyle, dietary and health characteristics. J. Nutr., 128: 2355-2362.
Neuhouser, M.L., R.E. Patterson and L. Levy, 1999. Motivations for using vitamin and mineral supplements. J. Acad. Nutr. Dietet., 99: 851-854.
Dundas, M.L. and J.R. Keller, 2003. Herbal, vitamin and mineral supplement use and beliefs of university students. Topics Clin. Nutr., 18: 49-53.
Eldridge, A.L. and E.T. Sheehan, 1994. Food supplement use and related beliefs: Survey of community college students. J. Nutr. Edu., 26: 259-265.
Kaufman, D.W., J.P. Kelly, L. Rosenberg, T.E. Anderson and A.A. Mitchell, 2002. Recent patterns of medication use in the ambulatory adult population of the United States: The Slone survey. J. Am. Med. Assoc., 287: 337-344.
Tamim, H., N. Dumit, A. Terro, R. Al-Hourany and D. Sinno et al., 2004. Weight control measures among university students in a developing country: A cultural association or a risk behavior. J. Am. Coll. Nutr., 23: 391-396.
Dorsch, K.D. and A. Bell, 2005. Dietary supplement use in adolescents. Curr. Opin. Pediat., 17: 653-657.
McDowall, J.A., 2007. Supplement use by young athletes. J. Sports Sci. Med., 6: 337-342.
English, E.C. and J.W. Carl, 1981. Use of nutritional supplements by family practice patients. JAMA., 246: 2719-2721.
Pally, A., J. Sobal and J.H. Muncie, 1984. Nutritional supplement utilization in an urban family practice center. J. Family Pract., 18: 249-253.
Dannehower, L., N. Maniscalco and B.Z. Paulshock, 1985. Vitamin and mineral usage in adult family practice patients. J. Family Pract., 21: 338-338.
Sobal, J., H.L. Muncie, Jr. and J.R. Guyther, 1986. Nutritional supplement use by patients in a rural family practice. J. Am. College Nutr., 5: 313-316.
Downloads
Published
Issue
Section
License
Copyright (c) 2018 The Author(s)

This work is licensed under a Creative Commons Attribution 4.0 International License.
This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution and reproduction in any medium, provided the original author and source are credited.