©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
Patterns of dietary supplement use among United States patients with steatotic liver disease: Vitamins, minerals and botanicals
Melinda Wang, Gabrielle Jutras, Giuseppe Cullaro, Anand Dhruva, Jennifer C Lai
Melinda Wang, Department of Internal Medicine, University of California San Francisco, San Francisco, CA 94143, United States
Gabrielle Jutras, Division of Hepatology, Department of Medicine, Centre Hospitalier de l’Université de Montréal, Montreal H2X 0A9, Quebec, Canada
Giuseppe Cullaro, Jennifer C Lai, Department of Medicine, Division of Gastroenterology and Hepatology, University of California – San Francisco, San Francisco, CA 94143, United States
Anand Dhruva, Osher Center for Integrative Medicine, University of California, California, MD 94143, United States
Co-first authors: Melinda Wang and Gabrielle Jutras.
Author contributions: Wang M and Jutras G contributed to study conception, study design, statistical analysis, manuscript writing and editing; Cullaro G contributed to manuscript editing, funding; Dhruva A contributed to study design, manuscript editing.
Supported by The National Institutes of Health, No. K24AG080021, No. R01AG059183, and No. P30DK026743.
Institutional review board statement: Written informed consent is obtained from all participants or proxies and NHANES survey protocol is approved by the Research Ethics Review Board at the Centers for Disease Control and Prevention, National Center for Health Statistics.
Informed consent statement: Written informed consent is obtained from all participants or proxies and NHANES survey protocol is approved by the Research Ethics Review Board at the Centers for Disease Control and Prevention, National Center for Health Statistics.
Conflict-of-interest statement: Lai: Nestle Nutrition Sciences (unrestricted educational grant); Novo Nordisk (advisory board; consultant); Genfit (consultant); Boehringer Ingelheim (advisory board).
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement- checklist of items.
Data sharing statement: No additional data are available.
Corresponding author: Jennifer C Lai, Department of Medicine, Division of Gastroenterology and Hepatology, University of California-San Francisco, 513 Parnassus Avenue, UCSF Box 0538, San Francisco, CA 94143, United States.
jennifer.lai@ucsf.edu
Received: November 22, 2024
Revised: December 26, 2024
Accepted: January 27, 2025
Published online: March 27, 2025
Processing time: 124 Days and 7.8 Hours
BACKGROUND
Dietary supplement (DS) usage among United States adults has significantly increased. Patients with steatotic liver disease (SLD) may have unique motivations to take DS in light of their liver condition and co-morbidities.
AIM
To characterize DS use in SLD patients and explore motivations for their use.
METHODS
Adults ≥ 18 years old with complete transient elastography and dietary data from the National Health and Nutrition Examination Survey between January 2017 and March 2020 were studied. SLD was defined using consensus criteria, combining clinical indicators with elastography thresholds. The DS Questionnaire (DSQ) was used to record participants’ use of DSQ. Sample weights were applied to estimate national prevalence.
RESULTS
Of 2413 participants with SLD, 1058 reported using DS, for an estimated prevalence of 44.8% [standard error (SE) 2.4] with an average of 2.6 (SE 0.2) DS per person. Among SLD participants taking DSQ, 53.2% (SE 3.3) reported using non-vitamin/non-mineral ones, with an average of 1.8 (SE 0.1) such supplements per person. DS users were more likely to be female, have higher levels of education, and have greater food security (P < 0.02 for all). The most common motivations for using DS were to follow doctor’s advice (36.7%, SE 1.8), to improve overall health (22.1%, SE 2.0), and to maintain health (19.2%, SE 1.9).
CONCLUSION
Nearly half of individuals with SLD report taking DS. This study underscores the pressing need to deepen our understanding of DS use/motivations to develop tailored patient counseling strategies.
Core Tip: Almost half of patients with steatotic liver disease (SLD) report taking dietary supplements (DS). Older patients, women, and patients with higher education/food security are more likely to use DS. Patients with SLD take DS to improve their health and by doctor’s advice. Hepatologists have an opportunity to address DS use during clinic visits.
