Variability of the Nutrient Composition of Multivitamin Supplements

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3th National Nutrient Databank Conference Variability of the Nutrient Composition of Multivitamin Supplements Song-Yi Park, PhD Suzanne P. Murphy, PhD, RD Donna Au, MPH, RD Laurence N. Kolonel, MD, PhD Cancer Research Center of Hawaii University of Hawaii

3th National Nutrient Databank Conference Objectives To examine the variability in nutrient composition among multivitamin supplements. To examine the variability in nutrient intakes from multivitamins supplements among users.

3th National Nutrient Databank Conference Subjects In 1993-1996, the Hawaii-Los Angeles Multiethnic Cohort was established to study diet and cancer. The cohort consists of >215, adults aged 45-75 years.

3th National Nutrient Databank Conference Subjects Of participants from Hawaii, 86,733 completed a follow-up questionnaire in 1999-21. Japanese Americans (44%), Caucasians (33%), Native Hawaiians (13%)

3th National Nutrient Databank Conference Multivitamin supplement use among men at the baseline (1993-1996) Any supplement 58% Multivitamin 48% Vitamin A 12% Vitamin C 37% Vitamin E 26% Beta-carotene 8% Calcium 15% Iron 8% Selenium 3% Foote et al, Am J Epidemiol 23

3th National Nutrient Databank Conference Multivitamin supplement use among women at the baseline (1993-1996) Any supplement 72% Multivitamin 56% Vitamin A 12% Vitamin C 43% Vitamin E 32% Beta-carotene 1% Calcium 44% Iron 14% Selenium 3% Foote et al, Am J Epidemiol 23

3th National Nutrient Databank Conference Multivitamin questionnaire at the follow-up (1999-21)

3th National Nutrient Databank Conference Supplement Composition Table Based on the label, the nutrient profile of each multivitamin was entered into the Cancer Research Center of Hawaii s Supplement Composition Table (SCT). >27 multivitamin products

3th National Nutrient Databank Conference Multivitamin Supplement Defined as a product containing 2 or more vitamins out of 13 (vitamin A, B-6, B-12, C, D, E, K, thiamin, riboflavin, niacin, folic acid, pantothenic acid, biotin), with or without minerals.

3th National Nutrient Databank Conference Nutrient intake from supplements Frequency of use per day the nutrient composition per dose from the SCT for each supplement product Total nutrient intake per day from multivitamins = each nutrient up to 3 supplements reported

3th National Nutrient Databank Conference Multivitamin users and products 29,44 participants provided complete information on brand name, product name, and frequency of use. A total of 1,465 multivitamin products with minerals (n=1,225, 84%) without minerals (n=24, 16%)

3th National Nutrient Databank Conference Variability of nutrient composition across products

3th National Nutrient Databank Conference Vitamin composition of multivitamin products (n=1,465) Vitamin 1th Pctl Median 9th Pctl Thiamin, mg 7.5 75 Riboflavin, mg 8.3 5 Vitamin B-6, mg 6 75 Folate, μg DFE 68 85 Vitamin B-12, μg 15 125 Vitamin C, mg Pctl, percentile; DFE, dietary folate equivalents 15 1

3th National Nutrient Databank Conference Vitamin composition of multivitamin products (n=1,465) Vitamin 1th Pctl Median 9th Pctl Thiamin, mg 7.5 75 Riboflavin, mg 8.3 5 Vitamin B-6, mg 6 75 Folate, μg DFE 68 85 Vitamin B-12, μg 15 125 Vitamin C, mg Pctl, percentile; DFE, dietary folate equivalents 15 1

3th National Nutrient Databank Conference Vitamin composition of multivitamin products (n=1,465) Vitamin 1th Pctl Median 9th Pctl Thiamin, mg 7.5 75 Riboflavin, mg 8.3 5 Vitamin B-6, mg 6 75 Folate, μg DFE 68 85 Vitamin B-12, μg 15 125 Vitamin C, mg Pctl, percentile; DFE, dietary folate equivalents 15 1

3th National Nutrient Databank Conference Vitamin composition of multivitamin products (n=1,465) Vitamin 1th Pctl Median 9th Pctl Thiamin, mg 7.5 75 Riboflavin, mg 8.3 5 Vitamin B-6, mg 6 75 Folate, μg DFE 68 85 Vitamin B-12, μg 15 125 Vitamin C, mg Pctl, percentile; DFE, dietary folate equivalents 15 1

3th National Nutrient Databank Conference Mineral composition of multivitamin with minerals products (n=1,225) Mineral 1th Pctl Median 9th Pctl Calcium, mg 14 6 Iron, mg 5 2 Zinc, mg 15 25 Selenium, μg 25 2

3th National Nutrient Databank Conference Variability of nutrient intake among users

3th National Nutrient Databank Conference Daily vitamin intake from multivitamin supplements among users (n=29,44) Nutrient 1th Pctl Median 9th Pctl RDA* Thiamin, mg 1.1 1.5 3 1.2/1.1 Riboflavin, mg 1.2 1.7 3 1.3/1.1 Vitamin B-6, mg 1.5 3 36 1.7/1.5 Folate, μg DFE 194 68 12 4 Vitamin B-12, μg 6 25 6 2.4 Vitamin C, mg 43 6 5 9/75 *RDA for men/women aged >51 years

3th National Nutrient Databank Conference Daily vitamin intake from multivitamin supplements among users (n=29,44) Nutrient 1th Pctl Median 9th Pctl RDA* Thiamin, mg 1.1 1.5 3 1.2/1.1 Riboflavin, mg 1.2 1.7 3 1.3/1.1 Vitamin B-6, mg 1.5 3 36 1.7/1.5 Folate, μg DFE 194 68 12 4 Vitamin B-12, μg 6 25 6 2.4 Vitamin C, mg 43 6 5 9/75 *RDA for men/women aged >51 years

3th National Nutrient Databank Conference Daily vitamin intake from multivitamin supplements among users (n=29,44) Nutrient 1th Pctl Median 9th Pctl RDA* Thiamin, mg 1.1 1.5 3 1.2/1.1 Riboflavin, mg 1.2 1.7 3 1.3/1.1 Vitamin B-6, mg 1.5 3 36 1.7/1.5 Folate, μg DFE 194 68 12 4 Vitamin B-12, μg 6 25 6 2.4 Vitamin C, mg 43 6 5 9/75 *RDA for men/women aged >51 years

3th National Nutrient Databank Conference Daily vitamin intake from multivitamin supplements among users (n=29,44) Nutrient 1th Pctl Median 9th Pctl RDA* Thiamin, mg 1.1 1.5 3 1.2/1.1 Riboflavin, mg 1.2 1.7 3 1.3/1.1 Vitamin B-6, mg 1.5 3 36 1.7/1.5 Folate, μg DFE 194 68 12 4 Vitamin B-12, μg 6 25 6 2.4 Vitamin C, mg 43 6 5 9/75 *RDA for men/women aged >51 years

3th National Nutrient Databank Conference Daily mineral intake from multivitamin supplements among users (n=29,44) Nutrient 1th Pctl Median 9th Pctl RDA/AI* Calcium, mg 2 45 12 Iron, mg 4 18 8 Zinc, mg 3.6 15 3 11/8 Selenium, μg 2 11 55 *RDA/AI for men/women aged >51 years

3th National Nutrient Databank Conference Daily mineral intake from multivitamin supplements among users (n=29,44) Nutrient 1th Pctl Median 9th Pctl RDA/AI* Calcium, mg 2 45 12 Iron, mg 4 18 8 Zinc, mg 3.6 15 3 11/8 Selenium, μg 2 11 55 *RDA/AI for men/women aged >51 years

3th National Nutrient Databank Conference Conclusions The composition of multivitamin supplements was highly variable. This variation in composition contributed substantially to the variation in nutrient intakes from multivitamins among users.

3th National Nutrient Databank Conference Implication To accurately estimate nutrient intakes from multivitamins, brand and product information should be collected so as to identify the exact supplement composition, instead of assuming a uniform nutrient profile.

3th National Nutrient Databank Conference More information Park et al, J Nutr 136:1359-64, 26 Allowing for variations in multivitamin supplement composition improves nutrient intake estimates for epidemiologic studies