Dietary supplements play an important role for more than 57% of Americans on a regular monthly basis2, but their use is not yet widely accepted by healthcare providers and payers as an important part of the system supporting a healthier lifestyle. The most active healthcare consumers purchase supplements an average of six times per year and spend more than $40 per occasion, with 60% of users repeating their purchases7. These practices are driven by self-motivation and informed health interests rather than by broader healthcare system recommendations. Despite significant growth in the category during the last year resulting from increased consumer awareness of their health benefits and value for preventive health outcomes6, more work must be done to fully integrate dietary supplements into healthcare systems.
Given the clinical evidence showing the positive effects of many nutrients and supplements on health outcomes, it's time for a balanced healthcare dialogue. Stakeholders ranging from industry, payors, practitioners and lawmakers should expand the discussion and share data and insights. Working together on behalf of the most important stakeholder—consumers—advocates can help advance the acceptance and use of dietary supplements as an effective part of a healthy lifestyle. This dialogue can grow as industry recognizes information and scientific gaps it must address to advance trust and reliability in the category, while healthcare advocates and lawmakers can collaborate to better define where dietary supplements fit into public health.
Compromised Health Due to Nutrient Gaps
For the first time, the 2020-2025 U.S. Department of Agriculture's (USDA) Dietary Guidelines 1 highlight consideration for supplementation across specific population groups most vulnerable to developing nutrient gaps. For example, 90% of Americans don't consume the daily recommended intake of vegetables and 40% don't consume the daily recommended intake for five or more key vitamins and minerals (vitamins D, E, magnesium, calcium, vitamins A and C). In a study published in PLOS Magazine, researchers from Brigham and Women's Hospital, in collaboration with investigators at the Friedman School of Nutrition Science and Policy at Tufts University,12 found nutrient gaps from poor diets contribute to $50 billion (or $300 per person) in U.S. healthcare costs—almost 20% of the total healthcare spend of the three leading diet-related diseases alone. When considering the American Public Health Association's (APHA) estimate that $1 spent on prevention saves $5.60 on healthcare costs3, encouraging and integrating practices that support and improve healthy lifestyles becomes even more important.
While dietary supplements alone will not solve the burden of healthcare costs or prevalence of chronic conditions, a combination of improved dietary practices and better food choices, along with supportive and appropriate use of supplements, can help improve healthy behaviors and outcomes.
This nutrition gap is also contributing to the progression and expansion of chronic health issues. Forty percent of Americans have cardiovascular disease, up to 60% have cardio-metabolic health concerns, nearly 12% have diabetes, and an additional 20% are prediabetic.2
However, many conditions can be improved by nutrition therapy and the selective use of appropriate dietary supplements. Epidemiological studies have demonstrated nutrients and phytonutrients available from just one additional serving of vegetables per day can reduce the risk of cardiovascular disease by 16% and reduce the risk of diabetes by 13%.8
While there is no substitute for healthy food choices and dietary practices must be improved in America, encouraging smart utilization of dietary supplements could decrease the number of chronic disease conditions by 3.28 million per year with significant cost savings.3
Advocating for small but significant steps in improved healthcare system practices can help increase the awareness of dietary supplement use and benefits. For example, integrated support of supplement use as a health and lifestyle practice would be expanded and encouraged through eligibility in flexible spending arrangement (FSA) and health savings account (HSA) programs. According to a recent survey of consumer healthcare product purchasers, an additional 30 percent of consumers state they would purchase products if they were able to use funds from their FSA/HSA accounts7,8.
These programs are an important vehicle for health practices as they provide benefits for all consumers, not just the wealthiest Americans. Recent research 4,5 reveals the relative percentage of contributions made to HSA accounts from employers and employees are not significantly different among income levels. This is also true for the balance of funds remaining in these accounts at the end of each year. By designating dietary supplements as a part of FSAs/HSAs, we can grow access of the category among all socio-economic groups and begin to address the growing nutrition gaps in our country.
The need for increased access and use of dietary supplements is clear. The Consumer Healthcare Products Association (CHPA) is engaging with stakeholders in healthcare delivery and coverage as well as media, lawmakers, policy and clinical experts to create positive dialogue on the expanded use of supplements in healthcare and advocate for meaningful legislation to advance and improve health practices. To be successful, industry must deliver strong supportive messages, highlighting a credible and relevant category that is part of an effective healthcare system, including:
- Educate stakeholders that the dietary supplement category is a regulated category that works and can provide confidence in product use by the healthcare system.
- Commit to and meet the high standards of product quality that support consumer and practitioner use of products with confidence and support retailer quality assurance programs to ensure products on the shelf are safe and appropriately manufactured.
- Advocate for FSA/HSA eligibility to help improve health practices and provide meaningful incentives for all socio-economic groups managing their health using supportive data and facts.
- Increase financial commitment for research that demonstrates the effective role of supplements on health states, including cost-effective care that can help manage overall healthcare costs.
- Sponsor and provide clinical research and education to help build the credibility of the category and build the support of payors and practitioners that make up the healthcare system.
As CHPA advocates on behalf of a vibrant industry sector, we will help to fill the healthcare gap by making the case that dietary supplements can be a recognized and appropriate part of healthcare solutions.
John P. Troup, Ph.D., is the vice president for scientific affairs and dietary supplements at the Consumer Healthcare Products Association (CHPA). With more than 25 years of category and clinical nutrition experience, Troup is responsible for leading the association's initiatives on dietary supplements, working to shape policy and leveraging credible nutrition sciences and clinical insights that will fuel the growth of this important consumer healthcare category. Prior to joining CHPA, Troup served as a member of the senior management teams at several Fortune 50 consumer nutrition health businesses, including Pfizer, Novartis and Unilever.
- USDA Dietary Guidelines Report 2020-2025
- National Center for Health Statistics Data Brief. No 339, February 2021
- American Public Health Association Press Reports 2019
- Employee Benefit Research Institute (EBRI) EBRI Issue Brief, January 21, 2021
- Employee Benefit Research Institute (EBRI) EBRI Issue Brief, December 5, 2019
- IRI Market analysis Report of dietary supplement sales, CHPA Health Academy 101 February 2021
- Nutrition Business Journal 2019 Annual report on Dietary Supplements (SPINS Database)
- Hu, F. et al. Epidemiological assessment of nutritional impact on health. Circulation 2018
- Li Mi et.al BMJ Open 2014 Nov.5; 4(11)
- Institute for Functional Medicine Systems of Care 2015
- Hyman, M. 'Food Fix' 2020. Published by Simon & Schuster
- Jardim TV, Mozaffarian D, Abrahams-Gessel S, Sy S, Lee Y, Liu J, et al. (2019) Cardiometabolic disease costs associated with suboptimal diet in the United States: A cost analysis based on a microsimulation model. PLoS Med 16(12): e1002981. https://doi.org/10.1371/journal.pmed.1002981