Patterns and Determinants of Dietary Supplement Use and Their Public Health Implications Among Adults in Saudi Arabia: A Cross-Sectional Study
Abstract
1. Introduction
2. Materials and Methods
2.1. Study Design and Participants
2.2. Sample Size Calculation
2.3. Research Instrument
2.4. Data Management and Statistical Analysis
- Pi is the probability of a participant i being a dietary supplement user.
- Log is the log-odds of a participant being a dietary supplement user.
- β0 is the intercept.
- X1i, X2i,..., Xki are the independent (explanatory) variables for participant i.
- β1, β2,..., βk are the regression coefficients for each independent variable, which represent the change in the log-odds of being a supplement user for a one-unit increase in the corresponding explanatory variable.
2.5. Ethical Considerations
3. Results
4. Discussion
5. Limitations and Suggestions for Future Research
6. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
Abbreviations
BMI | Body Mass Index |
CI | Confidence Interval |
OR | Odds Ratio |
SFDA | Saudi Food and Drug Authority |
NHANES | National Health and Nutrition Examination Survey |
PMS | Premenstrual Syndrome |
DSHEA | U.S. Dietary Supplement Health and Education Act |
CDC | Centers for Disease Control and Prevention |
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Variable Name | Description | Measurement |
---|---|---|
Outcome Variable | ||
Vitamin Supplement Use | Whether the participant currently uses any vitamin supplements which include multivitamins, vitamin A, vitamin B complex, vitamin C, vitamin D, vitamin E, and vitamin K. | Binary (1 = Yes; 0 = No) |
Explanatory Variables | ||
Age | Age of the participant measured in years. | Continuous (in years) |
Gender | Sex of the participant. | Binary (1 = Male (Ref); 0 = Female) |
Education | The highest level of education completed by the participant. | Ordinal (e.g., 1 = Secondary school and below (Ref); 2 = Bachelor’s; 3 = Higher education) |
Employment | The participant’s current employment status. | Categorical (e.g., 1 = Student (Ref); 2 = Employee; 3 = Non-employee; 4=Retired) |
Income (SAR) | Self-reported monthly income of the participant in Saudi Riyal (SAR). | Categorical (e.g., 1 = <2000 SAR (Ref); 2 = 2000–5000 SAR; 3 = 5000–10,000 SAR; 4= >10,000 SAR) |
Marital Status | The participant’s current marital status. | Categorical (e.g., 1 = Single (Ref); 2 = Married; 3 = Divorced; 4 = Widowed) |
Nationality | Categorical variable with two groups | Categorical (e.g., 1 = Saudi (Ref); 2 = Non-Saudi) |
BMI | The participant’s body mass index (in kg/m2) | Categorical (e.g., 1 = Normal (Ref); 2 = Underweight; 3 = Overweight; 4 = Obese) |
Characteristics | Category | All n (%) | Reported Dietary Supplement Consumption | ||
---|---|---|---|---|---|
Yes n = 248 (58%) | No n = 180 (42%) | p Value | |||
Gender | Male | 128 (27%) | 60 (51%) | 58 (49%) | 0.0665 |
Female | 349 (73%) | 122(39%) | 188 (61%) | ||
Age mean ± SD | 32.13 ± 11.14 | 32.5 ± 11.2 | 31.2 ± 11.28 | 0.2227 | |
Nationality | Saudi | 465 (97%) | 237 (57%) | 180 (43%) | 0.0042 * |
Non-Saudi | 12 (3%) | 11 (100%) | 0 (0%) | ||
BMI | Underweight | 27 (6%) | 16 (64%) | 9 (36%) | 0.3924 |
Normal | 202 (43%) | 107 (61%) | 68 (39%) | ||
Overweight | 144 (30%) | 75 (57%) | 57 (43%) | ||
Obese | 101 (21%) | 48 (51%) | 46 (49%) | ||
Region | Central | 303 (64%) | 160 (59%) | 111 (41%) | 0.0542 * |
West | 63 (13%) | 14 (37%) | 24 (63%) | ||
South | 42 (9%) | 21 (55%) | 17 (45%) | ||
North | 40 (8%) | 37 (67%) | 18 (33%) | ||
East | 29 (6%) | 16 (62%) | 10 (38%) | ||
Education | Secondary school and below | 113 (24%) | 49 (46%) | 58 (54%) | 0.0002 * |
Bachelor’s | 276 (58%) | 144 (58%) | 106 (42%) | ||
Higher education | 88 (18%) | 55 (77%) | 16 (23%) | ||
Employment | Student | 141 (30%) | 67 (50%) | 67 (50%) | 0.1087 |
Employed | 210 (44%) | 10 (61%) | 69 (39%) | ||
Non-employed | 98 (21%) | 65 (61%) | 42 (39%) | ||
Retired | 10 (2%) | 7 (78%) | 2 (22%) | ||
Specialty | Medical and Health | 117 (25%) | 67 (68%) | 31 (32%) | 0.0160 * |
Nutrition and Food | 74 (16%) | 45 (70%) | 19 (30%) | ||
Basic Sciences | 59 (12%) | 29 (56%) | 23 (44%) | ||
Business and Admin | 58 (12%) | 29 (54%) | 25 (46%) | ||
Humanities and Social | 46 (10%) | 19 (46%) | 22 (54%) | ||
No Background | 64 (13%) | 28 (45%) | 34 (55%) | ||
Others b | 59 (12%) | 31 (54%) | 26 (46%) | ||
Marital Status | Single | 248 (52%) | 127 (57%) | 97 (43%) | 0.9264 |
Married | 194 (41%) | 105 (59%) | 72 (41%) | ||
Divorced | 30 (6%) | 14 (61%) | 9 (39%) | ||
Widow | 5 (1%) | 2 (50%) | 2 (50%) | ||
Income (SAR) | <2000 | 165 (35%) | 79 (51%) | 75 (49%) | 0.1439 |
2000–5000 | 71 (15%) | 37 (57%) | 28 (43%) | ||
5000–10,000 | 91 (19%) | 50 (61%) | 32 (39%) | ||
>10,000 | 150 (31%) | 82 (65%) | 45 (35%) |
Supplement Category | Specific Examples | n (%) | Male n (%) | Female n (%) |
---|---|---|---|---|
Vitamins | Multivitamins, Vitamin A, Vitamin B complex, Vitamin C, Vitamin D, Vitamin E, Vitamin K | 201 (81%) | 45 (35%) | 156 (45%) * |
Minerals and Trace Elements | Calcium, Selenium, Zinc, Iron, Magnesium, Phosphorus, Iodine, Other Minerals (e.g., Potassium, Copper, Lithium, Chromium, Manganese) | 106 (43%) | 15 (12%) | 91 (26%) * |
Fatty Acids and Lipids | Omega-3 fatty acids Evening Primrose Oil, Borage Oil, Cod Liver Oil, Flaxseed Oil (Linseed Oil) | 61 (24%) | 15 (25%) | 46 (75%) |
Amino Acids and Protein Supplements | Amino Acids (e.g., Taurine, Arginine), Protein Powders (e.g., Whey Protein) | 24 (10%) | 12 (9%) | 12 (3%) * |
Dietary Fiber and Gut Health | Fiber Supplements, Probiotics | 14 (6%) | 4 (3%) | 10 (2%) |
Carotenoids and Antioxidant Compounds | Beta-carotene, Lutein, Zeaxanthin, Lycopene, Polyphenols | 1 (0.4%) | 1 (100%) | 0 (0%) |
Phytoestrogens and Hormone-Related Botanicals | Soy extracts (Phytoestrogens), Wild Yam Extract (Phytoprogestagens), Red Clover, Black Cohosh, Alfalfa, DHEA (Dehydroepiandrosterone) | 0 (0%) | 0 (0%) | 0 (0%) |
Stimulants and Tonics | Ginseng, Guarana, Acerola (Barbados Cherry), Mistletoe, Desmodium, Echinacea | 3 (1.2%) | 2 (2%) | 1 (0.2%) |
Others and Unspecified Herbal Supplements | 11 (4.4%) | 6 (5%) | 5 (1%) * |
Category | Specific Reasons Reported | n (%) | Males | Females |
---|---|---|---|---|
General Health Promotion | Improve health, immunity, disease prevention, pregnancy | 94 (19%) | 17 (18%) | 77 (82%) * |
Symptom Relief and Health Quality | Fatigue, stress, sleep, digestion, premenstrual syndrome (PMS) | 117 (24%) | 29 (25%) | 88 (75%) |
Physical Appearance and Weight | Body look, beauty, weight loss/gain | 50 (10%) | 14 (28%) | 36 (72%) |
Performance Enhancement | Physical, cognitive, mental, sexual performance | 0 | 0 | 0 |
Category | Subcategory | n (%) | 95% CI |
---|---|---|---|
Form of Vitamin Intake | Pill | 118 (59%) | 0.210–0.288 |
Capsule | 93 (45%) | 0.161–0.232 | |
Powder (envelop) | 4 (2%) | 0.003–0.021 | |
Powder (spoon) | 1 (0.4%) | 0.000–0.011 | |
Syrup | 3 (1%) | 0.002–0.018 | |
Other | 9 (4%) | 0.009–0.035 | |
Usage Frequency of Vitamin Supplements | Multiple times per day | 49 (24%) | 0.927–1 |
Daily | 116 (58%) | 0.967–1 | |
4–6 times per week | 27 (13%) | 0.087–1 | |
1–3 times per week | 51 (25%) | 0.929–1 | |
4–3 time per month | 25 (12%) | 0.866–1 | |
1–2 time per month | 18 (9%) | 0.824–1 | |
Less than once per month | 10 (5%) | 0.722–1 | |
9–11 time per year | 3 (1%) | 0.438–1 | |
5–8 time per year | 7 (3%) | 0.510–1 | |
1–4 time per year | 5 (2%) | 0.645–1 | |
Basis for Vitamin Use | Prescribed by a healthcare provider | 90 (45%) | 0.156–0.226 |
Self-directed use based on product label | 39 (19%) | 0.081–0.109 | |
Marketing Influence | 13 (6%) | 0.015–0.046 | |
General Recommendation | 38 (19%) | 0.058–0.107 | |
Physician-advised use | 32 (16%) | 0.067–0.093 | |
Clinical nutritionist recommendation | 22 (11%) | 0.030–0.068 | |
Pharmacist recommendation | 13 (6%) | 0.015–0.046 | |
Part of routine wellness practice | 2 (1%) | 0.001–0.015 | |
Recommendation by athletic trainer or coach | 5 (2%) | 0.004–0.024 | |
Advice from family or friends | 18 (9%) | 0.024–0.058 | |
Another source (unspecified) | 9 (4%) | 0.009–0.035 | |
Source of Product Acquisition | Pharmacy | 166 (83%) | 0.348–0.391 |
Supermarket/General Retailer | 3 (1%) | 0.006–0.018 | |
Specialized Supplement Store | 14 (7%) | 0.017–0.048 | |
Online Retailer | 45 (22%) | 0.071–0.123 | |
International Store | 12 (6%) | 0.014–0.043 | |
Fitness Center | 0 (0%) | - | |
Another Source | 3 (1%) | 0.002–0.018 |
Factor | Unadjusted OR (95% CI) | p-Value | Adjusted OR (95% CI) | p-Value |
---|---|---|---|---|
Age | 1.010 (0.993–1.028) | 0.2225 | 0.995 (0.973–1.016) | 0.6470 |
Gender | ||||
male (ref) | ||||
female | 0.671 (0.437–1.029) | 0.0675 | 2.037 (1.255–3.307) | 0.0040 * |
Education | ||||
Secondary school and below (ref) | ||||
Bachelor | 1.608 (1.020–2.542) | 0.0450 * | 1.515 (0.935–2.454) | 0.0912 |
Higher education | 4.068 (2.109–8.171) | 0.0001 * | 4.035 (1.884–8.641) | 0.0003 * |
Employment | ||||
Students (ref) | ||||
Employee | 1.579 (1.004–2.490) | 0.0479 * | _____ | _____ |
Non-employee | 1.579 (1.004–2.490) | 0.0952 | _____ | _____ |
Retired | 3.5 (0.810–24.063) | 0.0962 | ||
Income (SAR) | ||||
Less than 2000 (ref) | ||||
2000–5000 | 1.254 (0.701–2.261) | 0.4456 | 1.156 (0.626–2.135) | 0.6412 |
5000–10,000 | 1.483 (0.863–2.572) | 0.1538 | 1.629 (0.902–2.943) | 0.1056 |
>10,000 | 1.729 (1.071–2.812) | 0.0248 * | 1.573 (0.816–3.030) | 0.1757 |
Marital status | ||||
Single (ref) | ||||
Married | 1.113 (0.747–1.663) | 0.5969 | _____ | _____ |
Divorced | 1.188 (0.499–2.959) | 0.6991 | _____ | _____ |
Widow | 0.763 (0.090–6.453) | 0.7897 | ||
Nationality | ||||
Saudi (ref) | ||||
Non-Saudi | 8267075 (3.950) | 0.0005 * | 1.745 (0–.) | 0.9966 |
BMI | ||||
Normal (ref) | ||||
Underweight | 0.663 (0.399–1.099) | 0.1114 | _____ | _____ |
Overweight | 0.836 (0.527–1.324) | 0.4454 | _____ | _____ |
Obese | 1.129 (0.481–2.803) | 0.7828 |
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Al Turki, M.; Othman, F.; Aljasser, D.; Alzaben, A.S. Patterns and Determinants of Dietary Supplement Use and Their Public Health Implications Among Adults in Saudi Arabia: A Cross-Sectional Study. Int. J. Environ. Res. Public Health 2025, 22, 1512. https://doi.org/10.3390/ijerph22101512
Al Turki M, Othman F, Aljasser D, Alzaben AS. Patterns and Determinants of Dietary Supplement Use and Their Public Health Implications Among Adults in Saudi Arabia: A Cross-Sectional Study. International Journal of Environmental Research and Public Health. 2025; 22(10):1512. https://doi.org/10.3390/ijerph22101512
Chicago/Turabian StyleAl Turki, Maha, Fatmah Othman, Doaa Aljasser, and Abeer Salman Alzaben. 2025. "Patterns and Determinants of Dietary Supplement Use and Their Public Health Implications Among Adults in Saudi Arabia: A Cross-Sectional Study" International Journal of Environmental Research and Public Health 22, no. 10: 1512. https://doi.org/10.3390/ijerph22101512
APA StyleAl Turki, M., Othman, F., Aljasser, D., & Alzaben, A. S. (2025). Patterns and Determinants of Dietary Supplement Use and Their Public Health Implications Among Adults in Saudi Arabia: A Cross-Sectional Study. International Journal of Environmental Research and Public Health, 22(10), 1512. https://doi.org/10.3390/ijerph22101512