Relationships among Cardiovascular Disease Risk, Dietary Supplement Use, and Attempted Weight Loss in the National Health and Nutrition Examination Survey (1999-2004)

Few studies of the determinants of dietary supplement (DS) use have been based on a conceptual model of health behavior, and most have involved small, non-random samples, which limits the generality of their findings. A novel conceptual model was developed to explain DS use and engagement in other cardioprotective behaviors (CBs) as a function of cardiovascular disease (CVD) risk. The model purported that CVD risk would be positively associated with DS use and CB participation, DS use and CB participation would be positively correlated, and the association between DS use and CB participation would be moderated by CVD risk. Data were taken from the 1999-2004 waves of the National Health and Nutrition Examination Survey. Using reported diagnoses, participants were classified according to CVD risk as low-risk, at-risk, or diseased. After adjusting for age and other demographic and socioeconomic confounders, persons at risk for CVD or with evidence of disease were more likely to engage in DS use (5.0% [p=0.001] and 6.7% [p=0.013], respectively) and attempted weight loss (AWL) (5.0% [p<0.001] and 5.0% [p=0.001], respectively) than those with low CVD risk. Differences between the at-risk and diseased groups were insignificant. AWL and CDS use were positively correlated. The magnitude of this correlation increased with CVD risk (i.e., 0.038 for low-risk persons to 0.108 for diseased individuals), though there was no statistical support for moderation (p=0.484). Findings from this study provide evidence supporting the conceptual model developed to explain CDS use and CB participation. They also demonstrate that conceptually driven research can be performed using secondary data from population health surveys.