The supplement aisle looks different than it did 25 years ago. Multivitamins are still common, but a new study suggests U.S. adults are increasingly turning to a wider range of products tied to specific wellness goals, from vitamin D and magnesium to probiotics, collagen, elderberry and turmeric.
The study, published in JAMA Network Open, used National Health and Nutrition Examination Survey data from 1999 through 2023 to examine supplement use among 63,442 U.S. adults. The repeated cross-sectional analysis can show how supplement habits have changed over time, but it does not show whether the products people used improved their health, prevented disease or were necessary for them individually.
Overall supplement use rose from 51% of U.S. adults in 1999-2000 to 60% in August 2021-August 2023. Use also became more diverse. When researchers excluded multivitamin-multimineral products, supplement use increased from 34% to 50%.
That shift matters because many supplements are no longer marketed simply as a way to fill nutrient gaps. They are often positioned around highly specific health concerns, including immunity, inflammation, digestion, skin, joints and healthy aging. Those are all areas where consumers may be motivated by real concerns, but also exposed to marketing claims that can be hard to evaluate.
The study found that traditional multivitamin-multimineral use declined slightly, from 35% to 31%. At the same time, use of individual vitamins, minerals and botanicals outside multivitamins increased. Vitamin D use rose sharply, from 5.1% to 29%. Zinc increased from 4.6% to 11%, magnesium from 4.7% to 9.8% and vitamin B12 from 5.7% to 11%.
The analysis also found growth in newer or emerging categories. By 2021-2023, 6.7% of adults reported probiotic use, 5.2% reported turmeric or curcumin use, 3.6% reported collagen use, 3.2% reported prebiotic use, 2.1% reported elderberry use and 1.9% reported ashwagandha use.
Older adults saw the largest increase. Supplement use among adults 65 and older rose from 62% in 1999-2000 to 78% in 2021-2023, making them the highest-use age group in the study.
That finding is especially important because older adults are more likely to take prescription medications, manage chronic conditions and have reasons to be cautious about interactions. Supplements can be useful in some situations, including diagnosed deficiencies or clinician-recommended use. But more products in the cabinet can also mean more opportunities for duplication, unnecessary doses or interactions that patients may not think to mention.
The researchers also looked at changes around the COVID-19 pandemic. Vitamins, minerals and some supplement categories increased in the later-pandemic or postpandemic period compared with the prepandemic or early-pandemic period. Products associated with perceived immune support, including zinc and elderberry, were among those with notable increases.
The study does not prove the pandemic caused those changes. The authors noted that some shifts may reflect longer-running trends rather than a specific COVID-19 effect. Still, the timing fits a broader pattern many consumers recognize: health scares, wellness trends and social media attention can quickly change what people buy.
Some older supplement trends moved in the opposite direction. Use declined for several trace minerals and some botanicals that were more popular in earlier years. The authors noted that some declines may reflect safety concerns, limited evidence or changing consumer preferences as newer products took over similar marketing space.
The study has several limitations. Supplement use was self-reported for the past 30 days, which may not reflect regular use throughout the year. The analysis did not examine dose or frequency, so it cannot tell whether people used small amounts, high doses or products that overlapped with each other. The supplement marketplace also changed substantially over the study period, which can make long-term comparisons difficult.
Even with those limits, the findings offer a useful snapshot of how wellness habits have changed. Supplements are not just a niche product category or an occasional add-on to diet. For many adults, they have become part of everyday health routines.
That makes communication more important. A supplement may be reasonable for one person and unnecessary or risky for another. The same product can also have very different implications depending on the dose, health history, medications and reason someone is taking it.
For consumers, the study raises a practical question: Is this supplement filling a specific need, or is it responding to a vague promise? That distinction is worth making before adding another bottle to the routine.
The study was supported in part by a National Cancer Institute Cancer Center Support Grant to Memorial Sloan Kettering Cancer Center, the Laurance S. Rockefeller Fund supporting the Memorial Sloan Kettering Herbal Education and Research in Oncology program and the Geoffrey Beene Cancer Research Center at Memorial Sloan Kettering Cancer Center. One author reported National Cancer Institute grants during the study. Another reported institutional grants from Tibet CheeZheng Tibetan Medicine, Co., Ltd., and Zhongke Health International, LLC, outside the submitted work and being a cofounder of Greatly Health. Another reported being the Junior Faculty Chair at the Geoffrey Beene Cancer Research Center during the study.