The cross-sectional study was conducted through an online self-administered questionnaire among 531 adults (115 men and 416 women) aged 18 to 60 living in Saudi Arabia. The researchers behind the study collected information on participants’ sociodemographic characteristics, use and type of dietary supplements, and attitudes toward and patterns of dietary supplement use.
The study found that just over 51.8% (275) of the participants used dietary supplements, with most of these being younger people around the age of 29. Of those who used dietary supplements, 85.5% (235) were more highly educated and 63.7% (100) worked in the health sector.
Women, along with the older participants in this group, were more likely to use herbal supplements, while married, female, pregnant or breastfeeding participants and those not working in the health sector more frequently used single mineral supplements.
Participants with a higher level of education used fatty acid-based supplements more often, and women, singles and healthcare workers tended to have a more positive attitude towards dietary supplement use. These results were consistent with data from previous studies.
Patterns and concerns
The main reason for the participants’ dietary supplement use was to maintain health, with most of them saying they would read the labels and instructions that came with such products.
The majority of the supplement users in this study were aware of the importance of medical consultation, and laboratory testing before dietary supplement consumption, as well as potential negative side effects.
When it came to dietary supplement patterns, a single preparation of vitamins (such as beta carotene or vitamins A, B12, B9, B complex, C, D, and E) was found to be the most frequently consumed amongst the Saudi population. This was followed by a single preparation of minerals, such as calcium, zinc, iron, magnesium, potassium, and multi-vitamins or multi-minerals.
Overall, women were more likely to consume dietary supplements and herbs than men were, mainly for reasons related to pregnancy and physical appearance (healthy hair and skin). Furthermore, women tended to use calcium and iron supplements more than men did, possibly due to a higher risk of osteoporosis and anaemia among women.
However, while studies conducted in other countries have shown that over 79% of lactating women used dietary supplements, this study found that under 50% of those who were breastfeeding were consuming dietary supplements.
At the same time, the researchers also noted that the prevalence of dietary supplement use among the participants was “alarming because the Saudi population may be unaware of the adverse effects of dietary supplement overuse”.
They also noted that overuse had been reported among older individuals and long-term home residents, though this had “not been well-examined, especially in the higher education and medical sectors”.
Limitations and future indications
Among the study’s limitations was the self-reported questionnaire, which the researchers said may have introduced recall bias, along with its cross-sectional design where self-selection bias is inevitable. They added that those who used dietary supplements may have been more inclined to participate than those who did not, and that the respondents were mostly from the middle region of Saudi Arabia. Furthermore, approximately 70% of the respondents were women despite the survey link having been shared among both sexes across all regions of the country.
As the study measured the frequency of dietary supplement use but not the dosage, the researchers noted that future studies should measure the dosage per supplement, brand names, duration of use, and participants’ diet quality. There should also be more extensive investigation into the types of herbs used by individuals during illness, the necessity of use and the reasons behind use, they wrote.
The study also acknowledged the low level of awareness among Saudis regarding the ill effects of over-supplementation, which includes toxicity, contamination with heavy metal ions, bleeding, nausea, diarrhoea, stomach discomfort and liver failure. Additionally, the researchers wrote that “educating pregnant and breastfeeding women on the importance of dietary supplements” was necessary.
They concluded that since the study was conducted six months before the COVID-19 pandemic began, it would be “very interesting to re-conduct the study after COVID-19 to look at the difference in the prevalence and the patterns of dietary supplement use in Saudi Arabia”.
Source: PLOS One
“Prevalence, patterns, and attitude regarding dietary supplement use in Saudi Arabia: Data from 2019”
Authors: Anwar M. Alhashem, et al.