Patterns of dietary supplement use among United States patients with steatotic liver disease: Vitamins, minerals and botanicals.

Background: Dietary supplement (DS) usage among United States adults has significantly increased. Patients with steatotic liver disease (SLD) may have unique motivations to take DS in light of their liver condition and co-morbidities.

Aim: To characterize DS use in SLD patients and explore motivations for their use.

Methods: Adults ≥ 18 years old with complete transient elastography and dietary data from the National Health and Nutrition Examination Survey between January 2017 and March 2020 were studied. SLD was defined using consensus criteria, combining clinical indicators with elastography thresholds. The DS Questionnaire (DSQ) was used to record participants' use of DSQ. Sample weights were applied to estimate national prevalence.

Results: Of 2413 participants with SLD, 1058 reported using DS, for an estimated prevalence of 44.8% [standard error (SE) 2.4] with an average of 2.6 (SE 0.2) DS per person. Among SLD participants taking DSQ, 53.2% (SE 3.3) reported using non-vitamin/non-mineral ones, with an average of 1.8 (SE 0.1) such supplements per person. DS users were more likely to be female, have higher levels of education, and have greater food security (P < 0.02 for all). The most common motivations for using DS were to follow doctor's advice (36.7%, SE 1.8), to improve overall health (22.1%, SE 2.0), and to maintain health (19.2%, SE 1.9).

Conclusion: Nearly half of individuals with SLD report taking DS. This study underscores the pressing need to deepen our understanding of DS use/motivations to develop tailored patient counseling strategies.