Introduction: Multivitamin (MVI) intake is seen in more than one third of American population. Each form of MVI differs in content and quantity of nutrients. Approximately 1 billion people around the world suffer from the deficiency of Vitamin D (Vit-D). Vit-D is necessary for a range of important cellular functions including the maintenance of calcium metabolism and normal muscle function. Current American College of Physician guidelines suggest a daily intake of 1,500 to 2,000 IU/day for adults for Vit-D less than 30ng/ml. There are no current guidelines for MVI usage. The aim of this study to understand the differences in supplement use among varying education levels.
Methods: We evaluated 1,013 participants in the World Trade Center-CHEST Program from January 2011 to June 2014. Education level and supplement use for both MVI and Vit-D were self-reported in the questionnaire. Education levels were separated into 4 categories in regard to higher education: (1) None=Less than 12 years/High School/GED, (2) Some=Some college, no degree/associates degree, (3) College =Bachelor’s degree, (4) Graduate=Advanced degree (Masters’ and/or Doctorate Degrees) Chi-square analysis, independent t-test, and ANOVA analyses were performed in SAS 9.4.
Results: MVI usage was lowest among those with the lowest education (None group) at 7.97%. compared to the other education levels: 44.93% (Some group), 31.64% (College group) and 15.46% (Graduate group). There was significant relationship in terms of MVI usage between the lowest education level (None group) and the other education levels (p=0.0214). Among those taking Vit-D, the lowest usage was also seen in the lowest education level, at 9.65%, compared to ‘Some’ at 41.67%, ‘College’ at 31.14% and ‘Graduate’ at 17.54%. There was a trend towards significance in Vit-D usage among those with the lowest education levels (None) compared with the other education groups (p=0.0773).
Conclusion: There is no established data to suggest multivitamin use is directly associated with chronic illnesses such as increased cardiovascular risks, cancer and pulmonary disease. It has been established that hypovitaminosis D is associated with increased risk for hypertension and other cardiovascular diseases. Vitamin D supplementation is recommended to mitigate these risks. Those with higher education levels are more likely to take supplements possibly because of their increased health literacy. Patients with lower education levels may benefit from counseling of vitamin supplementation usage, MVI and especially in Vit-D as it has shown to have health benefits.