Dietary supplements are consumed by more than half of the US population, and purchasing has increased precipitously since the onset of the COVID-19 pandemic. Despite the widespread use of supplements by consumers of all ages, US federal law prohibits the FDA from prescreening supplements for safety or efficacy and instead relies on industry to perform these duties. FDA is largely constrained to taking enforcement action only postmarket once a product is linked with false claims or injury. The recent uptick in supplement sales raises concerns for the safety of consumers, especially those who may have heightened pandemic-related fears about their health and safety for a variety of reasons. Within the first few months of the pandemic, widespread psychological distress was documented, with an estimated threefold increase in depressive symptoms in US adults during this time. It is plausible that heightened pandemic-related psychological distress may in turn increase the likelihood that consumers will use supplements sold with claims to boost immunity, increase weight loss, or promote health in other ways with the mistaken belief that these products will protect them from infection or prevent weight gain. No studies to our knowledge have investigated changes in use of potentially dangerous supplements during the pandemic nor examined plausibly elevated risk of use in vulnerable groups. This administrative supplement to U01 HL145386: ?Integrating Lifecourse Approaches, Biologic and Digital Phenotypes in Support of Heart and Lung Disease Epidemiologic Research,? will allow us to estimate the prevalence of use and change of prevalence of use of dietary supplements during the COVID-19 pandemic and to evaluate whether these patterns of use relate to the course of the pandemic, whether they are more frequent in vulnerable populations as well as their relation with changes in mental health status during the course of the pandemic. This administrative supplement strengthens and expands the goals of the parent grant by allowing us to expand the scope of data collection of prevalent exposures without a well-characterized risk profile (a component of Aim 1) and understand its impact on the pandemic through thorough spatial and temporal characterization of this behavioral risk factor, as well as its interaction with other risk factors for heart and lung diseases.
We will investigate the spatiotemporal variation in prevalence of use of supplements sold for weight loss, energy, sports performance/muscle building, and immune function over the course of the first year of the pandemic in the United States. In addition, we will determine whether use of dietary supplements is more frequent among vulnerable populations, as well as its relation to psychological distress symptoms.
