A new study in JAMA Network Open looks at the supplement market, focusing on products that display the word immune or immunity in its labeling. Roughly 13.5% of the labels, over 25,000 supplement labels in the Dietary Supplement Label Database (DSLD) display those words. They must be very powerful words. The researchers went on to characterize the consumers of these products using our old friend, the National Health and Nutrition Examination Survey (NHANES). They paired those reporting the use of dietary supplements with those keywords to their demographics. They looked specifically at the prepandemic interval from January 2017 to March 2020 to avoid the anticipated bump in the search for protection against COVID. Slightly more than 15,500 individuals were included in the analysis.
- 1 in 9, 11.0% of the US population used a dietary supplement for perceived immune benefits.
- Of those, 28.3% used them exclusively for those perceptions, although a majority also had another reason, most commonly “to maintain health or stay healthy.”
- 16% took the supplement based on a physician's recommendation.
- 60.1% took a dietary supplement whose label had claims related to immune benefits.
- “…use for perceived immune benefits due to a doctor recommendation and dietary supplement use exclusively for perceived immune benefits were both generally low, but both increased among older adults and individuals in poorer health.”
Unfortunately, the researchers buried the lede, failing to discuss what I might consider memorable features.
For those taking the supplements based upon physician recommendation, when stratified by perceived overall health, while those in poorer health took more, a downward trend as self-described health improved was not statistically significant. I would dub this the “can’t hurt” recommendation.
The only demographic trends showing statistical significance were those related to the entire group. From the perspective of PT Barnum, as marketeer, those most likely to purchase these supplements were wealthier, more secure concerning food security, eating the best “quality” diet, and in “very good or excellent” health. Yes, those most likely to purchase supplements were those least in need. Perhaps they, too, had bought into the “can’t hurt” approach or were virtue signaling their focus on health.
It is true that the supplements “can’t hurt,” except fiscally, and none of these consumers were really at risk. The study adds little to our understanding of the supplement market from the point of view of consumers. However, it tells us something about the marketing. It is like some other healthcare grifts, and now I am considering the push for concierge medicine. Both the supplement and concierge industries rely on the wealthy, walking well – those needing little care besides a bit of hand-holding and assurance.
If the supplement industry has proven anything, it’s that people will gladly spend money on things they don’t need—especially if it comes wrapped in a health halo. The fact that the wealthiest, healthiest individuals are the biggest consumer of immune supplements isn’t shocking; it’s just another example of wellness culture selling reassurance more than results. And while the FDA’s mandatory disclaimer reminds us
“This product is not intended to diagnose, treat, cure, or prevent any disease.”
the marketing teams sure seem to be banking on the fact that no one reads the fine print.
Source: Prepandemic Prevalence of Dietary Supplement Use for Immune Benefits JAMA Network Open DOI: 10.1001/jamanetworkopen.2024.59291
Chuck Dinerstein, MD, MBA
Director of Medicine
Dr. Charles Dinerstein, M.D., MBA, FACS is Director of Medicine at the American Council on Science and Health. He has over 25 years of experience as a vascular surgeon.
