NIH Conference
Dietary Supplement Use in Women: Current Status and Future Directions

January 28-29, 2002

William H. Natcher Conference Center
National Institutes of Health (NIH) Campus
Bethesda, MD

Background

The use of dietary supplements has increased dramatically as our knowledge about the role of nutrients and other bioactive components of food in health has increased. Although much of the information about the diet and health connection that has driven this trend is related to the reduction of chronic disease risk in adults, belief in the prophylactic use of these substances has been extended to consumers throughout the life cycle.

Two recent conferences organized by the National Institute of Child Health and Human Development (NICHD) and the NIH Office of Dietary Supplements (ODS), in conjunction with the U.S. Department of Agriculture (USDA), the Food and Drug Administration (FDA), and the Centers for Disease Control and Prevention (CDC), focused on the research needed to expand our knowledge about: 1) the bioavailability of nutrients and other bioactive components of dietary supplements; and 2) the identification of critical gaps in our knowledge about the use of dietary supplements in children. Among the findings that emerged from these discussions was that women of reproductive age are a major user group and one particularly targeted to increase use of dietary supplements.

Because of the important developmental milestones (both physiological and behavioral) that occur in women in the period encompassing adolescence through menopause, it is essential that the health care community has a clearer understanding of how diet and nutrition may interact and impact on developmental processes. Little is known about the interaction between the use of the broad range of dietary supplements and health outcomes in women throughout these critical periods of development. Such knowledge is essential to the evaluation of both the justification and safety of dietary supplement use by women.

Therefore, a two-day conference/workshop is proposed to present current data/research about dietary supplement use by women in both U.S. and international populations. The goals of the conference are to develop a focused research program in this area. The issues to be explored include:

• Characteristics of women at different developmental and physiological stages who consume dietary supplements
• Exposure estimates regarding dietary supplement use: who and what
• Current knowledge of dietary status of women across this development period
• Identification of developmental differences over this period in the life span that affect physiological functions and bioavailability of nutrients and other bioactive substances, combined with environmental factors that influence behavior (development of attitudes and beliefs)
• Issues and data gaps related to supplement use in women, such as, safety and various types of interactions, i.e., drug/nutrient interactions, nutrient/nutrient, supplement/drug, etc.
• Evaluation of current justifications for use, including:
  
  
  • Effects of dietary supplement use in women on risk factors of adult disease(s)
  • Relative role of diet and/or dietary supplements to meet national health goals for women
  • The need for supplements in the context of reproductive health, healthy pregnancy, birth outcomes, and lactation

A case study approach will be used to explore these issues and the nature of the interaction between science, policy' and implementation (both in terms of promulgation or national policy and impact on consumer practices).

Coverage and Organization

The opening session of the conference will include overview presentations about the universe of dietary supplements currently marketed to women, possible justification for use based on national survey data, and history of use both in the U.S. and internationally.

Consistent with themes developed during previous NIH workshops on dietary supplement use, the agenda of this conference will include discussions of four key topical areas from a developmental and methodological perspective. The thematic topics include:

• Monitoring and data needs
• Developmental physiology
• Case studies utilizing experiences gained from four substances (calcium and other bone health related supplements, iron, folic acid, and phytomedicines) with well-characterized public health implications
• Factors influencing the decision to use dietary supplements

In addition to the plenary papers, each session will include a panel of experts charged with addressing a predetermined set of core questions regarding research needs.

The Session Panel Discussions are intended to be interactive opportunities for cross-fertilization of ideas between a panel of experts on the subjects covered in the plenary session and the audience. Panels will consist of four-to-five members with representation from each of the four stages/states, i.e., adolescence, pregnancy/lactation, adult women of reproductive age (ages 20-45), and post-menopausal women (ages 45-60), plus the Session Chair and will be charged with reaching some conclusions with regard to pre-assigned questions. To encourage active dialogue and a productive group dynamic, each member of the Panel will be provided a brief opportunity to present his or her current thinking on the subject topic.

At the end of each session, Session Chairs will summarize the results of the deliberations and identify three-to-five future research priorities. The summaries will become part of the official meeting record and will be used by the conference organizers for program planning activities and compilation of the conference proceedings.

Meeting Agenda

Travel Awards for Predoctoral and Postdoctoral Trainees