Objective: Supplements are an important source of micronutrient intake, which, unless taken into account, can misclassify individuals with regard to levels of nutrient exposure. A label-based vitamin and mineral supplements (ViMiS) database was developed to contain manufacturers' information and to enter supplement use by participants in the European Prospective Investigation into Cancer and Nutrition in Norfolk (EPIC-Norfolk). The ViMiS database contains information on all ingredients, broken down into nutrient information in order to be combined with nutrient intake derived from food consumption. Design: Development of the ViMiS database and cross-sectional analysis of supplement use in a population-based study. Setting: Men and women aged 40-79 years from the general population participating in the EPIC-Norfolk study between 1993 and 1997, with data available from 7 d diet diaries (7dDD). Subjects: A subset of 19 330 participants with available 7dDD and known supplement status. Results: To date, the ViMiS database includes 2066 supplements, which altogether contain 16 586 ingredients, with a median of eleven nutrient/ingredients per supplement. Forty per cent of the cohort took a supplement, of which cod liver oil was the most common (24?5 %). Conclusions: The ViMiS database provides a flexible tool for estimating total nutrient intake. The high prevalence of supplement use in the general population indicates that supplement use needs to be taken into account when examining the relationship of intake of particular nutrients to health outcomes.
Keywords
Dietary supplements Development label-based database EPIC-Norfolk ViMiSThe use of vitamin and mineral supplements (ViMiS; referred to as 'supplements') in the UK has risen to 40 % for women and 29 % for men according to national surveys held in 2000-2001 (1) . These results show that supplements can increase the mean intake of vitamins by 4-183 % and of minerals by 0-16 %, depending on the type of vitamin and sex and age of the participant. Previous studies indicate that supplement consumption should be taken into account when assessing dietary nutrient intake; otherwise misclassification of nutrient intakes of individuals and unclear relationships with biomarkers can occur (2) . Although several UK-based cohort studies have compared supplement users (SU) with nonsupplement users (NSU) with regard to sociodemographic factors, morbidity and nutrient and food intakes, they have not been able to estimate total nutrient exposure (3)(4)(5) , i.e. the combined nutrient exposure from foods and supplements.In order to analyse total nutrient exposure for the European Prospective Investigation into Cancer and Nutrition in Norfolk (EPIC-Norfolk), an equivalent to the UK National Food Composition Database (UK FCD) for supplement composition was needed. As laboratory analytical data were not available for supplements on the UK market in the early 1990s, nor to date, it was necessary to design a database structure and calculation method to calculate the nutrients fr...