(P26-34-26) Dietary Supplements Improve Vitamin D Adequacy, but Disparities Persist Among US Women Aged 40–60 Years

Objectives: The menopausal transition is associated with increased risk for bone loss and changes in micronutrient requirements, especially calcium (Ca) and vitamin D (vD). However, population-level nutrient adequacy during this stage is poorly characterized. Further, the contribution of dietary supplements to nutrient adequacy is unknown during this period. This study evaluated the prevalence of Ca and vD adequacy from food and total intake (food + supplements) among midlife women to capture intake across the menopausal transition.

Methods: Data from NHANES 2013-2023 among nonpregnant US women ages 40-60y (n=4703) were analyzed. Nutrient intakes from foods were estimated using day 1 24hr dietary recalls and supplement intakes were obtained from the NHANES 30-day dietary supplement questionnaire. Total nutrient intake captured the sum of nutrients from food and supplement sources. Nutrient adequacy was defined as intake at or above the Estimated Average Requirement (EAR) for this age group (800mg Ca, 10mcg vD). Survey-weighted analyses accounted for the complex NHANES sampling design and results were stratified by race and ethnicity.

Results: Among US women, average Ca and vD intake were below the EAR at 838mg and 4mcg, respectively; supplementation added approximately 161mg Ca (total ~999) and 22mcg vD (total ~26). Only 46.9% and 7.1% of women met the EAR from food for calcium and vitamin D, respectively. When supplements were included, 56.8% (Ca) and 44.4% (vD) met the EAR. Hence, supplementation resolved inadequacy for 9.9% (Ca) and 37.2% (vD) of women. When examining adequacy by race and ethnicity, 59.3% of non-Hispanic White women had adequate Ca intake compared to 58.6% for Hispanic and 41.6% for non-Hispanic Black women. Likewise, non-Hispanic White women had higher intakes of total vD (46.5% compared to 37.8% for Hispanic, 38.1% for non-Hispanic Black women).

Conclusions: Among U.S. women aged 40-60 years, dietary intake alone provided insufficient Ca and vD. Supplements substantially improved vD adequacy, but less than half of midlife women achieved adequate intake while Ca adequacy remained limited. Additionally, benefits varied by race and ethnicity with substantial disparities, highlighting the need for targeted strategies to support optimal nutrition status during the menopausal transition.

Funding Sources: N/A